A hospital in Irvine, KY. It ran an operating surplus of 13.4% in FY24 on $33.2M of operating revenue. It held -24 days of cash on hand — an Astrelis calculation outside expected range, shown at the chart boundary and ranked in its pool (1st percentile of 1,325 Critical Access Hospitals on liquidity, FY24 pool). Operating margin improved from -5.9% in FY20 to 13.4% in FY24.
Operating margin · FY24
+13.4%
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals88th pctl of 1,340 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY24
-24d
all sources
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals1st pctl of 1,325 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY24
$33.2M
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals55th pctl of 1,356 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY24
+13.5%
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals80th pctl of 1,341 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at MARCUM AND WALLACE MEMORIAL HOSPITAL is about $332K per year (1% of FY24 total operating revenue).
Where MARCUM AND WALLACE sits among Critical Access Hospitals
Operating margin · FY24 pool · n = 1,340 of 1,399 filed
Each point is one Critical Access Hospital in the national FY24 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 FY24 median is -1.8%. Descriptive context only, not a ranking.
One critical access hospitalMARCUM ANDCritical 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.
Astrelis calculation unavailable — the filed balance sheet does not reconcile as filed (statement values shown unchanged)
Total current assets ÷ current liabilities
Astrelis calculation · HCRIS WS G
Equity financing ratio
Astrelis calculation unavailable — the filed balance sheet does not reconcile as filed (statement values shown unchanged)
Total net assets ÷ total assets
Astrelis calculation · HCRIS WS G
Days in net patient A/R
Astrelis calculation unavailable — the filed balance sheet does not reconcile as filed (statement values shown unchanged)
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
Medicare inpatient contribution margin
+15.0% (FY24)
27th percentile of 476 CAHs (FY24 pool). Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+66.7% (FY24)
88th percentile of 476 CAHs (FY24 pool). Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
21,711
16,831
30,584
Other operating revenue
3,106
2,292
2,572
Total operating revenue
24,817
19,123
33,157
Total operating expenses
28,148
26,458
28,713
Operating income
(3,331)
(7,334)
4,443
Operating margin %
-13.4%
-38.4%
+13.4%
Investment income
0
0
0
Other non-operating, net
2,114
71
57
Net income
(1,217)
(7,263)
4,500
Net income %
-4.5%
-37.8%
+13.5%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY20–FY24 · FY20–21 may include COVID-era relief funding in nonoperating income
Display states.FY24 · Days cash on hand: -24 days — Astrelis calculation · outside expected range; shown at the chart boundary and included in peer statistics (out of display range)FY23 · Days cash on hand: -30 days — Astrelis calculation · outside expected range; shown at the chart boundary and included in peer statistics (out of display range)FY22 · Days cash on hand: -24 days — Astrelis calculation · outside expected range; shown at the chart boundary and included in peer statistics (out of display range)FY21 · Days cash on hand: -24 days — Astrelis calculation · outside expected range; shown at the chart boundary and included in peer statistics (out of display range)FY20 · Days cash on hand: -447 days — Astrelis calculation · outside expected range; shown at the chart boundary and included in peer statistics (out of display range)
How it operates
quality & operational context · CMS public reporting
A 25-bed hospital running at 14% occupancy, where swing beds are 57% of the inpatient business, and 83% 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
14.0%
Reported value2024
HCRIS WS S-3
Average daily census
3.51
Reported value2024
HCRIS WS S-3
Staffed beds (acute)
25
Reported value2024
HCRIS WS S-3
Annual discharges
618
Reported value2024
HCRIS WS S-3
Average length of stay
2 days
Reported value2024
HCRIS WS S-3
Cost per patient day
$22,415
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$46,461
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Swing-bed average daily census
4.58
Reported value2024
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
56.6%
Reported value2024
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
82.7%
Reported value2024
HCRIS WS G-2 L28
Who it serves
Total unreimbursed & uncompensated care
$0.8M
Reported value2023
HCRIS WS S-10 line 31
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%
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
FY24 days cash on hand is an Astrelis calculation outside expected range: charted at the boundary arrow, shown at its actual value in the tiles, and included in peer statistics.
The county this hospital serves
ESTILL County, KY · nonmetro, rural, metro-adjacent
Median household income
$43.9K
vs $82.1K US · $59.7K rural median
Poverty rate
22.0%
vs 12.5% US · 14.3% rural median
Uninsured
6.2%
vs 8.6% US · 8.4% rural median
Age 65+
19.4%
vs 16.8% US · 20.6% rural median
Fair or poor health
Not available
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 22.3% of county personal income is Medicare/Medicaid medical benefits; 42.6% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Estill County
Illustrative estimate · FY24 cost report
Direct annual spending
$28.7M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$66.0M
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 →
Medicare inpatient contribution marginFY24Astrelis calculation from reported HCRIS inputs
+15.0% — 27th percentile of 476 matched CAH peers (FY24).
The Board Briefing
What changed, what matters, and what your board should ask — every figure sourced to the public record.
CAH Performance Benchmark: FY24 peer pool · n = 1,340 · conservative low band; acuity limits stated in the report.
Report coverage: Limited Facility Benchmark. 15 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.
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