ML Analysis — MONROE COUNTY HOSPITAL
CCN 010120 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Speculative — only pursue if turnaround thesis is strong and entry multiple reflects risk.
42
/ 100 (D)
Financial Health2/25
RCM Upside18/25
Market Position14/20
Demand Defensibility4/15
Operational Efficiency2/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-18.0%
R²=0.34 | n=4,907 | Grade B | Actual: -14.1%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-46.3%, 10.3%]. P23 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 518432.978 | -0.1481 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 591667.261 | +0.1313 | Higher Expense/Bed increases predicted margin | |
| State Peer Margin | -0.085 | -0.0292 | Lower State Peer Margin decreases predicted margin | |
| Medicaid % | 0.313 | -0.0271 | Higher Medicaid % decreases predicted margin | |
| Bed Utilization Value | 103501.331 | -0.0255 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 22%Low turnaround probability (22%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Safety-Net/Medicaid Heavy
Archetype
62.2%
Distress Risk
$4.7M
RCM Opportunity
A
Opportunity Grade
5.6%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P57. High Medicaid dependence creates reimbursement risk. Assess DSH payments and state expansion status.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| WESTERN PEAKS SPECIALTY HOSPITAL | UT | 59 |
| HOSPITAL MENONITA AIBONITO | PR | 129 |
| TOPPENISH COMMUNITY HOSPITAL | WA | 47 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
Distress Analysis
Risk: High
National distress rate: 49.3%
AL distress rate: 58.3%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.200 | +0.302 | ▲ risk |
| Medicaid Day Pct | 0.313 | +0.224 | ▲ risk |
| Revenue Per Bed | 518432.978 | +0.063 | ▲ risk |
| Net To Gross Ratio | 0.283 | -0.038 | ▼ risk |
| Beds | 46.000 | -0.014 | ▼ risk |
| Medicare Day Pct | 0.260 | -0.012 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.7M
Current margin: -14.1%
Projected margin: 5.6%
Grade: A
Comps: 58
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Payer Mix Optimization | 0.427 | 0.586 | 15.9% | $2.4M | 50% | 24mo |
| Occupancy Improvement | 0.200 | 0.473 | 27.4% | $1.8M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.283 | 0.471 | 18.8% | $525K | 65% | 18mo |
Predicted RCM Performance (Public Data Only)
A
RCM Grade
Strong RCM profile — likely low-risk from an operations perspective. Focus diligence on growth thesis.
| Metric | Predicted | 90% CI | Percentile | Assessment |
|---|---|---|---|---|
| Denial Rate | 2.0% | [2.0%, 25.0%] | P0 | Strong — predicted denial rate is in the top third nationall |
| Days in AR | 32.5 | [25.0, 75.0] | P72 | Strong — predicted days in ar is in the top third nationally |
| Clean Claim Rate | 98.0% | [80.0%, 98.0%] | P0 | Strong — predicted clean claim rate is in the top third. |
| Net Collection Rate | 99.5% | [90.0%, 99.5%] | P8 | Strong — predicted net collection rate is in the top third. |