Prepared for lenders, CDCs, and federal agencies to SBA SOP 50 10 8, USDA RD Instruction 5001, and conventional underwriting standards. Fiduciary duty runs to the lender and the agency, never the borrower. More than 4,000 studies since 1998 covering $40.2 billion in evaluated project value.
Hospital feasibility — general acute care, specialty surgical and cardiac hospitals, freestanding emergency facilities, and the micro-hospital format — is underwritten on service-line economics inside a defined service area: discharges, surgical cases, and emergency visits the population generates, the shares incumbent systems already hold, and the payer mix that prices every projected encounter. The study sizes demand from state discharge data and use-rate benchmarks, tests the medical-staff plan against the physicians who actually admit, and treats regulatory posture — licensure, certificate-of-need where applicable, CMS certification path — as the gating architecture it is.
The methodology builds volume by service line from population use rates and documented market shares, prices it through a payer-mix model with commercial, Medicare, Medicaid, and self-pay yields stated separately, and stresses the census against physician-recruitment and ramp scenarios. Capital costs are benchmarked against healthcare construction data, and coverage is tested at the program minimum across census and payer-mix stress cases.
Every Wert-Berater financial model is fully linked with no hardcoded values, so any reviewer can stress any input. Deliverables comprise a complete narrative report and the linked Excel model, with ten-year pro forma, sensitivity analysis at ±5, 10, and 15 percent, interest-rate stress from +0.5 to +3.0 percent, and ratio analysis benchmarked against RMA and IBISWorld data.
SBA engagements are prepared to SOP 50 10 8, including its debt-service-coverage minimums of 1.15x operating and 1.00x global. USDA engagements follow RD Staff Instruction 5001 across the Business & Industry, Community Facilities, REAP, and Value-Added Producer Grant programs. Conventional engagements are built to the lender's stated coverage standard, typically 1.20x. Smaller and rural facilities reach USDA Community Facilities and B&I structures; specialty and physician-sponsored hospitals fit conventional and bond frameworks; the regulatory and reimbursement dimensions carry decisive weight in every program.
The firm's healthcare practice spans the medical-village, senior-care, and wellness-facility record, with the same payer-aware revenue discipline applied at hospital scale. Independence is non-negotiable: determinations follow the evidence and are not revised under pressure, and studies are built to pass lender, agency, and third-party review without exception items.
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