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Gain Control of Underperforming Assets With SCALE’s Turnaround & Restructuring Program
Building modernized healthcare delivery platforms that yield better results
SCALE Is Positioned to Improve Results Across the Entire Spectrum of Underperforming Asset Management
Unlike traditional restructuring firms, SCALE offers a dynamic
platform that melds technical restructuring expertise with
leading healthcare management advisory, execution &
fully-managed services.
Gain command over weaker portfolio company performance
through SCALE’s underperforming asset turnaround &
restructuring services.
▪ Preliminary Assessments
▪ “Early Intervention” Turnaround Execution
▪ Traditional Restructuring Services
Confidential 2
Effectively Managing Underperforming Assets Takes a Coordinated, Multidisciplinary Approach
Restructuring Team
Core Operations Team
Clinical Specialty Team
SCALE’s Healthcare Services Platform Combined with Turnaround & Restructuring Expertise Offers A Complete Business Solution
Confidential 3
SCALE’s healthcare services platform is designed
to enhance results across the diverse range of
domains that contribute to aggregate performance:
facilitate performance clarity; gain an expert
second opinion on strategic alternatives;
enhance on-going execution.
Advisory
Project Management
Execution Oversight & Leadership
Interim Leadership & Fully Managed Services
SCALE Turnaround & Restructuring
Core MSO Operations
Core Clinical Operations &
Ancillary Services
Site-of-Service Management
Clinical Specialty
Management
Healthcare & Restructuring Domain Experts Present Management, Board & Lenders With Preliminary Strategic
Outlook Findings
▪ Historical & projected financial performance
▪ Cost savings & underperforming site / service line restructuring opportunities
▪ Strategy, growth & development plans
▪ Market positioning
▪ Scope of clinical & ancillary services
▪ Team & operational infrastructure
▪ Broader specialty market trends & considerations
Efficient Assessment Process
▪ Engagement of only seasoned domain experts
▪ Assessment delivered within 1-4 weeks
▪ Recommendation report – access to SCALE’s team of domain experts
Confidential 4
Evaluation: What Key Opportunities
& Concerns Should We Focus On?
Prioritization: How Should We
Sequence Execution?
Market Positioning: How Do We Build
Defendable Equity Value?
Preliminary Assessments: Efficiently Define & Prioritize Value Enhancing Objectives
SCALE’s tailored turnaround teams have proven track records working on behalf of, and side-by-side with,
management teams, Boards, sponsors and lenders to augment execution wherewithal and performance.
SCALE integrates restructuring expertise into Early Intervention Turnaround Execution teams to complete
preliminary restructuring strategy development & contingency planning simultaneous with efforts to redirect the
Company’s standalone performance.
Confidential 5
“Early Intervention” Turnaround Execution: With Early Intervention and Sufficient Planning & Resources, Many Assets Can Avoid Formal Restructuring Processes
Illustrative SCALE “Early Intervention” Turnaround Team
SCALE Clinical Services Advisory SCALE Operations & Management
Core
SpecialtyPathology Radiology
Pharma Infusion
Payor
Strategy HR Finance
ITRevenue
Cycle Marketing
Executive /
Board Advisor
Analyst
SCALE
Restructuring
Capital
Restructuring
Business
RestructuringASC
Business model / plan & financial forecast – deep dive
due diligence.
Evaluate the Company’s strategic restructuring
alternatives & assess projected lender recovery rates.
Analyze restructuring plans & scenarios prepared by the
Company.
▪ Projection models
▪ Cash flow forecasts
▪ DIP budgets
▪ Credit agreement advisory
Represent creditors in negotiations with debtor and
debtor advisors.
Confidential 6
Creditor Advisory
Traditional Restructuring Services: Approach Formal Restructuring Processes with Confidence, Empowered by Proven & Practical Restructuring Expertise
Debtor Advisory
Evaluate the Company’s current liquidity profile & cash
position.
Reassess business plan & develop strategic
alternatives.
▪ Out-of-court vs. Chapter 11 bankruptcy
▪ Develop viable plan of reorganization; obtain creditor buy-in
▪ Bankruptcy preparation
Establish communication protocols with key
stakeholders, including the Company Board and its
lenders.
Represent debtors in negotiations with creditors and
creditor pool advisors.
Fully-Managed Services.
