ML Analysis — DOUGLAS COUNTY HOSPITAL
CCN 284009 | 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 Upside20/25
Market Position9/20
Demand Defensibility6/15
Operational Efficiency8/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-26.3%
R²=0.34 | n=4,907 | Grade B | Actual: -50.0%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-54.6%, 2.0%]. P15 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 3707768.312 | -0.2526 | Higher Expense/Bed decreases predicted margin | |
| Reimbursement Quality | 0.858 | -0.1890 | Higher Reimbursement Quality decreases predicted m | |
| Revenue/Bed | 2139015.188 | +0.0781 | Higher Revenue/Bed increases predicted margin | |
| Net-to-Gross | 1.000 | +0.0708 | Higher Net-to-Gross increases predicted margin | |
| Occupancy × Net-to-Gross | 0.847 | +0.0492 | Higher Occupancy × Net-to-Gross increases predicte |
Turnaround: 14%Low turnaround probability (14%). Structural disadvantages in Expense/Bed and Reimbursement Quality.
Under-Performing / Distre
Archetype
44.7%
Distress Risk
$0
RCM Opportunity
D
Opportunity Grade
-50.0%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P96. 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%
NE distress rate: 53.1%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.847 | -0.299 | ▼ risk |
| Net To Gross Ratio | 1.000 | +0.281 | ▲ risk |
| Medicaid Day Pct | 0.005 | -0.084 | ▼ risk |
| Revenue Per Bed | 2139015.188 | -0.033 | ▼ risk |
| Medicare Day Pct | 0.137 | -0.033 | ▼ risk |
| Beds | 16.000 | -0.018 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $0
Current margin: -50.0%
Projected margin: -50.0%
Grade: D
Comps: 68
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|
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. |