Carlsmed, Inc. — Earnings Quality Grade D
CARL · Healthcare
Significant concerns
Screening Summary
Management Signals
Financial Trends
Revenue & Net Income ($B)
Margins (%)
18-Point Screening
Revenue Quality
DSO 82 days, change -9 days YoY
AR growth 67.9% vs revenue growth 85.9%
Revenue grew 85.9% but CFFO declined -13.8%
Small-cap context: Small-cap revenue/CFFO ratio is sensitive to growth-stage working-capital draws.
Expense Quality
Inventory 85.4% vs COGS 75.2%. Normal
CapEx growth 653.9% is >2x revenue growth 85.9%
SG&A/Gross Profit = 135.6%, exceeds 70%
Gross margin 75.3%, change +1.5pp. Stable
Cash Flow Quality
CFFO/NI = 0.98. Profits backed by cash
FCF is negative ($-0.0B)
Accruals ratio = -0.5%. Low accruals
Cash $0.1B covers debt $0.0B
Balance Sheet Health
No goodwill. Clean balance sheet
Interest coverage = -21.4x (<2x). Financial stress
Other assets -76.4% vs revenue 85.9%. Normal
No write-off data
Acquisition Risk
FCF after acquisitions negative for 3 years
Small-cap context: A single acquisition on a small balance sheet can trip serial-acquirer logic.
No goodwill
Manipulation Score
M-Score = -2.03 (grey zone)
Portfolio monitoring
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Beneish M-Score
Altman Z-Score
Generated from public financial data using forensic accounting frameworks. Not investment advice. Data: Yahoo Finance · 2026-04-25