ML Analysis — EAST ADAMS RURAL HOSPITAL
CCN 501311 | 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.
47
/ 100 (C)
Financial Health4/25
RCM Upside19/25
Market Position15/20
Demand Defensibility6/15
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)
-23.3%
R²=0.34 | n=4,907 | Grade B | Actual: -46.6%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-51.6%, 5.0%]. P17 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 774492.917 | -0.1123 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 1135187.167 | +0.0643 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.379 | -0.0510 | Higher Reimbursement Quality decreases predicted m | |
| Net-to-Gross | 0.765 | +0.0445 | Higher Net-to-Gross increases predicted margin | |
| Log(Beds) | 2.485 | -0.0439 | Lower Log(Beds) decreases predicted margin |
Turnaround: 16%Low turnaround probability (16%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Under-Performing / Distre
Archetype
62.4%
Distress Risk
$2.4M
RCM Opportunity
A
Opportunity Grade
-20.7%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P88. 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: High
National distress rate: 49.3%
WA distress rate: 67.3%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.285 | +0.196 | ▲ risk |
| Net To Gross Ratio | 0.765 | +0.177 | ▲ risk |
| Occupancy Rate | 0.362 | +0.152 | ▲ risk |
| Revenue Per Bed | 774492.917 | +0.048 | ▲ risk |
| Medicare Day Pct | 0.220 | -0.018 | ▼ risk |
| Beds | 12.000 | -0.018 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.4M
Current margin: -46.6%
Projected margin: -20.7%
Grade: A
Comps: 16
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 | 0.495 | 0.628 | 13.4% | $2.0M | 50% | 24mo |
| Occupancy Improvement | 0.362 | 0.423 | 6.1% | $400K | 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 | 33.3 | [25.0, 75.0] | P74 | Average — predicted days in ar is near the median. |
| Clean Claim Rate | 98.0% | [80.0%, 98.0%] | P0 | Strong — predicted clean claim rate is in the top third. |
| Net Collection Rate | 99.3% | [90.0%, 99.5%] | P6 | Strong — predicted net collection rate is in the top third. |