Download worksheets here IMPORTANT:  Under Construction.  Many links may be broken.   Table of Contents ADA Requirements Basic Essentials The Four "Flows" Key to success! Important reminder!             ADA Requirements The Americans with Disabilities Act requires that every building meet a certain level of standards for accessibility to the disabled population.  Don't get too overwhelmed with these laws, I will list the essential requirements for most PT offices so you won't have to sift through the lengthy documents.  Your landlord or office owner should already be aware of most requirements. Some older buildings may not be in compliance with the more current standards and it is okay for you to open an office there without having to bring it up to code (If you are wanting to receive a medicare certification, however, then you will probably have to). If you plan on making structural changes to your space you will have to pull a city permit for the work and then all the standards of compliance must be met along with the changes you want to make.  So, don't just jump into making changes before doing the proper research and making sure your landlord is willing to pay for the compliance issue costs or else it could cost you a lot of money.  Make sure your landlord is ready to "pitch in" for these compliance costs, since it is technically their building. Here are some of the most essential codes to be aware of: Handicapped parking spaces must meet the requirements of the office building/space. Accessibility and ramps from parking lot to your facility must allow a disabled individual in a wheelchair convenient access from their car to your front door. Entrances and exits in your office space must be clearly marked and within a certain distance from each other. Doorways shall have a minimum clear opening of 32 in (815 mm) with the door open 90 degrees, Front counter should be a minimum of 36 in (915 mm) in length shall be provided with a maximum height of 36 in (915 mm). Bathrooms must be separately designated for male and female and the toilets must be compliant height with grab bars and allowable space. Smooth non-slip flooring should be used.  If carpet or carpet tile is used on a ground or floor surface, then it shall be securely attached; have a firm cushion, pad, or backing, or no cushion or pad; and have a level loop, textured loop, level cut pile, or level cut/uncut pile texture. The maximum pile thickness shall be 1/2 in (13 mm).  Exposed edges of carpet shall be fastened to floor surfaces and have trim along the entire length of the exposed edge. Sinks should be mounted with the counter or rim no higher than 34 in (865 mm) above the finish floor. More info>>> Back to top           Basic Essentials Storage space Most beginners make the mistake of not planning for enough storage space and end up creating clutter in their practice.  This creates very negative energy.  You do not want to have things laying around everywhere. It decreases the perceived value of your services. Linen supply You must decide if you want to use a linen service or have your own washer/dryer.  I recommend installing your own "stackable" washer and dryer.  It's nice to have towels when you need it.  And in the long run it saves you money.  You must have water supply and either a gas or electric source.  If you use electric for your dryer than make sure it is 220volt. Curtains versus walls I recommend a limited amount of walled treatment rooms.  Maybe one private room per therapist and the rest should be curtained.  Curtains are much more versatile and space saving.  Semi-walled treatment rooms are becoming more popular nowadays.  They are walls that do not go all the way to the ceiling and the entrance is curtained.  They give the patient a more sense of privacy than curtained rooms, however, they also provide some openness to the surroundings to curtail claims of improper conduct. Line-of-sight design It's always good to have a wide open space for exercises and extremity treatments where privacy is not as much an issue.  You want to make your practice favorable for supervision of assistants and aides.  See medicares definition of "supervision" in section 6a. Electrical outlets It's always better to have too many outlets than not enough.  If you want to add another outlet somewhere it will cost you (approx. $60-100). Computer wiring It's always good to think about your computer wiring needs as early as possible.  Most practices must utilize a computer for at least the billing procedures.  Many are beginning to use electronic documentation and scheduling as well, and most likely you will want to as well.  I recommend thinking about where your computer workstations will be and have the wiring installed with your other electrical and phone needs. Music Have ceiling speakers installed in your hallways to add a very professional and therapeutic touch.  You could also have music in the treatment rooms with volume controll.  If a patient has to wait or when on heat, etc. it adds a much more pleasant touch. Private area for staff I recommend planning out a staff break area with a refrigerator and table with chairs. Let your staff know you care about there well-being while at work. Lighting specific to patient population An area that is often overlooked is the lighting in the office. Many facilities use ordinary fluorescent lights which may be very uncomfortable to the population you may be working with such as the elderly or those with high levels of stress and tension.  Incandescent lighting is much more natural and therapeutic, however, they will add to your electric bill.  You can choose to mix and vary the types throughout your facility. Floor drain It's always good to have a floor drain for the purposes of utilizing a whirlpool, cleaning out a hydrocolator, etc.  