Prepared for lenders, CDCs, and federal agencies to SBA SOP 50 10 8, USDA 7 CFR Part 5001, and conventional underwriting standards. Fiduciary duty runs to the lender and the agency, never the borrower. 4,000+ engagements since 1998 covering $41.2 billion in evaluated project value. So far in 2026: 41 engagements and $1.54 billion evaluated — 17 SBA, 11 USDA.
Addiction treatment facilities — medical detox, residential treatment, medication-assisted treatment clinics, and sober-living adjacencies — are underwritten on census economics inside a payer landscape that has matured: in-network contracting now defines sustainable operators, and the study treats out-of-network-dependent pro formas with the skepticism their loss history has earned. The analysis sizes demand from prevalence and treatment-gap data, documents the licensure level-of-care ladder the facility will hold, and builds census ramp from referral-source evidence rather than marketing reach.
Census modeling by level of care with length-of-stay and step-down patterns, payer-yield analysis distinguishing contracted rates from out-of-network reimbursement reality, staffing at clinical-ratio requirements, and a referral-source concentration review — the admissions pipeline is the demand study.
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 fits SBA and conventional structures with the management and regulatory dimensions weighted heavily; community-based facilities reach USDA programs in eligible areas.
The engagement applies the firm's residential-care underwriting with the payer-contracting scrutiny this category specifically requires. 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.
A feasibility study for this asset class must do more than confirm that substance use disorder is prevalent. It must demonstrate that a specific facility, at a specific level-of-care ladder, can sustain census at contracted payer rates sufficient to cover debt service and operating obligations. The scope therefore extends from licensure documentation through referral-pipeline analysis to a fully built financial model that a credit officer can interrogate line by line.
Demand for addiction treatment is not self-evident from population size. The analysis begins with prevalence — the estimated share of the service-area population meeting diagnostic criteria for substance use disorder at each severity level — and then applies treatment-gap data to isolate the share not currently receiving care at the appropriate level. That gap is the addressable market; it is not the projected census. Census is built separately from referral-source evidence.
Public data sources consulted include state substance-abuse agency licensure registries, which identify every licensed provider by level of care and licensed capacity; SAMHSA treatment-locator records; state Medicaid managed-care provider directories; and certificate-of-need filings where the state requires them. Competitive supply is mapped by level of care, not by facility count, because a detox-only competitor does not constrain a residential operator in the same way a full-continuum competitor does.
Referral-source analysis draws on hospital emergency department discharge patterns, criminal-justice diversion program referral volumes, employer assistance program networks, and physician and prescriber referral relationships for MAT specifically. Each source type is assessed for volume, reliability, and the degree to which it is already committed to an existing provider. Geographic access barriers — transportation, rural isolation, and language — are documented where they affect realistic catchment. The result is a demand picture built from evidence, not from a percentage-of-population assumption applied to a radius map.
Four inputs account for the majority of coverage-ratio movement in this asset class. Each is tested explicitly in the sensitivity analysis rather than held at a single point estimate.
Each lending channel applies its own underwriting lens to this asset class, and the feasibility study must address all three angles when the financing structure is not yet fixed.
SBA: SBA engagements are prepared to SOP 50 10 8, with coverage minimums of 1.15x operating and 1.00x global. For addiction treatment facilities, SBA lenders focus heavily on management experience — specifically, whether the operator holds or can obtain the required behavioral-health licenses and whether the clinical leadership team has a documented track record at the proposed level of care. The payer-contracting status at the time of application is scrutinized because an unlicensed, uncontracted facility cannot generate the revenue the pro forma assumes.
USDA: Community Facilities program eligibility is available to nonprofit addiction treatment providers in eligible rural areas. RD Staff Instruction 5001 governs Business & Industry engagements for for-profit operators. USDA reviewers are attentive to community-need documentation — the treatment-gap analysis and the absence of duplicative services in the service area — and to the long-term sustainability of the payer mix, particularly Medicaid dependency in states with managed-care carve-outs for behavioral health.
