ML Analysis — SAKAKAWEA MEDICAL CENTER
CCN 351310 | 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.
36
/ 100 (D)
Financial Health2/25
RCM Upside18/25
Market Position8/20
Demand Defensibility3/15
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)
-13.6%
R²=0.34 | n=4,907 | Grade B | Actual: -5.1%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.9%, 14.7%]. P30 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1194942.231 | -0.0537 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 1255353.769 | +0.0495 | Higher Expense/Bed increases predicted margin | |
| Net-to-Gross | 0.766 | +0.0446 | Higher Net-to-Gross increases predicted margin | |
| Log(Beds) | 2.565 | -0.0420 | Lower Log(Beds) decreases predicted margin | |
| State Peer Margin | -0.093 | -0.0351 | Lower State Peer Margin decreases predicted margin |
Turnaround: 28%Low turnaround probability (28%). Structural disadvantages in Revenue/Bed and Expense/Bed.
nan%
Distress Risk
$3.2M
RCM Opportunity
A
Opportunity Grade
15.5%
Projected Margin
Distress Analysis
Risk: Unknown
National distress rate: 49.3%
ND distress rate: 69.4%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.220 | +0.284 | ▲ risk |
| Medicare Day Pct | 0.624 | +0.051 | ▲ risk |
| Medicaid Day Pct | nan | +nan | ▼ risk |
| Net To Gross Ratio | 0.766 | +0.177 | ▲ risk |
| Revenue Per Bed | 1194942.231 | +0.023 | ▲ risk |
| Beds | 13.000 | -0.018 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.2M
Current margin: -5.1%
Projected margin: 15.5%
Grade: A
Comps: 35
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 | 0.376 | 0.495 | 11.9% | $1.8M | 50% | 24mo |
| Occupancy Improvement | 0.220 | 0.398 | 17.8% | $1.2M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.766 | 0.895 | 12.8% | $233K | 65% | 18mo |
Predicted RCM Performance (Public Data Only)
B
RCM Grade
Average RCM profile — some improvement opportunities. Standard diligence scope recommended.
| Metric | Predicted | 90% CI | Percentile | Assessment |
|---|---|---|---|---|
| Denial Rate | 25.0% | [2.0%, 25.0%] | P83 | Below average — denial rate suggests RCM improvement opportu |
| Days in AR | 75.0 | [25.0, 75.0] | P83 | Below average — days in ar suggests RCM improvement opportun |
| 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. |