CCN 451313FISHER CountyGovernment - Hospital District or AuthorityRural (USDA RUCC)10 bedsLatest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
Operating margin: -49.2% in FY2025, the 2nd percentile of 1,322 critical access hospitals in the FY2025 pool. Days cash on hand: 100 days in FY2025, the 52nd percentile of 1,297 critical access hospitals in the FY2025 pool. Total operating revenue: $8.7M in FY2025, the 4th percentile of 1,331 critical access hospitals in the FY2025 pool. Total margin (including nonoperating): -1.2% in FY2025, the 22nd percentile of 1,322 critical access hospitals in the FY2025 pool. Figures as filed; not audited by Astrelis.
The read
A hospital in Rotan, TX. It ran an operating loss of 49.2% in FY25 on $8.7M of operating revenue. It held 100 days of cash on hand (52nd percentile of 1,297 Critical Access Hospitals on liquidity, FY25 pool). Operating margin declined from -21.0% in FY20 to -49.2% in FY25.
Operating margin · FY25
-49.2%
Astrelis calculation · as-filed inputs
▼ 28.1 pts vs FY24
vs Critical Access Hospitals2nd pctl of 1,322 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
100d
all sources
Astrelis calculation · as-filed inputs
▼ 43 days vs FY24
vs Critical Access Hospitals52nd pctl of 1,297 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY25
$8.7M
Astrelis calculation · as-filed inputs
▼ $0.9M vs FY24
vs Critical Access Hospitals4th pctl of 1,331 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY25
-1.2%
Astrelis calculation · as-filed inputs
▼ 14.1 pts vs FY24
vs Critical Access Hospitals22nd pctl of 1,322 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at FISHER COUNTY HOSPITAL DISTRICT is about $87K per year (1% of FY25 total operating revenue).
Where FISHER COUNTY HOSPITAL sits among Critical Access Hospitals
Operating margin · FY25 pool · n = 1,322 of 1,404 filed
Each point is one Critical Access Hospital in the national FY25 distribution for Critical Access Hospitals, this hospital's comparison cohort, 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 FY25 median is -0.6%. Descriptive context only, not a ranking.
One critical access hospitalFISHER COUNTYCritical 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 × days in the report's own period ÷ net patient revenue, same fiscal year
Astrelis calculation · HCRIS WS G / G-3
$ in thousands
Line item
FY23
FY24
FY25
Patient revenue
8,115
9,579
8,652
Other operating revenue
0
0
0
Total operating revenue
8,116
9,580
8,652
Total operating expenses
11,311
11,598
12,911
Operating income
(3,195)
(2,018)
(4,259)
Operating margin %
-39.4%
-21.1%
-49.2%
Investment income
182
270
225
Other non-operating, net
4,018
3,476
3,883
Net income
1,005
1,728
(151)
Net income %
+8.1%
+12.9%
-1.2%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY20–FY25 · where other operating income is not reported, total operating revenue reflects net patient revenue alone · FY20–21 may include COVID-era relief funding in nonoperating income
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
2.6%
Reported value2025
HCRIS WS S-3
Average daily census
0.26
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
10
Reported value2025
HCRIS WS S-3
Annual discharges
33
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$135,907
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$391,246
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Who it serves
Total unreimbursed & uncompensated care
$1.2M
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
Not reported in source (note 2)
CMS-reported measure07/01/2023 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.
Pricing
Pilot · FY24
Commercial rates vs Medicare
292%
Medicare baseline100%
Commercial negotiated rates292%
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 · 6 reporting years
Operating margin
Days cash on hand
The county this hospital serves
FISHER County, TX · nonmetro, rural, metro-adjacent
Median household income
$64.7K
vs $82.1K US · $59.7K rural median
Poverty rate
10.3%
vs 12.5% US · 14.3% rural median
Uninsured
12.0%
vs 8.6% US · 8.4% rural median
Age 65+
21.6%
vs 16.8% US · 20.6% rural median
Fair or poor health
20.2%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 13.5% of county personal income is Medicare/Medicaid medical benefits; 25.1% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Fisher County
Illustrative estimate · FY24 cost report
Direct annual spending
$11.6M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$26.7M
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 →
Operating margin vs its peer poolFY25Astrelis calculation
Operating margin vs its peer pool: FY25 pool · n = 1,322.
CAH Performance Benchmark: FY25 peer pool · n = 1,322 · conservative low band; acuity limits stated in the report.
Basis: 56 services in the basket · 5 classified commercial payers (100% of commercial volume classified) · pricing files · 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 75%).
Report coverage: Limited Facility Benchmark. 12 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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Astrelis Atlas, "Fisher County Hospital District", https://astrelis.co/hospitals/451313, release 2321a4fc37a7 (2026-10-22). Figures as filed in the named public sources; not audited by Astrelis.
Machine-readable twin of this page: astrelis.co/hospitals/451313.md (Markdown, the same figures with their fiscal years, pools and definitions). Last modified: release 2321a4fc37a7, 2026-10-22. Figures are as filed in the named public sources. Astrelis is not a CPA firm and performs no audit, review or attestation of any facility.
