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 Aberdeen, SD. It ran an operating loss of 4.9% in FY25 on $201.2M of operating revenue. It held 24 days of cash on hand (47th percentile of 201 Rural PPS hospitals on liquidity, FY25 pool). Operating margin declined from 0.7% in FY21 to -4.9% in FY25.
Operating margin · FY25
-4.9%
Astrelis calculation · as-filed inputs
▼ 2.6 pts vs FY24
vs Rural PPS hospitals46th pctl of 202 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
24d
all sources
Astrelis calculation · as-filed inputs
▼ 5 days vs FY24
vs Rural PPS hospitals47th pctl of 201 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY25
$201.2M
Astrelis calculation · as-filed inputs
▼ $4.8M vs FY24
vs Rural PPS hospitals77th pctl of 207 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY25
-2.4%
Astrelis calculation · as-filed inputs
▼ 1.2 pts vs FY24
vs Rural PPS hospitals36th pctl of 202 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at AVERA ST LUKES is about $2.0M per year (1% of FY25 total operating revenue).
Where AVERA ST LUKES sits among Rural PPS hospitals
Operating margin · FY25 pool · n = 202 of 410 filed
Each point is one Rural PPS 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 Rural PPS hospital FY25 median is -3.6%. Descriptive context only, not a ranking.
One rural pps hospitalAVERA STRural PPS 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
FY23
FY24
FY25
Patient revenue
210,630
201,275
198,111
Other operating revenue
4,652
4,795
3,121
Total operating revenue
215,282
206,070
201,232
Total operating expenses
225,986
210,788
211,154
Operating income
(10,704)
(4,718)
(9,922)
Operating margin %
-5.0%
-2.3%
-4.9%
Grants & contributions
720
561
1,899
Investment income
290
538
1,665
Other non-operating, net
964
1,106
1,409
Net income
(8,730)
(2,513)
(4,949)
Net income %
-4.0%
-1.2%
-2.4%
— = 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
How it operates
quality & operational context · CMS public reporting
A 44-bed hospital running at 57% occupancy, where 72% 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
57.0%
Reported value2025
HCRIS WS S-3
Average daily census
25.13
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
44
Reported value2025
HCRIS WS S-3
Annual discharges
2,778
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$23,079
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$76,009
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
1.21
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
4.6%
Reported value2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
71.6%
Reported value2025
HCRIS WS G-2 L28
Total FTEs
827.50
Reported value2025
HCRIS WS S-3 Pt II
Contract labor share of labor cost
19.5%
Reported value2025
HCRIS WS S-3 Pt V
How the care measures up
C. difficile infection (SIR)
1.271
No Different than National Benchmark
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
Medicare spending per beneficiary
1.02
CMS-reported measure01/01/2024 to 12/31/2024
CMS Care Compare
Patient-safety composite (PSI-90)
1.056651
CMS-reported measure07/01/2022 to 06/30/2024
CMS Care Compare
Trajectory
Cost-report basis · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
BROWN County, SD
Median household income
$70.2K
vs $82.1K US · $59.7K rural median
Poverty rate
10.6%
vs 12.5% US · 14.3% rural median
Uninsured
7.5%
vs 8.6% US · 8.4% rural median
Age 65+
17.6%
vs 16.8% US · 20.6% rural median
Fair or poor health
15.5%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 5.5% of county personal income is Medicare/Medicaid medical benefits; 14.7% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Brown County
Illustrative estimate · FY25 cost report
Direct annual spending
$211.2M
total operating expense · Reported value, not a local-capture estimate
Labor income
$109.9M
$92.4M direct compensation × 1.19 · NCRHW 2016 CAH study · Illustrative estimate
Economic activity
$485.7M
direct spending × 2.30 · AHA national hospital economic activity report — a national hospital ratio, not a CAH or county figure · Illustrative estimate
Share of county employment
4.2%
of all county jobs · Reported value
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 poolFY25Astrelis calculation
Operating margin vs its peer pool: FY25 pool · n = 202.
Performance Benchmark Report: FY25 peer pool · n = 202 · conservative low band; acuity limits stated in the report.
Report coverage: Limited Facility Benchmark. 16 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
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