SPRING MOUNTAIN SAHARA
1. Target Overview & Investment Thesis
SPRING MOUNTAIN SAHARA is a 30-bed suburban community hospital in nan, NV with $5.4M in net patient revenue and a 14.3% operating margin. The hospital serves a payer mix of 10.9% Medicare, 0.9% Medicaid, and 88.2% commercial.
Thesis: Turnaround. Our ML models identify $409K in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 14.3% to 21.9% (+757bps).
| Net Revenue HCRIS | $5.4M |
| Current EBITDA COMPUTED | $774K |
| Operating Margin COMPUTED | 14.3% |
| Occupancy HCRIS | 54.5% |
| Revenue / Bed COMPUTED | $180K |
| Net-to-Gross HCRIS | 40.8% |
| Distress Probability ML | 48.0% |
2. Market Context & Competitive Position
NV has 58 Medicare-certified hospitals with a median operating margin of 0.4%. The target's margin of 14.3% places it above the state median. Among 16 size-comparable peers (15-60 beds), the median margin is 4.7%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (15-60), prioritizing same-state peers. 16 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| SPRING MOUNTAIN SAHARA (Target) | NV | 30 | $5.4M | 14.3% |
| CARSON VALLEY MEDICAL CENTER | NV | 23 | $84.3M | 6.8% |
| NORTHEASTERN NEVADA REGIONAL H | NV | 59 | $84.2M | 15.5% |
| BANNER CHURCHILL COMMUNITY HOS | NV | 25 | $69.2M | 6.8% |
| DIGINTY HEALTH ST ROSE DOMINIC | NV | 32 | $61.5M | 12.2% |
| HUMBOLDT GENERAL HOSPITAL | NV | 25 | $58.8M | -37.3% |
| DIGNITY HEALTH REHABILITATION | NV | 60 | $41.4M | 12.1% |
| PAM REHAB HOSP OF CENTENNIAL H | NV | 44 | $35.7M | 29.1% |
| WILLIAM BEE RIRIE HOSPITAL | NV | 25 | $35.1M | -17.9% |
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: $409K (757bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $113K | +210bp | 18mo |
| Denial Rate Reduction | 12.0% | 6.5% | $112K | +208bp | 12mo |
| Cost to Collect | 4.5% | 2.5% | $108K | +200bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $66K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $10K | +18bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $774K |
| + RCM Uplift | +$409K |
| Pro Forma EBITDA | $1.2M |
| Current Margin | 14.3% |
| Pro Forma Margin | 21.9% |
| WC Released (1x) | $207K |
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 | $1.2M | $9.2M | 7.72x | 50.5% |
| Base (11x exit) | 10.0x | 11.0x | $1.2M | $10.5M | 8.82x | 54.5% |
| Bull Case | 9.0x | 11.0x | $1.1M | $12.2M | 11.41x | 62.7% |
| Bull (12x exit) | 9.0x | 12.0x | $1.1M | $13.7M | 12.75x | 66.4% |
| Bear Case | 11.0x | 10.0x | $1.3M | $6.8M | 5.16x | 38.9% |
| Bear (11x exit) | 11.0x | 11.0x | $1.3M | $7.9M | 6.00x | 43.1% |
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
- 16 hospitals with 15-60 beds
- Same-state prioritization (n=17)
- Comp margins: P25=-14.0% / P50=4.7% / P75=11.8%
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 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.