{
  "deal_id": "390049",
  "deal_name": "ST. LUKES HOSPITAL",
  "run_id": "20260425T212058Z-76ccdd",
  "generated_at": "2026-04-25T21:20:58.643639+00:00",
  "model_version": "1.0",
  "scenario_id": null,
  "as_of": null,
  "profile": {
    "bed_count": 633,
    "region": null,
    "state": "PA",
    "payer_mix": {},
    "teaching_status": null,
    "urban_rural": null,
    "system_affiliation": null,
    "cms_provider_id": null,
    "ein": null,
    "npi": null,
    "name": "ST. LUKES HOSPITAL"
  },
  "observed_metrics": {},
  "completeness": {
    "coverage_pct": 0.0,
    "total_metrics": 38,
    "observed_count": 0,
    "missing_fields": [
      {
        "metric_key": "denial_rate",
        "display_name": "Initial Denial Rate",
        "category": "denials",
        "ebitda_sensitivity_rank": 1
      },
      {
        "metric_key": "days_in_ar",
        "display_name": "Net Days in A/R",
        "category": "ar",
        "ebitda_sensitivity_rank": 2
      },
      {
        "metric_key": "final_denial_rate",
        "display_name": "Final Denial Write-off %",
        "category": "denials",
        "ebitda_sensitivity_rank": 3
      },
      {
        "metric_key": "net_collection_rate",
        "display_name": "Net Collection Rate (Cash as % of NPSR)",
        "category": "collections",
        "ebitda_sensitivity_rank": 4
      },
      {
        "metric_key": "cost_to_collect",
        "display_name": "Cost to Collect (% of NPSR)",
        "category": "collections",
        "ebitda_sensitivity_rank": 5
      },
      {
        "metric_key": "avoidable_denial_pct",
        "display_name": "Avoidable Denials Rate",
        "category": "denials",
        "ebitda_sensitivity_rank": 6
      },
      {
        "metric_key": "ar_over_90_pct",
        "display_name": "Aged A/R > 90 Days %",
        "category": "ar",
        "ebitda_sensitivity_rank": 7
      },
      {
        "metric_key": "bad_debt_rate",
        "display_name": "Bad Debt %",
        "category": "collections",
        "ebitda_sensitivity_rank": 8
      },
      {
        "metric_key": "dnfb_days",
        "display_name": "Days in Discharged Not Final Billed (DNFB)",
        "category": "ar",
        "ebitda_sensitivity_rank": 9
      },
      {
        "metric_key": "appeals_overturn_rate",
        "display_name": "Denial Overturn Rate",
        "category": "denials",
        "ebitda_sensitivity_rank": 10
      },
      {
        "metric_key": "denial_rate_medicare_advantage",
        "display_name": "Denial Rate \u2014 Medicare Advantage",
        "category": "denials",
        "ebitda_sensitivity_rank": 11
      },
      {
        "metric_key": "denial_rate_commercial",
        "display_name": "Denial Rate \u2014 Commercial",
        "category": "denials",
        "ebitda_sensitivity_rank": 12
      },
      {
        "metric_key": "clean_claim_rate",
        "display_name": "Clean Claim Rate",
        "category": "claims",
        "ebitda_sensitivity_rank": 13
      },
      {
        "metric_key": "denial_rate_medical_necessity",
        "display_name": "Denials \u2014 Medical Necessity",
        "category": "denials",
        "ebitda_sensitivity_rank": 14
      },
      {
        "metric_key": "denial_rate_coding",
        "display_name": "Denials \u2014 Coding",
        "category": "denials",
        "ebitda_sensitivity_rank": 15
      },
      {
        "metric_key": "denial_rate_authorization",
        "display_name": "Denials \u2014 Authorization",
        "category": "denials",
        "ebitda_sensitivity_rank": 16
      },
      {
        "metric_key": "denial_rate_medicare_ffs",
        "display_name": "Denial Rate \u2014 Medicare FFS",
        "category": "denials",
        "ebitda_sensitivity_rank": 17
      },
      {
        "metric_key": "denial_rate_eligibility",
        "display_name": "Denials \u2014 Eligibility",
        "category": "denials",
        "ebitda_sensitivity_rank": 18
      },
      {
        "metric_key": "denial_rate_timely_filing",
        "display_name": "Denials \u2014 Timely Filing",
        "category": "denials",
        "ebitda_sensitivity_rank": 19
      },
      {
        "metric_key": "denial_rate_medicaid",
