ML Analysis — KEOKUK AREA HOSPITAL
CCN 160008 | 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.
37
/ 100 (D)
Financial Health3/25
RCM Upside18/25
Market Position13/20
Demand Defensibility1/15
Operational Efficiency2/15
Entry Multiple: 6.0x – 8.5x
Est. MOIC: 1.5x
Risk Factors:
- Negative operating margin
- Heavy Medicare dependence (>55%)
- Small facility (<50 beds) — limited scale
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-16.2%
R²=0.34 | n=4,907 | Grade B | Actual: -50.0%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-44.5%, 12.1%]. P26 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 147428.490 | -0.1999 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 295031.878 | +0.1678 | Higher Expense/Bed increases predicted margin | |
| Bed Utilization Value | 5025.596 | -0.0288 | Lower Bed Utilization Value decreases predicted ma | |
| Occupancy | 0.034 | -0.0279 | Lower Occupancy decreases predicted margin | |
| Reimbursement Quality | 0.107 | +0.0273 | Higher Reimbursement Quality increases predicted m |
Turnaround: 24%Low turnaround probability (24%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Rural/Critical Access
Archetype
61.2%
Distress Risk
$4.6M
RCM Opportunity
A
Opportunity Grade
13.7%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P96. 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: High
National distress rate: 49.3%
IA distress rate: 67.2%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.034 | +0.456 | ▲ risk |
| Revenue Per Bed | 147428.490 | +0.085 | ▲ risk |
| Medicaid Day Pct | 0.011 | -0.078 | ▼ risk |
| Medicare Day Pct | 0.656 | +0.056 | ▲ risk |
| Net To Gross Ratio | 0.320 | -0.022 | ▼ risk |
| Beds | 49.000 | -0.013 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.6M
Current margin: -50.0%
Projected margin: 13.7%
Grade: A
Comps: 75
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 | 0.333 | 0.484 | 15.0% | $2.3M | 50% | 24mo |
| Occupancy Improvement | 0.034 | 0.354 | 32.0% | $2.1M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.320 | 0.592 | 27.2% | $230K | 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 | 39.2 | [25.0, 75.0] | P82 | 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 | 98.3% | [90.0%, 99.5%] | P1 | Strong — predicted net collection rate is in the top third. |