ML Analysis — BOYS TOWN NATIONAL RESEARCH HOSPITAL
CCN 283300 | 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.
50
/ 100 (C)
Financial Health7/25
RCM Upside19/25
Market Position9/20
Demand Defensibility5/15
Operational Efficiency10/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-23.0%
R²=0.34 | n=4,907 | Grade B | Actual: -29.1%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-51.3%, 5.3%]. P18 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 4298259.481 | -0.3254 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 3329765.692 | +0.2443 | Higher Revenue/Bed increases predicted margin | |
| Medicaid % | 0.450 | -0.0436 | Higher Medicaid % decreases predicted margin | |
| Reimbursement Quality | 0.282 | -0.0232 | Higher Reimbursement Quality decreases predicted m | |
| Occupancy | 0.235 | -0.0165 | Lower Occupancy decreases predicted margin |
Turnaround: 16%Low turnaround probability (16%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Safety-Net/Medicaid Heavy
Archetype
62.1%
Distress Risk
$2.5M
RCM Opportunity
D
Opportunity Grade
-27.7%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P70. High Medicaid dependence creates reimbursement risk. Assess DSH payments and state expansion status.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| WESTERN PEAKS SPECIALTY HOSPITAL | UT | 59 |
| HOSPITAL MENONITA AIBONITO | PR | 129 |
| TOPPENISH COMMUNITY HOSPITAL | WA | 47 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
Distress Analysis
Risk: High
National distress rate: 49.3%
NE distress rate: 53.1%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.450 | +0.360 | ▲ risk |
| Occupancy Rate | 0.235 | +0.270 | ▲ risk |
| Revenue Per Bed | 3329765.692 | -0.103 | ▼ risk |
| Net To Gross Ratio | 0.513 | +0.065 | ▲ risk |
| Medicare Day Pct | 0.001 | -0.056 | ▼ risk |
| Beds | 52.000 | -0.013 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.5M
Current margin: -29.1%
Projected margin: -27.7%
Grade: D
Comps: 16
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.235 | 0.564 | 32.9% | $2.2M | 55% | 24mo |
| Payer Mix Optimization | 0.549 | 0.568 | 1.9% | $285K | 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 | 30.6 | [25.0, 75.0] | P63 | 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. |