ML Analysis — TOPPENISH COMMUNITY HOSPITAL
CCN 500037 | 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.
45
/ 100 (C)
Financial Health3/25
RCM Upside20/25
Market Position14/20
Demand Defensibility5/15
Operational Efficiency4/15
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)
-17.2%
R²=0.34 | n=4,907 | Grade B | Actual: -17.1%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-45.5%, 11.1%]. P24 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1178618.702 | -0.0559 | Lower Revenue/Bed decreases predicted margin | |
| Medicaid % | 0.454 | -0.0441 | Higher Medicaid % decreases predicted margin | |
| State Peer Margin | -0.103 | -0.0426 | Lower State Peer Margin decreases predicted margin | |
| Expense/Bed | 1380538.660 | +0.0341 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.106 | +0.0273 | Higher Reimbursement Quality increases predicted m |
Turnaround: 23%Low turnaround probability (23%). Structural disadvantages in Revenue/Bed and Medicaid %.
Safety-Net/Medicaid Heavy
Archetype
56.7%
Distress Risk
$7.0M
RCM Opportunity
B
Opportunity Grade
-4.4%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P1. High Medicaid dependence creates reimbursement risk. Assess DSH payments and state expansion status.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| WESTERN PEAKS SPECIALTY HOSPITAL | UT | 59 |
| HOSPITAL MENONITA AIBONITO | PR | 129 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
| NORTH SUBURBAN MEDICAL CENTER | CO | 115 |
Distress Analysis
Risk: High
National distress rate: 49.3%
WA distress rate: 67.3%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.453 | +0.364 | ▲ risk |
| Net To Gross Ratio | 0.267 | -0.045 | ▼ risk |
| Medicare Day Pct | 0.148 | -0.031 | ▼ risk |
| Revenue Per Bed | 1178618.702 | +0.024 | ▲ risk |
| Beds | 47.000 | -0.014 | ▼ risk |
| Occupancy Rate | 0.528 | -0.002 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $7.0M
Current margin: -17.1%
Projected margin: -4.4%
Grade: B
Comps: 40
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 | 0.399 | 0.654 | 25.6% | $3.8M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.267 | 0.607 | 34.0% | $2.2M | 65% | 18mo |
| Occupancy Improvement | 0.528 | 0.678 | 15.0% | $993K | 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 | 32.0 | [25.0, 75.0] | P71 | 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. |