Mobile sterile-processing and biomedical-equipment service van running a 30-mile route across Baptist Health Richmond, Saint Joseph Berea, and EKU's nursing-simulation labs.

The healthcare anchor density is unusual for a county of 95,800 people. Baptist Health Richmond carries 488 employees behind a recent $20 million-plus renovation and the Telford Cancer Center expansion. Instrument-set volumes, flexible-scope inventories, and infusion-pump fleets all run larger than the population would predict. Health Care and Social Assistance is the second-largest sector by establishments at 283, carrying 4,167 employees and a $204 million payroll. EKU's School of Nursing simulation grants — $634,500 from the Council on Postsecondary Education plus an additional $150,000 home-simulation grant in April 2025 — add a second device population of high-fidelity manikins, Stryker beds, and simulation IV pumps that the hospital biomed shops do not service.

Baptist Health uses Medline as its named prime distributor under a 2014 agreement. Medline handles consumable distribution, par optimization across roughly 90 percent of nursing-floor storerooms, and the Put-Away-Ready cart program in Louisville, Lexington, and Richmond. Service categories that require on-site labor with hand-tools — instrument repair, scope reprocessing diagnostics, infusion-pump preventive maintenance — sit outside a prime distributor's scope. That split is the opening for a mobile carve-out operator.

Saint Joseph Berea sits on a separate procurement chain. As a CHI Saint Joseph Health facility under the CommonSpirit parent, its supplier master is independent of Baptist Health's. A single Madison-headquartered service operator with both vendor numbers can serve Richmond and Berea on the same morning route. Saint Joseph Berea's 25-bed scale puts it inside a service profile that national vendors price as an inconvenient stop, not a flagship account.

The satellite ring extends the route economics. Saint Joseph Berea's stated service area covers Madison, Estill, Garrard, Jackson, and Rockcastle — five counties of clinic, urgent-care, hospice, and outpatient-surgery sites within 30 miles. Hospice Care Plus at 208 Kidd Drive in Berea deploys hospital beds, infusion equipment, and durable medical inventory into homes that need preventive-maintenance cycles. Bluegrass Care Navigators in Lexington is the larger equivalent on the same scope. White House Clinics, Berea Urgent Care, Kentucky Urgent Care, and Madison County Health Department clinics in both seats absorb shoulder-hour route capacity.

Per-instrument-set repair pricing. SPD instrument-set repair is priced per piece at $4–$18 for sharpen/realign on scissors and clamps, $25–$85 for tip repair on rongeurs and needle holders, and $120–$350 for full Mayo-stand or laparoscopic-instrument refurbishment. A 105-bed Baptist Health Richmond OR running 8–14 cases/day cycles roughly 200–350 instruments through SPD daily; the repair-eligible subset (the 5–10% pulled at decontamination QC) is 10–35 instruments/day, of which 60–70% are sharpen/realign and 30–40% tip-repair. Conservative monthly repair revenue at 60% capture from a single 105-bed account: $8,000–$18,000/mo. Add Saint Joseph Berea (25-bed) at scaled volume + the EKU simulation manikin calibration scope: $12,000–$25,000/mo before the satellite ring.

Flexible-scope reprocessing ASP fees. Flexible endoscope reprocessing services are billed per scope per cycle at $35–$95 for high-level disinfection QA verification and per-event leak testing, and $450–$1,800 for repair of channel breaches and angulation problems. A small regional hospital with a GI suite running 20–40 procedures/week generates 1–4 leak-test failures per month and 1–2 repair events per quarter. Ballpark monthly scope-program revenue at one anchor: $2,500–$6,500/mo.

Infusion-pump biomed PM ranges. Infusion-pump preventive maintenance is priced at $35–$95/pump per annual PM (BMET labor) plus $150–$650 per repair event. A 105-bed hospital fleet runs 80–160 infusion pumps in active rotation; annual PM revenue per anchor is $5,000–$15,000, plus repair events through the year. Hospice Care Plus's in-home pump deployment (estimated 50–120 pumps in active service across the six-county footprint) adds a similar PM book on a different cadence. Combined infusion-pump PM revenue across the route: $18,000–$45,000/yr.

