DMEPOS supplier for UK St. Claire with cross-county routing into Carter County and an eight-county home-health catchment overlapping the Cumberland Ranger District footprint.

UK St. Claire is the only UK HealthCare satellite outside Fayette. The vendor-credentialing surface is both local (the 159-bed Morehead facility plus seven primary-care sites) and corporate (the Lexington academic-medical-center procurement structure). A Morehead-resident DMEPOS supplier credentialed onto both surfaces carries access to a procurement channel that did not exist before May 2026. The Sisters of Notre Dame Eastern Kentucky Foundation continues only as a separate philanthropic foundation, not as procurement counterparty.

Eight-county catchment plus the Carter cross-county routing pattern. UK St. Claire's clinical catchment runs Rowan, Bath, Carter, Elliott, and Menifee as the five-county primary-care footprint plus Morgan, Fleming, and Lewis on the broader referral side. Carter County has no county-resident acute-care hospital; Carter residents split eastward to King's Daughters in Ashland and westward to UK St. Claire in Morehead. The Carter-westward share is the cross-county routing surface a Morehead-resident DME supplier carries through the UK St. Claire discharge-planner channel without competing against an in-Carter hospital DME unit.

DMEPOS demand is Medicare-primary and survives Medicaid managed-care compression. Oxygen concentrators, hospital beds, mobility devices, CPAP and BiPAP supplies, ostomy and wound-care supplies, and enteral nutrition flow through CMS DMEPOS supplier enrollment under 42 CFR 424 Subpart P with the $50,000 surety-bond requirement and CMS-deemed accreditation. The lane is structurally less exposed to a Kentucky Medicaid managed-care rate reset than home-health or behavioral-health sub-tiers.

Three legs plus PrimaryPlus and Pathways adjacency clears banker concentration scrutiny. A single-facility UK St. Claire DME book is concentration-flagged. Three legs — UK St. Claire discharge-planner, UK HealthCare Lexington vendor portal downstream, and the eight-county home-health and SNF bench — plus the PrimaryPlus FQHC adjacent referral channel at 2300 KY-801 N and the Pathways cross-referral surface produce a five-counterparty diversification posture. Banker covenant: no single buyer above 60 percent of revenue by Year 2.

Per-engagement scope. DMEPOS gross margin runs 25 to 40 percent on standard catalog (oxygen, CPAP, mobility, wound care, ostomy, enteral). An 80 to 180 SKU inventory float at $60,000 to $160,000 plus a service van plus warehouse-and-office fit-out plus 2 to 4 counter/delivery/billing FTE supports $450,000 to $950,000 Year-1 revenue. Year-3 mature revenue $850,000 to $1.6 million.

Year 1: founder plus 2 to 4 FTE. Single anchor — UK St. Claire discharge-planner channel. CMS DMEPOS supplier enrollment, surety bond, and CMS-deemed accreditation in seat. Revenue base $180,000 to $420,000. Founder take-home $60,000 to $100,000.

Year 2: founder plus 3 to 5 FTE. UK HealthCare Lexington vendor portal credentialed. PrimaryPlus FQHC adjacency live. First cross-county catchment home-health and SNF accounts signed. Revenue base $480,000 to $1,000,000. Founder take-home $90,000 to $160,000. Banker covenant: no single buyer above 60 percent of revenue.

Year 3 onward: founder plus 4 to 7 FTE. Three legs mature plus PrimaryPlus and Pathways adjacency. Revenue base $850,000 to $1,600,000. Sustained founder take-home $130,000 to $220,000.

Founder-side capital $180,000 to $480,000. Inventory float $60,000 to $160,000. CMS DMEPOS $50,000 surety bond. CMS-deemed accreditation plus HIPAA-compliant intake software $15,000 to $35,000. Warehouse plus office lease and fit-out $20,000 to $60,000. Service van plus delivery vehicle $30,000 to $60,000. UK HealthCare vendor-portal credentialing plus payer credentialing $10,000 to $25,000. Insurance (general liability plus product liability plus auto plus home-setup E&O) $20,000 to $45,000 annually. 90-day payroll float plus 12-month working-capital reserve $55,000 to $150,000.

