ML Analysis — KINDRED HOSPITAL ST. LOUIS
CCN 262010 | 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 Health3/25
RCM Upside19/25
Market Position15/20
Demand Defensibility8/15
Operational Efficiency0/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-11.4%
R²=0.34 | n=4,907 | Grade B | Actual: -8.1%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-39.7%, 16.9%]. P34 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 346944.337 | -0.1720 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 374951.500 | +0.1580 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.109 | +0.0267 | Higher Reimbursement Quality increases predicted m | |
| Bed Utilization Value | 172628.328 | -0.0232 | Lower Bed Utilization Value decreases predicted ma | |
| Net-to-Gross | 0.195 | -0.0195 | Lower Net-to-Gross decreases predicted margin |
Turnaround: 31%Turnaround possible (31%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Under-Performing / Distre
Archetype
51.8%
Distress Risk
$5.5M
RCM Opportunity
A
Opportunity Grade
8.0%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P63. 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: High
National distress rate: 49.3%
MO distress rate: 53.0%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.188 | +0.099 | ▲ risk |
| Net To Gross Ratio | 0.195 | -0.078 | ▼ risk |
| Revenue Per Bed | 346944.337 | +0.073 | ▲ risk |
| Occupancy Rate | 0.498 | +0.026 | ▲ risk |
| Medicare Day Pct | 0.253 | -0.013 | ▼ risk |
| Beds | 98.000 | -0.007 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.5M
Current margin: -8.1%
Projected margin: 8.0%
Grade: A
Comps: 42
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 | 0.559 | 0.717 | 15.8% | $2.4M | 50% | 24mo |
| Occupancy Improvement | 0.498 | 0.778 | 28.0% | $1.8M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.195 | 0.509 | 31.4% | $1.2M | 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 | 27.9 | [25.0, 75.0] | P43 | 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. |