Astrelis
Critical Access Hospital · Decorah, IA

WINNMED

CCN 161371WINNESHIEK CountyGovernment - Local25 bedsLatest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
The read

A hospital in Decorah, IA. It ran an operating loss of 4.5% in FY25 on $98.6M of operating revenue. It held 132 days of cash on hand (56th percentile of 822 Critical Access Hospitals on liquidity, FY25 pool). Including nonoperating items, the all-in result was positive at 5.6%.

Operating margin · FY25
-4.5%
Astrelis calculation · as-filed inputs
▼ 2.7 pts vs FY24
vs Critical Access Hospitals36th pctl of 824 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
132d
all sources
Astrelis calculation · as-filed inputs
▲ 2 days vs FY24
vs Critical Access Hospitals56th pctl of 822 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY25
$98.6M
Astrelis calculation · as-filed inputs
▲ $8.7M vs FY24
vs Critical Access Hospitals92nd pctl of 833 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY25
+5.6%
Astrelis calculation · as-filed inputs
▲ 0.2 pts vs FY24
vs Critical Access Hospitals46th pctl of 824 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at WINNMED is about $986K per year (1% of FY25 total operating revenue).

Where WINNMED sits among Critical Access Hospitals

Operating margin · FY25 pool · n = 824 of 1,399 filed

Each point is one Critical Access Hospital in the national FY25 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 FY25 median is -0.2%. Descriptive context only, not a ranking.

-20%-10%0%+10%+20%Critical Access Hospital median -0.2%WINNMED -4.5%-20%0%+20%Critical Access Hospital median -0.2%WINNMED -4.5%
One critical access hospitalWINNMEDCritical 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.

Operating margin
-4.5% (FY25)
Operating income ÷ total operating revenue
Astrelis calculation · HCRIS WS G-3
Total margin
+5.6% (FY25)
Net income ÷ total revenue incl. nonoperating
Astrelis calculation · HCRIS WS G-3
Days cash on hand
132d (FY25)
Cash, investments & board-designated reserves ÷ daily operating expense (excl. depreciation)
Astrelis calculation · HCRIS WS G / G-3
Current ratio
2.94× (FY25)
Total current assets ÷ current liabilities
Astrelis calculation · HCRIS WS G
Equity financing ratio
53% (FY25)
Total net assets ÷ total assets
Astrelis calculation · HCRIS WS G
Days in net patient A/R
53d (FY25)
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
Medicare inpatient contribution margin
+49.0% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+69.3% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line itemFY23FY24FY25
Patient revenue77,64089,22597,905
Other operating revenue862723704
Total operating revenue78,50289,94798,609
Total operating expenses77,72991,591103,069
Operating income773(1,643)(4,460)
Operating margin %+1.0%-1.8%-4.5%
Grants & contributions1,9671,7251,863
Investment income6571,1141,077
Other non-operating, net4,9204,0377,678
Net income8,3175,2336,158
Net income %+9.7%+5.4%+5.6%
— = 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

How it operates

quality & operational context · CMS public reporting

A 25-bed hospital running at 23% occupancy, where swing beds are 24% of the inpatient business, and 90% of patient revenue is outpatient.

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
23.5%
Reported value2025
HCRIS WS S-3
Average daily census
5.88
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
25
Reported value2025
HCRIS WS S-3
Annual discharges
789
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$48,163
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$130,632
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
1.84
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
23.8%
Reported value2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
89.5%
Reported value2025
HCRIS WS G-2 L28
How the care measures up
C. difficile infection (SIR)
0
No Different than National Benchmark
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

Pricing

Pilot · FY25
Commercial rates vs Medicare
167%
Medicare baseline100%
Commercial negotiated rates167%
Commercial negotiated rates as a percent of Medicare rates, outpatient basket. Chart bound 300%; values beyond it are clipped at the bar edge and shown at their actual figure.
Hospital price files + Medicare rates

Directional indicator from public price files. Facility-specific rate positioning is the Commercial Pricing Study →

Trajectory

Cost-report basis · 5 reporting years
Operating margin
-4.3%+4.3%+1.0%-1.8%-4.5%FY21FY22FY23FY24FY25
Days cash on hand
181 days177 days66 days130 days132 daysFY21FY22FY23FY24FY25

The county this hospital serves

WINNESHIEK County, IA
Median household income
$75.7K
vs $82.1K US · $59.7K rural median
Poverty rate
7.9%
vs 12.5% US · 14.3% rural median
Uninsured
2.9%
vs 8.6% US · 8.4% rural median
Age 65+
22.6%
vs 16.8% US · 20.6% rural median
Fair or poor health
14.4%
self-reported, adults · CDC PLACES
Primary-care shortage
Not designated
HRSA HPSA
Economic context: 7.3% of county personal income is Medicare/Medicaid medical benefits; 18.9% arrives as government transfers (BEA, 2022).

Illustrative advocacy scenario: what this hospital means to Winneshiek County

Illustrative estimate · FY25 cost report
Direct annual spending
$103.1M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$237.1M
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 →
Medicare inpatient contribution marginFY24Astrelis calculation from reported HCRIS inputs

+49.0% (FY24).

The Board Briefing

Operating margin declined 2.7 points vs FY24 — the briefing traces why, line by line.

Reserve The Board Briefing →
CAH Performance Benchmark

4.3 points below the cohort median — at current revenue, approximately $4.2M less operating income than the median rate.

(-4.5% facility vs -0.2% peer median) = 4.3 points below the median × $98.6M revenue ≈ $4.2M less operating income than the median rate
Reserve CAH Performance Benchmark →
Commercial Pricing Study

Commercial rates run ≈ 1.67× the Medicare OPPS-equivalent on the measured basket (median across classified payers).

Request Commercial Pricing Study →
How we calculated this

Peer pool matched on: bed-size band · rural status · state (progressively widened to national at a 20-peer floor).

View the formula in the methodology →

CAH Performance Benchmark: FY25 peer pool · n = 824 · conservative low band; acuity limits stated in the report.

Basis: 92 services in the basket · 12 classified commercial payers (100% of commercial volume classified) · pricing files captured 2026-07-19 · numerator: negotiated commercial allowed amounts (classified payers) · denominator: Medicare OPPS-equivalent for the same services · weighting: volume-weighted line-level outpatient service basket (CY2026 OPPS equivalent) (weight coverage 97%).

Report coverage: Limited Facility Benchmark. 14 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.

The Board Briefing

Your facility and its world, board-ready. Measures the public record does not carry become findings, never a decline reason.

$1,000delivered within 2 business days of invoice
Reservation: invoice after coverage confirmation. No payment is collected on this site.
Download financial summary (CSV)

CAH Performance Benchmark

Contribution margin by department, Medicare take-back exposure, and capture gaps against matched peers, from your own filed cost report.

$2,500Founding Edition · within 30 days of coverage confirmation
Reservation: invoice after coverage confirmation. No payment is collected on this site. Full refund if the published scope cannot be delivered.

Commercial Pricing Study

Your negotiated commercial rates against Medicare and against peers, from hospitals' own published price files.

$10,000Scoped after rate-file validation
Rate file verified · captured July 2026
Request: scoped and quoted before any invoice. No payment is collected on this site. We validate your hospital's rate file before taking payment.

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