ML Analysis — MADISON RIVER OAKS MEDICAL CENTER
CCN 250038 | 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.
44
/ 100 (D)
Financial Health5/25
RCM Upside16/25
Market Position15/20
Demand Defensibility8/15
Operational Efficiency0/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Low occupancy (<30%) — demand risk
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-16.5%
R²=0.34 | n=4,907 | Grade B | Actual: -1.2%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-44.8%, 11.8%]. P25 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 490488.552 | -0.1520 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 496567.508 | +0.1430 | Higher Expense/Bed increases predicted margin | |
| State Peer Margin | -0.125 | -0.0591 | Lower State Peer Margin decreases predicted margin | |
| Reimbursement Quality | 0.052 | +0.0429 | Higher Reimbursement Quality increases predicted m | |
| Net-to-Gross | 0.097 | -0.0304 | Lower Net-to-Gross decreases predicted margin |
Turnaround: 24%Low turnaround probability (24%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Rural/Critical Access
Archetype
55.1%
Distress Risk
$3.9M
RCM Opportunity
B
Opportunity Grade
10.6%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P69. 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%
MS distress rate: 68.2%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.191 | +0.310 | ▲ risk |
| Net To Gross Ratio | 0.097 | -0.121 | ▼ risk |
| Revenue Per Bed | 490488.552 | +0.064 | ▲ risk |
| Medicaid Day Pct | 0.066 | -0.023 | ▼ risk |
| Medicare Day Pct | 0.397 | +0.012 | ▲ risk |
| Beds | 67.000 | -0.011 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.9M
Current margin: -1.2%
Projected margin: 10.6%
Grade: B
Comps: 39
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.191 | 0.625 | 43.3% | $2.9M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.097 | 0.367 | 27.0% | $1.0M | 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 | 31.5 | [25.0, 75.0] | P67 | 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. |