A hospital in Valley City, ND. It ran an operating surplus of 1.2% in FY24 on $14.1M of operating revenue. It held 283 days of cash on hand (83rd percentile of 1,325 Critical Access Hospitals on liquidity, FY24 pool). Operating margin declined from 3.3% in FY21 to 1.2% in FY24.
Operating margin · FY24
+1.2%
Astrelis calculation · as-filed inputs
▼ 0.9 pts vs FY23
vs Critical Access Hospitals59th 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
283d
all sources
Astrelis calculation · as-filed inputs
▼ 969 days vs FY23
vs Critical Access Hospitals83rd 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
$14.1M
Astrelis calculation · as-filed inputs
▲ $0.5M vs FY23
vs Critical Access Hospitals18th 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
+21.2%
Astrelis calculation · as-filed inputs
▲ 18.3 pts vs FY23
vs Critical Access Hospitals91st 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 CHI MERCY HEALTH is about $141K per year (1% of FY24 total operating revenue).
Where CHI MERCY HEALTH 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 hospitalCHI MERCYCritical 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.
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
Medicare inpatient contribution margin
+19.4% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
-117.6% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
13,048
13,213
13,166
Other operating revenue
(1,026)
381
976
Total operating revenue
12,022
13,593
14,142
Total operating expenses
13,903
13,317
13,978
Operating income
(1,881)
276
164
Operating margin %
-15.6%
+2.0%
+1.2%
Grants & contributions
—
—
28
Investment income
—
—
3,559
Other non-operating, net
0
116
4
Net income
(1,881)
392
3,755
Net income %
-15.6%
+2.9%
+21.2%
— = 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.FY25 · Operating margin — Astrelis calculation unavailable (net patient revenue was not reported (or is zero) on this filing)Filed inputs: Operating income -14,643KFY25 · Days cash on hand — Astrelis calculation unavailable (the corrected series carries no computable value for this year)
How it operates
quality & operational context · CMS public reporting
A 25-bed hospital running at 10% occupancy, where swing beds are 66% of the inpatient business.
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
10.1%
Reported value2025
HCRIS WS S-3
Average daily census
2.53
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
25
Reported value2025
HCRIS WS S-3
Annual discharges
289
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$15,881
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$50,666
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
4.92
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
66.0%
Reported value2025
HCRIS WS S-3 (acute + swing days)
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
14.4%
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.
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
Days cash on hand
The county this hospital serves
BARNES County, ND
Median household income
$70.2K
vs $82.1K US · $59.7K rural median
Poverty rate
11.3%
vs 12.5% US · 14.3% rural median
Uninsured
4.8%
vs 8.6% US · 8.4% rural median
Age 65+
22.8%
vs 16.8% US · 20.6% rural median
Fair or poor health
17.1%
self-reported, adults · CDC PLACES
Primary-care shortage
Not designated
HRSA HPSA
Economic context: 8.6% of county personal income is Medicare/Medicaid medical benefits; 18.8% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Barnes County
Illustrative estimate · FY25 cost report
Direct annual spending
$14.6M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$33.7M
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
+19.4% (FY24).
The Board Briefing
Operating margin declined 0.9 points vs FY23 — the briefing traces why, line by line.
CAH Performance Benchmark: FY24 peer pool · n = 1,340 · conservative low band; acuity limits stated in the report.
Basis: 88 services in the basket · 16 classified commercial payers (100% 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 95%).
Report coverage: Limited Facility Benchmark. 13 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.
$1,000delivered within 2 business days of invoice
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