ENCOMPASS HEALTH REHABILITATION HOSP
1. Target Overview & Investment Thesis
ENCOMPASS HEALTH REHABILITATION HOSP is a 50-bed community hospital in HILLSBOROUGH, FL with $25.1M in net patient revenue and a 5.2% operating margin. The hospital serves a payer mix of 69.2% Medicare, 0.0% Medicaid, and 30.8% commercial.
Thesis: Turnaround. Our ML models identify $1.8M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 5.2% to 12.5% (+736bps).
| Net Revenue HCRIS | $25.1M |
| Current EBITDA COMPUTED | $1.3M |
| Operating Margin COMPUTED | 5.2% |
| Occupancy HCRIS | 89.1% |
| Revenue / Bed COMPUTED | $502K |
| Net-to-Gross HCRIS | 60.2% |
| Distress Probability ML | nan% |
2. Market Context & Competitive Position
FL has 261 Medicare-certified hospitals with a median operating margin of 3.2%. The target's margin of 5.2% places it above the state median. Among 95 size-comparable peers (25-100 beds), the median margin is 3.9%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (25-100), prioritizing same-state peers. 95 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| ENCOMPASS HEALTH REHABILITATIO (Target) | FL | 50 | $25.1M | 5.2% |
| ADVENTHEALTH PALM COAST | FL | 99 | $285.7M | 8.1% |
| ASCENSION SACRED HEART EMERALD | FL | 80 | $187.9M | 16.1% |
| VIERA HOSPITAL INC | FL | 84 | $162.9M | 16.9% |
| GULF BREEZE HOSPITAL | FL | 65 | $121.8M | 12.8% |
| MELBOURNE REGIONAL MEDICAL CEN | FL | 96 | $120.2M | 7.3% |
| LOWER KEYS MEDICAL CENTER | FL | 99 | $119.5M | 27.1% |
| OVIEDO MEDICAL CENTER | FL | 64 | $110.9M | 7.4% |
| HCA FLORIDA POINCIANA HOSPITAL | FL | 94 | $108.5M | 18.9% |
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: $1.8M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $527K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $502K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $497K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $306K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $16K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $1.3M |
| + RCM Uplift | +$1.8M |
| Pro Forma EBITDA | $3.2M |
| Current Margin | 5.2% |
| Pro Forma Margin | 12.5% |
| WC Released (1x) | $963K |
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 | $2.0M | $27.1M | 13.52x | 68.3% |
| Base (11x exit) | 10.0x | 11.0x | $2.0M | $30.4M | 15.20x | 72.3% |
| Bull Case | 9.0x | 11.0x | $1.8M | $37.2M | 20.64x | 83.2% |
| Bull (12x exit) | 9.0x | 12.0x | $1.8M | $41.1M | 22.81x | 86.9% |
| Bear Case | 11.0x | 10.0x | $2.2M | $17.2M | 7.80x | 50.8% |
| Bear (11x exit) | 11.0x | 11.0x | $2.2M | $19.6M | 8.91x | 54.9% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Heavy Medicare dependence | Medicare comprises 69.2% 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
- 95 hospitals with 25-100 beds
- Same-state prioritization (n=96)
- Comp margins: P25=-15.2% / P50=3.9% / 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.