SPECIALISTS HOSPITAL OF SHREVEPORT
1. Target Overview & Investment Thesis
SPECIALISTS HOSPITAL OF SHREVEPORT is a 15-bed community hospital in CADDO PARISH, LA with $79.1M in net patient revenue and a 21.3% operating margin. The hospital serves a payer mix of 44.3% Medicare, 0.0% Medicaid, and 55.7% commercial.
Thesis: Turnaround. Our ML models identify $5.8M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 21.3% to 28.7% (+736bps).
| Net Revenue HCRIS | $79.1M |
| Current EBITDA COMPUTED | $16.9M |
| Operating Margin COMPUTED | 21.3% |
| Occupancy HCRIS | 37.2% |
| Revenue / Bed COMPUTED | $5.3M |
| Net-to-Gross HCRIS | 26.7% |
| Distress Probability ML | nan% |
2. Market Context & Competitive Position
LA has 212 Medicare-certified hospitals with a median operating margin of -3.5%. The target's margin of 21.3% places it above the state median. Among 88 size-comparable peers (8-30 beds), the median margin is -1.7%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (8-30), prioritizing same-state peers. 88 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| SPECIALISTS HOSPITAL OF SHREVE (Target) | LA | 15 | $79.1M | 21.3% |
| OCHSNER BAYOU LLC | LA | 25 | $76.5M | -0.9% |
| CENTRAL LOUISIANA SURGICAL HOS | LA | 24 | $69.1M | 7.7% |
| ST. CHARLES PARISH HOSPITAL | LA | 27 | $64.0M | -5.1% |
| AVALA | LA | 21 | $64.0M | 7.4% |
| THE SPINE HOSPITAL OF LOUISIAN | LA | 23 | $57.4M | 35.4% |
| PARK PLACE SURGERY CENTER | LA | 10 | $51.6M | 15.4% |
| SURGICAL SPECIALTY CENTER BATO | LA | 16 | $49.8M | 16.9% |
| LAFAYETTE SURGICAL SPECIALTY H | LA | 20 | $48.9M | 9.1% |
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: $5.8M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $1.7M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $1.6M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $1.6M | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $962K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $51K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $16.9M |
| + RCM Uplift | +$5.8M |
| Pro Forma EBITDA | $22.7M |
| Current Margin | 21.3% |
| Pro Forma Margin | 28.7% |
| WC Released (1x) | $3.0M |
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 | $26.0M | $169.6M | 6.53x | 45.5% |
| Base (11x exit) | 10.0x | 11.0x | $26.0M | $195.0M | 7.51x | 49.6% |
| Bull Case | 9.0x | 11.0x | $23.4M | $222.6M | 9.52x | 57.0% |
| Bull (12x exit) | 9.0x | 12.0x | $23.4M | $249.8M | 10.68x | 60.6% |
| Bear Case | 11.0x | 10.0x | $28.6M | $132.0M | 4.62x | 35.8% |
| Bear (11x exit) | 11.0x | 11.0x | $28.6M | $154.5M | 5.41x | 40.2% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Standard execution risk | RCM improvement requires management buy-in and 12-18 month implementation timeline |
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
- 88 hospitals with 8-30 beds
- Same-state prioritization (n=90)
- Comp margins: P25=-14.3% / P50=-1.7% / P75=7.6%
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.