Astrelis
Critical Access Hospital · Langdon, ND

CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION

CCN 351323CAVALIER CountyVoluntary non-profit - Private25 bedsLatest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
The read

A hospital in Langdon, ND. It ran an operating loss of 20.2% in FY25 on $12.1M of operating revenue. It held 204 days of cash on hand (69th percentile of 822 Critical Access Hospitals on liquidity, FY25 pool). Operating margin declined from 31.2% in FY21 to -20.2% in FY25.

Operating margin · FY25
-20.2%
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals12th 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
204d
all sources
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals69th 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
$12.1M
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals11th 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
-14.0%
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals3rd 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 CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION is about $121K per year (1% of FY25 total operating revenue).

Where CAVALIER COUNTY MEMORIAL 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%CAVALIER COUNTY -20.2%-20%0%+20%Critical Access Hospital median -0.2%CAVALIER COUNTY -20.2%
One critical access hospitalCAVALIER COUNTYCritical 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
-20.2% (FY25)
Operating income ÷ total operating revenue
Astrelis calculation · HCRIS WS G-3
Total margin
-14.0% (FY25)
Net income ÷ total revenue incl. nonoperating
Astrelis calculation · HCRIS WS G-3
Days cash on hand
204d (FY25)
Cash, investments & board-designated reserves ÷ daily operating expense (excl. depreciation)
Astrelis calculation · HCRIS WS G / G-3
Current ratio
4.03× (FY25)
Total current assets ÷ current liabilities
Astrelis calculation · HCRIS WS G
Equity financing ratio
80% (FY25)
Total net assets ÷ total assets
Astrelis calculation · HCRIS WS G
Days in net patient A/R
46d (FY25)
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
Medicare inpatient contribution margin
+59.8% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+8.7% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line itemFY23FY24FY25
Patient revenue12,77712,41410,917
Other operating revenue1,3791,5621,207
Total operating revenue14,15613,97612,124
Total operating expenses13,89314,26814,569
Operating income263(293)(2,445)
Operating margin %+1.9%-2.1%-20.2%
Grants & contributions82
Investment income356
Other non-operating, net0116296
Net income345(177)(1,793)
Net income %+2.4%-1.2%-14.0%
— = 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
Display states. FY21 · Days cash on hand: 2,907 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 5% occupancy, where swing beds are 57% of the inpatient business, and 64% 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
5.4%
Reported value2025
HCRIS WS S-3
Average daily census
1.35
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
25
Reported value2025
HCRIS WS S-3
Annual discharges
165
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$29,612
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$88,297
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
1.77
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
56.7%
Reported value2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
64.4%
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
15.2%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Note 1: Results are not available for this reporting period.

Trajectory

Cost-report basis · 5 reporting years
Operating margin
+31.2%+8.2%+1.9%-2.1%-20.2%FY21FY22FY23FY24FY25
Days cash on hand
2,907 days144 days125 days199 days204 daysFY21FY22FY23FY24FY25

The county this hospital serves

CAVALIER County, ND
Median household income
$67.1K
vs $82.1K US · $59.7K rural median
Poverty rate
7.7%
vs 12.5% US · 14.3% rural median
Uninsured
3.5%
vs 8.6% US · 8.4% rural median
Age 65+
27.3%
vs 16.8% US · 20.6% rural median
Fair or poor health
17.0%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 5.3% of county personal income is Medicare/Medicaid medical benefits; 11.2% arrives as government transfers (BEA, 2022).

Illustrative advocacy scenario: what this hospital means to Cavalier County

Illustrative estimate · FY25 cost report
Direct annual spending
$14.6M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$33.5M
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 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

+59.8% (FY24).

The Board Briefing

What changed, what matters, and what your board should ask — every figure sourced to the public record.

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CAH Performance Benchmark

20.0 points below the cohort median — at current revenue, approximately $2.4M less operating income than the median rate.

(-20.2% facility vs -0.2% peer median) = 20.0 points below the median × $12.1M revenue ≈ $2.4M less operating income than the median rate
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Commercial Pricing Study

Charge markup ratio 1.29× (gross charges ÷ total operating cost, HCRIS as filed) — the study prices your actual negotiated-rate file against it.

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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.

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.

CAH Performance Benchmark

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

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Commercial Pricing Study

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

$10,000Scoped after rate-file validation
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