Operating margin: +1.6% in FY2024, the 61st percentile of 1,307 critical access hospitals in the FY2024 pool. Days cash on hand: 309 days in FY2025. Total operating revenue: $13.2M in FY2024, the 15th percentile of 1,320 critical access hospitals in the FY2024 pool. Total margin (including nonoperating): +3.5% in FY2024, the 44th percentile of 1,307 critical access hospitals in the FY2024 pool. Figures as filed; not audited by Astrelis.
Financial anchor year: FY24. Margin and revenue are as filed for FY24. Balance-sheet measures (current ratio, equity financing, days in A/R) use FY25, the latest filing whose balance sheet reconciled as filed. Days cash on hand is FY25, the most recent year that passed the display gate. Every tile below states its own fiscal year; nothing is carried forward or estimated.
The read
A hospital in Elkader, IA. It ran an operating surplus of 1.6% in FY24 on $13.2M of operating revenue. It held 309 days of cash on hand in FY25, its most recent reported liquidity. Operating margin declined from 2.2% in FY21 to 1.6% in FY24.
Operating margin · FY24
+1.6%
Astrelis calculation · as-filed inputs
▼ 1.1 pts vs FY23
vs Critical Access Hospitals61st pctl of 1,307 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
309d
all sources
Astrelis calculation · as-filed inputs
▲ 134 days vs FY24
not ranked: no valid same-year pool for this metric (needs n ≥ 25 and ≥ 50% of the cohort's filers at FY25)
Total operating revenue · FY24
$13.2M
Astrelis calculation · as-filed inputs
▲ $0.7M vs FY23
vs Critical Access Hospitals15th pctl of 1,320 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY24
+3.5%
Astrelis calculation · as-filed inputs
▼ 2.0 pts vs FY23
vs Critical Access Hospitals44th pctl of 1,307 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at MERCYONE ELKADER MEDICAL CENTER is about $132K per year (1% of FY24 total operating revenue).
Where MERCYONE ELKADER MEDICAL sits among Critical Access Hospitals
Operating margin · FY24 pool · n = 1,307 of 1,404 filed
Each point is one Critical Access Hospital in the national FY24 distribution for Critical Access Hospitals, this hospital's comparison cohort, 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 FY24 median is -1.8%. Descriptive context only, not a ranking.
One critical access hospitalMERCYONE ELKADERCritical 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 computes only when every input is reported in the filing (otherwise its cell states which input is Not reported in source); a year whose balance sheet does not reconcile is labeled, and its derived ratios read Astrelis calculation unavailable. Not audited by Astrelis.
Net patient receivables × days in the report's own period ÷ net patient revenue, same fiscal year
Astrelis calculation · HCRIS WS G / G-3
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
9,775
12,333
12,862
Other operating revenue
110
220
371
Total operating revenue
9,884
12,553
13,233
Total operating expenses
10,458
12,216
13,027
Operating income
(574)
337
206
Operating margin %
-5.8%
+2.7%
+1.6%
Grants & contributions
222
287
78
Investment income
21
57
150
Other non-operating, net
145
29
36
Net income
(186)
709
471
Net income %
-1.8%
+5.5%
+3.5%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY21–FY25 · FY20–21 may include COVID-era relief funding in nonoperating income
Display states.FY25 · Operating margin — Astrelis calculation unavailable (net patient revenue was not reported (or is zero) on this filing)Filed inputs: Operating income -13,929K
How it operates
quality & operational context · CMS public reporting
A 15-bed hospital running at 4% occupancy, where swing beds are 57% of the inpatient business.
The metrics this hospital type is judged on: care quality, patient experience, and scale. Each is labeled by provenance class and public source; descriptive context only, never a ranking or adequacy claim. Provenance labels: Reported value is copied from the named public source; Astrelis calculation is a formula applied to unchanged reported inputs, with the formula shown; Illustrative estimate is a benchmark gap, multiplier, or scenario — never a measurement.
Scale and flow
Occupancy
3.8%
Reported value2025
HCRIS WS S-3
Average daily census
0.57
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
15
Reported value2025
HCRIS WS S-3
Annual discharges
66
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$67,290
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$211,046
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Swing-bed average daily census
0.75
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
56.9%
Reported value2025
HCRIS WS S-3 (acute + swing days)
How the care measures up
C. difficile infection (SIR)
Not reported in source (note 1)
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
15.5%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Note 1: Results cannot be calculated for this reporting period.
Trajectory
Cost-report basis · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
CLAYTON County, IA
Median household income
$62.3K
vs $82.1K US · $59.7K rural median
Poverty rate
13.6%
vs 12.5% US · 14.3% rural median
Uninsured
7.6%
vs 8.6% US · 8.4% rural median
Age 65+
24.3%
vs 16.8% US · 20.6% rural median
Fair or poor health
19.2%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 9.8% of county personal income is Medicare/Medicaid medical benefits; 21.5% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Clayton County
Illustrative estimate · FY25 cost report
Direct annual spending
$13.9M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$32.0M
direct spending × 2.30 · AHA national hospital economic activity report — a national hospital ratio, not a CAH or county figure · Illustrative estimate
Employment and labor income multipliers are from the National Center for Rural Health Works 2016 study of Critical Access Hospital economic impact (IMPLAN Type II, U.S. rural county populations); the economic-activity ratio is from the AHA national hospital economic activity report and describes U.S. hospitals as a whole; it is not a CAH-specific or county-specific figure. Applying any of these to an individual facility is an illustrative advocacy scenario, not a measurement: local capture depends on payroll residency, purchasing patterns, and county economic structure the sources do not observe. This facility is a critical access hospital, the NCRHW study population. Direct figures are reported values from the facility's HCRIS cost report. Want a defensible facility-specific figure? Request a Facility Economic Impact Study →
Operating margin vs its peer poolFY24Astrelis calculation
Operating margin vs its peer pool: FY24 pool · n = 1,307.
CAH Performance Benchmark: FY24 peer pool · n = 1,307 · conservative low band; acuity limits stated in the report.
Report coverage: Limited Facility Benchmark. 13 of 17 facility measures available from public sources. The report covers the available measures against their peer benchmarks; measures the public record does not carry become findings. Coverage is disclosed here before you reserve, and thin data is never a decline reason. The refund guarantee stands: if we cannot deliver the published scope, you pay nothing.
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Astrelis Atlas, "Mercyone Elkader Medical Center", https://astrelis.co/hospitals/161319, release 2321a4fc37a7 (2026-10-22). Figures as filed in the named public sources; not audited by Astrelis.
Machine-readable twin of this page: astrelis.co/hospitals/161319.md (Markdown, the same figures with their fiscal years, pools and definitions). Last modified: release 2321a4fc37a7, 2026-10-22. Figures are as filed in the named public sources. Astrelis is not a CPA firm and performs no audit, review or attestation of any facility.
