ML Analysis — NORTH COUNTRY HOSPITAL & HEALTH CTR
CCN 471304 | 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.
55
/ 100 (C)
Financial Health5/25
RCM Upside20/25
Market Position15/20
Demand Defensibility9/15
Operational Efficiency6/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-31.1%
R²=0.34 | n=4,907 | Grade B | Actual: -41.7%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-59.4%, -2.8%]. P12 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 4012216.960 | -0.2901 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 2832369.920 | +0.1749 | Higher Revenue/Bed increases predicted margin | |
| State Peer Margin | -0.266 | -0.1635 | Lower State Peer Margin decreases predicted margin | |
| Bed Utilization Value | 1792540.963 | +0.0305 | Higher Bed Utilization Value increases predicted m | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin |
Turnaround: 10%Low turnaround probability (10%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Under-Performing / Distre
Archetype
45.8%
Distress Risk
$5.0M
RCM Opportunity
C
Opportunity Grade
-34.6%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P81. 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: Elevated
National distress rate: 49.3%
VT distress rate: 86.7%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.633 | -0.100 | ▼ risk |
| Revenue Per Bed | 2832369.920 | -0.074 | ▼ risk |
| Medicaid Day Pct | 0.144 | +0.055 | ▲ risk |
| Net To Gross Ratio | 0.327 | -0.019 | ▼ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
| Medicare Day Pct | 0.409 | +0.014 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.0M
Current margin: -41.7%
Projected margin: -34.6%
Grade: C
Comps: 2513
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 | 0.632 | 18.5% | $2.8M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.327 | 0.591 | 26.4% | $2.2M | 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 | 33.1 | [25.0, 75.0] | P74 | 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 | 99.2% | [90.0%, 99.5%] | P5 | Strong — predicted net collection rate is in the top third. |