▪ CRO
▪ Interim CEO
▪ Interim CFO & Controller services
Confidential 7
Leverage SCALE’s Platform to Tackle Execution in a Manner That Best Aligns With Project-Specific Needs
Your Turnaround /
Restructuring Team
Restructuring
Frank Turner
Restructuring
David Friend
Financial Systems
& Controls
Richard Veltre
Project Specific
Clinical Executive
Project Specific
Ops Executive
Advisory / Light
Execution Support
Heavy Execution
Support
CRO / Interim
Management / Fully
Managed Solutions
Dynamic Range of Utilization Models Tailored to Best Achieve Tangible Results
Confidential 8
Physician Groupengagements
Our partners represent a broad network
Providers across our partners
States our partners operate across
Service line andoperational solutions
offered by SCALE
24 1,433 18 54
Healthcare companiesfounded by our team
Exits from healthcarecompanies our team
has led
Healthcare c-suite rolesour team has held
Healthcare private equity funds our team has advised
(operating partner)
41 31 116 33
Our team’s extensive and diverse expertise
SCALE Physician Group at a Glance
Confidential
9
SCALE Partners
*Completed engagement
Confidential
10
Select Turnaround & Restructuring Experience
Select Lenders SCALE Has Worked With To-Date
Select SCALE Turnaround & Restructuring Engagement Experience
Pharma / Infusion
Texas
Women’s Health
New York
Multispecialty
Texas
Multispecialty
California
Select Prior Restructuring Experience
Power Equipment Distributor
New Jersey
Retailer
New Jersey
Oil & Gas E&P
Oklahoma
Precision Manufacturer
New Jersey
Technology
New Jersey
SCALE Turnaround & Restructuring Team Overview
Confidential
12
Frank Turner - Chief Advisor, Restructuring
Frank P. Turner is the Chief Advisor of Restructuring at SCALE Physician Group.
Frank brings 30 years of experience to SCALE and has been involved in a variety of corporate debt restructurings totaling
more than $12 billion. He has successfully negotiated with first lien, second lien, unsecured, and subordinated debt
holders, and equity owners. His turnaround transactional experience encompasses both in and out-of-court
restructurings, leading DIP and exit financings, arranging equity rights offerings, negotiating debt-to-equity exchanges,
mergers & acquisitions, and selecting new boards of directors and management teams.
Frank is the Founder and Managing Partner of Interpeak Consulting LLC. Interpeak was founded to offer Frank’s unique
perspective and Wall Street insight to small and medium size firms, their boards, or other company stakeholders in need
of practical and non-conflicted advice on loan renegotiations and restructurings. Prior to Interpeak, Frank was a Partner
and Portfolio Manager at WCAS Fraser Sullivan Investment Management, LLC.
Previously, Frank was the Global Head of Commercial Loans for the Lehman Brothers bankruptcy estate. He was
responsible for the management and ultimate liquidation of a $40 billion corporate loan portfolio. During his thirteen-year
career at Lehman Brothers, his responsibilities included leveraged loan capital markets, corporate debt restructurings, and
portfolio management. He also acted as Co-Chief Credit Officer for Lehman Brothers Commercial Bank.
Prior to Lehman Brothers, Frank spent ten years at The Bank of New York. He began his banking career at the Irving
Trust Company.
Frank is a Certified Turnaround Professional with the Turnaround Management Association. Frank graduated with a BA in
Economics from Westminster College and an MBA in Finance from Purdue University – Krannert School of Management.
Confidential
13
Dr. David Friend – Chief Advisor, Restructuring
Dr. David Friend is the Chief Advisor of Restructuring at SCALE Physician Group.
Dr. Friend has 30 years of global healthcare experience serving as Chairman, CEO, COO, Chief Clinical Officer, Chief Medical Officer,
Board Member and Advisor for a variety of Fortune 500 Companies, Health Systems, Academic Medical Centers, Biotechnology, IT
Companies, Physician Groups and Post-Acute Care Organizations.
Most recently, Dr. Friend served as the Co-Founder and Chief Transformation Officer of the BDO Center for Healthcare Excellence &
Innovation. The BDO Center combined interdisciplinary expertise in finance, clinical, digital analytics and regulatory knowledge to help
clients solve their most complex challenges.
On behalf of BDO during 2018 and 2019, Dr. Friend served as Chief Executive Officer of Senior Care Centers, the largest post-acute care
provider in Texas caring for approximately 10,000 patients in 100 facilities with revenues of approximately $1 Billion. Dr. Friend was
brought in to stabilize operations, restructure the company, and guide the firm through the Chapter 11 process with the goal of emerging
with a court confirmed plan.
Prior to joining BDO, Dr. Friend held the positions of Executive Vice President and Chief Clinical Officer of Golden Living, a $3 Billion
leader in post-acute healthcare and President and Chief Medical Officer of Aseracare Hospice and Homecare, specializing in Home
Health, Palliative Medicine and Hospice. Other notable positions include serving as Chairman and CEO of The Palladium Group, a global
data analytics firm, Managing Director in the Healthcare Practice at Alvarez & Marsal, and Board Member, US Regional Co-Manager and
Global Leader of the Healthcare practice at Willis Towers Watson.
