SENTINEL EMERGENCY PHYSICIANS
Regional operations · Night coverage plan
| Rural sites in the region | 14 |
| Overnight shifts a year | 5,110 |
| Hospital agreements specify a physician on site at all hours. Each of the 14 hospitals must sign an amendment, and its medical staff must privilege the APPs for nights without a physician, including inpatient emergencies. | |
| Leverage at the 30 September test, debt to EBITDA | 5.8× |
| Maximum leverage 6.0×, stepping down to 5.5× at the 31 December test. Run-rate savings, net of the stipend repricing and APP billing, count at the test, up to 25% of EBITDA. | |
| Getting under 5.5× takes $1,363,636 of added EBITDA. A test above 5.5× is an event of default unless the lenders waive it or the fund cures with equity. | |
|
Share covered by APP alone
| |
| Physician hours cut, annual | |
| Wage saving, physician $225 an hour, APP $101.43 with benefits | |
| Physician call pay, $500 a night | |
| Night visits billed by APPs at 85%, Kentucky Medicaid 75% | |
| Hospital stipend recaptured at amendment, 50% of the net wage saving | |
| Net saving, annual | |
| Regional EBITDA margin, 14 sites | |
| Leverage at the 31 December test, debt to EBITDA, maximum 5.5× | |
| Leverage assumes all 14 amendments are signed and the savings certified before the 31 December test. With none signed it stays at 5.80×. | |
What the analyst was told
What the analyst was told
What the patient was told
You got sick.