A solo practice reported $285K in “cash flow” and sought a $975K purchase price.

But: ❌ 100% of services delivered by the physician-owner
❌ No owner compensation or payroll—only 1099 nurse, admin and billing help
❌ Medicaid accounted for 45% of payer mix with reimbursement delays
❌ Addbacks included personal vehicle, meals, and family insurance

✅ Adjusted FCF: ~$65K
✅ Final valuation: ~$420K with transition plan

📌 Lender recalibrated and saved the loan by separating income from infrastructure.