ML Analysis — LEWISGALE HOSPITAL-PULASKI
CCN 490116 | 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.
53
/ 100 (C)
Financial Health12/25
RCM Upside13/25
Market Position17/20
Demand Defensibility8/15
Operational Efficiency3/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Small facility (<50 beds) — limited scale
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
1.6%
R²=0.34 | n=4,907 | Grade B | Actual: 4.0%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-26.7%, 29.9%]. P66 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| State Peer Margin | 0.044 | +0.0666 | Higher State Peer Margin increases predicted margi | |
| Reimbursement Quality | 0.086 | +0.0334 | Higher Reimbursement Quality increases predicted m | |
| Net-to-Gross | 0.138 | -0.0259 | Lower Net-to-Gross decreases predicted margin | |
| Bed Count | 44.000 | +0.0163 | Higher Bed Count increases predicted margin | |
| Expense/Bed | 1537369.046 | +0.0148 | Higher Expense/Bed increases predicted margin |
Suburban Community Hospit
Archetype
48.1%
Distress Risk
$5.1M
RCM Opportunity
C
Opportunity Grade
11.2%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P4. 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: Elevated
National distress rate: 49.3%
VA distress rate: 29.6%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.379 | +0.136 | ▲ risk |
| Net To Gross Ratio | 0.138 | -0.103 | ▼ risk |
| Medicaid Day Pct | 0.017 | -0.072 | ▼ risk |
| Beds | 44.000 | -0.014 | ▼ risk |
| Medicare Day Pct | 0.362 | +0.006 | ▲ risk |
| Revenue Per Bed | 1600931.705 | -0.001 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.1M
Current margin: 4.0%
Projected margin: 11.2%
Grade: C
Comps: 41
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Net-to-Gross Ratio Improvement | 0.138 | 0.453 | 31.6% | $2.6M | 65% | 18mo |
| Occupancy Improvement | 0.379 | 0.753 | 37.5% | $2.5M | 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 | 30.2 | [25.0, 75.0] | P60 | 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. |