A hospital in Creston, IA. It ran an operating surplus of 6.5% in FY25 on $123.3M of operating revenue. It held 158 days of cash on hand (62nd percentile among Critical Access Hospitals on liquidity). Operating margin improved from 2.9% in FY21 to 6.5% in FY25, though it fell 4.6 points in the most recent year.
Operating margin · FY25
+6.5%
▼ 4.6 pts vs FY24
vs Critical Access Hospitals71st pctl of 824 (FY25)
Days cash on hand · FY25
158d
all sources
▲ 27.3 days vs FY24
vs Critical Access Hospitals62nd pctl of 827 (FY25)
Total operating revenue · FY25
$123.3M
▲ 5.0 $M vs FY24
vs Critical Access Hospitals96th pctl of 833 (FY25)
Total margin · incl. nonoperating · FY25
+8.8%
▼ 4.3 pts vs FY24
vs Critical Access Hospitals60th pctl of 824 (FY25)
One point of operating margin at GREATER REGIONAL MEDICAL CENTER is about $1.2M per year (1% of FY25 total operating revenue).
Where GREATER REGIONAL MEDICAL 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 hospitalGREATER REGIONALCritical 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
+43.2% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+68.2% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY23
FY24
FY25
Patient revenue
89,370
112,464
116,277
Other operating revenue
7,834
5,878
7,033
Total operating revenue
97,204
118,342
123,310
Total operating expenses
93,303
105,162
115,286
Operating income
3,901
13,179
8,023
Operating margin %
+4.0%
+11.1%
+6.5%
Grants & contributions
1,170
1,203
1,199
Other non-operating, net
552
1,527
1,969
Net income
5,623
15,909
11,191
Net income %
+5.7%
+13.1%
+8.8%
HCRIS Worksheet G-3 / S-3 · $ thousands · FY21–FY25 · FY20–21 may include COVID-era relief funding in nonoperating income
How it operates
quality & operational context · CMS public reporting
A 21-bed hospital at 29% occupancy 90% 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
29.3%
Verified fact2025
HCRIS WS S-3
Average daily census
6.16
Verified fact2025
HCRIS WS S-3
Staffed beds (acute)
21
Verified fact2025
HCRIS WS S-3
Annual discharges
792
Verified fact2025
HCRIS WS S-3
Average length of stay
2.8d
Verified fact2025
HCRIS WS S-3
Swing-bed average daily census
1.41
Verified fact2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
18.7%
Verified fact2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
90.0%
Verified fact2025
HCRIS WS G-2 L28
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
14.5%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Trajectory
Cost-report basis · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
UNION County, IA
Median household income
$56.8K
vs $82.1K US · $59.7K rural median
Poverty rate
12.6%
vs 12.5% US · 14.3% rural median
Uninsured
7.9%
vs 8.6% US · 8.4% rural median
Age 65+
20.5%
vs 16.8% US · 20.6% rural median
Fair or poor health
17.7%
self-reported, adults · CDC PLACES
Primary-care shortage
Not designated
HRSA HPSA
Economic context: 13.9% of county personal income is Medicare/Medicaid medical benefits; 29.4% arrives as government transfers (BEA, 2022).
What this hospital means to Union County
economic contribution · FY25 cost report
Direct annual spending
$115.3M
total operating expense · reported
Total economic output
$265.2M
× 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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