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Investment Committee Memorandum | GA | 25 beds | Grade D | EBITDA uplift $1.5M
Investment Committee Memorandum

JEFF DAVIS

CCN 111333 | JEFF DAVIS, GA | 25 beds | April 26, 2026
EBITDA BridgeData Room
D
Investability

1. Target Overview & Investment Thesis

JEFF DAVIS is a 25-bed under-performing / distressed in JEFF DAVIS, GA with $20.7M in net patient revenue and a -6.3% operating margin. The hospital serves a payer mix of 33.4% Medicare, 19.7% Medicaid, and 46.9% commercial.

Thesis: Turnaround. Our ML models identify $1.5M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from -6.3% to 1.0% (+736bps).

Net Revenue HCRIS$20.7M
Current EBITDA COMPUTED$-1.3M
Operating Margin COMPUTED-6.3%
Occupancy HCRIS26.8%
Revenue / Bed COMPUTED$827K
Net-to-Gross HCRIS29.1%
Distress Probability ML57.8%

2. Market Context & Competitive Position

165
GA Hospitals
-2.8%
State Median Margin
62
Comparable Hospitals

GA has 165 Medicare-certified hospitals with a median operating margin of -2.8%. The target's margin of -6.3% places it below the state median. Among 62 size-comparable peers (12-50 beds), the median margin is -3.7%. The target's below-peer margin suggests operational improvement opportunity.

3. RCM Performance Analysis — Comparable Hospitals

Comps selected by bed count (12-50), prioritizing same-state peers. 62 hospitals in the comp set.

HospitalStateBedsRevenueMargin
JEFF DAVIS (Target)GA25$20.7M-6.3%
UNION GENERAL HOSPITALGA39$108.6M2.4%
TATTNALL HOSPITAL COMPANY LLCGA25$101.7M41.9%
MILLER COUNTY HOSPITALGA25$81.6M-1.1%
BURKE MEDICAL CENTERGA40$55.7M34.7%
SGHS - CAMDEN CAMPUSGA40$54.9M-10.3%
EFFINGHAM HOSPITALGA25$53.8M-39.8%
STEPHENS COUNTY HOSPITALGA40$49.4M6.0%
LIBERTY REGIONAL MEDICAL CENTEGA25$46.0M-14.4%

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: $1.5M (736bps margin improvement).

LeverCurrentTargetEBITDA ImpactMarginRamp
Net Collection Rate93.5%97.0%$434K+210bp18mo
Cost to Collect4.5%2.5%$413K+200bp12mo
Denial Rate Reduction12.0%6.5%$409K+198bp12mo
A/R Days Reduction5200.0%3800.0%$252K+122bp9mo
Clean Claim Rate88.0%96.0%$13K+6bp6mo

5. EBITDA Bridge

Net Collection Rate
$434K
Cost to Collect
$413K
Denial Rate Reduction
$409K
A/R Days Reduction
$252K
Clean Claim Rate
$13K
Total EBITDA Uplift$1.5M
Current EBITDA$-1.3M
+ RCM Uplift+$1.5M
Pro Forma EBITDA$216K
Current Margin-6.3%
Pro Forma Margin1.0%
WC Released (1x)$793K

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.

ScenarioEntryExitEquity InEquity OutMOICIRR
Base Case10.0x10.0x$-2.0M$6.6M0.00x-100.0%
Base (11x exit)10.0x11.0x$-2.0M$6.6M0.00x-100.0%
Bull Case9.0x11.0x$-1.8M$11.0M0.00x-100.0%
Bull (12x exit)9.0x12.0x$-1.8M$11.4M0.00x-100.0%
Bear Case11.0x10.0x$-2.2M$-350K0.00x-100.0%
Bear (11x exit)11.0x11.0x$-2.2M$-1.1M0.00x-100.0%

7. Key Risks & Mitigants

SeverityRisk FactorMitigant
HighNegative operating marginRCM uplift bridge shows clear path to profitability; working capital release provides near-term cash cushion
MediumLow occupancyAt 26.8%, fixed costs are spread over fewer patient days. Mitigant: volume growth is an additional upside lever not modeled in base case
HighElevated distress probabilityModel estimates 57.8% 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

  • 62 hospitals with 12-50 beds
  • Same-state prioritization (n=63)
  • Comp margins: P25=-20.1% / P50=-3.7% / P75=5.7%

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.

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