Representative Case Study:

I transformed a multi-state mom and pop physical therapy practice into a professionally managed company while growing them rapidly from $15 million in annual revenue to $30 million and 25 locations to 75 over several years.

When I was hired to replace the retiring founder and CEO, things were a bit chaotic. The financial statements took two months to complete (making it difficult to react timely to issues they revealed). The Profit and Loss statement was a random list of 50 line items, making it difficult to focus on key items like labor (which was about 70% of costs), or other key drivers of revenue and expense. Healthcare costs were out of control. There wasn’t a systematic process for evaluating, acquiring and integrating an acquisition when an opportunity appeared. The treatments provided by over 100 licensed therapists at multiple locations were not consistent; there was no written guidance or documented treatment guidelines specific to the over 100 different conditions they treated. That was just the tip of the iceberg.

I was able to lead multiple changes to how accounting processes were performed and the financial statements were prepared, leading to completed statements 3 business days after month end. We changed payroll providers, the accounting system, and hardware to resolve technical problems. I directed a change to how the Profit and Loss statement was presented so that labor costs were grouped and totaled so it was much simpler to track and analyze the fully loaded labor costs. Other key expense items were also prioritized in the statement so they were easier to focus on as things changed over time.

I investigated options for re-structuring health insurance costs that led to a substantial cost reduction, and options for employees to select from that allowed them to pick a plan that best met their individual family’s needs. I investigated options for pension plans that created more choice and visibility for employees so they could be more engaged in managing their retirement and encouraged more employees to participate and invest more money.

When I focused on reducing legal costs, the first area I focused on was the review of leases, whether new because of a move or starting a new practice, or at time of renewal of an existing lease. After working with the attorneys on a number of leases, I learned several terms they focused on so we could do a preliminary evaluation and present our findings to the attorneys, shortening the review process turnaround time, and a large reduction of their substantial fees. I led similar review processes with other vendors.

The industry was changing rapidly during this time, leading to a large opportunity to grow through acquisitions as clinic owners retired and sold their practices. I developed a simple, systematic process for evaluating the performance and profitability of acquisition targets, and a target purchase price to guide the process of making offers and negotiating and structuring each deal. I also created a systematic process for preparing our talented therapists to be ready to step into the roll of a clinic manager so we could hit the ground running when an opportunity arose.

I was successful in engaging shareholders and key employees in an effort to bring order to the chaos of how treatments were provided (our core work). We organized groups around nine body parts (back, shoulders, knees, feet, etc.), and each group selected the most popular conditions treated. The result was the industry’s first manual of treatment guidelines. A top publisher of medical publications agreed to sell them. These guidelines not only provided a process for patient evaluation and treatment, but also identified key clinical metrics to track to demonstrate the patient’s progress over time. They also provided a great resource for training therapists, raising the quality of the services each therapist provided.

These are just highlights of transforming this business, establishing best practices, and using this solid platform to grow rapidly in a controlled manner. I have many other similar engagements across industries and markets, primarily domestic but also international.

Contact me to explore how I can help you with your business, resolving your challenges and strengthening your systems to support rapid growth.