ML Analysis — MT. SAN RAFAEL HOSPITAL
CCN 061321 | 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.
50
/ 100 (C)
Financial Health4/25
RCM Upside19/25
Market Position15/20
Demand Defensibility6/15
Operational Efficiency6/15
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)
-15.3%
R²=0.34 | n=4,907 | Grade B | Actual: -27.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-43.6%, 13.0%]. P27 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1304903.120 | -0.0383 | Lower Revenue/Bed decreases predicted margin | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Bed Utilization Value | 249683.381 | -0.0207 | Lower Bed Utilization Value decreases predicted ma | |
| Bed Count | 25.000 | +0.0193 | Higher Bed Count increases predicted margin | |
| Occupancy | 0.191 | -0.0190 | Lower Occupancy decreases predicted margin |
Turnaround: 25%Low turnaround probability (25%). Structural disadvantages in Revenue/Bed and Log(Beds).
Under-Performing / Distre
Archetype
58.9%
Distress Risk
$4.0M
RCM Opportunity
B
Opportunity Grade
-15.4%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P38. 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%
CO distress rate: 46.7%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.191 | +0.310 | ▲ risk |
| Medicaid Day Pct | 0.151 | +0.062 | ▲ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
| Revenue Per Bed | 1304903.120 | +0.016 | ▲ risk |
| Medicare Day Pct | 0.402 | +0.013 | ▲ risk |
| Net To Gross Ratio | 0.376 | +0.003 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.0M
Current margin: -27.8%
Projected margin: -15.4%
Grade: B
Comps: 50
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.191 | 0.531 | 34.0% | $2.2M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.376 | 0.635 | 25.9% | $991K | 65% | 18mo |
| Payer Mix Optimization | 0.447 | 0.501 | 5.4% | $810K | 50% | 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 | 33.6 | [25.0, 75.0] | P76 | 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. |