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Generate a candidate underwriting memo for Rachel Dominguez. She's interviewing for our COO role at Summit Surgical Partners.
Team Theory
I'll analyze Rachel's background against your ASC platform requirements and generate a comprehensive candidate evaluation. Let me pull her experience data and cross-reference against your success patterns...
Candidate Evaluation — Rachel Dominguez
Executive Summary
Rachel Dominguez is a Strong fit for the COO role at Summit Surgical Partners. She brings directly analogous ASC platform experience — 7 tuck-in integrations at NovaCare Surgical, $7.2M in documented procurement savings, EBITDA margin expansion from 19.8% to 25.1% in 3 years — paired with clinical credibility (OR nurse background) that is structurally rare among operators at her level. A material watch item: her reference confirmed she operates best with a strong #1 above her, which requires careful management given Kris Lombardi's planned transition to Executive Chairman within 18–24 months.
Recommendation: PROCEED to final rounds and third-party psychometric assessment.
Strengths & Weaknesses
Strengths
1. Career Trajectory & Validated Upward Performance
Dominguez has followed a consistently upward arc — OR nurse to perioperative director at NYU Langone, to VP of Operations building a greenfield ambulatory platform at TeamHealth, to SVP of Operations running a 22-facility, $210M revenue PE-backed ASC company. Each move was into greater scope and complexity.
Reference Data
Tom Kowalski, CEO, NovaCare Surgical: "When I met her the first time, within 20 minutes I thought, this is either going to be the best hire I've ever made or she's going to eventually take my job. Turns out it's both."
2. ASC M&A Integration — Repeatable Playbook
Dominguez has personally integrated 7 ASC facilities at NovaCare in 3.5 years, and 7 prior facilities at TeamHealth. She describes an integration failure (her first Tampa acquisition at TeamHealth), names what she got wrong, and built the "90-day listening tour" model as a result.
Interview Data
"My first acquisition was a disaster and it was my fault. I came in with the TeamHealth playbook and tried to standardize everything in 90 days. The physicians revolted."
3. EBITDA Margin Engineering — Demonstrated at Scale
Drove NovaCare's EBITDA margins from 19.8% to 25.1% over three years — a 530bps improvement — via procurement centralization, case mix management, and clinical quality infrastructure. Identified cross-facility implant pricing variance and delivered $7.2M in annual savings.
Reference Data
Tom Kowalski: "She built an entire centralized procurement infrastructure with analytics, benchmarking, and a governance process. It's still running and saving us money 3 years later."
4. Surgeon Relationship Sophistication
Her OR nurse background is a structural differentiator. She stood in operating rooms for eight years and understands the precision, culture, and ego of the surgical environment from the inside. Zero high-volume surgeon attrition across 3.5 years at NovaCare.
5. Communication Transparency & PE Relationship Management
She escalates bad news early and with context, and proactively builds tools that make her PE sponsor more effective. Built the pre-diligence operational scorecard that halved Audax's diligence timelines.
6. Talent Building — Decisive Upgrades with Unusual Generosity
Three VP-level changes in her first 6 months at NovaCare using a structured gap framework. One terminated executive described her as "the best boss I've ever had and she's the one who fired me."
Weaknesses
1. Structural Dependency on Strong #1 — Material Given SSP's Transition
Kowalski observed she "operates best with a strong #1 above her" and "wants partnership." Given Kris Lombardi's planned transition to Executive Chairman within 18–24 months, this requires careful management.
Watch Item
Flag for exploration in psychometric assessment and structured conversation with Lombardi about transition timeline.
2. Pace Impatience — Risk of Team Burnout
Multiple sources describe her as high-velocity in a way that can exhaust people. Kowalski: "She can be impatient with people who don't operate at her speed... Her team loves her but they work hard. Really hard."
3. No Evidence of Autonomous Board or Investor Ownership
At NovaCare, she shares board presentations with Kowalski — "He does the strategy and the financials, I do the operations and the talent." She has not owned the full board relationship independently.
Scorecard Ratings
Risks & Mitigations
Risk 1: Independence Gap at CEO Transition (High Severity)
SSP COO role designed to produce CEO successor within 18–24 months. Kowalski's observation: "she's at her best when she has a thought partner at the top" — most material flag in evaluation.
Mitigation:
Direct conversation about Lombardi transition structure; include in psychometric assessment; design first-year onboarding with explicit board access.
Risk 2: Team Pace Burnout at Platform Scale
Pattern of impatience with slower teammates; middle management underinvestment at TeamHealth. Risk of outrunning organizational layer as SSP scales 14 → 30+ facilities.
Mitigation:
Prioritize VP-level hires as explicit early agenda items; make "building the layer below" an explicit KPI alongside operational results.
Risk 3: Welsh Carson Partnership Style — Calibration Required
PE experience exclusively with Audax "deliberate" culture. WCAS collaborative model will feel different; instinct to build workarounds could be misread as resistance.
Mitigation:
Structured time with WCAS deal team in final rounds; genuine working sessions to experience partnership model firsthand.
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