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.
Medical office buildings are underwritten as leased real estate with a clinical tenancy overlay: physician and health-system demand within the patient draw area, the building's clinical specification — floor loads, HVAC, generator capacity, ADA clinical standards — and lease economics that run longer and stickier than commodity office when tenancy is genuinely medical. The study sizes provider demand from physician-supply data and health-system outpatient strategy, validates the rent thesis against medical comparables rather than office averages, and tests the rollover schedule against the anchor tenancy's credit and term.
Demand analysis from provider-per-capita gaps and system expansion patterns, rent and expense benchmarking against medical-specific comparables, tenant-improvement budgets at clinical buildout costs, and lease-up modeled against the submarket's documented medical absorption with anchor-tenant concentration stated plainly.
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. Owner-occupied physician buildings fit SBA 504 directly; multi-tenant MOBs route conventional; hybrid owner-user structures with leased suites are modeled to each program's occupancy rules.
The firm's $38,900,000 medical-village engagement — nineteen clinical buildings on a hybrid lease-and-sale program — supplies the category's reference 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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