A hospital in Boys Town, NE. It ran an operating loss of 18.3% in FY24 on $221.1M of operating revenue. It held 15 days of cash on hand (33rd percentile of 64 Children's hospitals on liquidity, FY24 pool). Operating margin declined from -13.9% in FY20 to -18.3% in FY24, though it rose 1.1 points in the most recent year.
Operating margin · FY24
-18.3%
Astrelis calculation · as-filed inputs
vs Children's hospitals9th pctl of 66 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY24
15d
all sources
Astrelis calculation · as-filed inputs
vs Children's hospitals33rd pctl of 64 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY24
$221.1M
Astrelis calculation · as-filed inputs
vs Children's hospitals21st pctl of 68 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY24
-11.9%
Astrelis calculation · as-filed inputs
vs Children's hospitals5th pctl of 66 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at BOYS TOWN NATIONAL RESEARCH HOSPITAL is about $2.2M per year (1% of FY24 total operating revenue).
Where BOYS TOWN NATIONAL sits among Children's hospitals
Operating margin · FY24 pool · n = 66 of 73 filed
Each point is one Children's 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 Children's hospital FY24 median is +5.6%. Descriptive context only, not a ranking.
One children's hospitalBOYS TOWNChildren's 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.
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
173,148
185,444
203,203
Other operating revenue
8,934
19,310
17,918
Total operating revenue
182,082
204,753
221,121
Total operating expenses
223,510
244,466
261,649
Operating income
(41,427)
(39,713)
(40,528)
Operating margin %
-22.8%
-19.4%
-18.3%
Grants & contributions
670
262
4,459
Investment income
624
929
873
Other non-operating, net
1,370
10,349
7,338
Net income
(38,763)
(28,173)
(27,858)
Net income %
-21.0%
-13.0%
-11.9%
— = 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 46-bed children's hospital running at 16% occupancy, where operating cost runs $312,603 per discharge (unadjusted), and 94% 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
16.3%
Reported value2024
HCRIS WS S-3
Average daily census
7.53
Reported value2024
HCRIS WS S-3
Staffed beds (acute)
46
Reported value2024
HCRIS WS S-3
Annual discharges
837
Reported value2024
HCRIS WS S-3
Average length of stay
3 days
Reported value2024
HCRIS WS S-3
Cost per patient day
$95,145
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$312,603
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Outpatient share of patient revenue
94.0%
Reported value2024
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 · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
DOUGLAS County, NE · metro, 250K–1M
Median household income
$79.1K
vs $82.1K US
Poverty rate
11.2%
vs 12.5% US
Uninsured
8.7%
vs 8.6% US
Age 65+
13.8%
vs 16.8% US
Fair or poor health
15.7%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 5.0% of county personal income is Medicare/Medicaid medical benefits; 12.3% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Douglas County
Illustrative estimate · FY24 cost report
Direct annual spending
$261.6M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$601.8M
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 vs its peer poolFY24Astrelis calculation
Operating margin vs its peer pool: FY24 pool · n = 66.
Performance Benchmark Report: FY24 peer pool · n = 66 · conservative low band; acuity limits stated in the report.
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