ML Analysis — CITIZENS MEDICAL CENTER
CCN 450023 | 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.
50
/ 100 (C)
Financial Health9/25
RCM Upside18/25
Market Position13/20
Demand Defensibility10/15
Operational Efficiency0/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Volume growth opportunity from low occupancy
Margin Prediction (Trained Ridge Model)
-7.8%
R²=0.34 | n=4,907 | Grade B | Actual: -12.2%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-36.1%, 20.5%]. P42 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 608434.392 | -0.1355 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 682978.147 | +0.1200 | Higher Expense/Bed increases predicted margin | |
| Log(Beds) | 5.656 | +0.0298 | Higher Log(Beds) increases predicted margin | |
| State Peer Margin | -0.006 | +0.0290 | Higher State Peer Margin increases predicted margi | |
| Bed Utilization Value | 169754.303 | -0.0233 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 37%Turnaround possible (37%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Under-Performing / Distre
Archetype
53.5%
Distress Risk
$4.9M
RCM Opportunity
D
Opportunity Grade
-9.4%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P60. 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%
TX distress rate: 42.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.279 | +0.229 | ▲ risk |
| Medicaid Day Pct | 0.016 | -0.072 | ▼ risk |
| Revenue Per Bed | 608434.392 | +0.057 | ▲ risk |
| Net To Gross Ratio | 0.246 | -0.055 | ▼ risk |
| Beds | 286.000 | +0.018 | ▲ risk |
| Medicare Day Pct | 0.280 | -0.008 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.9M
Current margin: -12.2%
Projected margin: -9.4%
Grade: D
Comps: 132
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.279 | 0.756 | 47.7% | $3.1M | 55% | 24mo |
| Payer Mix Optimization | 0.703 | 0.811 | 10.8% | $1.6M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.246 | 0.253 | 0.7% | $150K | 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 | 25.3 | [25.0, 75.0] | P29 | 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. |