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.
Inpatient hospice houses and palliative-care facilities are census businesses with a defined reimbursement frame: the Medicare hospice benefit dominates payment, level-of-care rules govern what inpatient days the benefit covers, and the census flows from the sponsoring agency's home-hospice population and community referral relationships. The study sizes demand from mortality and hospice-utilization data in the service area, models the inpatient census the sponsoring agency's caseload can actually support, and tests the facility's economics at the benefit's rates with the general-inpatient and respite criteria applied honestly.
Census modeling from service-area mortality, hospice penetration, and the sponsor's caseload, payer modeling at Medicare hospice rates by level of care, staffing at the clinical ratios inpatient hospice requires, and philanthropy treated as documented support rather than assumed subsidy.
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. Nonprofit sponsors reach USDA Community Facilities and philanthropic-leveraged conventional structures; the sponsoring agency's operating history is the core credit fact.
The engagement extends the firm's community-facility and senior-care record into end-of-life care's specific reimbursement architecture. 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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