Negotiate with the landlord to install one for you if one does not exist. Gas It's always nice having gas available at your space even though it is rare.  Gas is good if you plan to do your own linens (gas dryer) and gas water heaters are much more efficient than electric.   Back to top             The Four "Flows" Maximize New Patient Referral Flow Make your "Family & Friends Voucher" available in your facility day one.  Place them in several places around your office, especially at the front counter and in the treatment rooms.  They will read just about anything while waiting for you.  Make your Thank You postcards to MD's available to the patients throughout your office. Designate an area on the wall of every treatment room and near the front counter for patient and MD testimonials about your care.  The comments are collected from your satisfaction surveys and "MD Testimony Solicitation Letter" (template included on CD). Make your newsletter available in every treatment room as well as the waiting area. Place posters, 3D models, and information literature around your facility.  Basically use your walls to sell your business and services and gain more referrals than putting up art, pictures, and paintings advertising someone else. Efficient Patient Treatment Flow The front counter, or check-in station, should be at a central location with the treatment rooms and gym at the periphery of it. The front counter is usually the center of activity and therefore it's ideal to design other operations around it Your treatment areas should be on the periphery fully stocked with needed supplies and tools. The exercise or gym area should be open and spacious. Create a patient education area where you include posters, video, computer learning, newsletter, specialty materials. Think of "flow" when designing your space especially with patient check-in and treatment flow.  Track a patient's trail from the instant they walk-in through their entire treatment.  This will help you immensely in your design. Increase Cash Flow Include a product display area.  You must sell products not only  to open another revenue channel but to increase your credibility and professionalism.  Providing your patients with needed resources for self care and self help is a signficant part of servicing your patients. Design and create promotion posters and literature for your products as well as point-of-purchase displays. Create your own company's product packaging.  It's becoming more and more affordable to create your own label for products. Invest in a point-of-sale register system.  Many professional offices still write patients hand receipts purchased from Staples.  This wastes time, money and prevents you from automating and maximizing your product sales.  Guaranteed a POS system (computer, cash drawer, receipt printer, POS software) will pay for itself within the first year. Create a product inventory storage area that is lockable. Automate Regular Operations Flow Create a billing station where your staff can complete the daily billings easily.  Include a bin for the Fee Slips, ICD-9 reference sheets, and CPT codes. Have a charting station where the therapists can complete their charting.  Include a computer for easy reporting and faxing. Create an office and clinical supply closet or area.    Back to top                   Key to Success Recruit the services of a feng shui consultant professional.  What is feng shui? Simple officer solutions: DO sit in the corner farthest from the entrance to the room to have a "command" position. DON"T sit in line with the door, as you will be in the path of negative energy. DO keep your back toward a corner or a wall for support. If a post protrudes from the corner or wall, correct it by covering it with a hanging plant's draping foliage. DO sit with a tall building behind you to provide the support of a "mountain" if your back is to a window. DON"T face away from the door if you are conducting business from home. Business will symbolically come to you through the door, so don't turn your back on it. DON"T arrange your workspace so that you look straight out into a corridor or see the stairs, storage rooms, closets, elevators, escalators, or toilets. DO put your computer in the North or West area of your office to enhance your creativity. Place the computer in the Southeast if you use it to generate income. DO place an aquarium or tabletop fountain in the East, North, or Southeast. A small aquarium with black or blue fish in the North area of your desk or office will activate your business and career success. Guppies or a single arrowana are ideal for an aquarium made of glass and metal. DO place a safe, which is usually constructed of metal, in either West or Northwest, which both represent the metal element. The safe symbolizes the prosperity and financial security of a business. DO have a good balance of yin and yang when decorating your workspace. Balance light and dark colors, soft and hard surfaces, and smooth and rough textures in your choice of window treatments, furniture, and flooring. DON"T have any mirrors in your office, as they can reflect negative energy from clients to other people in the room. You should always maintain control over the energy in your office. DO treat the files in your office with respect. They represent your past, present, and future business. DO keep the cords to your office equipment well hidden. This eliminates clutter and allows for the free flow of chi. Back to top               Important Reminder Have three waiting chairs in the waiting area for every therapist on schedule for a given day.  For example, if you anticipate having two therapists treating at the same time in a given day than you will have three waiting seats times two therapists, or a total of six chairs in your waiting area.   Back to top