A hospital in De Smet, SD. It ran an operating surplus of 12.4% in FY25 on $9.1M of operating revenue. It held 0 days of cash on hand (5th percentile among Critical Access Hospitals on liquidity). Operating margin declined from 23.3% in FY21 to 12.4% in FY25, though it rose 2.0 points in the most recent year.
Operating margin · FY25
+12.4%
▲ 2.0 pts vs FY24
vs Critical Access Hospitals84th pctl of 824 (FY25)
Days cash on hand · FY25
0d
all sources
▬ 0.0 days vs FY24
vs Critical Access Hospitals5th pctl of 827 (FY25)
Total operating revenue · FY25
$9.1M
▲ 0.8 $M vs FY24
vs Critical Access Hospitals6th pctl of 833 (FY25)
Total margin · incl. nonoperating · FY25
+17.8%
▼ 0.4 pts vs FY24
vs Critical Access Hospitals86th pctl of 824 (FY25)
One point of operating margin at AVERA DE SMET MEMORIAL HOSPITAL - CAH is about $91K per year (1% of FY25 total operating revenue).
Where AVERA DE SMET sits among Critical Access Hospitals
Operating margin · FY25 pool · n = 824 of 1,404 filed
Each point is one Critical Access Hospital in the national 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 median is -0.2%. Descriptive context only, not a ranking.
One critical access hospitalAVERA DECritical 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 renders only when every input is reported in the filing; a year missing its core lines is not shown; a year whose balance sheet does not reconcile is labeled. Not audited by Astrelis.
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
HCRIS WS G / G-3
Medicare inpatient contribution margin
+13.1% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+57.7% (FY24)
Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY23
FY24
FY25
Patient revenue
8,318
8,255
9,052
Other operating revenue
8
9
11
Total operating revenue
8,326
8,263
9,063
Total operating expenses
6,631
7,405
7,943
Operating income
1,695
858
1,120
Operating margin %
+20.4%
+10.4%
+12.4%
Grants & contributions
—
—
15
Other non-operating, net
108
798
589
Net income
1,803
1,656
1,724
Net income %
+21.4%
+18.3%
+17.8%
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 6-bed hospital at 6% occupancy where swing beds are 43% of the inpatient business and 90% of patient revenue is outpatient.
The metrics this hospital type is judged on: care quality, patient experience, and scale. Each is labeled by evidence class and public source; descriptive context only, never a ranking or adequacy claim.
Scale and flow
Occupancy
5.9%
Verified fact2025
HCRIS WS S-3
Average daily census
0.35
Verified fact2025
HCRIS WS S-3
Staffed beds (acute)
6
Verified fact2025
HCRIS WS S-3
Annual discharges
59
Verified fact2025
HCRIS WS S-3
Average length of stay
2.2d
Verified fact2025
HCRIS WS S-3
Swing-bed average daily census
0.27
Verified fact2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
43.4%
Verified fact2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
90.1%
Verified fact2025
HCRIS WS G-2 L28
How the care measures up
C. difficile infection (SIR)
Results cannot be calculated for this reporting period.
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
The number of cases/patients is too few to report.
CMS-reported measure07/01/2023 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
KINGSBURY County, SD
Median household income
$70.2K
vs $82.1K US · $59.7K rural median
Poverty rate
9.7%
vs 12.5% US · 14.3% rural median
Uninsured
6.0%
vs 8.6% US · 8.4% rural median
Age 65+
23.0%
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: 6.6% of county personal income is Medicare/Medicaid medical benefits; 17.0% arrives as government transfers (BEA, 2022).
What this hospital means to Kingsbury County
economic contribution · FY25 cost report
Direct annual spending
$7.9M
total operating expense · reported
Total economic output
$18.3M
× 2.30 output multiplier · estimate, upper bound for rural
Method: NCRHW 2016 study of critical access hospitals (IMPLAN Type II), employment × 1.34, earnings × 1.19; output × 2.30 (AHA national, upper bound for rural). Direct figures are reported values from the facility's HCRIS cost report; multiplied figures are estimates.
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