/as-c-real-estate-construction-loans

/as‑c‑real‑estate‑construction‑loans

Yes — an ASC can get a real‑estate construction loan with a 620‑679 FICO, $1 M+ revenue, and 8‑12% debt coverage.

See your rate in 2 minutes — no credit‑score hit.

The specifics

To qualify, an ASC must:

• Credit: FICO 620‑679 is acceptable; fair‑credit borrowers see a 3‑5 % APR premium unless mitigated by collateral (see Crestmont Capital).
• Revenue: Minimum $1 M annual gross revenue, with 8‑12 % of monthly gross covering debt service.
• DSCR: At least 1.25×, ensuring payments remain below 12‑% of gross monthly revenue.
• Time in business: 12–24 months preferred; newly opened centers may be denied.
• Down payment: 15‑20 % of construction cost, typically required by Live Oak Bank.
• Term: 48‑84 months; APR ranges 8‑10 % for used equipment, 9‑12 % for new equipment.
• Collateral: Construction site equity and any purchased equipment lower APR by 1‑3 %.
• Other docs: Tax returns, lease agreements, detailed financial statements, and a business plan.

You can quickly estimate monthly payments using our in‑house Affordability Calculator or review recent market data with Deloitte’s 2026 commercial real‑estate outlook (Deloitte Insights). 

Qualification & edge cases

While fair‑credit ASC owners can qualify, certain scenarios differ:

• DSCR < 1.25× or revenue < $1 M – lenders typically deny or require a higher down payment.
• DSCR only 1.10× – may trigger a 4‑5 % APR increase or an alternative lender referral.
• Construction sites with < 70 % occupancy projections – higher risk, often requiring a 25 % down payment and a 6‑8 % APR.
• Late‑stage construction or incomplete zoning – can delay approval beyond 30‑45 days.

If your ASC sits near a threshold, consider securing a second financing plan (working capital or equipment loan) to strengthen cash flow before applying for the construction loan. 

Background & how it works

Surgery centers usually self‑fund expansions or seek specialized lenders. The ASC construction loan covers land acquisition, building, and major equipment, tying each loan portion to specific assets—this collateral adjustment lowers financing costs. Lenders assess revenue, DSCR, and asset value, using a blend of SBA rules and private‑sector flexibility. They also align terms with the 2026 payment rule changes from ASCA and CMS, ensuring compliance with new reimbursement caps.

The 2026 commercial real‑estate outlook predicts higher construction costs but improved loan availability for health‑care properties, especially outpatient centers, due to persistent demand (Deloitte). 

Bottom line

By meeting a modest 620‑679 FICO, $1 M+ revenue, and 1.25× DSCR, an ASC can secure a construction loan in 48–84 months at 8‑12 % APR, easing the capital burden on expansion. See your rate in 2 minutes – no credit‑score hit.

Disclosures

This content is for educational purposes only and is not financial advice. surgerycenterfinancing.com may receive compensation from partner lenders, which may influence which products are featured. Rates, terms, and availability vary by lender and applicant qualifications.

Sources

• Crestmont Capital
• Live Oak Bank
• Deloitte Insights
• Medical Imaging Center Equipment Financing & Practice Acquisition Capital in Huntington Beach, CA
• Affordability
• Affordability Calculator