PRHC is also leveraged, as demonstrated by debt to operating EBITDA of 5.
Located in Pella, IA in Marion County, approximately 50 miles southeast of Des Moines, PRHC is a critical access hospital with 25 acute care/swing beds.
PRHC started providing dialysis seven days a week in September 2004.
By providing dialysis seven days per week, PRHC is able to provide quality care in a cost-effective manner.
Fitch expects that PRHC will return to top-line revenue growth, which coupled with continued expense controls should generate strong operating cash flow and strengthened liquidity.
It is essential that PRHC maintain its CAH designation for operating profitability to continue at its current pace.
Despite a decrease in overall profitability in 2010, driven primarily by a decline in utilization, PRHC has rebounded somewhat in the three-month interim period.
Finally, PRHC maintained its leading market position in Marion County, which weathered the recession well with no significant company closings or layoffs.
In addition, PRHC benefits from a strong relationship with the two largest employers in the service area.
As PRHC has completed its major capital projects, top line revenue growth and continued expense controls should continue to generate strong operating cash flow which should bolster the balance sheet.
PRHC covenants to provide annual and quarterly disclosure to the Municipal Securities Rulemaking Boards EMMA system, consisting of a management discussion and analysis, balance sheet, income statement, statement of cash flows, and utilization statistics.
Thus far through March 2009 (unaudited), PRHC
is ahead of its budget and made approximately $357,000 from operations in the quarter (2.