This is not consulting.
This is execution.
St Raphael Health works alongside hospital leadership teams to stabilize operations, restore profitability, and create durable long-term value.
We do not advise from the sidelines. We embed directly, take responsibility for execution, and remain accountable for outcomes.
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How We Work
A disciplined, operator-led framework
Rapid Diagnosis
We begin by quickly identifying the operational and financial constraints preventing performance.
Our goal is clarity—fast.
Hands-On Execution
Once priorities are clear, we move immediately into execution. We work directly with hospital leadership and teams to drive operational decisions and implement changes on the ground.
We stay involved until change is real and measurable.
Profitability First
Profitability is the foundation of every successful hospital outcome. By restoring predictable cash flow and sustainable margins early, we stabilize operations and create optionality for leadership.
Profit enables better care and long-term stability.
Build for Sustainability
Stabilization is not the finish line. We ensure operational improvements are repeatable, teams are aligned and supported, and systems are institutionalized.
A hospital that performs without constant intervention.
Create Strategic Options
Once operations are stable and profitability restored, leadership has choices. We support long-term independent operation, strategic partnerships, or improved valuations.
Options only exist when operations are healthy.
Our Operating Pillars
An integrated operating system, not standalone services
Our approach is executed through a proven, repeatable operating framework. Each pillar reinforces the others and is applied based on urgency and context.
Cash Flow Acceleration
Hospitals rarely fail due to lack of revenue. They fail because cash is delayed, trapped, or leaking through broken processes.
Cash flow is the fastest lever to restore control.
Cost Efficiency & Margin Improvement
Distressed hospitals often carry cost structures misaligned with actual operating volume.
Sustainable margins create options and stability.
Revenue Expansion
Underperformance is often driven by underutilized capacity, not lack of demand.
Revenue growth supports reinvestment and long-term stability.
Capital Structure Optimization
Many hospitals are constrained by misaligned capital and restrictive financial structures.
Capital should support operations, not constrain them.
Regulatory Compliance & Operational Integrity
Operational distress often increases regulatory risk.
Operational integrity protects patients, staff, and leadership.
Sale or Partnership Strategy
Strategic outcomes are pursued only once stability is restored.
Optionality is created through execution, not assumption.
Execution Model
A disciplined operating model designed for speed and stability
St Raphael Health operates using a structured execution model designed to stabilize hospitals quickly while building toward sustainable, long-term performance. Every engagement follows the same core phases. The sequence may compress or overlap depending on urgency, but the discipline remains constant.
Phase 1: Immediate Stabilization
Objective: Stop financial and operational bleed. Restore control.
Focus Areas:
- Cash flow visibility and short-term liquidity
- Critical vendor and payroll stabilization
- Revenue cycle triage
- Immediate compliance or operational risks
- Leadership alignment and decision clarity
Outcome: The hospital moves from reactive crisis management to controlled operations.
Phase 2: Performance Reset
Objective: Restore predictable performance across core functions.
Focus Areas:
- Margin improvement and cost realignment
- Revenue cycle optimization
- Service line performance review
- Staffing and operational workflow stabilization
- Governance and reporting discipline
Outcome: The hospital operates with predictable cash flow, stabilized margins, and measurable performance improvements.
Phase 3: Sustainable Operations
Objective: Embed systems and teams that perform without constant intervention.
Focus Areas:
- Institutionalized processes and controls
- Leadership capability and accountability
- Compliance readiness and quality frameworks
- Capital alignment and balance sheet health
Outcome: The hospital performs sustainably with reduced dependency on crisis intervention.
Phase 4: Strategic Optionality
Objective: Create and evaluate long-term strategic choices.
Focus Areas:
- Independent growth planning
- Strategic partnerships
- Capital restructuring or refinancing
- Sale or transaction (if aligned with objectives)
Outcome: Leadership makes decisions from a position of strength, not distress.
What Makes This Different
This is not consulting as usual. It's a fundamentally different approach to hospital turnarounds.
Operators, Not Advisors
Our team brings over 200 years of combined hospital operating, turnaround, and transaction experience. We have worked inside these environments and understand what works under pressure.
Speed Without Chaos
We move quickly, but not recklessly. Our framework prioritizes actions that matter most and avoids unnecessary disruption.
Accountability to Outcomes
We measure success by results, not recommendations. Performance improvement, margin restoration, and operational stability are the benchmarks.
"In only two years, emergency room visits increased 380%, surgical volume grew 300%, and inpatient census increased 14x."
These outcomes are the result of disciplined execution, not theory.
Who This Approach Is For
- Hospitals experiencing financial or operational distress
- Boards and municipalities seeking stability and accountability
- Investors and lenders requiring predictable performance
- Leadership teams who want partners, not consultants