Urgent Care Feasibility Study in Texas

Texas is first in the nation for urgent care and ambulatory surgery loans

Texas takes first place, 1 of 41, among states for loans to walk-in and day-surgery clinics, with 44 loans over FY2017 to FY2026 worth $74.1 million. A location quotient of 1.95x says the class takes close to double the share of Texas lending that it takes nationally, even though inside Texas the class sits 28 of 39. Loans are large: a median of $1.1 million is 1.41x the national figure, with most requests from $571,125 to $2.3 million, which fits a clinic that needs imaging, procedure rooms and a leased or owned building.

Programs, lenders and the counties

SBA 7(a) carried 40 loans and SBA 504 carried 4, and franchise affiliation is 4.5%. PNC Bank, National Association stands alone among lenders in this cell, with 6 loans worth $11.4 million. Harris County has 7 loans, Fort Bend 6, Collin 5 and Bexar 4, with Travis at 3. The suburban pattern is clear: Fort Bend and Collin outrank Dallas and Tarrant.

Cancellation and an uneven calendar

About one approval in ten fell away: cancellations reached at least 10.3% in the FY2017 to FY2024 group, and the ceiling is unchanged. Texas has no published charge-off percentage in this cell, because the funded group contains under 30 loans; the gap is no sign of zero. Approvals arrive in clumps: 9 loans and $19.5 million in FY2017, 0 loans and $0 in FY2020, 6 loans and $11.9 million in FY2024, and 1 loan worth $500,000 in FY2025.

What an urgent care study must settle

Urgent care stands or falls on visit volume, so the study should test population and commuter flows around the site, competing clinics and freestanding emergency rooms, and payer contracts. It must test the build-out and equipment budget against loan sizes that have been available, then run coverage at a patient volume below the sponsor's forecast. Staffing physicians and nurse practitioners is a real risk. The appraisal has to distinguish the building from the operating business.

The industry list files walk-in clinics, surgery centers and freestanding emergency rooms under one code, which is why those competing topics cannot be told apart here.