GET IN TOUCH

Healthcare Infrastructure.Operator Discipline.

Jay Dahal combines Silicon Valley systems thinking with Texas healthcare execution. He builds, funds, and operates facilities under one model.

Freestanding ER · White Rock
Freestanding ER · White Rock
Grand Opening · Lufkin
Wellness Center · Irving
Wellness Center · Irving
Wellness Clinic
Wellness Clinic
Emergency Facility
Emergency Facility
Emergency Room · Lufkin
Emergency Room · Lufkin
Facility OperationsPatient GrowthHealthcare FinanceAI Data SystemsFreestanding ERTexas MarketsOperator DisciplineFacility OperationsPatient GrowthHealthcare FinanceAI Data SystemsFreestanding ERTexas MarketsOperator DisciplineFacility OperationsPatient GrowthHealthcare FinanceAI Data SystemsFreestanding ERTexas MarketsOperator Discipline

Operating record

Numbers from the work, not from a deck.

Every figure below is sourced from the company that produced it. Click a source code to verify.

The operating model

How a healthcare business gets built, funded, operated, and grown.

Each step stands on its own. Together they let a facility open, fill the schedule, report clean numbers, and improve.

01

Market

Pick markets where population, access gaps, and demand meet. Texas first.

02

Facility

Remodel the site, staff the team, license, and open. Real doors, a real opening day.

03

Patient growth

Fill the schedule with search, reviews, and referral systems that compound.

04

Finance

Run site-level P&L, cash discipline, and reporting that survives diligence.

05

Data

Turn operating data into dashboards and AI that improve the next decision.

Case studies

Proof measured in patient visits, acquisition cost, and revenue.

Every case study below is sourced and avoids implying guaranteed results.

Freestanding ER growth

Freestanding ER network grew patient visits 45% in 90 days, DFW Metroplex

A three-location freestanding ER network in the DFW Metroplex had weak Google local pack placement, high patient acquisition cost, a 3.2 average rating, and a slow mobile experience. Disciplined local SEO, Google Ads restructuring, and a post-visit review system added $800K+ in annual revenue across all three locations in 90 days.

Read the case study →

Results

  • +45%

    patient visit growth

  • $800K+

    added annual revenue

  • -65%

    patient acquisition cost

  • 4.7

    Google rating (was 3.2)

Urgent care growth

Houston multi-location urgent care group tripled appointment volume at 60% lower acquisition cost

A multi-location urgent care group in the Houston MSA was losing patients to better-positioned competitors in a saturated market. Trade-area campaign segmentation, call attribution from scratch, and intent-mapped local creative tripled appointments across all locations with no budget increase, while cutting per-appointment acquisition cost by 60%.

Read the case study →

Results

  • 3x

    appointment growth

  • -60%

    patient acquisition cost

Healthcare local SEO

Independent Texas wellness clinic ranked #1 in Google local pack with 70% more appointments

An independent wellness clinic in suburban Texas was invisible in the Google local pack despite strong patient satisfaction. A full Google Business Profile rebuild, healthcare citation cleanup, and a HIPAA-compliant post-visit review workflow produced a #1 local pack ranking and 70% more appointment bookings, with zero paid ad spend.

Read the case study →

Results

  • #1

    local pack ranking

  • +70%

    appointment bookings

Freestanding ER launch

De novo freestanding ER opened cash-flow positive in 90 days, East Texas

A new freestanding emergency room launched in an East Texas market with no brand recognition and a competing hospital-affiliated ER nearby. A pre-opening local SEO foundation, physician referral network activation, and an intake-to-discharge workflow built for throughput put the facility at breakeven in 45 days and cash-flow positive by day 90.

Read the case study →

Results

  • 90 days

    to cash-flow positive

  • 4.8

    Google rating at day 90

  • 45 min

    average door-to-discharge

  • 3

    active physician referral relationships by day 60

Healthcare staffing operations

Healthcare staffing company scaled from 120 to 600+ employees while cutting turnover 40%

A growing Texas healthcare staffing operation was scaling headcount but losing clinical staff faster than it could hire. A workforce operations overhaul covering onboarding, scheduling, compensation structure, and manager accountability grew active staff from 120 to 600+ while cutting voluntary turnover from 68% to under 40% annualized.

