ML Analysis — ST THOMAS HICKMAN HOSPITAL
CCN 441300 | 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.
47
/ 100 (C)
Financial Health4/25
RCM Upside18/25
Market Position14/20
Demand Defensibility6/15
Operational Efficiency4/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-12.0%
R²=0.34 | n=4,907 | Grade B | Actual: -27.5%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-40.3%, 16.3%]. P33 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 648735.320 | -0.1299 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 826925.440 | +0.1023 | Higher Expense/Bed increases predicted margin | |
| State Peer Margin | -0.006 | +0.0291 | Higher State Peer Margin increases predicted margi | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Bed Utilization Value | 114390.699 | -0.0252 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 30%Low turnaround probability (30%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Under-Performing / Distre
Archetype
60.2%
Distress Risk
$7.7M
RCM Opportunity
A
Opportunity Grade
20.0%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P47. Deeply negative margins signal severe distress. Evaluate asset-level acquisition at 4-6x normalized EBITDA.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| HOLY FAMILY MEMORIAL INC | WI | 58 |
| MIDDLESBORO ARH | KY | 46 |
| ATRIUM HEALTH NAVICENT BALDWIN | GA | 86 |
| BON SECOURS COMMUNITY HOSPITAL | NY | 98 |
| ADVANCED SPECIALTY HOSP. OF TOLEDO | OH | 40 |
| COMMUNITY HEALTH CENTER BRANCH | MI | 75 |
Distress Analysis
Risk: High
National distress rate: 49.3%
TN distress rate: 43.2%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.176 | +0.324 | ▲ risk |
| Revenue Per Bed | 648735.320 | +0.055 | ▲ risk |
| Medicaid Day Pct | 0.128 | +0.039 | ▲ risk |
| Medicare Day Pct | 0.442 | +0.020 | ▲ risk |
| Net To Gross Ratio | 0.409 | +0.018 | ▲ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $7.7M
Current margin: -27.5%
Projected margin: 20.0%
Grade: A
Comps: 55
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 | 0.430 | 0.704 | 27.4% | $4.1M | 50% | 24mo |
| Occupancy Improvement | 0.176 | 0.703 | 52.7% | $3.5M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.409 | 0.469 | 6.0% | $115K | 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 | 33.7 | [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%] | P7 | Strong — predicted net collection rate is in the top third. |