        "display_name": "Denial Rate \u2014 Medicaid",
        "category": "denials",
        "ebitda_sensitivity_rank": 20
      },
      {
        "metric_key": "charge_lag_days",
        "display_name": "Charge Lag (Days)",
        "category": "ar",
        "ebitda_sensitivity_rank": 21
      },
      {
        "metric_key": "patient_payment_yield",
        "display_name": "Patient Payment Yield",
        "category": "collections",
        "ebitda_sensitivity_rank": 22
      },
      {
        "metric_key": "autopost_rate",
        "display_name": "Auto-Posting Rate",
        "category": "collections",
        "ebitda_sensitivity_rank": 23
      },
      {
        "metric_key": "claim_rejection_rate",
        "display_name": "Claim Rejection Rate (Pre-Payer)",
        "category": "claims",
        "ebitda_sensitivity_rank": 24
      },
      {
        "metric_key": "first_pass_resolution_rate",
        "display_name": "First Pass Resolution Rate",
        "category": "claims",
        "ebitda_sensitivity_rank": 25
      },
      {
        "metric_key": "insurance_verification_rate",
        "display_name": "Insurance Verification Rate",
        "category": "claims",
        "ebitda_sensitivity_rank": 26
      },
      {
        "metric_key": "late_charge_pct",
        "display_name": "Late Charges %",
        "category": "claims",
        "ebitda_sensitivity_rank": 27
      },
      {
        "metric_key": "coding_accuracy_rate",
        "display_name": "Coding Accuracy Rate",
        "category": "coding",
        "ebitda_sensitivity_rank": 28
      },
      {
        "metric_key": "case_mix_index",
        "display_name": "Case Mix Index (CMI)",
        "category": "coding",
        "ebitda_sensitivity_rank": 29
      },
      {
        "metric_key": "gross_revenue",
        "display_name": "Gross Patient Revenue",
        "category": "financial",
        "ebitda_sensitivity_rank": 30
      },
      {
        "metric_key": "net_revenue",
        "display_name": "Net Patient Service Revenue (NPSR)",
        "category": "financial",
        "ebitda_sensitivity_rank": 31
      },
      {
        "metric_key": "total_operating_expenses",
        "display_name": "Total Operating Expenses",
        "category": "financial",
        "ebitda_sensitivity_rank": 32
      },
      {
        "metric_key": "current_ebitda",
        "display_name": "Current EBITDA",
        "category": "financial",
        "ebitda_sensitivity_rank": 33
      },
      {
        "metric_key": "ebitda_margin",
        "display_name": "EBITDA Margin",
        "category": "financial",
        "ebitda_sensitivity_rank": 34
      },
      {
        "metric_key": "payer_mix_commercial_pct",
        "display_name": "Payer Mix \u2014 Commercial %",
        "category": "financial",
        "ebitda_sensitivity_rank": 35
      },
      {
        "metric_key": "payer_mix_medicare_pct",
        "display_name": "Payer Mix \u2014 Medicare %",
        "category": "financial",
        "ebitda_sensitivity_rank": 36
      },
      {
        "metric_key": "payer_mix_medicaid_pct",
        "display_name": "Payer Mix \u2014 Medicaid %",
        "category": "financial",
        "ebitda_sensitivity_rank": 37
      },
      {
        "metric_key": "payer_mix_selfpay_pct",
        "display_name": "Payer Mix \u2014 Self-Pay %",
        "category": "financial",
        "ebitda_sensitivity_rank": 38
      }
    ],
    "stale_fields": [],
    "conflicting_fields": [],
    "quality_flags": [],
    "missing_ranked_by_sensitivity": [
      "denial_rate",
      "days_in_ar",
      "final_denial_rate",
      "net_collection_rate",
      "cost_to_collect",
      "avoidable_denial_pct",
      "ar_over_90_pct",
      "bad_debt_rate",
      "dnfb_days",
      "appeals_overturn_rate",
      "denial_rate_medicare_advantage",
      "denial_rate_commercial",
      "clean_claim_rate",
      "denial_rate_medical_necessity",
      "denial_rate_coding",
      "denial_rate_authorization",
      "denial_rate_medicare_ffs",
      "denial_rate_eligibility",
      "denial_rate_timely_filing",
      "denial_rate_medicaid",
      "charge_lag_days",
      "patient_payment_yield",
