ML Analysis — HOWARD MEMORIAL HOSPITAL
CCN 041311 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Hold / Selective — investigate specific opportunities but be prepared for execution risk.
46
/ 100 (C)
Financial Health2/25
RCM Upside19/25
Market Position14/20
Demand Defensibility5/15
Operational Efficiency6/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Heavy Medicare dependence (>55%)
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-13.5%
R²=0.34 | n=4,907 | Grade B | Actual: -15.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.8%, 14.8%]. P30 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1325510.700 | -0.0354 | Lower Revenue/Bed decreases predicted margin | |
| Log(Beds) | 2.996 | -0.0320 | Lower Log(Beds) decreases predicted margin | |
| State Peer Margin | -0.075 | -0.0222 | Lower State Peer Margin decreases predicted margin | |
| Bed Count | 20.000 | +0.0201 | Higher Bed Count increases predicted margin | |
| Reimbursement Quality | 0.134 | +0.0196 | Higher Reimbursement Quality increases predicted m |
Turnaround: 28%Low turnaround probability (28%). Structural disadvantages in Revenue/Bed and Log(Beds).
Rural/Critical Access
Archetype
54.4%
Distress Risk
$4.7M
RCM Opportunity
A
Opportunity Grade
1.7%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P3. Rural/small hospitals face structural headwinds. Evaluate CAH conversion, telehealth, and rural health funding.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| BRECKINRIDGE HEALTH INC | KY | 25 |
| SHERIDAN MEMORIAL HOSPITAL | MT | 19 |
| DAYTON GENERAL HOSPITAL | WA | 25 |
| BLUE MOUNTAIN HOSPITAL DISTRICT | OR | 16 |
| COMMUNITY HOSPITAL | WY | 25 |
| CARLE EUREKA HOSPITAL | IL | 25 |
Distress Analysis
Risk: High
National distress rate: 49.3%
AR distress rate: 53.3%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.316 | +0.194 | ▲ risk |
| Medicare Day Pct | 0.554 | +0.039 | ▲ risk |
| Medicaid Day Pct | 0.066 | -0.022 | ▼ risk |
| Beds | 20.000 | -0.017 | ▼ risk |
| Revenue Per Bed | 1325510.700 | +0.015 | ▲ risk |
| Net To Gross Ratio | 0.352 | -0.007 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.7M
Current margin: -15.8%
Projected margin: 1.7%
Grade: A
Comps: 49
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 | 0.379 | 0.558 | 17.9% | $2.7M | 50% | 24mo |
| Occupancy Improvement | 0.316 | 0.553 | 23.7% | $1.6M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.352 | 0.482 | 13.0% | $404K | 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 | 33.8 | [25.0, 75.0] | P77 | Average — predicted days in ar is near the median. |
| Clean Claim Rate | 98.0% | [80.0%, 98.0%] | P0 | Strong — predicted clean claim rate is in the top third. |
| Net Collection Rate | 99.4% | [90.0%, 99.5%] | P6 | Strong — predicted net collection rate is in the top third. |