Astrelis
Rural Emergency Hospital · Friend, NE

FRIEND COMMUNITY HEALTHCARE SYSTEM

CCN 280779SALINE CountyGovernment - LocalRural (USDA RUCC)Latest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
Financial anchor year: FY25. Margin and revenue are as filed for FY25. Balance-sheet measures (current ratio, equity financing, days in A/R) use FY24, the latest filing whose balance sheet reconciled as filed. Every tile below states its own fiscal year; nothing is carried forward or estimated.
The read

A hospital in Friend, NE. It ran an operating loss of 3.1% in FY25 on $5.3M of operating revenue. It held -15 days of cash on hand — an Astrelis calculation outside expected range, shown at the chart boundary and ranked in its pool. Operating margin improved from -8.6% in FY24 to -3.1% in FY25.

Operating margin · FY25
-3.1%
Astrelis calculation · as-filed inputs
5.5 pts vs FY24
not ranked: no valid same-year pool for this metric (needs n ≥ 25 and ≥ 50% of the cohort's filers at FY25)
Days cash on hand · FY25
-15d
all sources
Astrelis calculation · as-filed inputs
44 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 · FY25
$5.3M
Astrelis calculation · as-filed inputs
$1.3M 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 margin · incl. nonoperating · FY25
-0.5%
Astrelis calculation · as-filed inputs
1.3 pts vs FY24
not ranked: no valid same-year pool for this metric (needs n ≥ 25 and ≥ 50% of the cohort's filers at FY25)
One point of operating margin at FRIEND COMMUNITY HEALTHCARE SYSTEM is about $53K per year (1% of FY25 total operating revenue).

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
-3.1% (FY25)
Operating income ÷ total operating revenue
Astrelis calculation · HCRIS WS G-3
Total margin
-0.5% (FY25)
Net income ÷ total revenue incl. nonoperating
Astrelis calculation · HCRIS WS G-3
Days cash on hand
-15d (FY25)
Cash, investments & board-designated reserves ÷ daily operating expense (excl. depreciation)
Astrelis calculation · HCRIS WS G / G-3
Current ratio
0.72× (FY24)
Total current assets ÷ current liabilities
Astrelis calculation · HCRIS WS G
Equity financing ratio
8% (FY24)
Total net assets ÷ total assets
Astrelis calculation · HCRIS WS G
Days in net patient A/R
44d (FY24)
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
$ in thousands
Line itemFY24FY25
Patient revenue3,8565,239
Other operating revenue8644
Total operating revenue3,9425,283
Total operating expenses4,2805,447
Operating income(338)(164)
Operating margin %-8.6%-3.1%
Grants & contributions7292
Investment income30
Other non-operating, net18646
Net income(77)(26)
Net income %-1.8%-0.5%
2 of 3 years available for this statement.
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY24–FY25
Display states. FY25 · Days cash on hand: -15 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 Rural Emergency Hospital (no inpatient beds by design), where 100% of patient revenue is outpatient — the post-conversion model working as designed.

Rural Emergency Hospital continuity. An REH runs emergency and outpatient services without inpatient beds by design; the outpatient economics below are the model working, not a shrinking acute hospital. No predecessor CCN cross-references this record in the public termination file — linkage not established.

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
Outpatient share of patient revenue
100.0%
Reported value2025
HCRIS WS G-2 L28
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
Not reported in source (note 1)
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Medicare spending per beneficiary
Not reported in source (note 1)
CMS-reported measure01/01/2024 to 12/31/2024
CMS Care Compare
Patient-safety composite (PSI-90)
Not reported in source (note 1)
CMS-reported measure07/01/2022 to 06/30/2024
CMS Care Compare
Note 1: CMS does not publish these measures for this provider subtype (it does not participate in the acute-care IQR/OQR reporting programs, which do not apply here).

Trajectory

Cost-report basis · 2 reporting years
Operating margin
-8.6%-3.1%FY24FY25
Days cash on hand
29 days-15 daysFY24FY25
FY25 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

SALINE County, NE
Median household income
$77.0K
vs $82.1K US
Poverty rate
9.5%
vs 12.5% US
Uninsured
9.7%
vs 8.6% US
Age 65+
15.5%
vs 16.8% US
Fair or poor health
18.5%
self-reported, adults · CDC PLACES
Primary-care shortage
Not designated
HRSA HPSA
Economic context: 9.5% of county personal income is Medicare/Medicaid medical benefits; 20.6% arrives as government transfers (BEA, 2022).

Illustrative advocacy scenario: what this hospital means to Saline County

Illustrative estimate · FY25 cost report
Direct annual spending
$5.4M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$12.5M
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 not a critical access hospital, so the NCRHW-derived lines borrow from a different hospital type; the label says so here rather than in the number. 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 (as filed)FY25Astrelis calculation

-3.1% operating margin in FY25.

The Board Briefing

Operating margin improved 5.5 points vs FY24 — the briefing traces why, line by line.

Reserve The Board Briefing →
Performance Benchmark Report

A facility-specific dollar comparison cannot be calculated because a valid same-year peer pool was not reported. The report still includes all available facility measures, peer benchmarks, and a source-coverage inventory.

Reserve Performance Benchmark Report →
Report coverage: Limited Facility Benchmark. 5 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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