ML Analysis — ADVENTHEALTH WATERMAN
CCN 100057 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Buy — solid fundamentals with identifiable value creation levers. Proceed to detailed diligence.
62
/ 100 (B)
Financial Health10/25
RCM Upside19/25
Market Position17/20
Demand Defensibility15/15
Operational Efficiency2/15
Entry Multiple: 9.5x – 11.5x
Est. MOIC: 2.3x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
1.4%
R²=0.34 | n=4,907 | Grade B | Actual: -5.4%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-26.9%, 29.7%]. P66 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| State Peer Margin | 0.032 | +0.0578 | Higher State Peer Margin increases predicted margi | |
| Revenue/Bed | 1176092.399 | -0.0563 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 1239722.444 | +0.0514 | Higher Expense/Bed increases predicted margin | |
| Log(Beds) | 5.663 | +0.0299 | Higher Log(Beds) increases predicted margin | |
| Reimbursement Quality | 0.122 | +0.0227 | Higher Reimbursement Quality increases predicted m |
Turnaround: 52%Turnaround possible (52%) but uncertain. Margin improvement depends on State Peer Margin.
Suburban Community Hospit
Archetype
43.5%
Distress Risk
$3.1M
RCM Opportunity
D
Opportunity Grade
-4.5%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P18. Community hospitals — the largest PE deal category. Focus on RCM improvement and cost optimization at 9-11x.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| CLARA MAASS MEDICAL CENTER | NJ | 259 |
| PRESENCE SAINTS MARY & ELIZABETH MED | IL | 266 |
| ADVENTIST HEALTH BAKERSFIELD | CA | 254 |
| BRISTOL REGIONAL MEDICAL CENTER | TN | 244 |
| HOLSTON VALLEY HOSP & MED CTR | TN | 286 |
| SPRINGFIELD REGIONAL MEDICAL CENTER | OH | 230 |
Distress Analysis
Risk: Elevated
National distress rate: 49.3%
FL distress rate: 30.3%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.657 | -0.122 | ▼ risk |
| Net To Gross Ratio | 0.190 | -0.080 | ▼ risk |
| Medicaid Day Pct | 0.012 | -0.077 | ▼ risk |
| Revenue Per Bed | 1176092.399 | +0.024 | ▲ risk |
| Beds | 288.000 | +0.019 | ▲ risk |
| Medicare Day Pct | 0.342 | +0.003 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.1M
Current margin: -5.4%
Projected margin: -4.5%
Grade: D
Comps: 106
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 | 0.646 | 0.767 | 12.1% | $1.8M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.190 | 0.206 | 1.7% | $663K | 65% | 18mo |
| Occupancy Improvement | 0.657 | 0.754 | 9.7% | $640K | 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 | 25.0 | [25.0, 75.0] | P0 | 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. |