Quality of Earnings / Quality of Revenue
Normalize EBITDA and revenue by removing nonrecurring items, identifying payer-mix shifts, testing collection quality, and separating durable earnings from accounting noise.
The evidence system behind the file
Why a Branmoor diligence file holds up.
A Provider Diligence Sheet is only as strong as the evidence beneath it. This is that evidence: a 15-module financial spine where every claim resolves to a dated source, an entity key, a peer benchmark, and a confidence flag.
Provider Diligence Sheet is the paid artifact; the financial diligence spine is the evidence system underneath it.
Hospital Financial Pulse is one module, not the whole diligence answer.
The founder path should make Branmoor commercially useful as a CPA-adjacent, non-attest healthcare diligence platform: workpaper discipline, source-to-claim traceability, and buyer-ready evidence packs.
Every financial claim must resolve to a dated source, an entity key, a peer benchmark, and a confidence/completeness flag.
Request diligence access
Sample sheet (PDF) ›
Sample sheet data (CSV) ›
Cross-vertical dataset (CSV) ›
Full workbook — every product (XLSX) ›
The sample sheet presents the most notable, source-tagged findings on a fictional hospital; the companion CSV carries every underlying line item. The cross-vertical dataset and workbook go further — the same fictional entity (Nakatomi Plaza Medical Center) seen through all six record sets plus the context layer, with multi-year history and every Branmoor product reflected as sortable, analyzable rows. All illustrative and non-attest. It also reads against the context layer.
CPA-ready layer
Make the file useful to a professional reviewer
Workpaper Evidence Pack
Export a reviewer-readable package with lead schedules, tickmarks, source-to-claim IDs, uploaded support references, assumptions, preparer notes, and confidence flags.
Private Financial Data Ingestion
Accept engagement-bound uploads such as trial balance, general ledger, AR aging, payer revenue detail, claims/denials exports, payroll, debt schedules, and related-party schedules.
Healthcare Tax Diligence Review
Flag tax and exemption issues that change diligence: nonprofit posture, 990/Schedule H, UBIT, payroll classification, sales/use tax, transaction structure, and state nexus.
Provider Transaction Readiness Review
Seller-side readiness artifact for owners preparing a provider, clinic, ASC, post-acute facility, or RCM asset for buyer diligence.
Diligence questions
What the financial spine must answer
Is reported margin durable?
Cost-report trajectory, payer mix, service-line mix, labor pressure, supply/input cost, and payment-update exposure.
What can break the capital structure?
Debt load, bond covenants, lease obligations, days cash, refinancing calendar, material events, and rating actions.
How real is revenue?
Contracted rate position, denial/reversal behavior, receivable risk, prompt-pay exposure, bad debt, charity care, and payer concentration.
Who economically controls the entity?
Ownership, related-party leases and management fees, parent/subsidiary links, nonprofit board/officer relationships, and roll-up adjacency.
What is the forward pressure?
MA benchmark movement, Medicaid enrollment/spend, hospital market basket updates, wage inflation, capex backlog, and local macro context.
Can the file survive professional review?
A reviewer should be able to trace each assertion to a source record, uploaded support, tickmark, workpaper index, preparer note, and stated limitation.
What tax or deal-structure issues change the answer?
Entity type, nonprofit status, unrelated business income, sales/use tax exposure, payroll classification, transaction tax posture, and purchase-agreement adjustments.
Pending modules
Financial diligence products to build
Each module is represented in the product register as pending methodology.
