ML Analysis — MOLOKAI GENERAL HOSPITAL
CCN 121303 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Speculative — only pursue if turnaround thesis is strong and entry multiple reflects risk.
40
/ 100 (D)
Financial Health2/25
RCM Upside17/25
Market Position13/20
Demand Defensibility2/15
Operational Efficiency6/15
Entry Multiple: 6.0x – 8.5x
Est. MOIC: 1.5x
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)
-24.3%
R²=0.34 | n=4,907 | Grade B | Actual: -5.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-52.6%, 4.0%]. P16 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| State Peer Margin | -0.147 | -0.0753 | Lower State Peer Margin decreases predicted margin | |
| Log(Beds) | 2.708 | -0.0387 | Lower Log(Beds) decreases predicted margin | |
| Revenue/Bed | 1318101.600 | -0.0365 | Lower Revenue/Bed decreases predicted margin | |
| Reimbursement Quality | 0.315 | -0.0326 | Higher Reimbursement Quality decreases predicted m | |
| Expense/Bed | 1394099.733 | +0.0324 | Higher Expense/Bed increases predicted margin |
Turnaround: 15%Low turnaround probability (15%). Structural disadvantages in State Peer Margin and Log(Beds).
Under-Performing / Distre
Archetype
60.3%
Distress Risk
$3.0M
RCM Opportunity
A
Opportunity Grade
9.4%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P83. 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%
HI distress rate: 68.0%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.094 | +0.401 | ▲ risk |
| Medicaid Day Pct | 0.127 | +0.038 | ▲ risk |
| Net To Gross Ratio | 0.451 | +0.037 | ▲ risk |
| Medicare Day Pct | 0.175 | -0.026 | ▼ risk |
| Beds | 15.000 | -0.018 | ▼ risk |
| Revenue Per Bed | 1318101.600 | +0.015 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.0M
Current margin: -5.8%
Projected margin: 9.4%
Grade: A
Comps: 1814
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.094 | 0.487 | 39.3% | $2.6M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.451 | 0.625 | 17.4% | $403K | 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 | 33.0 | [25.0, 75.0] | P74 | 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. |