ENCOMPASS HEALTH REHABILITATION HOSP
1. Target Overview & Investment Thesis
ENCOMPASS HEALTH REHABILITATION HOSP is a 60-bed rural/critical access in MONMOUTH, NJ with $28.9M in net patient revenue and a 18.0% operating margin. The hospital serves a payer mix of 74.7% Medicare, 1.9% Medicaid, and 23.4% commercial.
Thesis: Turnaround. Our ML models identify $2.1M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 18.0% to 25.3% (+736bps).
| Net Revenue HCRIS | $28.9M |
| Current EBITDA COMPUTED | $5.2M |
| Operating Margin COMPUTED | 18.0% |
| Occupancy HCRIS | 72.4% |
| Revenue / Bed COMPUTED | $481K |
| Net-to-Gross HCRIS | 72.9% |
| Distress Probability ML | 50.1% |
2. Market Context & Competitive Position
NJ has 95 Medicare-certified hospitals with a median operating margin of -3.9%. The target's margin of 18.0% places it above the state median. Among 30 size-comparable peers (30-120 beds), the median margin is -4.6%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (30-120), prioritizing same-state peers. 30 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| ENCOMPASS HEALTH REHABILITATIO (Target) | NJ | 60 | $28.9M | 18.0% |
| DEBORAH HEART AND LUNG CENTER | NJ | 85 | $211.9M | -5.5% |
| ST LUKES WARREN HOSPITAL | NJ | 92 | $200.8M | 28.1% |
| BERGEN NEW BRIDGE MEDICAL CENT | NJ | 101 | $187.0M | -39.4% |
| HUDSON REGIONAL HOSPITAL | NJ | 102 | $152.7M | 2.4% |
| CHILDRENS SPECIALIZED HOPSITAL | NJ | 68 | $150.1M | -18.1% |
| HACKENSACK UMC AT PASCACK VALL | NJ | 78 | $148.8M | 15.0% |
| HOBOKEN UNIVERSITY MEDICAL CEN | NJ | 114 | $133.9M | -48.9% |
| HACKETTSTOWN MEDICAL CENTER | NJ | 95 | $119.6M | 2.8% |
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: $2.1M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $606K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $577K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $571K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $351K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $18K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $5.2M |
| + RCM Uplift | +$2.1M |
| Pro Forma EBITDA | $7.3M |
| Current Margin | 18.0% |
| Pro Forma Margin | 25.3% |
| WC Released (1x) | $1.1M |
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 | $8.0M | $55.5M | 6.95x | 47.4% |
| Base (11x exit) | 10.0x | 11.0x | $8.0M | $63.6M | 7.97x | 51.4% |
| Bull Case | 9.0x | 11.0x | $7.2M | $73.2M | 10.19x | 59.1% |
| Bull (12x exit) | 9.0x | 12.0x | $7.2M | $82.0M | 11.41x | 62.7% |
| Bear Case | 11.0x | 10.0x | $8.8M | $42.3M | 4.81x | 36.9% |
| Bear (11x exit) | 11.0x | 11.0x | $8.8M | $49.3M | 5.62x | 41.2% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Heavy Medicare dependence | Medicare comprises 74.7% of days; rate updates may lag inflation. Mitigant: CDI/CMI lever directly increases Medicare reimbursement |
| High | Elevated distress probability | Model estimates 50.1% 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
- 30 hospitals with 30-120 beds
- Same-state prioritization (n=31)
- Comp margins: P25=-26.7% / P50=-4.6% / 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 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.