Who we are
Wert-Berater, Inc. has prepared independent feasibility studies for lenders, certified development companies, and federal agencies since 1998 — more than four thousand engagements representing $40.2 billion in evaluated project value across all fifty states and international assignments. Our fiduciary duty runs to the lender and the agency, never to the sponsor’s optimism: fees are fixed, quoted up front, never contingent on findings, and a determination is never changed under pressure.
What we do
Critical access and rural hospital projects — replacements, conversions under the Rural Emergency Hospital designation, and service-line restorations — are underwritten on a different chassis than urban facilities: cost-based and designation-driven reimbursement, a service population defined by distance, and a payer mix that leans government. The study documents the designation status and its reimbursement consequences, sizes realistic volumes from the service area's actual utilization and outmigration history, and tests sustainability against the staffing economics that decide whether rural facilities live: physician coverage, traveling-clinician cost, and the recruitment plan behind both.
How we do it
Volume modeling from service-area discharge and emergency-visit data with outmigration quantified, reimbursement modeled to the designation's actual rules rather than generic hospital ratios, swing-bed and outpatient lines built separately, and a federal-and-state support layer documented program by program.
How we can help you
Rural hospitals are the archetypal USDA Community Facilities credit, with B&I serving for-profit structures; the 7 CFR 5001 factor framework and agency review expectations are native territory for the firm's rural practice. The engagement extends the firm's standing rural community-facility record — schools, clinics, and senior care — into the hospital designation framework.
How to engage us
Standard delivery is 10 to 15 business days from complete project data. Rush delivery for deals already in underwriting is accepted case by case for an additional fixed fee, quoted up front and committed in writing. Engagements are typically initiated by the borrower, with lender or CDC confirmation obtained before work begins — institutions differ, so confirm the procedure with your lending contact.