SOUTH BALDWIN REGIONAL MEDICAL CENTE
1. Target Overview & Investment Thesis
SOUTH BALDWIN REGIONAL MEDICAL CENTE is a 112-bed suburban community hospital in BALDWIN, AL with $168.2M in net patient revenue and a 46.4% operating margin. The hospital serves a payer mix of 27.5% Medicare, 13.2% Medicaid, and 59.3% commercial.
Thesis: Turnaround. Our ML models identify $12.4M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 46.4% to 53.8% (+736bps).
| Net Revenue HCRIS | $168.2M |
| Current EBITDA COMPUTED | $78.1M |
| Operating Margin COMPUTED | 46.4% |
| Occupancy HCRIS | 59.8% |
| Revenue / Bed COMPUTED | $1.5M |
| Net-to-Gross HCRIS | 9.5% |
| Distress Probability ML | 45.5% |
2. Market Context & Competitive Position
AL has 115 Medicare-certified hospitals with a median operating margin of -8.5%. The target's margin of 46.4% places it above the state median. Among 33 size-comparable peers (56-224 beds), the median margin is -2.3%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (56-224), prioritizing same-state peers. 33 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| SOUTH BALDWIN REGIONAL MEDICAL (Target) | AL | 112 | $168.2M | 46.4% |
| NORTH ALABAMA MEDICAL CENTER | AL | 223 | $259.5M | 0.5% |
| CRESTWOOD MEDICAL CENTER | AL | 164 | $258.9M | 14.6% |
| THOMAS HOSPITAL | AL | 164 | $244.7M | 6.2% |
| FLOWERS HOSPITAL | AL | 193 | $235.5M | 14.2% |
| SPRINGHILL MEMORIAL HOSPITAL | AL | 179 | $216.2M | -3.8% |
| MARSHALL MEDICAL CENTERS SOUTH | AL | 178 | $186.9M | -6.3% |
| GADSDEN REGIONAL MEDICAL CENTE | AL | 219 | $174.6M | 2.3% |
| BAPTIST MEDICAL CENTER EAST | AL | 208 | $169.5M | -9.9% |
4. Predicted Improvement Opportunities
Improvement targets set at P75 of comparable peers with 60% gap closure assumption. Coefficients calibrated to published research bands. Total EBITDA uplift: $12.4M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $3.5M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $3.4M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $3.3M | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $2.0M | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $108K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $78.1M |
| + RCM Uplift | +$12.4M |
| Pro Forma EBITDA | $90.4M |
| Current Margin | 46.4% |
| Pro Forma Margin | 53.8% |
| WC Released (1x) | $6.4M |
6. Returns Analysis — Scenario Matrix
5-year hold, 5.5x leverage, 3% organic growth, 10%/yr debt paydown. Base case uses 100% of predicted RCM uplift. Bull case: 130% uplift at lower entry. Bear case: 50% uplift at higher entry.
| Scenario | Entry | Exit | Equity In | Equity Out | MOIC | IRR |
|---|---|---|---|---|---|---|
| Base Case | 10.0x | 10.0x | $120.1M | $638.7M | 5.32x | 39.7% |
| Base (11x exit) | 10.0x | 11.0x | $120.1M | $741.6M | 6.17x | 43.9% |
| Bull Case | 9.0x | 11.0x | $108.1M | $821.4M | 7.60x | 50.0% |
| Bull (12x exit) | 9.0x | 12.0x | $108.1M | $928.0M | 8.59x | 53.7% |
| Bear Case | 11.0x | 10.0x | $132.1M | $537.8M | 4.07x | 32.4% |
| Bear (11x exit) | 11.0x | 11.0x | $132.1M | $634.5M | 4.80x | 36.9% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Low | Low net-to-gross ratio | Large contractual allowances suggest pricing discipline issues. Mitigant: payer renegotiation is an additional upside lever |
8. Data Sources & Methodology Appendix
Data Sources
- CMS HCRIS Cost Reports (Medicare-certified hospitals)
- CMS Medicare Utilization (DRG-level volumes)
- CMS Chronic Conditions (county-level disease prevalence)
- HCRIS multi-year trend data (financial time series)
Comparable Selection
- 33 hospitals with 56-224 beds
- Same-state prioritization (n=34)
- Comp margins: P25=-11.9% / P50=-2.3% / P75=9.5%
Bridge Methodology
- Targets: P75 of comparable peers (60% gap closure)
- Denial: avoidable share = 35% of delta × NPR
- AR: bad debt coefficient = $0.65 per day per $1K NPR
- NCR: 60% coefficient on collection rate improvement
- CDI: 0.75% of Medicare revenue per 0.01 CMI point
Returns Assumptions
- Leverage: 5.5x entry (84.6% debt / 15.4% equity)
- Organic growth: 3% annual EBITDA growth
- Debt paydown: 10% of principal per year
- Hold period: 5 years
Generated by SeekingChartis on April 26, 2026. All predictions use public data only. Confidence intervals calibrated via split conformal prediction (90% coverage target). This memo is for informational purposes and does not constitute investment advice.