      "autopost_rate",
      "claim_rejection_rate",
      "first_pass_resolution_rate",
      "insurance_verification_rate",
      "late_charge_pct",
      "coding_accuracy_rate",
      "case_mix_index",
      "gross_revenue",
      "net_revenue",
      "total_operating_expenses",
      "current_ebitda",
      "ebitda_margin",
      "payer_mix_commercial_pct",
      "payer_mix_medicare_pct",
      "payer_mix_medicaid_pct",
      "payer_mix_selfpay_pct"
    ],
    "missing_fields_ranked": [
      "denial_rate",
      "days_in_ar",
      "final_denial_rate",
      "net_collection_rate",
      "cost_to_collect",
      "avoidable_denial_pct",
      "ar_over_90_pct",
      "bad_debt_rate",
      "dnfb_days",
      "appeals_overturn_rate",
      "denial_rate_medicare_advantage",
      "denial_rate_commercial",
      "clean_claim_rate",
      "denial_rate_medical_necessity",
      "denial_rate_coding",
      "denial_rate_authorization",
      "denial_rate_medicare_ffs",
      "denial_rate_eligibility",
      "denial_rate_timely_filing",
      "denial_rate_medicaid",
      "charge_lag_days",
      "patient_payment_yield",
      "autopost_rate",
      "claim_rejection_rate",
      "first_pass_resolution_rate",
      "insurance_verification_rate",
      "late_charge_pct",
      "coding_accuracy_rate",
      "case_mix_index",
      "gross_revenue",
      "net_revenue",
      "total_operating_expenses",
      "current_ebitda",
      "ebitda_margin",
      "payer_mix_commercial_pct",
      "payer_mix_medicare_pct",
      "payer_mix_medicaid_pct",
      "payer_mix_selfpay_pct"
    ],
    "grade": "D",
    "status": "INCOMPLETE",
    "reason": "only 0/38 metrics observed",
    "anomalies": []
  },
  "comparables": {
    "peers": [],
    "features_used": [],
    "weights": {},
    "robustness_check": {},
    "status": "INCOMPLETE",
    "reason": "no comparable pool provided"
  },
  "predicted_metrics": {},
  "rcm_profile": {},
  "ebitda_bridge": {
    "current_ebitda": 0.0,
    "target_ebitda": 0.0,
    "total_ebitda_impact": 0.0,
    "new_ebitda_margin": 0.0,
    "ebitda_delta_pct": 0.0,
    "per_metric_impacts": [],
    "waterfall_data": [],
    "sensitivity_tornado": [],
    "working_capital_released": 0.0,
    "margin_improvement_bps": 0,
    "ev_impact_at_multiple": {},
    "status": "INCOMPLETE",
    "reason": "no metrics"
  },
  "simulation": {
    "n_sims": 0,
    "seed": 0,
    "ebitda_uplift": {
      "p10": 0.0,
      "p25": 0.0,
      "p50": 0.0,
      "p75": 0.0,
      "p90": 0.0
    },
    "moic": {
      "p10": 0.0,
      "p25": 0.0,
      "p50": 0.0,
      "p75": 0.0,
      "p90": 0.0
    },
    "irr": {
      "p10": 0.0,
      "p25": 0.0,
      "p50": 0.0,
      "p75": 0.0,
      "p90": 0.0
    },
    "probability_of_covenant_breach": 0.0,
    "variance_contribution_by_metric": {},
    "convergence_check": {},
    "status": "SKIPPED",
    "reason": "skip_simulation=True"
  },
  "risk_flags": [
    {
      "category": "DATA_QUALITY",
      "severity": "CRITICAL",
      "explanation": "Only 0% of required metrics are available (0/38). Core diligence conclusions need more data before they can be defended in IC.",
      "trigger_metric": "completeness.coverage_pct",
      "trigger_value": 0.0,
      "title": "Insufficient data for reliable analysis",
      "detail": "Only 0% of required metrics are available (0/38). Core diligence conclusions need more data before they can be defended in IC.",
      "trigger_metrics": [
        "completeness.coverage_pct"
      ],
      "ebitda_at_risk": null
    }
  ],
  "provenance": {
    "nodes": {}
  },
  "diligence_questions": [
    {
      "question": "Request 24 months of RCM scorecard data covering denial volumes, days in A/R, cash collections, and clean-claim rate. Include payer-split where available.",
      "trigger_metric": "completeness.coverage_pct",
      "trigger_reason": "Insufficient data for reliable analysis",
      "priority": "P0",
      "category": "DATA_QUALITY",
      "trigger": "Insufficient data for reliable analysis",
      "context": "Only 0% of required metrics are available (0/38). Core diligence conclusions need more data before they can be defended in IC."