• UK St. Claire

  159-bed UK HealthCare-affiliated satellite hospital — acquired July 1, 2024

  Active in market

  222 Medical Circle, Morehead. Don Lloyd CEO; Chris McClurg CFO. Discharge-planner channel is the primary DME referral surface.
• UK HealthCare (Lexington corporate parent)

  Academic-medical-center enterprise vendor portal

  Out-of-county

  Lexington, Fayette County. Vendor-portal credentialing is the strategic access lever.
• Eight-county home-health agency roster

  Rowan, Bath, Menifee, Morgan, Elliott, Fleming, Lewis, Carter — Certificate of Need-gated

  Institution

  Three to six Morehead-resident home-health agencies plus catchment-county roster.
• PrimaryPlus FQHC Morehead site

  Lewis County-headquartered FQHC — four-bay drive-thru clinic

  Active in market

  2300 KY-801 N, Morehead. Adjacent primary-care referral channel for DME orders.
• Pathways Inc

  Regional CMHC and CCBHC, Ashland-headquartered

  Out-of-county

  Cross-referral surface for behavioral-health-adjacent DME (CPAP, mobility devices for chronic-illness populations).
• Carter County residents (cross-county westward routing)

  Carter County zero-county-resident-acute-care routing pattern

  Out-of-county

  Carter residents split eastward to King's Daughters in Ashland and westward to UK St. Claire in Morehead.
• CMS Region IV (Atlanta)

  DMEPOS supplier-enrollment counterparty under 42 CFR 424 Subpart P

  Out-of-county

  $50,000 surety bond. CMS-deemed accreditors: BOC, ABC, HQAA, NABP, TJC, ACHC, CHAP.
• Kentucky CHFS Department for Medicaid Services

  Kentucky Medicaid DMEPOS bilateral credentialing — managed-care MCO contract administration

  Out-of-county

  Five-plan MCO panel: Aetna Better Health, Anthem BCBS KY, Humana Healthy Horizons, Passport by Molina, UnitedHealthcare Community Plan, and WellCare.

The founder profile is mid-career with one of three on-ramps: prior DMEPOS supplier or home-medical-equipment operations tenure with established CMS-deemed accreditation; prior UK HealthCare or academic-medical-center vendor-portal tenure willing to add CMS DMEPOS credentialing over 6 to 12 months; or prior regional-hospital discharge-planner or case-management tenure adding the supplier-side credentialing arc over 12 to 18 months. A first-time founder without prior DMEPOS or academic-medical-vendor tenure cannot enter this lane cold.

Relationship-portfolio target at launch: UK St. Claire CEO Don Lloyd and CFO Chris McClurg's offices; UK St. Claire discharge-planning department head and director of case management; UK HealthCare Lexington vendor-portal administrator; the UK College of Medicine Morehead Rural Program coordinator for referral cross-channel; PrimaryPlus Morehead FQHC clinical director; the Pathways Rowan-resident clinical lead; home-health-agency directors of operations across Rowan, Bath, Menifee, Morgan, and Elliott; Kentucky CHFS OIG home-health licensure contact; and Kentucky Medicaid managed-care DMEPOS credentialing contacts across the five-plan roster. Twelve to eighteen named contacts by end of Year 1.

Entity and credentialing posture. Kentucky business registration, KOSHA workers' comp, healthcare-elevated general-liability, product-liability, auto-liability, and home-setup E&O. CMS Medicare DMEPOS supplier enrollment under 42 CFR 424 Subpart P plus the $50,000 surety bond plus CMS-deemed accreditation (BOC, ABC, HQAA, NABP, TJC, ACHC, or CHAP). Kentucky Medicaid DMEPOS bilateral credentialing plus the five-MCO managed-care DMEPOS panel. HIPAA-compliant intake and DMEPOS billing systems.

National DMEPOS suppliers — Apria Healthcare, Lincare, Rotech, AdaptHealth, and Quipt Home Medical — bid at multi-state distribution-network scope and run Eastern Kentucky routes from Lexington or Knoxville hubs. A Morehead-resident operator carrying the dual-portal credential stack (UK St. Claire local plus UK HealthCare Lexington) plus same-shift mobilization sits below their pricing floor.

• — UK St. Claire 2026 corporate-governance structure post-acquisition (CEO/CFO continuity, 159-bed-count confirmation, service-line scope).
• — UK HealthCare Lexington vendor-portal credentialing pathway for non-incumbent DMEPOS suppliers — credentialing timeline and whether the satellite is governed by the Lexington portal or a separate satellite-local procurement structure.
• — UK St. Claire's 340B status post-acquisition.
• — The three-to-six Morehead-resident home-health agencies plus catchment-county roster and their contracted DME vendor relationships.
• — PrimaryPlus Morehead FQHC corporate-of-record and Rowan-site operating status.
• — Pathways Inc 2026 CEO, Rowan operating-site address, and service-line list.
• — Kentucky Medicaid managed-care DMEPOS credentialing timelines and rate schedules across the five-plan roster.
• — The Carter County westward versus eastward routing split on acute-care discharges.

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