BRIGHTWELL BEHAVIORAL HEALTH
1. Target Overview & Investment Thesis
BRIGHTWELL BEHAVIORAL HEALTH is a 23-bed community hospital in HENRY, MI with $6.5M in net patient revenue and a -9.1% operating margin. The hospital serves a payer mix of 47.4% Medicare, 0.0% Medicaid, and 52.6% commercial.
Thesis: Turnaround. Our ML models identify $486K in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from -9.1% to -1.6% (+752bps).
| Net Revenue HCRIS | $6.5M |
| Current EBITDA COMPUTED | $-587K |
| Operating Margin COMPUTED | -9.1% |
| Occupancy HCRIS | 72.5% |
| Revenue / Bed COMPUTED | $281K |
| Net-to-Gross HCRIS | 51.9% |
| Distress Probability ML | nan% |
2. Market Context & Competitive Position
MI has 163 Medicare-certified hospitals with a median operating margin of -5.2%. The target's margin of -9.1% places it below the state median. Among 63 size-comparable peers (12-46 beds), the median margin is 0.9%. The target's below-peer margin suggests operational improvement opportunity.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (12-46), prioritizing same-state peers. 63 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| BRIGHTWELL BEHAVIORAL HEALTH (Target) | MI | 23 | $6.5M | -9.1% |
| TRINITY HEALTH LIVINGSTON | MI | 42 | $200.4M | 15.2% |
| SPECTRUM HEALTH UNITED MEMORIA | MI | 45 | $129.4M | 9.7% |
| SPECTRUM HEALTH GERBER | MI | 25 | $116.2M | 16.0% |
| SPECTRUM HEALTH LUDINGTON | MI | 45 | $110.1M | 5.3% |
| OTSEGO MEMORIAL HOSPITAL | MI | 46 | $109.4M | -3.2% |
| ST. FRANCIS HOSPITAL | MI | 25 | $106.2M | 7.8% |
| SPECTRUM HEALTH PENNOCK HOSPIT | MI | 25 | $96.5M | 11.1% |
| MUNSON HEALTHCARE GRAYLING HOS | MI | 42 | $87.2M | -10.3% |
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: $486K (752bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $136K | +210bp | 18mo |
| Denial Rate Reduction | 12.0% | 6.5% | $133K | +205bp | 12mo |
| Cost to Collect | 4.5% | 2.5% | $129K | +200bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $79K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $10K | +15bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $-587K |
| + RCM Uplift | +$486K |
| Pro Forma EBITDA | $-101K |
| Current Margin | -9.1% |
| Pro Forma Margin | -1.6% |
| WC Released (1x) | $248K |
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 | $-903K | $993K | 0.00x | -100.0% |
| Base (11x exit) | 10.0x | 11.0x | $-903K | $799K | 0.00x | -100.0% |
| Bull Case | 9.0x | 11.0x | $-813K | $2.1M | 0.00x | -100.0% |
| Bull (12x exit) | 9.0x | 12.0x | $-813K | $2.1M | 0.00x | -100.0% |
| Bear Case | 11.0x | 10.0x | $-993K | $-1.1M | 0.00x | -100.0% |
| Bear (11x exit) | 11.0x | 11.0x | $-993K | $-1.6M | 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
- 63 hospitals with 12-46 beds
- Same-state prioritization (n=64)
- Comp margins: P25=-10.5% / P50=0.9% / P75=9.2%
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 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.