ROCHELLE COMMUNITY HOSPITAL
1. Target Overview & Investment Thesis
ROCHELLE COMMUNITY HOSPITAL is a 17-bed rural/critical access in OGLE, IL with $50.4M in net patient revenue and a 4.2% operating margin. The hospital serves a payer mix of 54.5% Medicare, 0.5% Medicaid, and 45.0% commercial.
Thesis: Turnaround. Our ML models identify $3.7M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 4.2% to 11.5% (+736bps).
| Net Revenue HCRIS | $50.4M |
| Current EBITDA COMPUTED | $2.1M |
| Operating Margin COMPUTED | 4.2% |
| Occupancy HCRIS | 18.9% |
| Revenue / Bed COMPUTED | $3.0M |
| Net-to-Gross HCRIS | 48.9% |
| Distress Probability ML | 54.8% |
2. Market Context & Competitive Position
IL has 208 Medicare-certified hospitals with a median operating margin of -5.3%. The target's margin of 4.2% places it above the state median. Among 59 size-comparable peers (8-34 beds), the median margin is -0.9%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (8-34), prioritizing same-state peers. 59 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| ROCHELLE COMMUNITY HOSPITAL (Target) | IL | 17 | $50.4M | 4.2% |
| GIBSON AREA HOSPITAL AND HEALT | IL | 25 | $125.0M | -6.7% |
| PARIS COMMUNITY HOSPITAL | IL | 25 | $100.7M | -4.2% |
| SAINT JOSEPH MEMORIAL HOSPITAL | IL | 25 | $86.0M | 33.9% |
| WABASH GENERAL HOSPITAL | IL | 25 | $71.8M | 4.5% |
| HOOPESTON COMMUNITY MEMORIAL H | IL | 22 | $71.5M | -5.2% |
| CRAWFORD MEMORIAL HOSPITAL | IL | 25 | $67.7M | 2.9% |
| ST. FRANCIS HOSPITAL | IL | 25 | $61.6M | 17.4% |
| LINCOLN MEMORIAL HOSPITAL | IL | 25 | $61.5M | 14.8% |
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: $3.7M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $1.1M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $1.0M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $998K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $613K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $32K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $2.1M |
| + RCM Uplift | +$3.7M |
| Pro Forma EBITDA | $5.8M |
| Current Margin | 4.2% |
| Pro Forma Margin | 11.5% |
| WC Released (1x) | $1.9M |
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 | $3.2M | $51.0M | 15.72x | 73.5% |
| Base (11x exit) | 10.0x | 11.0x | $3.2M | $57.2M | 17.62x | 77.5% |
| Bull Case | 9.0x | 11.0x | $2.9M | $70.5M | 24.13x | 89.0% |
| Bull (12x exit) | 9.0x | 12.0x | $2.9M | $77.7M | 26.62x | 92.8% |
| Bear Case | 11.0x | 10.0x | $3.6M | $31.4M | 8.80x | 54.5% |
| Bear (11x exit) | 11.0x | 11.0x | $3.6M | $35.7M | 10.00x | 58.5% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Low occupancy | At 18.9%, 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 54.8% 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
- 59 hospitals with 8-34 beds
- Same-state prioritization (n=60)
- Comp margins: P25=-6.1% / P50=-0.9% / P75=7.8%
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 27, 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.