Enquirer Consulting Group

Reachable Buyer Map

Prepared for Clay Rose, US Med-Equip · August 2026
Here is the map Dan promised for the walkthrough. US Med-Equip's reach today rides on the branch network and the relationships the people in those branches carry into the buildings they already serve. That reach is real, and it is also finite. This page is the market on the other side of it: the facility segments that rent, service and manage movable medical equipment, the roles inside each that actually decide, and rough counts, so the conversation can be about where the next layer of demand comes from. There is nothing to buy at the end of it.
About 27,000
Medicare-certified facilities nationally across the four counted lanes below. A finite, knowable list, which means coverage can be measured against it rather than guessed at.
Short-term acute care hospitals, the core lane
The lane the whole category is built around, and the one with the longest decision ladder. Equipment need is spotted on the floor, vetted technically, and signed commercially, usually by different people on different rungs. A relationship with one rung is not a relationship with the account.
Who decides: the standing agreement is won on one ladder: clinical engineering vets the fleet, materials management owns the rate card, and at multi-site systems a supply chain VP, a value analysis committee or an existing group purchasing agreement sits above them all. Day-to-day rentals then flow under that agreement, triggered from the floor. Rent-versus-buy is a periodic CFO policy call, not a rung in every order.
About 3,100
short-term acute care hospitals nationally
Critical access and rural hospitals
The ladder collapses here: one administrator or COO usually holds the technical, commercial and financial call in one chair. These facilities sit furthest from any branch network by definition, which makes this the lane where relationship reach thins out first and where a systematic channel changes the most.
Who decides: the administrator or CEO of the facility, directly. One conversation, one signer.
About 1,400
critical access hospitals nationally, about one in four of all US hospitals
Post-acute: long-term acute care, skilled nursing, inpatient rehab
Demand here moves with census, not with capital cycles: beds, support surfaces and respiratory equipment get rented when the building fills. The buyer is an administrator or director of nursing rather than a supply chain function, and the sale looks more like a standing relationship than a procurement event.
Who decides: the facility administrator, with the director of nursing as the demand trigger during a surge.
About 16,000
sites: roughly 300 long-term acute care hospitals, 1,200 inpatient rehab facilities and 14,700 skilled nursing facilities
Ambulatory surgery centers, the short-ladder lane
A different building and a different buyer. No clinical engineering department, no materials hierarchy, equipment need set by case volumes, and the decision usually sitting with one clinical operations leader. Fast decisions, and the easiest lane to over-invest in if it is not sized deliberately first.
Who decides: the center administrator or director of nursing in independent and physician-owned centers; where a management platform runs the center, procurement routes through the platform, not the building. Whether this lane belongs on your map at all is a product-mix question, worth deciding on purpose rather than by default.
About 6,600
Medicare-certified surgery centers nationally, active sites only
The new-metro cell: Portland, your newest branch market
A new market entry starts with zero relationship inventory, but the market cell itself is knowable on day one: every facility and every deciding role, before the first delivery. Portland, opened in April, counted here the same way as the national lanes.
Read it as: the accounts a new branch has to win, enumerated, rather than discovered one delivery at a time. Small enough to work completely.
About 15 to 20
hospitals in the Portland metro; about 60 to 65 across Oregon, before Southwest Washington is added
The split that changes who you are selling to: in-house vs outsourced HTM
A meaningful share of hospitals hand the clinical engineering function to an outside manager, and in a full conversion the on-site team moves onto the outsourcer's payroll. In those accounts the person who first spots an equipment need reports outside the building, and the decision routes differently.
Why it matters: the two halves of the hospital market need two different first conversations, and knowing which half an account sits in before anyone reaches out is cheap to establish and expensive to skip.
No reliable public split
no census separates in-house from outsourced; we would rather show nothing here than a number that cannot be defended

Where the openings are

1
Relationship reach is branch-shaped. The strongest accounts are the buildings the branches already serve, and that is exactly the property that caps it: reach grows only where a truck already drives. The counted lanes above are the denominator. Measured against it, the question stops being "how do we grow" and becomes "which of these named segments do we reach next, and with whom."
2
Each lane has a different first conversation. The acute care ladder rewards being known by the technical gate before the commercial gate is ever approached. The rural and post-acute lanes reward reaching one administrator directly. The ASC lane rewards speed and a surgical-specific message. One motion run identically across all four underperforms in every one of them.
3
A new metro is the cleanest test of a systematic channel. Where there are no legacy relationships, the difference between waiting for the phone and working a named list is fully visible. The two counted cells above are small enough to work completely, which makes them the natural proving ground before anything scales.
Built from public federal registries, counted live on 31 August 2026, and banded deliberately. These are certified-site records, not a census of buying entities: health systems and chains collapse many sites into fewer decisions, and a registry entry proves a facility exists and nothing beyond that. The one split with no credible public number says so rather than showing one.
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