ML Analysis — NELSON COUNTY HEALTH SYSTEM-HOSPITAL
CCN 351308 | 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.
39
/ 100 (D)
Financial Health4/25
RCM Upside18/25
Market Position11/20
Demand Defensibility1/15
Operational Efficiency4/15
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)
-13.0%
R²=0.34 | n=4,907 | Grade B | Actual: -24.9%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.3%, 15.3%]. P31 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 376635.579 | -0.1679 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 470453.684 | +0.1462 | Higher Expense/Bed increases predicted margin | |
| Net-to-Gross | 1.000 | +0.0708 | Higher Net-to-Gross increases predicted margin | |
| State Peer Margin | -0.093 | -0.0351 | Lower State Peer Margin decreases predicted margin | |
| Log(Beds) | 2.944 | -0.0332 | Lower Log(Beds) decreases predicted margin |
Turnaround: 28%Low turnaround probability (28%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Rural/Critical Access
Archetype
67.4%
Distress Risk
$7.0M
RCM Opportunity
A
Opportunity Grade
72.5%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P74. 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 | 0.068 | +0.424 | ▲ risk |
| Net To Gross Ratio | 1.000 | +0.281 | ▲ risk |
| Medicaid Day Pct | 0.006 | -0.082 | ▼ risk |
| Medicare Day Pct | 0.771 | +0.076 | ▲ risk |
| Revenue Per Bed | 376635.579 | +0.071 | ▲ risk |
| Beds | 19.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $7.0M
Current margin: -24.9%
Projected margin: 72.5%
Grade: A
Comps: 38
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 | 0.223 | 0.526 | 30.2% | $4.5M | 50% | 24mo |
| Occupancy Improvement | 0.068 | 0.438 | 36.9% | $2.4M | 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 | 30.0 | [25.0, 75.0] | P58 | 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. |