ML Analysis — SAN ANTONIO STATE HOSPITAL
CCN 454011 | 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 Health5/25
RCM Upside19/25
Market Position9/20
Demand Defensibility11/15
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
Margin Prediction (Trained Ridge Model)
-14.2%
R²=0.34 | n=4,907 | Grade B | Actual: -24.2%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-42.5%, 14.1%]. P29 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Reimbursement Quality | 0.994 | -0.2280 | Higher Reimbursement Quality decreases predicted m | |
| Revenue/Bed | 215404.254 | -0.1904 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 267482.750 | +0.1712 | Higher Expense/Bed increases predicted margin | |
| Net-to-Gross | 1.000 | +0.0708 | Higher Net-to-Gross increases predicted margin | |
| Occupancy × Net-to-Gross | 0.731 | +0.0406 | Higher Occupancy × Net-to-Gross increases predicte |
Turnaround: 27%Low turnaround probability (27%). Structural disadvantages in Reimbursement Quality and Revenue/Bed.
Suburban Community Hospit
Archetype
50.4%
Distress Risk
$171K
RCM Opportunity
D
Opportunity Grade
-23.9%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P88. 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: High
National distress rate: 49.3%
TX distress rate: 42.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Net To Gross Ratio | 1.000 | +0.281 | ▲ risk |
| Occupancy Rate | 0.731 | -0.191 | ▼ risk |
| Medicaid Day Pct | 0.000 | -0.088 | ▼ risk |
| Revenue Per Bed | 215404.254 | +0.081 | ▲ risk |
| Medicare Day Pct | 0.006 | -0.055 | ▼ risk |
| Beds | 268.000 | +0.016 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $171K
Current margin: -24.2%
Projected margin: -23.9%
Grade: D
Comps: 136
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.731 | 0.757 | 2.6% | $171K | 55% | 24mo |
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. |