    },
    {
      "question": "Please provide Initial Denial Rate data for the last 36 months. This metric has the #1 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "denial_rate",
      "trigger_reason": "missing Initial Denial Rate",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:denial_rate",
      "context": "Initial Denial Rate is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Net Days in A/R data for the last 36 months. This metric has the #2 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "days_in_ar",
      "trigger_reason": "missing Net Days in A/R",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:days_in_ar",
      "context": "Net Days in A/R is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Final Denial Write-off % data for the last 36 months. This metric has the #3 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "final_denial_rate",
      "trigger_reason": "missing Final Denial Write-off %",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:final_denial_rate",
      "context": "Final Denial Write-off % is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Net Collection Rate (Cash as % of NPSR) data for the last 36 months. This metric has the #4 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "net_collection_rate",
      "trigger_reason": "missing Net Collection Rate (Cash as % of NPSR)",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:net_collection_rate",
      "context": "Net Collection Rate (Cash as % of NPSR) is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Cost to Collect (% of NPSR) data for the last 36 months. This metric has the #5 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "cost_to_collect",
      "trigger_reason": "missing Cost to Collect (% of NPSR)",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:cost_to_collect",
      "context": "Cost to Collect (% of NPSR) is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "What is the current CDI program structure and staffing?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P1",
      "category": "CODING",
      "trigger": "standard",
      "context": "Most of our value-creation planning assumes a CDI program capable of lifting CMI by 0.05-0.10; need to know the baseline staffing."
    },
    {
      "question": "What EHR and billing system(s) are in use? Are there planned technology transitions?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P1",
      "category": "OPERATIONAL",
      "trigger": "standard",
      "context": "EHR transitions and billing-system migrations routinely disrupt cash for 2-3 quarters \u2014 the investment committee needs a heads-up."
    },
    {
      "question": "Are there any pending payer contract renegotiations or change-of-control provisions that could affect post-acquisition revenue?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P1",
      "category": "PAYER",
      "trigger": "standard",
      "context": "Change-of-control clauses can trigger rate renegotiation or termination rights \u2014 left undiscovered they destroy the underwriting case."
    },
    {
      "question": "Provide the charge description master (CDM) for review.",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P2",
      "category": "OPERATIONAL",
      "trigger": "standard",
      "context": "Outdated CDMs leak revenue on high-volume service lines. A clean CDM review is cheap and catches errors that the operator has stopped noticing."
    },
    {
      "question": "What is the IT contract portfolio (managed services, outsourced coding, clearinghouse agreements)?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P2",
      "category": "OPERATIONAL",
      "trigger": "standard",
      "context": "Vendor lock-in on coding or clearinghouse agreements constrains the operational-improvement playbook; price the exit fees into the thesis."
    }
  ],
  "integrity_checks": [],
  "exports": {
    "json": "render_on_demand",
    "html": "render_on_demand",
    "pptx": "render_on_demand"
  },
  "reimbursement_profile": {
    "payer_classes": {},
    "method_weights": {},
    "inpatient_outpatient_mix": null,
    "notes": [
      "no payer mix provided; skipping reimbursement inference"
    ],
    "provenance": {
      "payer_mix": "benchmark_default"
    }
  },
  "revenue_realization": null,
  "metric_sensitivity_map": null,
  "value_bridge_result": null,
  "leverage_table": null,
  "recurring_vs_one_time_summary": null,
  "enterprise_value_summary": null,
  "v2_simulation": null,
  "analyst_overrides": null,
  "scenario_comparison": null,
  "regulatory_context": {
    "state": "PA",
    "bed_count": 633,
    "con_status": "NO_CON",
    "con_implication": "none",
    "medicaid_risk": "LOW",
    "market_risk": "LOW",
    "risk_score": 0,
    "narrative": "PA has no active CON law \u2014 new entrants can stand up competing capacity without state review. The state expanded Medicaid (FMAP 52%, Medicaid pays 77% of Medicare rates).",
    "con_profile": {
      "has_con": false,
      "covered_services": [],
      "bed_threshold": null,
      "capital_threshold": null,
      "moratorium_active": false,
      "source_url": "https://www.ncsl.org/health/con-certificate-of-need-state-laws"
    },
    "payer_profile": {
      "medicaid_expanded": true,
      "medicaid_fmap_pct": 52.39,
      "medicaid_rate_as_pct_of_medicare": 0.77,
      "uninsured_rate": 5.8,
      "commercial_market_hhi": "MEDIUM",
      "dominant_insurer": null
    }
  },
  "metric_forecasts": {},
  "_provenance": {
    "run_id": "20260425T212058Z-76ccdd",
    "generated_at": "2026-04-25T21:20:58.643639+00:00",
    "model_version": "1.0",
    "source": "analysis_runs"
  }
}