| Module | Status | Primary source contract | Use inside diligence |
|---|---|---|---|
| Cost Report Forensics | Pending | CMS HCRIS hospital, SNF, home health, hospice, and renal cost reports | Five-year margin, cost-center, utilization, bed, payer-mix, wage-index, and ownership trajectory by provider entity. |
| Bond and Covenant Watch | Pending | MSRB EMMA, rating notices, audited financials, IRS 990, continuing disclosures | Liquidity, days cash, debt-service coverage, material events, covenant proximity, and refinancing calendar. |
| Payer Mix and Reimbursement Exposure | Pending | HCRIS, CMS enrollment/rate files, MA ratebooks, Medicaid reports, HPT/TiC rates | Revenue exposure by payer class, public-program dependency, MA/Medicaid sensitivity, and local rate leverage. |
| Revenue Cycle Leakage | Pending | Denial disclosures, payer manuals, state prompt-pay files, NSA IDR, TiC, complaint data | Denial, overturn, prompt-pay, AR, underpayment, and administrative friction risk for RCM underwriting. |
| Ownership and Related-Party Economics | Pending | PECOS, HCRIS ownership exhibits, IRS 990, EDGAR, state SoS, leases and audited statements | Control, management-fee, lease, transfer-pricing, roll-up, and related-party risk. |
| Labor and Input-Cost Pressure | Pending | BLS, QCEW, OEWS, JOLTS, CMS staffing, HCRIS wage/cost centers, OSHA | Nurse and clinical labor pressure, contract-labor dependency, staffing risk, and margin sensitivity. |
| Service-Line Economics | Pending | CMS utilization, HPT/TiC rates, cost reports, quality/outcome feeds, local demographics | Procedure-line pricing, volume, payer mix, quality penalty, and strategic attractiveness by service line. |
| Capex and Facility Investment | Pending | Cost reports, audited financials, CON filings, building permits, parcel records, equipment/device signals | Deferred maintenance, facility age, capex backlog, expansion plans, and asset-quality risk. |
| Healthcare Transaction Comps | Pending | SEC filings, HSR where disclosed, press releases, bankruptcy docs, nonprofit conversion filings | Comparable transaction context, valuation multiple references, roll-up maps, and buyer/seller pattern recognition. |
| Nonprofit Financial and Community-Benefit Review | Pending | IRS 990, Schedule H, audited statements, community-benefit reports, executive compensation records | Community-benefit posture, charity care, executive compensation, related-party grants, and exemption-risk context. |
Private support
Engagement-bound data that completes the diligence file
Private records stay out of public previews and attach only to scoped client work.
| Private support | Use inside diligence |
|---|---|
| Trial balance and general ledger | Tie public-source findings to internal account structure, recurring adjustments, and unusual account movement. |
| AR aging and payer revenue detail | Test collection quality, payer concentration, contractual allowance pressure, denial leakage, and reserve reasonableness. |
| Claims, denials, and remittance exports | Connect revenue-cycle leakage to payer, code, denial reason, appeal outcome, and underpayment evidence. |
| Payroll and staffing files | Separate base labor, premium labor, contract labor, turnover pressure, and provider compensation economics. |
| Debt, lease, capex, and related-party schedules | Reconcile obligations, refinancing exposure, facility investment needs, and economic control relationships. |
| Tax returns, 990s, notices, and nexus support | Support tax posture, exemption risk, state exposure, transaction adjustments, and diligence limitation notes. |
Founder-applicable offers
Commercial shapes this can support
Healthcare Financial Diligence Memo
Buyer: Lower-middle-market buyers, lenders, independent sponsors, and operator-founders.
Deliverable: PDF memo, structured exhibit pack, source appendix, and workpaper index for one named entity or deal target.
Healthcare QoE / QoR Pack
Buyer: Buy-side and lender teams that need revenue durability and earnings normalization before deeper diligence spend.
Deliverable: Adjusted earnings bridge, revenue-quality analysis, AR/denial findings, source support, and flagged follow-up requests.
Provider Transaction Readiness Review
Buyer: Owners preparing a practice, ASC, post-acute asset, health-tech vendor, or RCM company for a process.
Deliverable: Readiness score, missing-support list, buyer issue log, cleanup priorities, and evidence-room map.
Paid report shape
Provider Diligence Sheet sections
Entity identity and ownership
Historical financials and normalization
Quality of earnings and revenue
Payer exposure and revenue-cycle leakage
Debt, covenants, leases, and refinancing
Labor, input cost, and operational pressure
Service-line economics
Tax posture and transaction readiness
Capex, facility, and local-market context
Valuation and transaction context
Workpaper index, source appendix, and confidence flags
A finance module can be public as pending methodology before it is live. It becomes a diligence claim only when every numeric field has a source record, date, entity join, peer benchmark, confidence/completeness flag, and workpaper reference when private support is used.
Public preview language must stay non-attest. Branmoor should not represent pending diligence products as an audit, review, compilation, valuation opinion, tax opinion, or CPA-firm service. Any future CPA-licensed service needs separate engagement terms, conflict checks, confidentiality controls, insurance, state-board review, and clear scope language.
See the product register for module status and methodology pages, and the Context Layer for macro and healthcare benchmark rails.