WRAY COMMUNITY DISTRICT HOSPITAL
1. Target Overview & Investment Thesis
WRAY COMMUNITY DISTRICT HOSPITAL is a 16-bed suburban community hospital in YUMA, CO with $34.0M in net patient revenue and a 4.0% operating margin. The hospital serves a payer mix of 44.5% Medicare, 25.4% Medicaid, and 30.1% commercial.
Thesis: Turnaround. Our ML models identify $2.5M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 4.0% to 11.4% (+736bps).
| Net Revenue HCRIS | $34.0M |
| Current EBITDA COMPUTED | $1.4M |
| Operating Margin COMPUTED | 4.0% |
| Occupancy HCRIS | 22.5% |
| Revenue / Bed COMPUTED | $2.1M |
| Net-to-Gross HCRIS | 61.2% |
| Distress Probability ML | 62.1% |
2. Market Context & Competitive Position
CO has 108 Medicare-certified hospitals with a median operating margin of -3.6%. The target's margin of 4.0% places it above the state median. Among 38 size-comparable peers (8-32 beds), the median margin is -5.5%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (8-32), prioritizing same-state peers. 38 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| WRAY COMMUNITY DISTRICT HOSPIT (Target) | CO | 16 | $34.0M | 4.0% |
| VALLEY VIEW HOSPITAL | CO | 31 | $285.3M | -3.1% |
| NATIONAL JEWISH HEALTH | CO | 13 | $150.4M | -50.0% |
| ASPEN VALLEY HOSPITAL DISTRICT | CO | 25 | $130.1M | 0.4% |
| HEART OF THE ROCKIES REG MED C | CO | 25 | $117.5M | 5.4% |
| GRAND RIVER HOSPITAL DISTRICT | CO | 25 | $85.2M | -30.8% |
| CENTURA ST. THOMAS MORE HOSPIT | CO | 25 | $83.7M | 18.4% |
| SOUTHWEST MEMORIAL HOSPITAL | CO | 23 | $74.6M | -4.5% |
| GUNNISON VALLEY HOSPITAL | CO | 20 | $63.3M | 2.8% |
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: $2.5M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $714K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $680K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $673K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $414K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $22K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $1.4M |
| + RCM Uplift | +$2.5M |
| Pro Forma EBITDA | $3.9M |
| Current Margin | 4.0% |
| Pro Forma Margin | 11.4% |
| WC Released (1x) | $1.3M |
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 | $2.1M | $34.0M | 16.26x | 74.7% |
| Base (11x exit) | 10.0x | 11.0x | $2.1M | $38.1M | 18.22x | 78.7% |
| Bull Case | 9.0x | 11.0x | $1.9M | $47.0M | 24.99x | 90.3% |
| Bull (12x exit) | 9.0x | 12.0x | $1.9M | $51.8M | 27.56x | 94.1% |
| Bear Case | 11.0x | 10.0x | $2.3M | $20.8M | 9.05x | 55.4% |
| Bear (11x exit) | 11.0x | 11.0x | $2.3M | $23.6M | 10.28x | 59.4% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Elevated Medicaid exposure (25.4%) | Medicaid reimburses below cost in most states. Mitigant: denial reduction lever has highest impact on Medicaid claims |
| Medium | Low occupancy | At 22.5%, fixed costs are spread over fewer patient days. Mitigant: volume growth is an additional upside lever not modeled in base case |
| High | Elevated distress probability | Model estimates 62.1% probability of financial distress. Mitigant: distressed entry pricing (7-9x) compensates for risk |
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
- 38 hospitals with 8-32 beds
- Same-state prioritization (n=41)
- Comp margins: P25=-21.2% / P50=-5.5% / P75=0.5%
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.