ML Analysis — COULEE MEDICAL CENTER
CCN 501308 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Speculative — only pursue if turnaround thesis is strong and entry multiple reflects risk.
41
/ 100 (D)
Financial Health2/25
RCM Upside19/25
Market Position9/20
Demand Defensibility5/15
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:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-14.6%
R²=0.34 | n=4,907 | Grade B | Actual: -7.0%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-42.9%, 13.7%]. P28 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Medicaid % | 0.597 | -0.0615 | Higher Medicaid % decreases predicted margin | |
| State Peer Margin | -0.103 | -0.0426 | Lower State Peer Margin decreases predicted margin | |
| Revenue/Bed | 1352572.480 | -0.0316 | Lower Revenue/Bed decreases predicted margin | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Expense/Bed | 1446989.680 | +0.0259 | Higher Expense/Bed increases predicted margin |
Turnaround: 26%Low turnaround probability (26%). Structural disadvantages in Medicaid % and State Peer Margin.
Safety-Net/Medicaid Heavy
Archetype
63.4%
Distress Risk
$6.8M
RCM Opportunity
A
Opportunity Grade
13.0%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P32. 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 |
| TOPPENISH COMMUNITY HOSPITAL | WA | 47 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
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 | 0.597 | +0.508 | ▲ risk |
| Net To Gross Ratio | 0.584 | +0.096 | ▲ risk |
| Medicare Day Pct | 0.190 | -0.023 | ▼ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
| Revenue Per Bed | 1352572.480 | +0.013 | ▲ risk |
| Occupancy Rate | 0.524 | +0.001 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $6.8M
Current margin: -7.0%
Projected margin: 13.0%
Grade: A
Comps: 42
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 | 0.212 | 0.629 | 41.7% | $6.3M | 50% | 24mo |
| Occupancy Improvement | 0.524 | 0.582 | 5.8% | $382K | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.584 | 0.613 | 2.9% | $113K | 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 | 31.5 | [25.0, 75.0] | P67 | 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. |