ML Analysis — BOONE COUNTY HOSPITAL
CCN 161372 | 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.
48
/ 100 (C)
Financial Health2/25
RCM Upside19/25
Market Position15/20
Demand Defensibility7/15
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)
-17.0%
R²=0.34 | n=4,907 | Grade B | Actual: -19.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-45.3%, 11.3%]. P24 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2132033.760 | -0.0585 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 1780222.600 | +0.0280 | Higher Revenue/Bed increases predicted margin | |
| State Peer Margin | -0.082 | -0.0269 | Lower State Peer Margin decreases predicted margin | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Bed Count | 25.000 | +0.0193 | Higher Bed Count increases predicted margin |
Turnaround: 23%Low turnaround probability (23%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Under-Performing / Distre
Archetype
58.6%
Distress Risk
$2.0M
RCM Opportunity
D
Opportunity Grade
-15.3%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P46. 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%
IA distress rate: 67.2%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.218 | +0.285 | ▲ risk |
| Medicaid Day Pct | 0.147 | +0.058 | ▲ risk |
| Net To Gross Ratio | 0.472 | +0.046 | ▲ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
| Medicare Day Pct | 0.410 | +0.014 | ▲ risk |
| Revenue Per Bed | 1780222.600 | -0.012 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.0M
Current margin: -19.8%
Projected margin: -15.3%
Grade: D
Comps: 93
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 | 0.472 | 0.617 | 14.5% | $755K | 65% | 18mo |
| Occupancy Improvement | 0.218 | 0.330 | 11.2% | $738K | 55% | 24mo |
| Payer Mix Optimization | 0.443 | 0.475 | 3.2% | $476K | 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 | 31.6 | [25.0, 75.0] | P68 | 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. |