PEKIN MEMORIAL HOSPITAL
1. Target Overview & Investment Thesis
PEKIN MEMORIAL HOSPITAL is a 39-bed suburban community hospital in TAZEWELL, IL with $55.5M in net patient revenue and a 25.8% operating margin. The hospital serves a payer mix of 41.4% Medicare, 12.0% Medicaid, and 46.6% commercial.
Thesis: Turnaround. Our ML models identify $4.1M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 25.8% to 33.2% (+736bps).
| Net Revenue HCRIS | $55.5M |
| Current EBITDA COMPUTED | $14.3M |
| Operating Margin COMPUTED | 25.8% |
| Occupancy HCRIS | 51.4% |
| Revenue / Bed COMPUTED | $1.4M |
| Net-to-Gross HCRIS | 17.2% |
| Distress Probability ML | 48.4% |
2. Market Context & Competitive Position
IL has 208 Medicare-certified hospitals with a median operating margin of -5.3%. The target's margin of 25.8% places it above the state median. Among 75 size-comparable peers (20-78 beds), the median margin is -3.4%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (20-78), prioritizing same-state peers. 75 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| PEKIN MEMORIAL HOSPITAL (Target) | IL | 39 | $55.5M | 25.8% |
| MIDWESTERN REGIONAL MEDICAL CE | IL | 73 | $1.38B | 80.5% |
| KATHERINE SHAW BETHEA HOSPITAL | IL | 66 | $136.9M | -12.8% |
| PROCTOR HOSPITAL | IL | 72 | $133.9M | 34.9% |
| GIBSON AREA HOSPITAL AND HEALT | IL | 25 | $125.0M | -6.7% |
| GRAHAM HOSPITAL ASSOCIATION | IL | 43 | $105.0M | -4.7% |
| PARIS COMMUNITY HOSPITAL | IL | 25 | $100.7M | -4.2% |
| OSF SAINT ANTHONYS HEALTH CENT | IL | 49 | $91.4M | -9.8% |
| ST. MARGARETS HEALTH - SPRING | IL | 44 | $88.1M | -12.7% |
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: $4.1M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $1.2M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $1.1M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $1.1M | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $675K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $35K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $14.3M |
| + RCM Uplift | +$4.1M |
| Pro Forma EBITDA | $18.4M |
| Current Margin | 25.8% |
| Pro Forma Margin | 33.2% |
| WC Released (1x) | $2.1M |
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 | $22.0M | $135.2M | 6.14x | 43.8% |
| Base (11x exit) | 10.0x | 11.0x | $22.0M | $155.9M | 7.08x | 47.9% |
| Bull Case | 9.0x | 11.0x | $19.8M | $176.5M | 8.91x | 54.9% |
| Bull (12x exit) | 9.0x | 12.0x | $19.8M | $198.4M | 10.01x | 58.5% |
| Bear Case | 11.0x | 10.0x | $24.2M | $107.7M | 4.45x | 34.8% |
| Bear (11x exit) | 11.0x | 11.0x | $24.2M | $126.3M | 5.21x | 39.1% |
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
- 75 hospitals with 20-78 beds
- Same-state prioritization (n=76)
- Comp margins: P25=-9.3% / P50=-3.4% / 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.