Mobile-van route capacity 8–12 sites/route + RMA NAICS 811219 margins + SBA 7(a) worked example. A 30-mile mobile route from Richmond reaches Berea, Berea hospital, three urgent-care clinics, two health-department sites, three FQHC sites, and the EKU simulation center — 8–12 stop capacity per day, 4-day operational rotation. NAICS 811219 (Other Electronic & Precision Equipment Repair) industry medians run 38–48% gross margin, 14–22% net at an owner-operator scale. Year-2 revenue target $480K–$720K with two CRCST/BMET techs + owner; SDE $95K–$160K. Acquisition path: small regional biomed firm at 2.0–2.5× SDE = $200K–$400K purchase. SBA 7(a) at 25% down ($50K–$100K), 10-year term at ~11%: debt service ~$22K–$44K/yr, year-one owner take-home $55K–$120K after debt service. Start-from-zero path: van + diagnostic kit + sharpening tooling + autoclave-tester + scope leak-tester + 1-2 CRCST/BMET tech salaries + ~6mo working capital = $150K–$350K.

• Baptist Health Richmond

  Regional hospital — 105 beds (94 acute + 11 psych), 488 employees

  Institution

  Recent $20M+ renovation; Robert L. Telford Cancer Center expansion dedicated August 2024 ($3M, doubled chemo chair capacity); $7.9M campaign close December 2024. Baptist Health system uses Medline as named prime distributor since 2014 — leaves SPD instrument repair, scope reprocessing, and biomed PM as discrete service-vendor scope.
• Saint Joseph Berea (CHI Saint Joseph Health / CommonSpirit)

  Critical access hospital — 25 beds, separate corporate procurement

  Institution

  305 Estill Street, Berea. Established 1898 on the Berea College grounds. Service area covers Madison, Estill, Garrard, Jackson, Rockcastle. Separate vendor master from Baptist Health — a single mobile operator with both vendor numbers carries the regional route.
• EKU School of Nursing — Clinical Skills Laboratory & Simulation Center

  Nursing simulation center — manikin + simulation-IV-pump device population

  Institution

  $634,500 CPE grant for simulation equipment; $150,000 additional home-simulation grant April 2025; seven Stryker beds donated by Baptist Health Richmond 2022. Calibration and PM scope distinct from hospital biomed contracts.
• Madison County Health Department (Richmond + Berea clinics)

  Public-health clinics — both county seats

  Institution

  Phone 859-623-7312. Vaccination, immunization, and family-planning clinic device populations on shoulder-hour mobile route.
• White House Clinics

  FQHC — Richmond + Berea locations

  Institution

  Federally Qualified Health Center. Multi-site primary-care device fleet on the regional route.
• Hospice Care Plus

  Non-profit hospice — Berea HQ at 208 Kidd Drive

  Institution

  Serves Estill/Jackson/Lee/Madison/Owsley/Rockcastle. Deploys hospital beds, wheelchairs, and home medical equipment into homes — PM cycle on durable medical inventory is a recurring carve-out scope. Phone 859-986-1500.
• Bluegrass Care Navigators

  Hospice / palliative — Lexington HQ, regional footprint

  Out-of-county

  Lexington-headquartered (1733 Harrodsburg Rd). Larger up-system equivalent of Hospice Care Plus; their Madison County in-home device fleet is a separate sales conversation through the corporate clinical-engineering office, not the local clinical staff.
• STERIS Instrument Management Services

  National surgical-instrument repair

  Out-of-county

  STERIS IMS offers scheduled same-day on-site repair from regional service centers. Parent STERIS plc operates from Mentor, Ohio. Main competitor for hospital-system instrument-set repair contracts. Lexington-area coverage exists but does not preclude a Madison-headquartered local with one-day turnaround on small-set work.
• Agiliti Health

  National biomedical equipment service

  Out-of-county

  Service center at 3881 Business Park Drive, Louisville (about 85 miles from Richmond). Nationwide biomedical equipment service, surgical-instrument repair, and a sterile-processing microcredential program in partnership with the Competency and Credentialing Institute. The defender for any large hospital-system PM contract, but Louisville's drive time leaves a 30-mile mobile-route gap that a Madison operator fills on tight turnaround scope.
• SterilMed (Johnson & Johnson MedTech)

