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.
Skilled nursing is census-and-acuity underwriting under the industry's heaviest regulatory and reimbursement frame: certificate-of-need posture where applicable, state Medicaid rates that set the floor for most beds, Medicare post-acute volume that carries the margin, and a staffing mandate environment that has repriced the expense base. The study sizes demand from the 75-plus population and hospital-discharge patterns, models the payer mix bed by bed, and tests the labor build against the market's actual wages and the ratio requirements in force — because in this category the expense side fails projects more often than the census does.
Census modeling from demographic and referral data, payer-mix yield with Medicaid, Medicare, and managed-care rates stated separately, labor builds at mandated ratios and market wages with agency-staffing reality included, and survey-history review of the operator as core management diligence.
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. The category spans HUD-insured, USDA, and conventional structures; operator capability and regulatory standing weigh decisively in every program's review.
The firm's senior-care record — assisted living, memory care, and CCRC analysis — extends directly into the skilled-nursing reimbursement frame. 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.
Qualify a project. Tell us about the project and the program. We will tell you the truth about it — scope, timeline, and fee confirmed before work begins.
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