Dr. Friend is currently on the Board of Fallon Health and is a member of the Audit and Clinical Care Committees. He is also on the
Executive Advisory Board of The University of Pennsylvania, LDI Health Policy Institute. Dr. Friend was previously appointed by the
Governor of the State of Connecticut to be a Founding Board Member of The University of Connecticut Health Center where he served on
the Board of the Teaching Hospital and Medical School.
Dr. Friend received a MBA from Wharton, University of Pennsylvania, a MD from The University of Connecticut, and a BA in Economics
from Brandeis University.
Confidential
14
Inform Turnaround & Restructuring Efforts With a Diverse Portfolio of Strategies & Best-Practice “Lessons Learned”
Core MSO Operations and Payor Contracting Teams
Suniti Ponkshe
Chief Advisor, Payor Contracting Strategy
Robert Trenczer
President, SCALE RCM
Sandy Seay
Chief Advisor, Human Resource Solutions
Jason Schifman
Co-Founder & President
Jack Trunz
Analyst, Platform Development
Roy Bejarano
Co-Founder & CEO
Bill Ingram
Vice President, Platform Development
Jeff Kahn
Chief Advisor, Human Capital Management
David Kovel
Chief Advisor, IT & Data Strategy
Mike Mirt
Chief Advisor, Executive Payor Strategy
Rob Popdan
Analyst, Platform Development
Jack Carrier
Associate, Platform Development
Susan Silhan
Vice President, Marketing
& Communications
Tracy Bahl
Chief Advisor, National Payor Strategy
Jonathan Kron
Operating Partner, SCALE Europe
Jatinder Garcha
Vice President, Platform Development, SCALE
Europe
David Friend
Chief Advisor, Restructuring
Richard Veltre
Chief Advisor, Financial Systems
and Controls
Peter Cunningham
Chief Advisor, Direct to Patient Marketing
Robert Dondes
Chief Advisor, Managed Care and
Payor Networks
Frank Turner
Chief Advisor, Restructuring
15
Inform Turnaround & Restructuring Efforts With a Diverse Portfolio of Strategies & Best-Practice “Lessons Learned”
SCALE’s Clinical Service Line and Site-of-Service Team
Bob DeCresce
Chief Advisor, Pathology
Thomas Petrone
Chief Advisor, Radiology & Radiation
Oncology
Michael Reed
Chief Advisor, Primary Care, Medicare Advantage, ER
Staffing and Hospital Physician Services Programs
James Usdan
Chief Advisor, Dental Provider Platforms
& Physical Rehab
Keith F. Safian, MBA, FACHE
Chief Advisor, Healthcare System
Strategy
Charles Trunz
Chief Advisor, Hospital Relations
& Urgent Care
Richard Loewenstein
Chief Advisor, Behavioral Health
Platforms
Janice Pyrce
Chief Advisor, Behavioral Health
Platforms
Marcello Celentano
Chief Advisor, Ophthalmology
Provider Platforms
Steve Straus
Chief Advisor, Ophthalmology
and Dermatology Provider Platforms
Adam Nielsen
Chief Advisor, Home, Health & Hospice
Platforms
Chad Eriksen
Chief Advisor, Clinical Research
Laurie East
Chief Advisor, Pediatric Provider
Platforms
Steven Graubart
Chief Advisor, Micro Hospitals
Gregory Levitin, M.D., F.A.C.S.
Chief Advisor, ENT Provider Platforms
Mark Sapner
Chief Advisor, Telemedicine &
Remote Care Delivery
David Reese
Chief Advisor, Infusion & Pharma
Services
Steve Fiore
Chief Advisor, Orthopedic
Provider Platforms
Dr. Jordan Stewart
Chief Advisor, Podiatry Provider
Platforms
Nicholas Pachuda
Chief Advisor, Medical Devices
Chris Ennis
Chief Advisor, Urology
Brent Westhoven
Chief Advisor, Women’s Health
Dr. Howard Greenfield
Chief Advisor, Anesthesia
Dr. Joseph Racanelli
Chief Advisor, Radiology
Andrew Mazzella
Chief Advisor, Radiology
Marc Olsen
Chief Advisor, Urgent Care and Consumer
Directed Health Services
Ernest A. Varvoutis, III
Chief Advisor, Hospital Systems
Joe Carlon
Chief Advisor, Pain Management
Provider Platforms