ML Analysis — BARLOW RESPIRATORY HOSPITAL
CCN 052031 | 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.
45
/ 100 (C)
Financial Health6/25
RCM Upside20/25
Market Position8/20
Demand Defensibility11/15
Operational Efficiency0/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Heavy Medicare dependence (>55%)
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-6.2%
R²=0.34 | n=4,907 | Grade B | Actual: -13.6%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-34.5%, 22.1%]. P46 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 623597.990 | -0.1334 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 708344.333 | +0.1169 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.039 | +0.0466 | Higher Reimbursement Quality increases predicted m | |
| Net-to-Gross | 0.096 | -0.0306 | Lower Net-to-Gross decreases predicted margin | |
| Bed Utilization Value | 417115.055 | -0.0151 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 39%Turnaround possible (39%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Rural/Critical Access
Archetype
43.3%
Distress Risk
$6.7M
RCM Opportunity
B
Opportunity Grade
-3.3%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P83. 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: Elevated
National distress rate: 49.3%
CA distress rate: 49.7%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.669 | -0.133 | ▼ risk |
| Net To Gross Ratio | 0.095 | -0.122 | ▼ risk |
| Medicaid Day Pct | 0.006 | -0.083 | ▼ risk |
| Revenue Per Bed | 623597.990 | +0.056 | ▲ risk |
| Medicare Day Pct | 0.581 | +0.044 | ▲ risk |
| Beds | 105.000 | -0.006 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $6.7M
Current margin: -13.6%
Projected margin: -3.3%
Grade: B
Comps: 171
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 | 0.413 | 0.728 | 31.5% | $4.7M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.095 | 0.306 | 21.0% | $1.6M | 65% | 18mo |
| Occupancy Improvement | 0.669 | 0.727 | 5.8% | $384K | 55% | 24mo |
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 | 29.7 | [25.0, 75.0] | P57 | 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. |