ENCOMPASS HEALTH REHABILITATION HOSP
1. Target Overview & Investment Thesis
ENCOMPASS HEALTH REHABILITATION HOSP is a 65-bed suburban community hospital in SEBASTIAN, AR with $28.6M in net patient revenue and a 14.6% operating margin. The hospital serves a payer mix of 67.3% Medicare, 6.1% Medicaid, and 26.6% commercial.
Thesis: Turnaround. Our ML models identify $2.1M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 14.6% to 22.0% (+736bps).
| Net Revenue HCRIS | $28.6M |
| Current EBITDA COMPUTED | $4.2M |
| Operating Margin COMPUTED | 14.6% |
| Occupancy HCRIS | 80.6% |
| Revenue / Bed COMPUTED | $441K |
| Net-to-Gross HCRIS | 66.2% |
| Distress Probability ML | 48.3% |
2. Market Context & Competitive Position
AR has 108 Medicare-certified hospitals with a median operating margin of -7.6%. The target's margin of 14.6% places it above the state median. Among 39 size-comparable peers (32-130 beds), the median margin is -4.7%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (32-130), prioritizing same-state peers. 39 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| ENCOMPASS HEALTH REHABILITATIO (Target) | AR | 65 | $28.6M | 14.6% |
| ARKANSAS HEART HOSPITAL | AR | 112 | $205.9M | 1.2% |
| NATIONAL PARK MEDICAL CENTER | AR | 126 | $118.8M | 2.6% |
| BHMC-CONWAY | AR | 108 | $94.7M | -15.6% |
| SALINE MEMORIAL HOSPITAL | AR | 130 | $91.4M | -8.0% |
| NORTH ARKANSAS REGIONAL MEDICA | AR | 120 | $89.1M | -13.9% |
| SILOAM SPRINGS MEMORIAL HOSPIT | AR | 64 | $85.0M | 8.4% |
| ARKANSAS SURGICAL HOSPITAL | AR | 47 | $75.1M | 11.7% |
| ST VINCENT NORTH | AR | 68 | $72.1M | -18.7% |
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: $2.1M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $602K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $573K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $567K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $349K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $18K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $4.2M |
| + RCM Uplift | +$2.1M |
| Pro Forma EBITDA | $6.3M |
| Current Margin | 14.6% |
| Pro Forma Margin | 22.0% |
| WC Released (1x) | $1.1M |
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 | $6.5M | $48.8M | 7.55x | 49.8% |
| Base (11x exit) | 10.0x | 11.0x | $6.5M | $55.7M | 8.63x | 53.9% |
| Bull Case | 9.0x | 11.0x | $5.8M | $64.8M | 11.15x | 62.0% |
| Bull (12x exit) | 9.0x | 12.0x | $5.8M | $72.4M | 12.46x | 65.6% |
| Bear Case | 11.0x | 10.0x | $7.1M | $36.1M | 5.09x | 38.5% |
| Bear (11x exit) | 11.0x | 11.0x | $7.1M | $42.0M | 5.92x | 42.7% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Heavy Medicare dependence | Medicare comprises 67.3% of days; rate updates may lag inflation. Mitigant: CDI/CMI lever directly increases Medicare reimbursement |
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
- 39 hospitals with 32-130 beds
- Same-state prioritization (n=40)
- Comp margins: P25=-17.5% / P50=-4.7% / P75=7.8%
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.