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.
ASC feasibility is case-volume arithmetic with a regulatory frame: the surgeons who will bring cases, the case mix they perform, the payer rates each case commands, and the licensure, certification, and (where applicable) certificate-of-need posture that gates the door. The study documents committed surgeon utilization — an ASC without signed surgeon commitments is an operating room searching for a reason — models case volume by specialty against credentialed capacity, and prices the case mix through Medicare ASC rates and commercial contracts rather than hospital benchmarks that do not transfer.
Case modeling from surgeon-by-surgeon commitments and historical volumes, room-utilization mathematics — cases per operating room per day against staffed hours — payer-mix yield with the migration trend toward higher-acuity outpatient procedures documented, and a physician-ownership structure review against program eligibility rules.
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. Physician-owned centers fit SBA structures subject to ownership rules; joint-venture and system-affiliated centers route conventional; equipment-heavy buildouts suit 504 debenture economics.
The firm's procedural-facility work connects to its broader clinical real-estate record, with surgeon-commitment evidence treated as the demand study it is. 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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