CCN 450658FREESTONE CountyGovernment - Hospital District or AuthorityRural (USDA RUCC)37 bedsLatest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
The read
A hospital in Fairfield, TX. It ran an operating loss of 28.5% in FY25 on $18.6M of operating revenue. It held 38 days of cash on hand (56th percentile of 201 Rural PPS hospitals on liquidity, FY25 pool). 6 reporting years are on file, but revenue scale shifts too much between them for a like-for-like trend, so trend context is limited.
Operating margin · FY25
-28.5%
Astrelis calculation · as-filed inputs
▲ 0.3 pts vs FY24
vs Rural PPS hospitals8th 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
38d
all sources
Astrelis calculation · as-filed inputs
▼ 24 days vs FY24
vs Rural PPS hospitals56th 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
$18.6M
Astrelis calculation · as-filed inputs
▲ $3.0M vs FY24
vs Rural PPS hospitals6th 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
-5.2%
Astrelis calculation · as-filed inputs
▲ 3.6 pts vs FY24
vs Rural PPS hospitals27th 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 FREESTONE MEDICAL CENTER is about $186K per year (1% of FY25 total operating revenue).
Where FREESTONE MEDICAL CENTER 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 hospitalFREESTONE MEDICALRural 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
15,954
15,652
18,580
Other operating revenue
367
(1)
23
Total operating revenue
16,321
15,651
18,602
Total operating expenses
20,129
20,164
23,907
Operating income
(3,808)
(4,513)
(5,305)
Operating margin %
-23.3%
-28.8%
-28.5%
Grants & contributions
2,632
2,676
3,985
Investment income
58
109
44
Other non-operating, net
76
92
97
Net income
(1,042)
(1,636)
(1,179)
Net income %
-5.5%
-8.8%
-5.2%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY20–FY25 · FY20–21 may include COVID-era relief funding in nonoperating income
How it operates
quality & operational context · CMS public reporting
A 37-bed hospital running at 6% occupancy, where 87% 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
5.8%
Reported value2025
HCRIS WS S-3
Average daily census
2.14
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
37
Reported value2025
HCRIS WS S-3
Annual discharges
268
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$30,729
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$89,205
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
0.09
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
4.2%
Reported value2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
87.4%
Reported value2025
HCRIS WS G-2 L28
Total FTEs
112.40
Reported value2025
HCRIS WS S-3 Pt II
Contract labor share of labor cost
18.5%
Reported value2025
HCRIS WS S-3 Pt V
Who it serves
Total unreimbursed & uncompensated care
$2.7M
Reported value2023
HCRIS WS S-10 line 31
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
14.3%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Medicare spending per beneficiary
0.87
CMS-reported measure01/01/2024 to 12/31/2024
CMS Care Compare
Patient-safety composite (PSI-90)
Not reported in source (note 2)
CMS-reported measure07/01/2022 to 06/30/2024
CMS Care Compare
Note 1: Results cannot be calculated for this reporting period.Note 2: The number of cases/patients is too few to report.
Trajectory
Cost-report basis · 6 reporting years
Operating margin
Days cash on hand
The county this hospital serves
FREESTONE County, TX · nonmetro, rural, remote
Median household income
$58.5K
vs $82.1K US · $59.7K rural median
Poverty rate
14.3%
vs 12.5% US · 14.3% rural median
Uninsured
12.4%
vs 8.6% US · 8.4% rural median
Age 65+
20.0%
vs 16.8% US · 20.6% rural median
Fair or poor health
22.5%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 13.9% of county personal income is Medicare/Medicaid medical benefits; 29.7% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Freestone County
Illustrative estimate · FY25 cost report
Direct annual spending
$23.9M
total operating expense · Reported value, not a local-capture estimate
Labor income
$9.1M
$7.7M direct compensation × 1.19 · NCRHW 2016 CAH study · Illustrative estimate
Economic activity
$55.0M
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
2.3%
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: Standard Facility Benchmark. 17 of 17 facility measures available from public sources. Every declared facility measure is available for this record, benchmarked against its same-year peer pools. The refund guarantee stands: if we cannot deliver the published scope, you pay nothing.
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