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1. Choose The Right Niche
2a. Choose the Right Name & Entity
2b. Define Your Practice
3a. Build Your Identity
3b. Determine Your Startup Budget
4a. Choose the Right Location
4b. Choose the Right Equipment
5a. Get Your Federal ID & State Numbers
5b. Open Bank Account & Begin Bookeeping
6a. Get Your Insurance Contracts
6b. Choose Your Supplies
7a. Setup Your Billing and Payment Channels
7b. Prepare Your Facility
8a. Pre-open Advertising
8b. Setup Your Scheduling System
9a. Create Your Intake System
9b. Create Your Evaluation System
10a. Create Your Treatment System
10b. Recruit Employee(s)
11a. Implement Your Marketing Plan
11b. Screen/Hire/Orient Your Employee(s)
12a. Train/Motivate/Pay Your Employee(s)
12b. Implement Policies for Success
13a. Collection Procedures
13b. Track Your Daily Productivity & Cash Flow
14a. Make Contact with Referral Sources
14b. TRUE MARKETING |
Download worksheets here
IMPORTANT:
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Table
of Contents
How
do I determine what I can afford for rent?
You must complete all
sections prior to this one in order to answer
that. The worksheet you completed in the
prior section (3b) should give you a good idea of
what your startup and first years financial needs will
be. If you don't have enough money than you will have to
downsize your plan and the rent is a great place to start!
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What location is best
for me
You have many options when deciding where you want
to operate from. Remember, if you follow
all the steps in positioning yourself to be
in demand, the location you choose is mere
geography. If you have a large startup budget
with strong contacts and resources in your community
then and only then do I recommend any space beyond 1,000 - 2,000 ft2 at
startup.
For most of you who are solo starters, I
would recommend subletting from an existing private practice such as a
physician, physical therapist, chiropractor, health club, etc. Do not
get tied into a space that is beyond your means. After
succeeding in your first location, then open another that is larger and
better. Some beginners make the mistake of doing
this backwards. They try to open a large
facility from the beginning which takes
longer to startup and establish.
And when they finally open another it's a
mere "satellite". Don't make this mistake because the sooner
you can open your second site, the sooner
you can begin reaping the rewards of duplication such as:
- Quantity discounts when buying supplies and
inventory
- Marketability and credibility with multiple
locations
- Referral convenience for your referral
sources
- Marketing advantage
of advertising two for the price of one
- Two income sources, and more...
The key to choosing a profitable location
is determining the factors that will increase patient volume
for your practice. Ask yourself questions such as:
- What type of location is best for the niche I've
carved-out?
- How much rent can I afford?
- Is the potential location appropriate for
what I plan to do there?
- Will patients/customers come on foot?
- Will patients/customers drive and, if so, where
will they park?
- Will more patients/customers come if I
locate near other businesses?
- Will the reputation of the neighborhood or even of
a particular building help draw patients/customers?
Ultimately, the perfect location for your
practice is a very individual matter. Spend some time figuring out the
habits of the patients/customers you want to attract, and then choose a
location that fits.
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Where do I begin?
Determine the average rent in your
area by contacting commercial brokers and agents. They are
great sources of information on rental costs in various neighborhoods.
They'll generally give you an average figure for the cost of commercial
space per square foot per year in a given area. Once you have this
figure, you can compare it to the costs of other spaces you're
considering.
There are several ways to
research potential locations. The way I recommend is blow up
a map of the city/area you are in (kinkos or copy centers can do this
for you) and do the following:
Mark where
other physical therapy private practices are. Even though
they you should not view them
as competitors because of your specialized niche it behooves
you to keep a little distance from them (if you want to join
PTPN - not recommended - they have a rule where
you must be a certain distance away from other provider
members).
- Mark where acupuncturists,
chiropractors, podiatrists are
- Mark where the nearest
hospital is.
- Mark where primary MD's are.
- Mark where orthopedists are.
- Mark any outpatient surgical
centers, etc.
- Where are the health clubs?
- Where are the professional
massage therapists (not parlors)?
- Where are the senior
communities?
- Where are the residential
communities, high schools?
Once you do this and get a
birds eye view, you can strategize a better area/location based on your
niche service. Think about issues of traffic, people coming
home from work, where new developments may occur, what part of the city
is newer, etc.
