ML Analysis — NORTHERN INYO HOSPITAL
CCN 051324 | 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.
58
/ 100 (C)
Financial Health7/25
RCM Upside19/25
Market Position15/20
Demand Defensibility7/15
Operational Efficiency10/15
Entry Multiple: 9.5x – 11.5x
Est. MOIC: 2.3x
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)
-20.4%
R²=0.34 | n=4,907 | Grade B | Actual: -33.7%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-48.7%, 7.9%]. P20 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 5636281.480 | -0.4902 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 4217350.520 | +0.3682 | Higher Revenue/Bed increases predicted margin | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Bed Count | 25.000 | +0.0193 | Higher Bed Count increases predicted margin | |
| Net-to-Gross | 0.528 | +0.0179 | Higher Net-to-Gross increases predicted margin |
Turnaround: 19%Low turnaround probability (19%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Under-Performing / Distre
Archetype
53.5%
Distress Risk
$6.6M
RCM Opportunity
C
Opportunity Grade
-27.4%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P87. Deeply negative margins signal severe distress. Evaluate asset-level acquisition at 4-6x normalized EBITDA.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| HOLY FAMILY MEMORIAL INC | WI | 58 |
| MIDDLESBORO ARH | KY | 46 |
| ATRIUM HEALTH NAVICENT BALDWIN | GA | 86 |
| BON SECOURS COMMUNITY HOSPITAL | NY | 98 |
| ADVANCED SPECIALTY HOSP. OF TOLEDO | OH | 40 |
| COMMUNITY HEALTH CENTER BRANCH | MI | 75 |
Distress Analysis
Risk: High
National distress rate: 49.3%
CA distress rate: 49.7%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.274 | +0.233 | ▲ risk |
| Revenue Per Bed | 4217350.520 | -0.156 | ▼ risk |
| Net To Gross Ratio | 0.528 | +0.071 | ▲ risk |
| Medicare Day Pct | 0.428 | +0.017 | ▲ risk |
| Medicaid Day Pct | 0.106 | +0.017 | ▲ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $6.6M
Current margin: -33.7%
Projected margin: -27.4%
Grade: C
Comps: 71
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 | 0.466 | 0.653 | 18.7% | $2.8M | 50% | 24mo |
| Occupancy Improvement | 0.274 | 0.687 | 41.4% | $2.7M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.528 | 0.614 | 8.6% | $1.1M | 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 | 32.9 | [25.0, 75.0] | P73 | 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. |