ML Analysis — CITIZENS MEDICAL CENTER
CCN 171362 | 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 Upside20/25
Market Position12/20
Demand Defensibility4/15
Operational Efficiency8/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Heavy Medicare dependence (>55%)
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-15.3%
R²=0.34 | n=4,907 | Grade B | Actual: -13.9%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-43.6%, 13.0%]. P27 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2450061.739 | -0.0977 | Higher Expense/Bed decreases predicted margin | |
| State Peer Margin | -0.177 | -0.0972 | Lower State Peer Margin decreases predicted margin | |
| Revenue/Bed | 2150572.261 | +0.0797 | Higher Revenue/Bed increases predicted margin | |
| Log(Beds) | 3.135 | -0.0288 | Lower Log(Beds) decreases predicted margin | |
| Reimbursement Quality | 0.116 | +0.0245 | Higher Reimbursement Quality increases predicted m |
Turnaround: 25%Low turnaround probability (25%). Structural disadvantages in Expense/Bed and State Peer Margin.
Rural/Critical Access
Archetype
50.4%
Distress Risk
$6.0M
RCM Opportunity
B
Opportunity Grade
-1.7%
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: High
National distress rate: 49.3%
KS distress rate: 76.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.017 | -0.072 | ▼ risk |
| Medicare Day Pct | 0.721 | +0.068 | ▲ risk |
| Occupancy Rate | 0.453 | +0.067 | ▲ risk |
| Revenue Per Bed | 2150572.261 | -0.034 | ▼ risk |
| Net To Gross Ratio | 0.443 | +0.033 | ▲ risk |
| Beds | 23.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $6.0M
Current margin: -13.9%
Projected margin: -1.7%
Grade: B
Comps: 111
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 | 0.263 | 0.521 | 25.8% | $3.9M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.443 | 0.818 | 37.5% | $2.2M | 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 | 32.1 | [25.0, 75.0] | P71 | 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. |