Financial anchor year: FY24. Margin and revenue are as filed for FY24. Balance-sheet measures (current ratio, equity financing, days in A/R) use FY22, 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 Williston, ND. It ran an operating loss of 10.1% in FY24 on $90.7M of operating revenue. It held 29 days of cash on hand (29th percentile of 1,325 Critical Access Hospitals on liquidity, FY24 pool). Operating margin declined from -6.3% in FY21 to -10.1% in FY24.
Operating margin · FY24
-10.1%
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals27th 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
29d
all sources
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals29th 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
$90.7M
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals91st 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
-8.3%
Astrelis calculation · as-filed inputs
vs Critical Access Hospitals9th 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 ST ALEXIUS HEALTH WILLISTON is about $907K per year (1% of FY24 total operating revenue).
Where CHI ST ALEXIUS 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 STCritical 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
-170.6% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
-305.3% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
86,534
85,165
83,029
Other operating revenue
1,030
4,981
7,678
Total operating revenue
87,564
90,146
90,707
Total operating expenses
94,909
97,273
99,853
Operating income
(7,345)
(7,127)
(9,146)
Operating margin %
-8.4%
-7.9%
-10.1%
Grants & contributions
1,401
—
258
Investment income
30
—
921
Other non-operating, net
2,725
0
327
Net income
(3,189)
(7,127)
(7,640)
Net income %
-3.5%
-7.9%
-8.3%
— = 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 -104,869KFY25 · 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
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
44.3%
Reported value2025
HCRIS WS S-3
Average daily census
11.11
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
25
Reported value2025
HCRIS WS S-3
Annual discharges
1,613
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$25,938
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$65,015
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
How the care measures up
C. difficile infection (SIR)
0
No Different than National Benchmark
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
15.6%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Pricing
Pilot · FY25
Commercial rates vs Medicare
242%
Medicare baseline100%
Commercial negotiated rates242%
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
WILLIAMS County, ND
Median household income
$90.2K
vs $82.1K US · $59.7K rural median
Poverty rate
8.8%
vs 12.5% US · 14.3% rural median
Uninsured
11.7%
vs 8.6% US · 8.4% rural median
Age 65+
9.9%
vs 16.8% US · 20.6% rural median
Fair or poor health
16.6%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 3.8% of county personal income is Medicare/Medicaid medical benefits; 9.7% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Williams County
Illustrative estimate · FY25 cost report
Direct annual spending
$104.9M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$241.2M
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
-170.6% (FY24).
The Board Briefing
What changed, what matters, and what your board should ask — every figure sourced to the public record.
CAH Performance Benchmark: FY24 peer pool · n = 1,340 · conservative low band; acuity limits stated in the report.
Basis: 87 services in the basket · 6 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. 11 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.
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