What does RX Consulting Ops Turnaround Work Actually Look Like?

I read on here that the rx co firms, Alix in particular, do a lot of distressed operational turnarounds for underperforming or broken sponsor portcos outside of court. Was wondering if anyone can walk me through what a real distressed PEPI file (like the ones Alix does) actually looks like?

I’m curious about a few things in particular.

What triggers the call? How close to the brink are these companies typically?

What does a typical file look like from Day 1? Can you break down a realistic scenario (e.g., severe margin compression, supply chain blowup, or failed carve-out)? How do you triage the business in the first 30 days vs. implementation?

What are the key deliverables for junior/mid-level consultants? What are you physically building/running?

I’m also curious about the C-suite corporate exit op for rx consultants. For those that did it, did your time in turnaround consulting give you the skills needed to be a strong long-term steward of a business? Or is there a big shift in mindset required when moving from fixing short-term operational issues to building and scaling a company's vision over a multi-year horizon?

Would love to hear how former turnaround consultants view the transition from advisory into building and running a business long-term.