Once you choose the best
area for your niche service you can either approach an existing
business listed above or lease your own space.
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Is Your
Proposed Location Appropriate for What You Plan to Do There?
Communications
Wiring
Another
consideration that's important for practice these days is
having modern phone and other data lines into the business. When you're
considering a specific space, ask the owner, agent or landlord for
information about communications wiring, such as whether the space is
connected to a fiber optic network or is wired for DSL or a T1 line
(high-volume Internet connections). Also, find out to
whom the landlord has sold the rights to the risers (wire
conduits) in the building. A commercial landlord cannot enter into
exclusive contracts with a single telecommunications provider such as
MCI or AT&T. However, to bring in another provider of your
choosing could be expensive.
Electricity and
Air Conditioning
Besides
high-tech communications wiring, don't overlook plain-old electrical
power as an important consideration in choosing a business space. Make
sure that any space you're looking at has enough power for your needs,
both in terms of the number of outlets in your space and the capacity
of the circuits. Check to see if any of your equipment require
220v, if so then make sure the space offers it or ask them to
install prior to you moving in (if you don't it could cost
roughly $300-$400 later). If you'll be running machinery or
other electricity-hungry equipment, make sure to find out from the
landlord how much juice the circuits can handle and whether a generator
is available during power outages. Also, if you'll keep sensitive
computer equipment at your office, ask the landlord how many hours of
air conditioning are included in the terms of your lease, and negotiate
longer hours if necessary.
Parking
Another common
need for many businesses is adequate parking. If a significant
percentage of your customers will come by car and there isn't enough
parking at your chosen spot, it's probably best to look elsewhere. In
fact, the city planning or zoning board might not allow you to operate
in a space that doesn't have adequate parking.
Zoning Rules
Finally, the
location that you choose needs to be legally acceptable for whatever
you plan to do there. Most physical therapy services can be
offered almost anywhere (even in peoples homes) but if you need a pool,
floor drain etceterra you should consult with your landlord.
You should
never sign a lease without being sure you'll be permitted to operate
your business in that space. Your city planning or zoning board
determines what activities are permissible in a given location. If your
zoning board has a problem with any of your business activities, and
it's not willing to work out a way to accommodate your business, you
may have to find another space.
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Lease
Types
Even though you may work
with a commercial real estate broker in your area, you should become
familiar with the different kinds of leases available as they can
substantially impact whether or not your business will
succeed. These vary from property to property and include:
Gross Lease.
This is the most common kind of lease in which you as the tenant willl
pay rent and your landlord takes care of taxes, insurance and
maintenance costs related to the property. Generally, gross leases
contain escalation clauses allowing the amount of your rent to be
adjusted (usually each year) to offset you landlords increased expenses.
Net Lease. A net
lease transfers some or all of the expenses a landlord is traditionally
responsible for to you as the tenant. With a single net lease, you will
pay rent plus taxes related to the portion of property you are leasing.
Under a double net lease, you will also pay proportional part of the
building's insurance premium. With a triple net lease, you
will pay all of the charges under a double net lease plus maintenance
costs.
Fixed Lease. This
kind of lease provides for a fixed amount of rent over a fixed rental
period (term). This kind of lease seems most non-threatening at first
glance, since you are not obligating yourself for rent increases in the
future (as with a gross lease). However, there is a downside to a fixed
lease. If you want to renew the lease when it expires, the
landlord may choose to raise your rent substantially (especially if
your business appears to be doing well and would suffer from relocating
elsewhere). It may be better to opt for a longer
term lease with a pre-fixed or determinable rent increase so you know
what you are getting into in advance.
Step Lease A step
lease provides for pre-set rent increases that go into effect at stated
times. This can provide you with peace of mind insofar that you will
know in advance what your rental amounts willl be for a longer period.
However, you should take a careful look at each scheduled increase and
determine if they seem reasonable; i.e., in keeping with historic
consumer price indexes or local rental increases.
Percentage Lease.
This kind of lease allows your landlord to share in your success or bad
fortune. A percentage lease provides for a fixed amount of rent plus an
additional amount that is set as a percentage of your gross receipts or
sales.
