Operating margin: -2.1% in FY2025, the 36th percentile of 2,523 urban pps hospitals in the FY2025 pool. Days cash on hand: 134 days in FY2025, the 77th percentile of 2,413 urban pps hospitals in the FY2025 pool. Total operating revenue: $2.02B in FY2025, the 96th percentile of 2,553 urban pps hospitals in the FY2025 pool. Total margin (including nonoperating): +9.8% in FY2025, the 61st percentile of 2,523 urban pps hospitals in the FY2025 pool. Figures as filed; not audited by Astrelis.
The read
A hospital in Roanoke, VA. It ran an operating loss of 2.1% in FY25 on $2020.5M of operating revenue. It held 134 days of cash on hand (77th percentile of 2,413 Urban PPS hospitals on liquidity, FY25 pool). Operating margin improved from -2.7% in FY20 to -2.1% in FY25. Including nonoperating items, the all-in result was positive at 9.8%.
Operating margin · FY25
-2.1%
Astrelis calculation · as-filed inputs
▲ 2.5 pts vs FY24
vs Urban PPS hospitals36th pctl of 2,523 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
134d
all sources
Astrelis calculation · as-filed inputs
▼ 36 days vs FY24
vs Urban PPS hospitals77th pctl of 2,413 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY25
$2.02B
Astrelis calculation · as-filed inputs
▲ $282.5M vs FY24
vs Urban PPS hospitals96th pctl of 2,553 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY25
+9.8%
Astrelis calculation · as-filed inputs
▲ 1.5 pts vs FY24
vs Urban PPS hospitals61st pctl of 2,523 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at CARILION MEDICAL CENTER is about $20.2M per year (1% of FY25 total operating revenue).
Where CARILION MEDICAL CENTER sits among Urban PPS hospitals
Operating margin · FY25 pool · n = 2,523 of 2,652 filed
Each point is one Urban PPS hospital in the national FY25 distribution for Urban PPS 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 Urban PPS hospital FY25 median is +2.4%. Descriptive context only, not a ranking.
One urban pps hospitalCARILION MEDICALUrban 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 × 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
1,525,865
1,716,832
1,998,387
Other operating revenue
22,781
21,227
22,135
Total operating revenue
1,548,646
1,738,060
2,020,522
Total operating expenses
1,701,735
1,818,872
2,062,274
Operating income
(153,089)
(80,812)
(41,753)
Operating margin %
-9.9%
-4.6%
-2.1%
Grants & contributions
11,630
11,355
9,303
Investment income
137,777
159,838
142,636
Other non-operating, net
103,634
74,522
114,448
Net income
99,952
164,904
224,635
Net income %
+5.6%
+8.4%
+9.8%
— = 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
Display states.FY22 · Net patient A/R: 255,746K — Astrelis calculation (allowance line blank on the filing, counted as zero: Worksheet G line 6 (allowances for uncollectible accounts) is blank on this cost report; under ruling 11 a blank additive component adds zero and the value publishes flagged (blank components: line 600))FY21 · Net patient A/R: 274,849K — Astrelis calculation (allowance line blank on the filing, counted as zero: Worksheet G line 6 (allowances for uncollectible accounts) is blank on this cost report; under ruling 11 a blank additive component adds zero and the value publishes flagged (blank components: line 600))FY20 · Net patient A/R: 227,015K — Astrelis calculation (allowance line blank on the filing, counted as zero: Worksheet G line 6 (allowances for uncollectible accounts) is blank on this cost report; under ruling 11 a blank additive component adds zero and the value publishes flagged (blank components: line 600))
How it operates
quality & operational context · CMS public reporting
A 483-bed hospital running at 83% occupancy, where 46% 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
83.1%
Reported value2025
HCRIS WS S-3
Average daily census
401.57
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
483
Reported value2025
HCRIS WS S-3
Annual discharges
37,706
Reported value2025
HCRIS WS S-3
Average length of stay
4 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$14,070
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$54,694
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Outpatient share of patient revenue
46.5%
Reported value2025
HCRIS WS G-2 L28
Total FTEs
7,221
Reported value2025
HCRIS WS S-3 Pt II
Contract labor share of labor cost
14.9%
Reported value2025
HCRIS WS S-3 Pt V
Who it serves
Total unreimbursed & uncompensated care
$23.3M
Reported value2023
HCRIS WS S-10 line 31
How the care measures up
C. difficile infection (SIR)
0.289
Better than the National Benchmark
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
14.1%
Better Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Medicare spending per beneficiary
1.01
CMS-reported measure01/01/2024 to 12/31/2024
CMS Care Compare
Patient-safety composite (PSI-90)
0.99803
CMS-reported measure07/01/2022 to 06/30/2024
CMS Care Compare
Trajectory
Cost-report basis · 6 reporting years
Operating margin
Days cash on hand
The county this hospital serves
ROANOKE CITY, VA · metro, 250K–1M
Median household income
$52.7K
vs $82.1K US · $59.7K rural median
Poverty rate
19.7%
vs 12.5% US · 14.3% rural median
Uninsured
9.6%
vs 8.6% US · 8.4% rural median
Age 65+
17.5%
vs 16.8% US · 20.6% rural median
Fair or poor health
23.0%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 14.7% of county personal income is Medicare/Medicaid medical benefits; 30.0% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Roanoke City County
Illustrative estimate · FY25 cost report
Direct annual spending
$2.06B
total operating expense · Reported value, not a local-capture estimate
Labor income
$915.2M
$769.1M direct compensation × 1.19 · NCRHW 2016 CAH study · Illustrative estimate
Economic activity
$4.74B
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
11.0%
the county's largest employer · 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 = 2,523.
Performance Benchmark Report: FY25 peer pool · n = 2,523 · conservative low band; acuity limits stated in the report.
Report coverage: Limited Facility Benchmark. 15 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.
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Astrelis Atlas, "Carilion Medical Center", https://astrelis.co/hospitals/490024, 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/490024.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.