  Single-use device reprocessing — Ethicon subsidiary

  Out-of-county

  SterilMed reprocesses single-use medical devices including surgical instruments, power tools, endoscopes, and video equipment. Ethicon Endo-Surgery (J&J) acquired SterilMed in 2011. Its scope is FDA-regulated single-use device reprocessing, a different scope from on-site SPD instrument repair and flexible-scope reprocessing.
• BMES (Biomedical Equipment Services)

  Regional biomedical repair — Louisville-area depot model

  Out-of-county

  Ships-in biomedical equipment to Louisville facility for repair. Depot-only model — not a same-day on-site competitor for a Madison-headquartered mobile operator on infusion-pump PM.
• Auxo Medical

  Sterilizer / autoclave maintenance — Lexington presence

  Out-of-county

  Located in Lexington with stated coverage of Lexington, Frankfort, Somerset, Louisville, Cincinnati and surrounding areas. Sterilizer + autoclave specialist — adjacent scope to but not identical with SPD instrument repair, scope reprocessing, and infusion-pump biomed.

Two acquisition lanes. The first is a small regional biomed firm — an existing CRCST/BMET-credentialed shop in Lexington or Louisville that would relocate or open a Madison-county branch under new ownership. The cert transfer (HSPA / former IAHCSMM CRCST credentials, ISO 13485 if held, OEM-trained-tech credentials per pump manufacturer) is the asset; the customer book follows. KY Secretary of State NAICS 811219 (Other Electronic & Precision Equipment Repair) and 811310 (Commercial & Industrial Machinery Repair) entity pulls produce the candidate list — entities with 8–20 years tenure, founder-era ownership, and a stated service area touching Madison/Fayette are the screen.

The second lane is a clean greenfield with a credentialed founder. An ex-Baptist Health Richmond SPD manager or ex-UK HealthCare biomed tech with five years of in-system experience and an existing relationship with anchor SPD directors enters as a single-truck operator, books one anchor account, and adds the second. The capital tier is lower ($150K–$350K) but the customer-acquisition cycle is 6–12 months. The credentialed-founder path is the more defensible fit — the credentials are the moat.

Named target list pending verification — the KY SoS pull on NAICS 811219/811310 entities headquartered in Fayette, Madison, Jessamine, Clark, Garrard, and Rockcastle, screened for founder-era principals and absence of a public successor, generates the working list. None of the named regional incumbents (Auxo Medical, BMES, American Surgical Instrument Repair) are confirmed acquisition targets without verificationcalls; their inclusion here is structural, not transactional.

• — Baptist Health system supplier-onboarding details. The exact vendor-number-issuance process, insurance minimums (general liability, professional, auto), W-9 and W-8BEN handling, and the split between Louisville corporate procurement and Richmond facility-level procurement are not public.
• — Where the Medline prime-distributor scope ends and outside instrument-repair or biomed PM contractors begin. The line is contract-specific and not visible from the outside.
• — How Saint Joseph Berea vendor onboarding routes — through CHI Saint Joseph Health in Lexington, through CommonSpirit's national supplier portal, or through both.
• — Whether EKU's School of Nursing simulation center currently uses Stryker, Laerdal direct, a regional sim-center vendor, or in-house lab staff for manikin calibration and simulation-IV-pump preventive maintenance.
• — Inspection records from the Kentucky Office of Inspector General Division of Health Care for the Baptist Health Richmond and Saint Joseph Berea sterile-processing departments. Open findings or remediation orders would change the urgency profile.
• — How many CRCST and HSPA (formerly IAHCSMM) certificate-holders live in Richmond zip 40475 and Berea zip 40403. HSPA does not publish geographic distribution, so the credentialed labor-pool depth is unknown.
• — Baptist Health Richmond's actual instrument-set inventory and annual repair-spend allocation. We estimate 200 to 350 instruments cycled through SPD per day, but the actual figures are internal.
• — Hospice Care Plus and Bluegrass Care Navigators in-home pump fleet count. Both deploy hospital beds, infusion pumps, and oxygen concentrators; neither publishes fleet size.
• — Whether the Lexington VA medical center (Leestown and Cooper campuses, about 25 miles from Richmond) holds biomed preventive-maintenance and instrument-repair scope on a national VA contract or procures it regionally.
• — Whether STERIS, Agiliti, SterilMed, and American Surgical Instrument Repair are federally registered awardees (verified via SAM.gov by entity name) before any federal-contracting framing.

Tonight, this week, this month — in that order. Each step produces a yes/no or a number, not a deeper understanding.