ML Analysis — GRAFTON CITY HOSPITAL
CCN 511307 | 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.
48
/ 100 (C)
Financial Health5/25
RCM Upside18/25
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
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-11.1%
R²=0.34 | n=4,907 | Grade B | Actual: -15.5%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-39.4%, 17.2%]. P35 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 646542.680 | -0.1302 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 746949.960 | +0.1121 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.328 | -0.0365 | Higher Reimbursement Quality decreases predicted m | |
| State Peer Margin | -0.003 | +0.0316 | Higher State Peer Margin increases predicted margi | |
| Net-to-Gross | 0.615 | +0.0276 | Higher Net-to-Gross increases predicted margin |
Turnaround: 31%Turnaround possible (31%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Rural/Critical Access
Archetype
60.2%
Distress Risk
$3.9M
RCM Opportunity
A
Opportunity Grade
8.7%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P50. Rural/small hospitals face structural headwinds. Evaluate CAH conversion, telehealth, and rural health funding.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| BRECKINRIDGE HEALTH INC | KY | 25 |
| SHERIDAN MEMORIAL HOSPITAL | MT | 19 |
| DAYTON GENERAL HOSPITAL | WA | 25 |
| BLUE MOUNTAIN HOSPITAL DISTRICT | OR | 16 |
| COMMUNITY HOSPITAL | WY | 25 |
| CARLE EUREKA HOSPITAL | IL | 25 |
Distress Analysis
Risk: High
National distress rate: 49.3%
WV distress rate: 41.7%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.161 | +0.338 | ▲ risk |
| Net To Gross Ratio | 0.615 | +0.110 | ▲ risk |
| Medicaid Day Pct | 0.024 | -0.065 | ▼ risk |
| Revenue Per Bed | 646542.680 | +0.055 | ▲ risk |
| Medicare Day Pct | 0.442 | +0.020 | ▲ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.9M
Current margin: -15.5%
Projected margin: 8.7%
Grade: A
Comps: 30
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.161 | 0.572 | 41.1% | $2.7M | 55% | 24mo |
| Payer Mix Optimization | 0.534 | 0.614 | 8.0% | $1.2M | 50% | 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 | 30.6 | [25.0, 75.0] | P62 | 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. |