A hospital in West Union, IA. It ran an operating surplus of 4.5% in FY25 on $46.9M of operating revenue. It held 176 days of cash on hand (65th percentile among Critical Access Hospitals on liquidity). Operating margin improved from -3.2% in FY20 to 4.5% in FY25, though it fell 6.1 points in the most recent year.
Operating margin · FY25
+4.5%
vs Critical Access Hospitals65th pctl of 824 (FY25)
Days cash on hand · FY25
176d
all sources
vs Critical Access Hospitals65th pctl of 827 (FY25)
Total operating revenue · FY25
$46.9M
vs Critical Access Hospitals68th pctl of 833 (FY25)
Total margin · incl. nonoperating · FY25
+8.1%
vs Critical Access Hospitals58th pctl of 824 (FY25)
One point of operating margin at GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS is about $469K per year (1% of FY25 total operating revenue).
Where GUNDERSEN PALMER LUTHERAN sits among Critical Access Hospitals
Operating margin · FY25 pool · n = 824 of 1,404 filed
Each point is one Critical Access Hospital in the national distribution for this provider type, placed by operating margin. Facilities are not matched on size, case mix, or market — that is the matched-peer comparison in the paid benchmark. The Critical Access Hospital median is -0.2%. Descriptive context only, not a ranking.
One critical access hospitalGUNDERSEN PALMERCritical Access Hospital median
The money
$ thousands · HCRIS cost-report basis · as filed, QA-gated
Ratios tell you how this hospital is doing. Statements tell you what kind of organization it is, and where the money comes from. Every figure below traces to a public cost-report filing, shown as filed. A ratio renders only when every input is reported in the filing; a year missing its core lines is not shown; a year whose balance sheet does not reconcile is labeled. Not audited by Astrelis.
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
HCRIS WS G / G-3
Medicare inpatient contribution margin
+27.4% (FY25)
47th percentile of 476 CAHs. Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+56.2% (FY25)
51st percentile of 476 CAHs. Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY23
FY24
FY25
Patient revenue
27,900
46,623
44,458
Other operating revenue
1,378
2,207
2,417
Total operating revenue
29,279
48,829
46,875
Total operating expenses
30,650
43,670
44,771
Operating income
(1,371)
5,159
2,104
Operating margin %
-4.7%
+10.6%
+4.5%
Grants & contributions
164
47
—
Investment income
65
87
155
Other non-operating, net
1,464
1,424
1,668
Net income
322
6,717
3,927
Net income %
+1.0%
+13.3%
+8.1%
HCRIS Worksheet G-3 / S-3 · $ thousands · FY20–FY25 · FY20–21 may include COVID-era relief funding in nonoperating income
How it operates
quality & operational context · CMS public reporting
A 25-bed hospital at 6% occupancy where swing beds are 71% of the inpatient business and 91% of patient revenue is outpatient.
The metrics this hospital type is judged on: care quality, patient experience, and scale. Each is labeled by evidence class and public source; descriptive context only, never a ranking or adequacy claim.
Scale and flow
Occupancy
6.4%
Verified fact2025
HCRIS WS S-3
Average daily census
1.61
Verified fact2025
HCRIS WS S-3
Staffed beds (acute)
25
Verified fact2025
HCRIS WS S-3
Annual discharges
215
Verified fact2025
HCRIS WS S-3
Average length of stay
2.7d
Verified fact2025
HCRIS WS S-3
Swing-bed average daily census
3.94
Verified fact2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
71.0%
Verified fact2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
90.5%
Verified fact2025
HCRIS WS G-2 L28
Who it serves
Total unreimbursed & uncompensated care
$2.7M
Verified fact2023
HCRIS WS S-10 line 31
How the care measures up
C. difficile infection (SIR)
Results cannot be calculated for this reporting period.
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
14.4%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Trajectory
Cost-report basis · 6 reporting years
Operating margin
Days cash on hand
The county this hospital serves
FAYETTE County, IA · nonmetro, urban 5–20K, metro-adjacent
Median household income
$58.8K
vs $82.1K US · $59.7K rural median
Poverty rate
12.5%
vs 12.5% US · 14.3% rural median
Uninsured
4.7%
vs 8.6% US · 8.4% rural median
Age 65+
22.1%
vs 16.8% US · 20.6% rural median
Fair or poor health
18.7%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 12.5% of county personal income is Medicare/Medicaid medical benefits; 26.4% arrives as government transfers (BEA, 2022).
What this hospital means to Fayette County
economic contribution · FY25 cost report
Direct annual spending
$44.8M
total operating expense · reported
Total economic output
$103.0M
× 2.30 output multiplier · estimate, upper bound for rural
Method: NCRHW 2016 study of critical access hospitals (IMPLAN Type II), employment × 1.34, earnings × 1.19; output × 2.30 (AHA national, upper bound for rural). Direct figures are reported values from the facility's HCRIS cost report; multiplied figures are estimates.
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