ML Analysis — MOUNTRAIL COUNTY MEDICAL CENTER
CCN 351301 | 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.
40
/ 100 (D)
Financial Health3/25
RCM Upside19/25
Market Position10/20
Demand Defensibility2/15
Operational Efficiency6/15
Entry Multiple: 6.0x – 8.5x
Est. MOIC: 1.5x
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)
-12.2%
R²=0.34 | n=4,907 | Grade B | Actual: -12.2%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-40.6%, 16.1%]. P32 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1205330.727 | -0.0522 | Lower Revenue/Bed decreases predicted margin | |
| Log(Beds) | 2.398 | -0.0459 | Lower Log(Beds) decreases predicted margin | |
| Net-to-Gross | 0.710 | +0.0382 | Higher Net-to-Gross increases predicted margin | |
| Expense/Bed | 1351837.182 | +0.0376 | Higher Expense/Bed increases predicted margin | |
| State Peer Margin | -0.093 | -0.0351 | Lower State Peer Margin decreases predicted margin |
Turnaround: 30%Low turnaround probability (30%). Structural disadvantages in Revenue/Bed and Log(Beds).
Rural/Critical Access
Archetype
61.4%
Distress Risk
$5.1M
RCM Opportunity
A
Opportunity Grade
26.5%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P62. 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%
ND distress rate: 69.4%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.166 | +0.333 | ▲ risk |
| Net To Gross Ratio | 0.710 | +0.152 | ▲ risk |
| Medicare Day Pct | 0.829 | +0.086 | ▲ risk |
| Medicaid Day Pct | 0.004 | -0.084 | ▼ risk |
| Revenue Per Bed | 1205330.727 | +0.022 | ▲ risk |
| Beds | 11.000 | -0.018 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.1M
Current margin: -12.2%
Projected margin: 26.5%
Grade: A
Comps: 16
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 | 0.166 | 0.385 | 21.8% | $3.3M | 50% | 24mo |
| Occupancy Improvement | 0.166 | 0.387 | 22.0% | $1.5M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.710 | 0.960 | 25.0% | $388K | 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 | 33.6 | [25.0, 75.0] | P76 | 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 | 99.5% | [90.0%, 99.5%] | P8 | Strong — predicted net collection rate is in the top third. |