ML Analysis — GOSHEN HOSPITAL
CCN 150026 | 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 Upside20/25
Market Position15/20
Demand Defensibility10/15
Operational Efficiency6/15
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)
-4.9%
R²=0.34 | n=4,907 | Grade B | Actual: -22.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-33.2%, 23.4%]. P50 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2962670.291 | -0.1608 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 2411766.359 | +0.1162 | Higher Revenue/Bed increases predicted margin | |
| State Peer Margin | -0.011 | +0.0255 | Higher State Peer Margin increases predicted margi | |
| Bed Utilization Value | 1340697.038 | +0.0155 | Higher Bed Utilization Value increases predicted m | |
| Medicaid % | 0.007 | +0.0099 | Higher Medicaid % increases predicted margin |
Turnaround: 42%Turnaround possible (42%) but uncertain. Margin improvement depends on improving Expense/Bed.
Under-Performing / Distre
Archetype
44.2%
Distress Risk
$2.3M
RCM Opportunity
D
Opportunity Grade
-21.9%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P39. 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: Elevated
National distress rate: 49.3%
IN distress rate: 42.0%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.007 | -0.082 | ▼ risk |
| Revenue Per Bed | 2411766.359 | -0.049 | ▼ risk |
| Net To Gross Ratio | 0.303 | -0.029 | ▼ risk |
| Occupancy Rate | 0.556 | -0.029 | ▼ risk |
| Medicare Day Pct | 0.264 | -0.011 | ▼ risk |
| Beds | 103.000 | -0.006 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.3M
Current margin: -22.8%
Projected margin: -21.9%
Grade: D
Comps: 58
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Net-to-Gross Ratio Improvement | 0.303 | 0.353 | 5.1% | $1.5M | 65% | 18mo |
| Occupancy Improvement | 0.556 | 0.665 | 10.9% | $722K | 55% | 24mo |
| Payer Mix Optimization | 0.729 | 0.736 | 0.7% | $100K | 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 | 26.9 | [25.0, 75.0] | P38 | 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. |