ML Analysis — CITIZENS MEMORIAL HOSPITAL DISTRICT
CCN 260195 | 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.
58
/ 100 (C)
Financial Health8/25
RCM Upside20/25
Market Position15/20
Demand Defensibility8/15
Operational Efficiency8/15
Entry Multiple: 9.5x – 11.5x
Est. MOIC: 2.3x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-10.5%
R²=0.34 | n=4,907 | Grade B | Actual: -19.3%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-38.8%, 17.8%]. P36 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 4091010.846 | -0.2998 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 3429194.692 | +0.2582 | Higher Revenue/Bed increases predicted margin | |
| Bed Utilization Value | 1505376.722 | +0.0210 | Higher Bed Utilization Value increases predicted m | |
| Bed Count | 52.000 | +0.0151 | Higher Bed Count increases predicted margin | |
| State Peer Margin | -0.062 | -0.0125 | Lower State Peer Margin decreases predicted margin |
Turnaround: 32%Turnaround possible (32%) but uncertain. Margin improvement depends on improving Expense/Bed.
Under-Performing / Distre
Archetype
46.9%
Distress Risk
$4.4M
RCM Opportunity
D
Opportunity Grade
-16.8%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P55. 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: Elevated
National distress rate: 49.3%
MO distress rate: 53.0%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Revenue Per Bed | 3429194.692 | -0.109 | ▼ risk |
| Occupancy Rate | 0.439 | +0.080 | ▲ risk |
| Medicare Day Pct | 0.203 | -0.021 | ▼ risk |
| Net To Gross Ratio | 0.321 | -0.021 | ▼ risk |
| Beds | 52.000 | -0.013 | ▼ risk |
| Medicaid Day Pct | 0.077 | -0.012 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.4M
Current margin: -19.3%
Projected margin: -16.8%
Grade: D
Comps: 43
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 | 0.321 | 0.429 | 10.7% | $2.2M | 65% | 18mo |
| Occupancy Improvement | 0.439 | 0.768 | 32.9% | $2.2M | 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 | 29.2 | [25.0, 75.0] | P52 | 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. |