ML Analysis — RUBY VALLEY HOSPITAL
CCN 271319 | 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.
48
/ 100 (C)
Financial Health4/25
RCM Upside19/25
Market Position14/20
Demand Defensibility4/15
Operational Efficiency6/15
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:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-13.9%
R²=0.34 | n=4,907 | Grade B | Actual: -24.7%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-42.2%, 14.4%]. P29 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Log(Beds) | 1.946 | -0.0564 | Lower Log(Beds) decreases predicted margin | |
| Net-to-Gross | 0.801 | +0.0485 | Higher Net-to-Gross increases predicted margin | |
| Revenue/Bed | 1276850.286 | -0.0422 | Lower Revenue/Bed decreases predicted margin | |
| State Peer Margin | -0.096 | -0.0373 | Lower State Peer Margin decreases predicted margin | |
| Reimbursement Quality | 0.296 | -0.0271 | Higher Reimbursement Quality decreases predicted m |
Turnaround: 27%Low turnaround probability (27%). Structural disadvantages in Log(Beds) and Net-to-Gross.
Rural/Critical Access
Archetype
54.4%
Distress Risk
$2.9M
RCM Opportunity
A
Opportunity Grade
8.0%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P50. 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%
MT distress rate: 69.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Net To Gross Ratio | 0.801 | +0.193 | ▲ risk |
| Medicaid Day Pct | 0.007 | -0.081 | ▼ risk |
| Medicare Day Pct | 0.624 | +0.051 | ▲ risk |
| Occupancy Rate | 0.481 | +0.041 | ▲ risk |
| Beds | 7.000 | -0.019 | ▼ risk |
| Revenue Per Bed | 1276850.286 | +0.018 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.9M
Current margin: -24.7%
Projected margin: 8.0%
Grade: A
Comps: 193
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 | 0.369 | 0.564 | 19.5% | $2.9M | 50% | 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 | 32.0 | [25.0, 75.0] | P70 | 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. |