ML Analysis — HOSPITAL SAN CARLOS BORROMEO
CCN 400111 | 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.
49
/ 100 (C)
Financial Health4/25
RCM Upside19/25
Market Position15/20
Demand Defensibility7/15
Operational Efficiency4/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
- Volume growth opportunity from low occupancy
Margin Prediction (Trained Ridge Model)
-17.6%
R²=0.34 | n=4,907 | Grade B | Actual: -23.2%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-45.9%, 10.7%]. P24 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 201615.094 | -0.1923 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 248319.472 | +0.1736 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.349 | -0.0424 | Higher Reimbursement Quality decreases predicted m | |
| State Peer Margin | -0.088 | -0.0313 | Lower State Peer Margin decreases predicted margin | |
| Bed Utilization Value | 77998.830 | -0.0264 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 22%Low turnaround probability (22%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Safety-Net/Medicaid Heavy
Archetype
60.7%
Distress Risk
$4.1M
RCM Opportunity
A
Opportunity Grade
-4.0%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P30. High Medicaid dependence creates reimbursement risk. Assess DSH payments and state expansion status.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| WESTERN PEAKS SPECIALTY HOSPITAL | UT | 59 |
| HOSPITAL MENONITA AIBONITO | PR | 129 |
| TOPPENISH COMMUNITY HOSPITAL | WA | 47 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
Distress Analysis
Risk: High
National distress rate: 49.3%
PR distress rate: 55.2%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.297 | +0.208 | ▲ risk |
| Occupancy Rate | 0.387 | +0.128 | ▲ risk |
| Net To Gross Ratio | 0.570 | +0.090 | ▲ risk |
| Revenue Per Bed | 201615.094 | +0.081 | ▲ risk |
| Medicare Day Pct | 0.091 | -0.041 | ▼ risk |
| Beds | 106.000 | -0.006 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.1M
Current margin: -23.2%
Projected margin: -4.0%
Grade: A
Comps: 40
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.387 | 0.733 | 34.6% | $2.3M | 55% | 24mo |
| Payer Mix Optimization | 0.612 | 0.706 | 9.4% | $1.4M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.570 | 0.735 | 16.4% | $411K | 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 | 25.9 | [25.0, 75.0] | P34 | 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. |