ML Analysis — TOURO INFIRMARY
CCN 190046 | 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.
53
/ 100 (C)
Financial Health9/25
RCM Upside18/25
Market Position15/20
Demand Defensibility9/15
Operational Efficiency2/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
- Volume growth opportunity from low occupancy
Margin Prediction (Trained Ridge Model)
-5.1%
R²=0.34 | n=4,907 | Grade B | Actual: -3.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-33.4%, 23.2%]. P49 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1368253.344 | -0.0295 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 1419547.800 | +0.0293 | Higher Expense/Bed increases predicted margin | |
| Log(Beds) | 5.598 | +0.0284 | Higher Log(Beds) increases predicted margin | |
| Net-to-Gross | 0.194 | -0.0196 | Lower Net-to-Gross decreases predicted margin | |
| Bed Count | 270.000 | -0.0189 | Higher Bed Count decreases predicted margin |
Turnaround: 41%Turnaround possible (41%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Suburban Community Hospit
Archetype
46.8%
Distress Risk
$7.0M
RCM Opportunity
D
Opportunity Grade
-1.9%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P42. Community hospitals — the largest PE deal category. Focus on RCM improvement and cost optimization at 9-11x.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| CLARA MAASS MEDICAL CENTER | NJ | 259 |
| PRESENCE SAINTS MARY & ELIZABETH MED | IL | 266 |
| ADVENTIST HEALTH BAKERSFIELD | CA | 254 |
| BRISTOL REGIONAL MEDICAL CENTER | TN | 244 |
| HOLSTON VALLEY HOSP & MED CTR | TN | 286 |
| SPRINGFIELD REGIONAL MEDICAL CENTER | OH | 230 |
Distress Analysis
Risk: Elevated
National distress rate: 49.3%
LA distress rate: 46.3%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Net To Gross Ratio | 0.194 | -0.078 | ▼ risk |
| Medicaid Day Pct | 0.014 | -0.075 | ▼ risk |
| Occupancy Rate | 0.467 | +0.054 | ▲ risk |
| Medicare Day Pct | 0.146 | -0.031 | ▼ risk |
| Beds | 270.000 | +0.016 | ▲ risk |
| Revenue Per Bed | 1368253.344 | +0.012 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $7.0M
Current margin: -3.8%
Projected margin: -1.9%
Grade: D
Comps: 30
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 | 0.194 | 0.314 | 12.1% | $5.2M | 65% | 18mo |
| Occupancy Improvement | 0.467 | 0.736 | 26.9% | $1.8M | 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 | 25.0 | [25.0, 75.0] | P0 | 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. |