Astrelis
Critical Access Hospital · Machias, ME

DOWN EAST COMMUNITY HOSPITAL

CCN 201311WASHINGTON CountyVoluntary non-profit - PrivateRural (USDA RUCC)25 bedsLatest FY 2024
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
The read

A hospital in Machias, ME. It ran an operating surplus of 6.6% in FY24 on $64.7M of operating revenue. It held 152 days of cash on hand (64th percentile of 1,325 Critical Access Hospitals on liquidity, FY24 pool). Operating margin improved from 2.2% in FY20 to 6.6% in FY24.

Operating margin · FY24
+6.6%
Astrelis calculation · as-filed inputs
7.9 pts vs FY23
vs Critical Access Hospitals75th 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
152d
all sources
Astrelis calculation · as-filed inputs
64 days vs FY23
vs Critical Access Hospitals64th 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
$64.7M
Astrelis calculation · as-filed inputs
$2.6M vs FY23
vs Critical Access Hospitals81st 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
+6.6%
Astrelis calculation · as-filed inputs
7.9 pts vs FY23
vs Critical Access Hospitals56th 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 DOWN EAST COMMUNITY HOSPITAL is about $647K per year (1% of FY24 total operating revenue).

Where DOWN EAST COMMUNITY 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.

-20%-10%0%+10%+20%Critical Access Hospital median -1.8%DOWN EAST +6.6%-20%0%+20%Critical Access Hospital median -1.8%DOWN EAST +6.6%
One critical access hospitalDOWN EASTCritical 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
+6.6% (FY24)
Operating income ÷ total operating revenue
Astrelis calculation · HCRIS WS G-3
Total margin
+6.6% (FY24)
Net income ÷ total revenue incl. nonoperating
Astrelis calculation · HCRIS WS G-3
Days cash on hand
152d (FY24)
Cash, investments & board-designated reserves ÷ daily operating expense (excl. depreciation)
Astrelis calculation · HCRIS WS G / G-3
Current ratio
2.76× (FY24)
Total current assets ÷ current liabilities
Astrelis calculation · HCRIS WS G
Equity financing ratio
63% (FY24)
Total net assets ÷ total assets
Astrelis calculation · HCRIS WS G
Days in net patient A/R
24d (FY24)
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
Medicare inpatient contribution margin
+26.1% (FY24)
45th percentile of 476 CAHs (FY24 pool). Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+63.3% (FY24)
77th percentile of 476 CAHs (FY24 pool). Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line itemFY22FY23FY24
Patient revenue57,18160,05262,280
Other operating revenue4,7302,1032,445
Total operating revenue61,91162,15564,726
Total operating expenses59,98062,96560,486
Operating income1,931(810)4,240
Operating margin %+3.1%-1.3%+6.6%
Other non-operating, net000
Net income1,931(810)4,240
Net income %+3.1%-1.3%+6.6%
— = 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

How it operates

quality & operational context · CMS public reporting

A 25-bed hospital running at 20% occupancy, where swing beds are 27% of the inpatient business, and 89% 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
19.6%
Reported value2024
HCRIS WS S-3
Average daily census
4.91
Reported value2024
HCRIS WS S-3
Staffed beds (acute)
25
Reported value2024
HCRIS WS S-3
Annual discharges
455
Reported value2024
HCRIS WS S-3
Average length of stay
4 days
Reported value2024
HCRIS WS S-3
Cost per patient day
$33,772
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$132,936
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
1.78
Reported value2024
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
26.6%
Reported value2024
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
89.3%
Reported value2024
HCRIS WS G-2 L28
Who it serves
Total unreimbursed & uncompensated care
$1.7M
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
14.7%
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.

Pricing

Pilot · FY24
Commercial rates vs Medicare
234%
Medicare baseline100%
Commercial negotiated rates234%
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
+2.2%+7.5%+3.1%-1.3%+6.6%FY20FY21FY22FY23FY24
Days cash on hand
146 days161 days92 days88 days152 daysFY20FY21FY22FY23FY24

The county this hospital serves

WASHINGTON County, ME
Median household income
$52.2K
vs $82.1K US · $59.7K rural median
Poverty rate
17.8%
vs 12.5% US · 14.3% rural median
Uninsured
9.8%
vs 8.6% US · 8.4% rural median
Age 65+
25.8%
vs 16.8% US · 20.6% rural median
Fair or poor health
21.7%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 19.0% of county personal income is Medicare/Medicaid medical benefits; 39.5% arrives as government transfers (BEA, 2022).

Illustrative advocacy scenario: what this hospital means to Washington County

Illustrative estimate · FY24 cost report
Direct annual spending
$60.5M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$139.1M
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

+26.1% — 45th percentile of 476 matched CAH peers (FY24).

The Board Briefing

Operating margin improved 7.9 points vs FY23 — the briefing traces why, line by line.

Reserve The Board Briefing →
CAH Performance Benchmark

8.4 points above the cohort median — at current revenue, approximately $5.4M more operating income than the median rate.

(6.6% facility vs -1.8% peer median) = 8.4 points above the median × $64.7M revenue ≈ $5.4M more operating income than the median rate
Reserve CAH Performance Benchmark →
Commercial Pricing Study

Commercial rates run ≈ 2.34× 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).

Medicare inpatient contribution margin: FY24 pool · n = 476.

View the formula in the methodology →

CAH Performance Benchmark: FY24 peer pool · n = 1,340 · conservative low band; acuity limits stated in the report.

Basis: 88 services in the basket · 7 classified commercial payers (78% 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 96%).

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.

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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