Posts Tagged ‘healthcare’
Following on Part 1 in this series of articles, entitled “The structure of your business“, we will be looking at the concept of “Preparing your Business for Sale”.
This is a concept I came across in a business course, where it was suggested that from day 1 of running a business, one should look at the structures of the business in the light of selling your business. Now this might seem like a strange concept, as your mind is on the new challenge that has presented itself in starting your practice. But think about how you would like to have a new business opportunity presented to you, when someone is trying to encourage you to part with some of your well earned money, to buy a practice.
Now the idea of buying “Good Will” is a contentious issue, which should perhaps be carried over to the next article in this series. For now let’s look at adding the tangible elements which are taken into account when presenting a practice or business for sale. You may in the future wish to either sell the practice whole-sale, or get a partner / shareholder to join you in running the practice. In both these cases you would surely like to get some sort of financial reward for the time and effort put into building your practice and name.
What can I do to add value to my business?
Let’s start with some of the documents that you need to have in place, when preparing your practice for sale. You will see that many of these documents are in fact legislative requirements which need to be in place any way, while others will assist greatly in the smooth running of your practice.
This will include contracts with third parties, as well as with your staff
1. Employment contracts
As per the requirements of the Basic Conditions of Employment Act (BCEA), staff need to be employed contractually. There is a transaction taking place, where you pay someone a salary in exchange for specific services offered to the business. Remember that should you not have a contract in place, the employee is then contracted on the terms of the BCEA, which may be more or less favourable to the employer than if you were to have a contract in place.
Be sure to draw up an employment contract, covering essential issues like leave entitlements, salary, working hours, dress code, place of work, meal intervals, policies & procedures and restraint of trade. This needs to be signed by both the employer and the employee.
2. Job descriptions
While we are usually quite sure and comfortable of the requirements around our duties as healthcare professionals, it is important for all staff and employers to be sure as to what is required from them, and according to which they are contracted.
Please keep in mind that job descriptions are specific, they are not cast in stone. As the working requirements may develop through the growth of the business, it is important for the staff to understand this, and grasp that one cannot respond with that is not part of my job description, unless of course the request is outside of their abilities, or totally unrelated to the position.
You may want to revisit the job description with your annual performance appraisals and salary increases year on year.
3. Lease or rental agreements
Should you be renting your premises, keep in mind that should the landlord not renew your lease contract, you may find yourself in a very difficult position where you need to set up shop in new premises on short notice. This will clearly have a great impact on your practice. With a lease agreement in place, you can negotiate time frames as to which the lease period extends, as well as notice for non-renewal. You may also want to include an annual escalation percentage applicable.
Policies & Procedures
These are the documents within your practice which guide both the conduct and processes within your business. This allows the staff to have a clear understanding of your expectations, gives direction and certainty, and guides any labour issues which may occur. The following are some of the critical policies that should be part of your practice:
a. Disciplinary procedure
b. Grievance procedure
c. Patient confidentiality policy – consider having the staff sign an agreement around patient confidentiality and the protection of their information
You may want to also include the following:
d. Performance Appraisal Procedure
e. Staff Savings Policy
f. Staff Loan Policy
g. Internet & Telephone Policy
h. Dress Code Policy
i. Petty Cash Policy and procedure etc.
You may then also include procedure documents, to assist staff who need to approach a task systematically. An example would be the data capturing procedure, explaining how the treatments are recorded; codes are defined, submitted for capturing, and added to the billing system. And then of course the procedure in submitting these claims to the funders, and finally the credit control procedure which is followed for accounts that are not paid. This also helps should one staff member need to cover for another, or new staff need to be inducted into the practice processes.
Explore if there are any accreditation programmes you can subscribe to, or set up a peer review process where other practitioners review your practice, and you review theirs, to support and improve the standard of care delivered to your patients and staff.