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Terms I Must Know
Lease Term. This
identifies the amount of time the lease will be in effect. If you think
you may want to stay at this same business location beyond the initial
term, you should negotiate an inclusion in your lease agreement that
entitles you to renew the lease for a specified period and rent.
Rental Rate. This
defines what your rent is and when it must be paid. Most leases also
include late payment provisions that impose additional charges if you
fail to pay the rent when it's due or within a specified time period.
If your business experiences seasonal or irregular sales activity, try
negotiating a flexible rental rate that will correspond to the
anticipated changes in your cash flow.
Escalation
Clause. This clause
provides for specified increases in rent over a specified time. These
escalations can be fixed or determined with reference to an outside
factor; i.e., increases in the landlord's operating costs, increases in
a cost index, or increases in your business's gross receipts or sales.
Improvements
and Modifications. This
provision identifies whether or not you have the right to make
improvements or modifications to the facility so that it better suits
your needs. In some cases, a landlord will build or modify a space to
suit a tenant's particular needs, prior to the tenant moving in. These
agreements must be spelled out in the lease. Additionally, watch out
for language requiring you to restore the space to its original
condition: if you knock down a wall, you don't want to be stuck with a
bill to undo the work.
Maintenance/CAM. This
provision determines who is to maintain which portions of building
and/or land. If you are responsible, you must make sure the lease
specifies whether you can contract with anyone of your own choosing to
provide these services, or if these service providers must be approved
by the landlord.CAM is Common Area Maintenance—be clear on exactly what
the landlord can charge back to you, such as installing a new elevator
or stairwell, etc.
Competition. If you are
leasing retail space in a larger facility, such as a store in a mall,
there may be restrictions placed on the landlord's right to lease
nearby space to businesses offering goods or services similar to your
own. (If the lease does not include such a provision, you should push
for one.)
Subletting. This
provision spells out whether—and under what conditions and
circumstances—you are entitled to sublease all or part of your premises
to another. (Remember, even if you sublet, you are still the one
legally responsible for paying the rent, etc. to the landlord). Should
you outgrow the space and want to move, you'll want the right to
sublease or assign the space to another company without a hassle from
the landlord.
Taxes. This clause
specifies who is responsible for the real property taxes or portion
thereof.
Insurance
and Liability. This
provision determines who is responsible for casualty and liability
insurance and the amount of coverage to be carried. Additionally, this
provision may specify under what circumstances you and your landlord
may excuse each other for liability for injury to persons or to the
property. Watch out for language that would legally excuse your
landlord from damages to persons or to the leased property caused by
the landlord.
Renewal
Option. This
specifies whether you have the option to renew the lease when it
expires and for what amount of rent. Including a renewal option in your
lease can protect you from an unreasonably large rent hike when your
first term expires.
Purchase
Option. This
provision spells out whether you'll have the right or obligation to
purchase the facility at the end of the lease term. This provision
should spell out the option price or range, and how and when the option
to purchase can be exercised.
Destruction/Condemnation. This
provision states whether the landlord is required to rebuild and
specifies whether the rent will be abated and if your lease obligations
are terminated in the event the facility is totally or partially
destroyed. This provision will also define what rights you and your
landlord will have if the facility is taken over by eminent domain
(acquired by a government body for a public purpose). Most leases
include a provision for termination of the lease following destruction
of the facility based on the time it will take to repair or the costs
involved. Insist on a cutoff time after which the lease is terminated
to prevent your losing business while a landlord takes forever to make
repairs.
Landlord's
Solvency. This is a
necessary provision protecting your rights as a tenant if your
landlord's building—along with your leased premises—are foreclosed
upon. If you are concerned about the landlord's solvency before you
enter the lease, require your landlord to obtain a non-disturbance
agreement from any mortgage holder. This would obligate them to adhere
to the terms of your lease even in the event of foreclosure.
Zoning and
Land Use Restrictions. This
provision spells out the zoning and other restrictions that apply to
the building and your use of it. If your intended use would violate a
zoning rule or private land use agreement, insist-or have your attorney
insist-on a provision that lets you out of the lease if you are unable
to obtain a zoning variance or other judicial relief.
Going Dark. In a mall
or office building, smaller businesses can be hurt when a major tenant
"goes dark" by not renewing their lease or by going out of business.