Read the case study →

Results

  • 600+

    active staff (from 120)

  • -40%

    voluntary turnover reduction

  • -35%

    cost-per-hire reduction

  • 5x

    headcount growth in 18 months

Healthcare revenue cycle management

Physician group recovered $1.4M in denied claims and cut billing lag from 42 to 11 days

A multi-specialty Texas physician group was running a 42-day average billing lag, losing $1.4M annually to preventable claim denials, and operating without a denial management workflow. A revenue cycle overhaul covering charge capture, coding compliance, denial root-cause analysis, and payer contract renegotiation recovered the denied revenue and cut billing lag to 11 days within six months.

Read the case study →

Results

  • $1.4M

    denied claims recovered

  • 11 days

    average billing lag (from 42)

  • -72%

    denial rate reduction (18% to 5%)

  • 3

    payer contracts renegotiated

Healthcare network expansion

Texas healthcare network expanded from 4 to 24+ locations while maintaining operating margin

A Texas healthcare operator needed to scale a four-location network to meet market demand across multiple metros, without losing the operational control and reporting visibility that made the existing locations profitable. A disciplined site selection model, standardized operating playbook, and centralized reporting infrastructure supported expansion to 24+ locations while holding operating margin within three percentage points of the original four-site baseline.

Read the case study →

Results

  • 24+

    locations operated

  • $100M+

    annual revenue

  • 600+

    staff managed

  • <3pts

    operating margin variance vs baseline

Healthcare technology and reporting

Healthcare operator deployed tech-enabled reporting across 24 locations with real-time visibility in 60 days

A 24-location Texas healthcare network was managing operations through disconnected EHR instances, manual billing reports, and spreadsheet-based staffing models, with no real-time visibility into network-level performance. A technology integration and reporting infrastructure build gave ownership a live multi-site dashboard within 60 days, enabling decisions that improved margin by 8% in the first operating quarter.

Read the case study →

Results

  • 60 days

    to live multi-site dashboard

  • +8%

    margin improvement in first quarter

  • 24

    locations reporting in real time

  • 6 EHRs

    integrated into one reporting layer

Texas thesis · Silicon Valley tech

Where the patients are. Where the demand is going.

Texas continues to add population faster than its emergency facility footprint. The market logic for FSER and disciplined operators is structural, not seasonal.

Market shape

  • 700+freestanding ERs operating in Texas, a working baseline of demand.
  • 8%annual growth rate, with DFW continuing to absorb major population in-migration.
  • 24/7access. Emergency care can’t wait for office hours, and operators that show up keep market share.

Source [S5] Focus Health investors. Texas thesis content reflects publicly stated positioning. See /healthcare-thesis for the full reasoning.

TX

Why it matters

A healthcare facility is more than real estate. It is a 24/7 operating commitment with clinical, regulatory, and capital obligations, managed end-to-end with Silicon Valley grade data systems and AI tooling. That is the bar Jay’s portfolio operates against.

Read the thesis →

Founder

From accounting in Kathmandu to Silicon Valley systems and Texas healthcare operations.

Jay Dahal

Path

Kathmandu → BYU → PwC → Consulting → Machnet (SV) → Healthcare

Jay Dahal has 20+ years of operations, finance, and technology experience. He is a founder, operator, and finance leader who builds healthcare companies where Texas markets meet Silicon Valley technology. His work connects facility operations, AI-powered growth systems, finance, and data into one operating story.

  1. Over two decades, Jay worked in accounting in Kathmandu, studied at BYU, spent five years at PwC where he learned disciplined reporting, and consulted for small and mid-sized companies.
  2. He then helped build remittance and cross-border payments infrastructure as co-founder and CFO of Machnet, based in Silicon Valley. There he absorbed the product velocity, data culture, and investor rigor that the Bay Area runs on.
  3. Today he lives in Silicon Valley and runs healthcare operations across Texas. He opens and operates facilities, grows patient volume, holds the finance line, and uses Silicon Valley-grade data systems to make operating decisions in real time. He also invests in early-stage founders across fintech, AI, healthcare tech, and infrastructure.
  4. His edge is the combination. He thinks like a Silicon Valley founder and executes like a Texas business builder. He handles money, people, systems, and risk with the discipline real facilities require.

The finance background is why capital, facilities, people, and patient growth can all be managed with discipline.

Read the long story →

For Capital Partners

An operating portfolio. Not a concept.

Focus Health operates 24+ locations across Texas. Site-level P&L, patient demand metrics, and cash position are reported to capital partners on a documented cadence. Investor materials are available to qualified parties on request.

Informational only. Not an offer to sell securities. Materials shared with accredited investors under applicable exemptions.

Work with Jay

Building or funding healthcare in Texas? Start a conversation.

You bring the clinical work. Jay runs facilities, patient growth, finance, and reporting. One operator, accountable for the numbers.

Book a 30-min call