Ransomware Readiness Assessment for a Mid-Size Healthcare SaaS Provider
A mid-size healthcare SaaS provider operating a cloud-based EHR platform engaged us to assess their ransomware resilience and HIPAA technical safeguard compliance. Our assessment uncovered critical network architecture and backup access vulnerabilities that created a viable ransomware deployment path within their environment.
Confidential engagement. NDA available upon request.
88%
HIPAA Compliance
97%
EDR Coverage
4hr
Recovery RTO
0
Critical Findings
About the Client
Industry
Healthcare SaaS
Company Size
250 to 400 employees, established mid market
Background
A HIPAA covered entity operating a cloud based Electronic Health Records (EHR) platform used by outpatient clinics and specialty practices. The platform handled Protected Health Information (PHI) for tens of thousands of patients and was subject to HIPAA Security Rule requirements.
Security Challenges Identified
Backup Systems Accessible from Employee Workstations
Primary backup servers were reachable from standard user workstations with no additional authentication, making backup encryption feasible and RTO guarantees unverifiable in a ransomware scenario.
11 Unpatched Servers with Publicly Available Exploits
Multiple production servers were running software with known exploits, including two with CVSS scores above 9.0, providing trivial initial access vectors for threat actors.
No Network Segmentation Between Clinical and Employee Systems
No meaningful segmentation existed between clinical data servers and employee workstations, enabling unrestricted lateral movement once any endpoint was compromised.
Incomplete EDR Coverage Across Managed Endpoints
Endpoint detection and response tools were deployed on only 67% of managed endpoints, creating unmonitored blind spots that a threat actor could exploit to move laterally undetected.
The Mission
Assess ransomware resilience end to end, eliminate all viable lateral movement paths, validate backup recovery capabilities, and achieve HIPAA Security Rule technical safeguard compliance with a focus on practical remediation over checkbox compliance.
How We Approached It
01. Infrastructure Discovery & Asset Inventory
Week 1- Nmap network discovery and service fingerprinting
- PHI data flow mapping and classification
- HIPAA Technical Safeguard baseline assessment
- Backup system architecture review
02. Vulnerability Assessment
Week 1 to 2- Nessus credentialed scans across all managed systems
- Patch level and EOL software inventory
- VPN and remote access appliance firmware review
- CIS-CAT Pro assessment against CIS Benchmarks
03. Network Segmentation & Lateral Movement Testing
Week 2 to 3- VLAN boundary testing and segmentation gap analysis
- Workstation-to-server lateral movement simulation
- Backup system accessibility testing from user segments
- Wireshark-based traffic analysis for unencrypted PHI in transit
04. Ransomware Attack Path Simulation
Week 3 to 4- Metasploit Framework exploitation of identified vulnerabilities
- Backup system access attempt from compromised workstation
- EDR detection capability validation across covered endpoints
- Recovery time objective (RTO) measurement from isolated backups
05. HIPAA Gap Analysis & IR Planning
Week 5 to 6- HIPAA Security Rule technical safeguard gap mapping
- Ransomware-scenario tabletop exercise with leadership
- IR playbook development with assigned roles and escalation paths
- Remediation roadmap prioritized by risk and compliance impact
Vulnerabilities Discovered
2
CRITICAL
2
HIGH
2
MEDIUM
0
LOW
Backup Systems Network-Accessible
Primary backup servers were reachable from standard user workstations with no additional authentication, making backup encryption feasible in a ransomware scenario.
Primary backup servers were reachable from standard user workstations with no additional authentication, making backup encryption feasible in a ransomware scenario.
Unpatched Systems with Known Exploits
11 servers were running software with publicly available exploits, including two with CVSS scores above 9.0.
11 servers were running software with publicly available exploits, including two with CVSS scores above 9.0.
Flat Network Architecture
No meaningful segmentation existed between clinical data servers and employee workstations, enabling unrestricted lateral movement.
No meaningful segmentation existed between clinical data servers and employee workstations, enabling unrestricted lateral movement.
Outdated VPN with Known Vulnerabilities
Remote access VPN appliance was running firmware 3 major versions behind current release, with published CVEs.
Remote access VPN appliance was running firmware 3 major versions behind current release, with published CVEs.
Inconsistent EDR Coverage
Endpoint detection and response tools were deployed on only 67% of managed endpoints.
Endpoint detection and response tools were deployed on only 67% of managed endpoints.
No Tested Incident Response Plan
A documented IR plan existed but had never been exercised, with no defined roles or communication procedures.
A documented IR plan existed but had never been exercised, with no defined roles or communication procedures.
How We Fixed It
Backup Isolation
Migrated backup systems to an isolated network segment with MFA required for access, and implemented immutable backup storage with 30-day retention.
Emergency Patching Program
Executed emergency patching for all critical and high-severity vulnerabilities within a 30-day remediation sprint, prioritizing internet-facing and PHI-adjacent systems.
Network Segmentation
Implemented VLAN-based segmentation separating clinical data systems, employee workstations, and management networks with enforced firewall policies.
VPN Upgrade
Replaced end-of-life VPN appliance with a current-generation solution featuring MFA enforcement and split-tunneling controls.
EDR Rollout Completion
Achieved 97% endpoint coverage for EDR deployment with standardized detection policy configurations.
Incident Response Tabletop
Facilitated a ransomware-scenario tabletop exercise, producing a tested and role-assigned IR playbook.
Measurable Outcomes
Post-remediation attack path simulation confirmed the previously identified ransomware deployment scenario was no longer viable within the tested environment.
88%
HIPAA Compliance Improvement
97%
EDR Coverage
75%
Vulnerability Reduction (All Severities)
4hr
Validated Recovery RTO
Critical Vulnerabilities
2
0
High Vulnerabilities
6
1
EDR Coverage
67%
97%
Backup Recovery Tested
Never
Validated within 4-hour RTO
HIPAA Technical Safeguard Compliance
~54%
~88%
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