A solid set of financial results
Be sure to keep your practice finances separate from personal spending. A dedicated practice account goes a long way to introducing financial discipline, together with a formal petty cash process to account for cash payments made to the practice, and monthly books of accounts. Be sure to review the financial status of your practice monthly, rather than wait for the year end audit or tax submission.
Regular valuation of the business
It is of value to track the growth of your business through simple practice valuation methods. These can become complicated, especially in the situation where a shareholder / partner wishes to buy in or sell out of the practice. For regular financial management of your business, it is important to choose a simple method of valuating your business to indicate possible growth in the business. Just going with the cash balance in the bank may not be sufficient in identifying areas where the business can be improved, or where the risk areas are.
While there are other areas in which development will add to the preparation of your practice for sale, these mentioned above offer a good and solid start to getting off on the right foot.
Should you require any assistance in “Preparing your practice for sale”, and maximising the return on all the hard work and effort you put into your practice, feel free to contact PROFFESSA Health Services. We also offer complete financial and HR services to practices who wish to outsource these, allowing the practitioner to focus on the areas in which they are trained and are expert in, being patient care!
To make a clear distinction between the concept of owning or running a practice, and establishing and growing a business, one needs to develop the acuity of separating the caring therapist role from clear business principles and investment opportunities which present themselves.
In the next few articles, I will be presenting a series looking at the various aspects of developing the business edge of your practice.
The business structure of your practice
Due to the fact that we as Healthcare Providers need to be registered with the Health Professions Council of South Africa (HPCSA) as our regulatory body in order to practice, we are also required to keep to the ethical and legal requirements as laid out by the HPCSA Regulations.
The HPCSA is quite clear on the manner and vehicle through which we can run a practice. It is important that we take cognisance of these rules before embarking on the process of registering a company at the Companies and Intellectual Property Commission (CIPC– the old CIPRO).
As a healthcare provider, we need to maintain direct liability for the treatment we provide. In other words, we can’t hide behind a “Corporate veil” should a patient want to sue us for malpractice. An owner of a Pty (Ltd) could have an aggrieved client take legal action against the company they work for rather than them as an individual, but we as healthcare providers are not afforded this alternative.
For this reason, we have the following options when establishing a practice:
1. Run your business in your own name, as an individual – Solus Practitioner
2. Run your business with a partner or partners – Partnership
3. Run your business in association with other healthcare providers – Association
4. Run your business with other healthcare providers as shareholders – Incorporated Company
There are of course pros and cons in each of these structures, which you will need to understand well before making your decision.
Often we find that practitioners start their practice as a one-man-practice, trading in their personal capacity not having any formal business registered. In these cases, it would be critical to introduce carefully structured and well planned strategies to monitor and track the performance of the business. Now this may seem obvious, but too often we find that personal expenses and business expenses are run from the same bank account. Books of accounts are not drawn up on a regular basis, and the business owner has no idea of the current financial status of their practice.
This can only be achieved through clear financial management, regular analysis of the business’s performance, and timeous reaction and realignment of goals on current financial indicators. The only crude measure of financial success of the practice may be the cash in the bank! Very often a response to this may be too late.
Although the SARS requirements regarding annual tax submissions in the case of a Solus Practitioner is that individual and practice income and expenses are submitted together after the February year end, it would be a good idea to run your personal and business finances separately throughout the year, only merging these prior to the annual tax submission, with good tax advice and reconciliation.
I think it is critical that we look at the business structure in which we practice with a long term view. Not only regarding its current structure to ensure a business approach, but also with the view of “Preparing my business for sale”. We should in fact start a practice with this in mind. In keeping with this motto, one looks at the practice as a business, seeing in the light of an investment, which will hopefully offer you good returns in the future, for all the hard work you put into its growth and development.
In the next part of this series, we will look at the various elements that you should consider when “Preparing your business for sale”, and how this can add value to your business.
MedChronicle: HPCSA Suspends Acting Registrar: http://www.medicalchronicle.co.za/hpcsa-suspends-acting-registrar/