ML Analysis — REFUGIO MEMORIAL HOSPITAL
CCN 451317 | 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.
35
/ 100 (D)
Financial Health4/25
RCM Upside18/25
Market Position8/20
Demand Defensibility4/15
Operational Efficiency2/15
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)
-12.8%
R²=0.34 | n=4,907 | Grade B | Actual: -43.7%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.1%, 15.5%]. P31 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 568427.950 | -0.1411 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 817056.800 | +0.1035 | Higher Expense/Bed increases predicted margin | |
| Log(Beds) | 2.996 | -0.0320 | Lower Log(Beds) decreases predicted margin | |
| State Peer Margin | -0.006 | +0.0290 | Higher State Peer Margin increases predicted margi | |
| Bed Utilization Value | 48588.910 | -0.0274 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 29%Low turnaround probability (29%). Structural disadvantages in Revenue/Bed and Expense/Bed.
nan%
Distress Risk
$7.3M
RCM Opportunity
A
Opportunity Grade
20.1%
Projected Margin
Distress Analysis
Risk: Unknown
National distress rate: 49.3%
TX distress rate: 42.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.085 | +0.408 | ▲ risk |
| Medicare Day Pct | 0.553 | +0.039 | ▲ risk |
| Medicaid Day Pct | nan | +nan | ▼ risk |
| Revenue Per Bed | 568427.950 | +0.060 | ▲ risk |
| Net To Gross Ratio | 0.301 | -0.030 | ▼ risk |
| Beds | 20.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $7.3M
Current margin: -43.7%
Projected margin: 20.1%
Grade: A
Comps: 220
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 | 0.447 | 0.717 | 27.0% | $4.0M | 50% | 24mo |
| Occupancy Improvement | 0.085 | 0.523 | 43.7% | $2.9M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.301 | 0.542 | 24.1% | $321K | 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. |