SCHWAB REHAB HOSP & CARE NETWORK
1. Target Overview & Investment Thesis
SCHWAB REHAB HOSP & CARE NETWORK is a 52-bed suburban community hospital in COOK, IL with $46.2M in net patient revenue and a -1.5% operating margin. The hospital serves a payer mix of 11.7% Medicare, 10.6% Medicaid, and 77.7% commercial.
Thesis: Turnaround. Our ML models identify $3.4M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from -1.5% to 5.8% (+736bps).
| Net Revenue HCRIS | $46.2M |
| Current EBITDA COMPUTED | $-713K |
| Operating Margin COMPUTED | -1.5% |
| Occupancy HCRIS | 86.9% |
| Revenue / Bed COMPUTED | $888K |
| Net-to-Gross HCRIS | 45.2% |
| Distress Probability ML | 42.5% |
2. Market Context & Competitive Position
IL has 208 Medicare-certified hospitals with a median operating margin of -5.3%. The target's margin of -1.5% places it above the state median. Among 44 size-comparable peers (26-104 beds), the median margin is -6.8%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (26-104), prioritizing same-state peers. 44 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| SCHWAB REHAB HOSP & CARE NETWO (Target) | IL | 52 | $46.2M | -1.5% |
| MIDWESTERN REGIONAL MEDICAL CE | IL | 73 | $1.38B | 80.5% |
| SARAH BUSH LINCOLN HEALTH CENT | IL | 100 | $448.6M | -18.1% |
| KISHWAUKEE COMMUNITY HOSPITAL | IL | 98 | $355.3M | 25.5% |
| CGH MEDICAL CENTER | IL | 95 | $247.1M | -7.6% |
| MORRIS HOSPITAL | IL | 89 | $210.8M | 1.7% |
| HERRIN HOSPITAL | IL | 85 | $198.4M | 20.2% |
| FHN MEMORIAL HOSPITAL | IL | 100 | $149.3M | 3.6% |
| OTTAWA REGIONAL HOSPITAL & HEA | IL | 97 | $147.1M | 18.2% |
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: $3.4M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $969K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $923K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $914K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $562K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $30K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $-713K |
| + RCM Uplift | +$3.4M |
| Pro Forma EBITDA | $2.7M |
| Current Margin | -1.5% |
| Pro Forma Margin | 5.8% |
| WC Released (1x) | $1.8M |
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 | $-1.1M | $29.3M | 0.00x | -100.0% |
| Base (11x exit) | 10.0x | 11.0x | $-1.1M | $31.8M | 0.00x | -100.0% |
| Bull Case | 9.0x | 11.0x | $-988K | $42.7M | 0.00x | -100.0% |
| Bull (12x exit) | 9.0x | 12.0x | $-988K | $46.3M | 0.00x | -100.0% |
| Bear Case | 11.0x | 10.0x | $-1.2M | $12.6M | 0.00x | -100.0% |
| Bear (11x exit) | 11.0x | 11.0x | $-1.2M | $13.5M | 0.00x | -100.0% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| High | Negative operating margin | RCM uplift bridge shows clear path to profitability; working capital release provides near-term cash cushion |
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
- 44 hospitals with 26-104 beds
- Same-state prioritization (n=45)
- Comp margins: P25=-17.7% / P50=-6.8% / P75=14.2%
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.