SBA 504 Medical Office Feasibility Study in Nevada

Concentrated in one county, and first in the state

Physician offices are the 1 of 39 class in Nevada's SBA 504 lending, with 74 loans and $87.9 million in gross dollars approved, and the state ranks 5th among states for the pairing. The median of $712,000 is 1.06x the national 504 median, and the center of the book lies between $478,000 and $1.5 million. No franchise is involved: the share is 0.00%. Nothing about the size is unusual, but the concentration is. Clark County alone has 53 loans, with Washoe at 16, Carson City at 4 and Elko at 1.

Holding 32 loans, The Mortgage Capital Development Corporation is first. Nevada State Development Corporation follows with 29, and California Statewide Certified Development Corporation has 11. These holder counts come from SBA and do not describe any company's judgment. Annual volume was 12 loans and $10.2 million in FY2021 and has fallen sharply since: 4 loans in FY2024, 4 more in FY2025, and 2 loans and $3.5 million in FY2026. A study should account for that recent drop rather than assume the early volume will return.

Cancellation is high, charge-offs are not recorded

At least 17.6% of approvals through FY2024 were cancelled, and 19.1% if loans not yet disbursed are counted. Of 37 funded loans in the older cohort, none had been charged off at the floor, either so far or by year five (0.00% each). That reports an empty record, not an impossibility. Neither measure cleared our distinctness margin against Nevada lending overall or physician offices nationally.

Nevada's practice and its property

Because the building secures the loan, test the real estate by itself: cost against appraised value and whether another medical user could occupy the space. For the practice, it should show the patient base in the actual submarket, payer mix, reimbursement for the specialty, and the time a new provider takes to build a panel. Competing groups and hospital systems also draw patients, so the study should show how referrals are secured. Coverage of the two loan pieces together should hold in a slow first year, and the appraisal should treat practice income and property value apart. The study should also say how the loan request compares with the median shown above, and what the extra or lesser amount pays for.