ML Analysis — OGALLALA COMMUNITY HOSPITAL
CCN 281355 | 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.
42
/ 100 (D)
Financial Health3/25
RCM Upside19/25
Market Position12/20
Demand Defensibility3/15
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
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-11.4%
R²=0.34 | n=4,907 | Grade B | Actual: -11.4%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-39.7%, 16.9%]. P34 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1252195.000 | -0.0457 | Lower Revenue/Bed decreases predicted margin | |
| Log(Beds) | 2.890 | -0.0345 | Lower Log(Beds) decreases predicted margin | |
| Expense/Bed | 1395430.611 | +0.0322 | Higher Expense/Bed increases predicted margin | |
| Net-to-Gross | 0.611 | +0.0272 | Higher Net-to-Gross increases predicted margin | |
| Bed Count | 18.000 | +0.0204 | Higher Bed Count increases predicted margin |
Turnaround: 31%Turnaround possible (31%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Rural/Critical Access
Archetype
60.7%
Distress Risk
$2.7M
RCM Opportunity
B
Opportunity Grade
0.3%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P8. 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%
NE distress rate: 53.1%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.227 | +0.277 | ▲ risk |
| Net To Gross Ratio | 0.611 | +0.108 | ▲ risk |
| Medicare Day Pct | 0.647 | +0.055 | ▲ risk |
| Medicaid Day Pct | 0.109 | +0.020 | ▲ risk |
| Revenue Per Bed | 1252195.000 | +0.019 | ▲ risk |
| Beds | 18.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.7M
Current margin: -11.4%
Projected margin: 0.3%
Grade: B
Comps: 69
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 | 0.244 | 0.381 | 13.8% | $2.1M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.611 | 0.779 | 16.8% | $442K | 65% | 18mo |
| Occupancy Improvement | 0.227 | 0.249 | 2.2% | $146K | 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 | 31.9 | [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. |