Conventional: Conventional lenders typically require 1.20x coverage and place additional weight on the operator’s existing in-network contracting status, CARF or Joint Commission accreditation, and the absence of outstanding licensing deficiencies. A facility proposing to operate out-of-network, or one whose pro forma relies on self-pay at rack rates, will face a materially higher burden of evidence. The study addresses this directly rather than deferring it to the borrower’s narrative.
The fee is fixed and quoted in writing within one business day of receiving the project description. No portion of the fee is contingent on the finding, and the determination is not revised under pressure. That structure is not a marketing position; it is the condition under which a study carries weight with a lender or agency reviewer who knows that a contingent-fee study has a selection problem built into it.
Standard delivery is ten to fifteen business days from a complete data room. A complete data room for this asset class includes the proposed license application or existing license, the draft or executed payer contracts, the staffing plan with clinical ratios, the site control documentation, the construction or renovation budget, and any existing operating statements if the facility is a going concern or an acquisition. Incomplete data rooms extend the timeline; the engagement clock does not start until the data room is complete.
Rush delivery is available and is quoted at the time of engagement. Every engagement is published to a secure client portal where the fully linked Excel model stays live and recalculates when inputs change. A credit officer who wants to run a stress case does not need to request a revised study; the model is accessible directly. The narrative report is delivered as a bound document. Wert-Berater, Inc. has completed 4,000+ engagements representing $41.2 billion in evaluated project value, and the engagement process is the same regardless of project size or financing channel.
The fee is fixed and quoted in writing within one business day of receiving the project description. It does not vary with the finding, and no portion is contingent on approval. The exact amount depends on facility complexity — number of levels of care, payer-mix depth, and whether the engagement is SBA, USDA, or conventional — but the quote is binding and delivered before any work begins.
Standard delivery is ten to fifteen business days from a complete data room. For addiction treatment facilities, a complete data room includes the license application or existing license, draft or executed payer contracts, the staffing plan, site control documentation, and the construction or renovation budget. Rush delivery is available. The clock starts when the data room is complete, not when the engagement is signed.
Payer-yield uncertainty is the central difficulty. Net revenue per patient day depends on contracted rates that may not yet exist at the time of application, and out-of-network reimbursement has a loss history that lenders now treat with skepticism. Layered on top are licensing timelines, clinical-staffing-ratio requirements, and referral-source concentration risk — any one of which can impair census before the facility reaches stabilization.
SBA engagements from this firm are prepared to SOP 50 10 8, including its debt-service-coverage minimums of 1.15x operating and 1.00x global, and are built to pass lender, agency, and third-party review. The study addresses the management, licensing, and payer-contracting dimensions that SBA lenders specifically scrutinize for behavioral-health facilities. No study can guarantee approval; the determination follows the evidence.
USDA Community Facilities financing is available to eligible nonprofit providers in qualifying rural areas; USDA Business & Industry financing is available to for-profit operators in eligible areas. USDA engagements are prepared to RD Staff Instruction 5001 and address the community-need documentation and long-term sustainability analysis that USDA reviewers require for behavioral-health facilities. Eligibility depends on location and organizational structure, which are confirmed before the engagement begins.
The standard deliverable includes a ten-year pro forma, sensitivity analysis at plus and minus five, ten, and fifteen percent on key revenue and expense inputs, interest-rate stress from plus 0.5 to plus 3.0 percent, and ratio analysis benchmarked against RMA and IBISWorld data. For addiction treatment facilities, the model is built by level of care with separate occupancy, length-of-stay, and payer-yield assumptions at each level, and the Excel workbook is fully linked with no hardcoded values.
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Wert-Berater, Inc. is an independent provider of feasibility studies and other related services. The firm does not provide financing or equity investment advice, and does not arrange, broker, or place debt or equity capital of any kind.
All appraisal assignments are performed by Bruce E. Jones, MAI, ASA-GC, BCA, CMEA, a member of the Appraisal Institute since 2006, a staff member of Wert-Berater, Inc. and owner of Special Purpose Realty Valuation.