ML Analysis — TWIN COUNTY REGIONAL HOSPITAL
CCN 490115 | 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 Health8/25
RCM Upside16/25
Market Position17/20
Demand Defensibility9/15
Operational Efficiency0/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Low occupancy (<30%) — demand risk
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
- Volume growth opportunity from low occupancy
Margin Prediction (Trained Ridge Model)
-3.8%
R²=0.34 | n=4,907 | Grade B | Actual: -1.5%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-32.1%, 24.5%]. P52 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 426146.064 | -0.1610 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 432717.362 | +0.1508 | Higher Expense/Bed increases predicted margin | |
| State Peer Margin | 0.044 | +0.0666 | Higher State Peer Margin increases predicted margi | |
| Bed Utilization Value | 69968.605 | -0.0266 | Lower Bed Utilization Value decreases predicted ma | |
| Occupancy | 0.164 | -0.0205 | Lower Occupancy decreases predicted margin |
Turnaround: 43%Turnaround possible (43%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Suburban Community Hospit
Archetype
55.9%
Distress Risk
$5.4M
RCM Opportunity
C
Opportunity Grade
7.5%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P76. Community hospitals — the largest PE deal category. Focus on RCM improvement and cost optimization at 9-11x.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| PROMEDICA HICKMAN HOSPITAL | MI | 58 |
| WATAUGA MEDICAL CENTER | NC | 95 |
| ST LUKES HOSPITAL - EASTON CAMPUS | PA | 29 |
| CULPEPER MEMORIAL HOSPITAL | VA | 70 |
| SOUTHSIDE COMMUNITY HOSPITAL | VA | 80 |
| SPECTRUM HEALTH LUDINGTON | MI | 45 |
Distress Analysis
Risk: High
National distress rate: 49.3%
VA distress rate: 29.6%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.164 | +0.335 | ▲ risk |
| Medicaid Day Pct | 0.017 | -0.071 | ▼ risk |
| Revenue Per Bed | 426146.064 | +0.068 | ▲ risk |
| Net To Gross Ratio | 0.222 | -0.065 | ▼ risk |
| Medicare Day Pct | 0.310 | -0.003 | ▼ risk |
| Beds | 141.000 | -0.001 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.4M
Current margin: -1.5%
Projected margin: 7.5%
Grade: C
Comps: 45
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.164 | 0.805 | 64.1% | $4.2M | 55% | 24mo |
| Payer Mix Optimization | 0.672 | 0.714 | 4.2% | $630K | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.222 | 0.302 | 7.9% | $557K | 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 | 27.3 | [25.0, 75.0] | P40 | 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. |