ML Analysis — HIGHLANDS CASHIERS HOSPITAL
CCN 341316 | 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.
45
/ 100 (D)
Financial Health4/25
RCM Upside19/25
Market Position14/20
Demand Defensibility4/15
Operational Efficiency4/15
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)
-9.8%
R²=0.34 | n=4,907 | Grade B | Actual: -39.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-38.1%, 18.5%]. P37 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 792121.042 | -0.1099 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 1107740.875 | +0.0677 | Higher Expense/Bed increases predicted margin | |
| Log(Beds) | 3.178 | -0.0278 | Lower Log(Beds) decreases predicted margin | |
| Bed Count | 24.000 | +0.0195 | Higher Bed Count increases predicted margin | |
| State Peer Margin | -0.020 | +0.0188 | Higher State Peer Margin increases predicted margi |
Turnaround: 33%Turnaround possible (33%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Rural/Critical Access
Archetype
51.5%
Distress Risk
$6.0M
RCM Opportunity
A
Opportunity Grade
-8.5%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P83. 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%
NC distress rate: 36.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.423 | +0.095 | ▲ risk |
| Medicaid Day Pct | 0.004 | -0.084 | ▼ risk |
| Medicare Day Pct | 0.607 | +0.048 | ▲ risk |
| Revenue Per Bed | 792121.042 | +0.046 | ▲ risk |
| Beds | 24.000 | -0.017 | ▼ risk |
| Net To Gross Ratio | 0.368 | -0.000 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $6.0M
Current margin: -39.8%
Projected margin: -8.5%
Grade: A
Comps: 36
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 | 0.389 | 0.671 | 28.2% | $4.2M | 50% | 24mo |
| Occupancy Improvement | 0.423 | 0.673 | 25.0% | $1.7M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.368 | 0.402 | 3.4% | $76K | 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 | 34.2 | [25.0, 75.0] | P78 | Average — predicted days in ar is near the median. |
| Clean Claim Rate | 98.0% | [80.0%, 98.0%] | P0 | Strong — predicted clean claim rate is in the top third. |
| Net Collection Rate | 99.2% | [90.0%, 99.5%] | P5 | Strong — predicted net collection rate is in the top third. |