You may want to consider adding a clause to your lease that would give
you a substantial rent reduction or the right to close your store if a
major tenant or several other tenants go dark.
Security
Deposit. This is the
amount you'll pay in addition to rent in order to activate the lease.
This is in addition to other costs spelled out above.
Ancillaries. Look at
clauses related to parking and building hours, etc. when you negotiate
your lease. If the AC or heating is normally shut off at 8:00 p.m. each
night and your staff always works late, try to get those hours
extended.
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Negotiating the
Best Lease
Negotiating a good lease can
save you money. Learn where landlords are willing to make
concessions. When
you are ready to expand and are looking for available
business space, chances are you'll be presented with a typed or printed
commercial lease prepared by the landlord or the landlord's lawyer. As
you read the lease, keep these points in mind:
- Rule
1: Understand that the terms almost always favor the
landlord.
- Rule 2: Know that
with a little effort you can almost always negotiate significant
improvements to the terms
In
theory, all terms of a lease are negotiable. But your negotiating power
depends on whether your local rental market is hot or cold. If plenty
of commercial space is available, you can probably win many landlord
concessions. If your area's rental market is tight or you are chasing a
unique space, you'll have considerably less leverage.
Length of the
Lease
One
area of the lease you should always focus on is its length -- also
called its "term." A short-term lease is almost always to your benefit.
Shorter leases give you more flexibility if the needs of your business
change -- for example, you want more space or decide that a different
location would be better. There is a trade-off here, of course. A
long-term lease ensures that you'll have an affordable business space
for a predictable period of time. And landlords are often willing to
make more concessions on longer-term leases.
If
your practice isn't particularly
location-sensitive and plenty of commercial space is available
in your area, then a short-term lease makes sense. Even if the landlord
doesn't renew your lease, finding comparable space won't be a problem.
On
the other hand, if you have found an especially favorable
location deciding on the best lease term is more problematic.
If your business does well, you'll want the right to stay on for an
extended period. On the other hand, you'll probably be nervous about
signing a four-year lease in case your business goes kaput.
A
good solution is to bargain for a short initial lease with one or more
options to renew -- perhaps a one- or two-year lease with an option to
renew for two or three more years. Typically, an option to renew gives
you the right to exercise your option to stay by notifying your
landlord in writing a certain number of days or months before the
initial lease period expires.
If
you ask for an option, expect the landlord to want a higher rent for
the renewal period. If the property is particularly desirable, the
owner may also want an extra fee in exchange for giving you the option
of staying or leaving after your initial term is up. This is a common
arrangement, and if the space is important to the success of your
business, seriously consider paying it.
Rent and Rent
Increases
Another
primary issue to consider when leasing space is how much rent you'll
pay. It's sensible to check out rates for comparable spaces. If the
rent seems unjustifiably high, you could try asking for a reduction.
Many landlords, however, usually won't consider lowering the rent
(except in poor economic times or areas), but you may be able to get a
few months of reduced rent to compensate for moving costs.
Landlords
will usually include an annual increase to your rent in your lease
terms. If the landlord insists on keeping the clause, try to get a cap
on the amount of each year's increase, and try to exclude a rent
increase for the first year.
When
you're shopping around, look carefully at whether the landlord will pay
utilities, repairs, taxes and insurance. With a "gross lease," your
rent includes these costs. By contrast, with a " net lease" you pay for
them separately -- potentially a large sum. In fact, the best approach
may be to offer to pay a higher amount for rent in exchange for
eliminating these extras.
Tenant
Improvements
If
you'll need lots of improvements to the space (called build outs), you
may want to use the lion's share of your bargaining power to have the
landlord provide them at no cost to you. If you're willing to sign a
long-term lease, the landlord will be more willing to pay for
improvements to the property.
Subleases and
Assignments
Ask for an
option to sublease or assign your space. That way, if you need to move
out, you'll be able to have another company take your space and payt
the rent without having to break the lease. Or, if you rent
enough space to grow into, you can sublease some of the space until
you're ready to use it.
*Excerpts
from Nolo Press
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Key
to Success
Be prepared.
The key to saving money when negotiating a
good lease is knowledge.
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Important
Reminder
Do not get in over your head. Start out
in a space that humbly meet your needs and grow into
a larger space later.
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Resource
Links
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