OLYMPIC MEDICAL CENTER
1. Target Overview & Investment Thesis
OLYMPIC MEDICAL CENTER is a 78-bed suburban community hospital in CLALLAM, WA with $237.9M in net patient revenue and a -12.2% operating margin. The hospital serves a payer mix of 45.9% Medicare, 4.0% Medicaid, and 50.1% commercial.
Thesis: Turnaround. Our ML models identify $17.5M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from -12.2% to -4.8% (+736bps).
| Net Revenue HCRIS | $237.9M |
| Current EBITDA COMPUTED | $-29.0M |
| Operating Margin COMPUTED | -12.2% |
| Occupancy HCRIS | 46.0% |
| Revenue / Bed COMPUTED | $3.0M |
| Net-to-Gross HCRIS | 47.3% |
| Distress Probability ML | 49.0% |
2. Market Context & Competitive Position
WA has 104 Medicare-certified hospitals with a median operating margin of -10.3%. The target's margin of -12.2% places it below the state median. Among 28 size-comparable peers (39-156 beds), the median margin is -9.7%. The target's below-peer margin suggests operational improvement opportunity.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (39-156), prioritizing same-state peers. 28 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| OLYMPIC MEDICAL CENTER (Target) | WA | 78 | $237.9M | -12.2% |
| PHD#1 DBA SKAGIT VALLEY HOSPI | WA | 137 | $414.3M | -17.9% |
| ST. JOHN MEDICAL CENTER | WA | 122 | $335.0M | -4.4% |
| ST FRANCIS HOSPITAL | WA | 118 | $274.2M | -0.5% |
| PROVIDENCE CENTRALIA HOSPITAL | WA | 116 | $240.6M | -0.5% |
| MULTICARE AUBURN MEDICAL CENTE | WA | 84 | $214.7M | -21.1% |
| PROV ST MARY MEDICAL CENTER | WA | 95 | $211.5M | -11.7% |
| ST ANTHONY HOSPITAL | WA | 112 | $200.1M | -4.3% |
| HIGHLINE MEDICAL CENTER | WA | 132 | $168.8M | -28.6% |
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: $17.5M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $5.0M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $4.8M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $4.7M | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $2.9M | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $152K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $-29.0M |
| + RCM Uplift | +$17.5M |
| Pro Forma EBITDA | $-11.4M |
| Current Margin | -12.2% |
| Pro Forma Margin | -4.8% |
| WC Released (1x) | $9.1M |
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 | $-44.5M | $-15.9M | 0.00x | -100.0% |
| Base (11x exit) | 10.0x | 11.0x | $-44.5M | $-32.0M | 0.00x | -100.0% |
| Bull Case | 9.0x | 11.0x | $-40.1M | $11.3M | 0.00x | -100.0% |
| Bull (12x exit) | 9.0x | 12.0x | $-40.1M | $545K | 0.00x | -100.0% |
| Bear Case | 11.0x | 10.0x | $-49.0M | $-89.0M | 0.00x | -100.0% |
| Bear (11x exit) | 11.0x | 11.0x | $-49.0M | $-113.8M | 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
- 28 hospitals with 39-156 beds
- Same-state prioritization (n=29)
- Comp margins: P25=-19.0% / P50=-9.7% / P75=-2.0%
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.