ML Analysis — SAINT JOHN HOSPITAL
CCN 170009 | 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.
46
/ 100 (C)
Financial Health2/25
RCM Upside19/25
Market Position15/20
Demand Defensibility8/15
Operational Efficiency2/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-20.7%
R²=0.34 | n=4,907 | Grade B | Actual: -20.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-49.0%, 7.6%]. P20 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| State Peer Margin | -0.177 | -0.0972 | Lower State Peer Margin decreases predicted margin | |
| Revenue/Bed | 1221611.500 | -0.0499 | Lower Revenue/Bed decreases predicted margin | |
| Reimbursement Quality | 0.086 | +0.0333 | Higher Reimbursement Quality increases predicted m | |
| Log(Beds) | 3.091 | -0.0298 | Lower Log(Beds) decreases predicted margin | |
| Net-to-Gross | 0.168 | -0.0225 | Lower Net-to-Gross decreases predicted margin |
Turnaround: 19%Low turnaround probability (19%). Structural disadvantages in State Peer Margin and Revenue/Bed.
Rural/Critical Access
Archetype
48.9%
Distress Risk
$2.4M
RCM Opportunity
C
Opportunity Grade
-11.7%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P39. 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: Elevated
National distress rate: 49.3%
KS distress rate: 76.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.387 | +0.128 | ▲ risk |
| Net To Gross Ratio | 0.168 | -0.090 | ▼ risk |
| Medicaid Day Pct | 0.003 | -0.086 | ▼ risk |
| Medicare Day Pct | 0.486 | +0.027 | ▲ risk |
| Revenue Per Bed | 1221611.500 | +0.021 | ▲ risk |
| Beds | 22.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.4M
Current margin: -20.8%
Projected margin: -11.7%
Grade: C
Comps: 109
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 | 0.168 | 0.820 | 65.2% | $2.0M | 65% | 18mo |
| Payer Mix Optimization | 0.510 | 0.530 | 2.0% | $295K | 50% | 24mo |
| Occupancy Improvement | 0.387 | 0.402 | 1.5% | $100K | 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 | 34.2 | [25.0, 75.0] | P78 | 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 | 99.1% | [90.0%, 99.5%] | P4 | Strong — predicted net collection rate is in the top third. |