HCA FLORIDA PUTNAM HOSPITAL
1. Target Overview & Investment Thesis
HCA FLORIDA PUTNAM HOSPITAL is a 82-bed suburban community hospital in PUTNAM, FL with $82.7M in net patient revenue and a 11.5% operating margin. The hospital serves a payer mix of 33.8% Medicare, 2.0% Medicaid, and 64.2% commercial.
Thesis: Turnaround. Our ML models identify $6.1M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 11.5% to 18.8% (+736bps).
| Net Revenue HCRIS | $82.7M |
| Current EBITDA COMPUTED | $9.5M |
| Operating Margin COMPUTED | 11.5% |
| Occupancy HCRIS | 64.3% |
| Revenue / Bed COMPUTED | $1.0M |
| Net-to-Gross HCRIS | 10.2% |
| Distress Probability ML | 42.6% |
2. Market Context & Competitive Position
FL has 261 Medicare-certified hospitals with a median operating margin of 3.2%. The target's margin of 11.5% places it above the state median. Among 116 size-comparable peers (41-164 beds), the median margin is 2.6%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (41-164), prioritizing same-state peers. 116 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| HCA FLORIDA PUTNAM HOSPITAL (Target) | FL | 82 | $82.7M | 11.5% |
| WEST KENDALL BAPTIST HOSPITAL | FL | 127 | $361.6M | 18.5% |
| ADVENTHEALTH PALM COAST | FL | 99 | $285.7M | 8.1% |
| HOMESTEAD HOSPITAL | FL | 159 | $270.4M | -11.1% |
| NEMOURS CHILDRENS HOSPITAL | FL | 130 | $268.7M | -10.2% |
| DOCTORS HOSPITAL | FL | 130 | $250.0M | 0.9% |
| ADVENTHEALTH ZEPHYRHILLS | FL | 149 | $207.1M | -0.8% |
| ADVENTHEALTH DELAND | FL | 142 | $197.1M | 2.8% |
| ASCENSION SACRED HEART BAY | FL | 126 | $192.1M | -6.7% |
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: $6.1M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $1.7M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $1.7M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $1.6M | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $1.0M | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $53K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $9.5M |
| + RCM Uplift | +$6.1M |
| Pro Forma EBITDA | $15.6M |
| Current Margin | 11.5% |
| Pro Forma Margin | 18.8% |
| WC Released (1x) | $3.2M |
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 | $14.6M | $123.4M | 8.46x | 53.3% |
| Base (11x exit) | 10.0x | 11.0x | $14.6M | $140.5M | 9.63x | 57.3% |
| Bull Case | 9.0x | 11.0x | $13.1M | $165.3M | 12.60x | 66.0% |
| Bull (12x exit) | 9.0x | 12.0x | $13.1M | $184.2M | 14.04x | 69.6% |
| Bear Case | 11.0x | 10.0x | $16.0M | $88.2M | 5.50x | 40.6% |
| Bear (11x exit) | 11.0x | 11.0x | $16.0M | $102.2M | 6.37x | 44.8% |
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
- 116 hospitals with 41-164 beds
- Same-state prioritization (n=117)
- Comp margins: P25=-10.2% / P50=2.6% / P75=11.8%
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.