ML Analysis — CHILDRENS HOSPITAL OF SAN ANTONIO
CCN 453315 | 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 Position9/20
Demand Defensibility8/15
Operational Efficiency6/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-0.2%
R²=0.34 | n=4,907 | Grade B | Actual: -2.8%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-28.5%, 28.1%]. P62 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 2163975.339 | +0.0816 | Higher Revenue/Bed increases predicted margin | |
| Expense/Bed | 2224193.885 | -0.0698 | Higher Expense/Bed decreases predicted margin | |
| State Peer Margin | -0.006 | +0.0290 | Higher State Peer Margin increases predicted margi | |
| Log(Beds) | 5.159 | +0.0182 | Higher Log(Beds) increases predicted margin | |
| Reimbursement Quality | 0.264 | -0.0180 | Higher Reimbursement Quality decreases predicted m |
Turnaround: 50%Turnaround possible (50%) but uncertain. Margin improvement depends on Revenue/Bed.
Suburban Community Hospit
Archetype
44.4%
Distress Risk
$2.0M
RCM Opportunity
D
Opportunity Grade
-2.3%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P55. Community hospitals — the largest PE deal category. Focus on RCM improvement and cost optimization at 9-11x.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| CLARA MAASS MEDICAL CENTER | NJ | 259 |
| PRESENCE SAINTS MARY & ELIZABETH MED | IL | 266 |
| ADVENTIST HEALTH BAKERSFIELD | CA | 254 |
| BRISTOL REGIONAL MEDICAL CENTER | TN | 244 |
| HOLSTON VALLEY HOSP & MED CTR | TN | 286 |
| SPRINGFIELD REGIONAL MEDICAL CENTER | OH | 230 |
Distress Analysis
Risk: Elevated
National distress rate: 49.3%
TX distress rate: 42.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicare Day Pct | 0.000 | -0.056 | ▼ risk |
| Occupancy Rate | 0.583 | -0.054 | ▼ risk |
| Net To Gross Ratio | 0.283 | -0.038 | ▼ risk |
| Revenue Per Bed | 2163975.339 | -0.035 | ▼ risk |
| Medicaid Day Pct | 0.068 | -0.021 | ▼ risk |
| Beds | 174.000 | +0.003 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.0M
Current margin: -2.8%
Projected margin: -2.3%
Grade: D
Comps: 157
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.583 | 0.749 | 16.6% | $1.1M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.283 | 0.304 | 2.0% | $892K | 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 | 25.0 | [25.0, 75.0] | P0 | 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. |