While there may be numerous rehabilitation facilities available, it is all too common that patients must travel long distances to receive
their treatment. For those living in more rural areas, the options are often very limited. One of these underserved areas is southern Rhode Island,
where there are many residents, but almost no nearby options for rehabilitation services. This is why Richmond Rehabilitation, located in
Richmond, Rhode Island, will be an important new business to help serve this currently underserved region.
4
Richmond Rehabilitation is a short-term rehabilitation center that welcomes outpatients from pediatric to geriatric. Washington County,
encompassing nearly all of southwestern Rhode Island, is currently an underserved region in terms of rehabilitation services, despite having a
population of over one hundred and twenty-six thousand (“Washington County, Rhode Island”, 2018). We will offer a wide range of commonly
needed therapies and services, including physical therapy, occupational therapy, speech therapy, and pulmonary rehabilitation. Nurses are also
available to assist patients during treatments and provide education to patients and family members when needed. Our physical therapy services
will include orthopedic, cardiopulmonary, and neurological. Our occupational therapy services will include gerontology and physical
rehabilitation. Our speech therapists will work with patients to be able to speak again after loss of muscle strength or motor control. Lastly, our
pulmonary rehabilitation program focuses on exercise, activities of daily living, breathing techniques, and respiratory medication education.
Because Richmond Rehabilitation will not serve just one patient group, patients of all ages and with various rehabilitation needs will be able to
seek treatment here who previously needed to travel or temporarily relocate to central or northern Rhode Island to seek rehabilitation treatment.
5
Due to the location a wide variety of services offered, Richmond Rehabilitation has the ability to serve a large
population that is currently in need of these services and who will be thrilled to have such a facility that is not far away
from their home. Richmond Rehabilitation will not have to expect to offer wages far higher than current centers in order to
draw health care professionals, as there are many therapists and nurses currently living in these communities that have to
commute into the city for work who will be thrilled to have the opportunity to work much closer to their homes, serving
their own community. Additionally, because these are not particularly newly invented services, nor is Rhode Island a
newly formed state, the threat of competitors moving into the area is not a likely source of competition in the short- or
long-term. Richmond Rehabilitation will therefore be able to offer services at a fair price in a location that is convenient
for this community and surrounding communities.
6
EXECUTIVE SUMMARY REFERENCE
Washington County, Rhode Island (2018, July 1). In United States Census Bureau. Retrieved from
https://www.census.gov/quickfacts/washingtoncountyrhodeisland
7
SWOT ANALYSIS
8
9
MARKET ANALYSIS
10
Richmond Rehabilitation is an outpatient rehabilitation clinic that will be located in Richmond, Rhode Island. Richmond Rehab
will offer a variety of services, including physical therapy, occupational therapy, and speech therapy. Richmond Rehab will also offer
pulmonary rehabilitation programs. Additionally, there is nursing care available to patients who need it while they are at the clinic. Richmond
Rehabilitation will offer a range of high-quality services, all administered by professional, caring, and trustworthy staff.
11
Like many branches of health care, rehabilitation therapies and programs are in high demand as the aging
population continues to grow, people continue to suffer from strokes, have musculoskeletal disorders, suffer physical
trauma, and so forth. The need for these physical rehabilitation clinics is on the rise and is predicted to have demand
continue to outweigh supply by 2020 (Landry, Hack, Coulson, Freburger, Johnson, et al., 2016). What this means for
Richmond Rehab is a stable, if not steadily increasing, demand for services. This has been attributed to many factors,
including a growing elderly population as well as the ability for more people to have access to health insurance coverage
now since the passing of the Affordable Care Act, or ACA (Landry, Hack, Coulson, Freburger, Johnson, et al., 2016).
Pulmonary rehabilitation programs are newer than some other types of rehabilitation program and services, but have
proven through research to be highly effective for those with COPD (Alison & McKeough, 2014). Therefore, as more
people learn about the availability of these programs, growth can be expected.
12
The target market for Richmond Rehabilitation is people of all ages who need a short-term physical (including occupational and
speech) or pulmonary rehabilitation program. While a large amount of these patients may be seeking treatment due to minor sports
injuries or on the recommendation of their primary care physician, much of our target market is looking for a short-term rehabilitation
program after a hospital stay from something such as a fall, surgery, pulmonary exacerbation, stroke, or other various accidents
(“Who uses short-term rehab?”, 2017). Because of the many different types of reasons for a patient seeking a rehabilitation program,
we will offer multiple kinds of rehabilitation services and programs, as different situations require different types of rehab based on
the patient’s individual needs (“Rehabilitation after major trauma “, 2018). While many of the patients are elderly, there are also
younger patients who require rehabilitation services, which is why Richmond Rehabilitation will not serve just one age group.
Richmond Rehab will serve pediatrics to geriatrics in order to not only also be available and convenient for our older and younger
patients, but also to help attract the largest amount of the market possible.
13
Due to the various populations that will be served at Richmond Rehabilitation, the size of the target market is quite large.
The most common groups utilizing services at Richmond Rehabilitation, however, include those with COPD and
skeletomuscular disorders, including those who seek treatment for injury-related conditions and chronic conditions. Those with
COPD can benefit greatly from pulmonary rehabilitation programs. 6.3% of the population of Rhode Island has COPD (“COPD
among adults in Rhode Island”, 2018). Many people in this population claimed that their condition limited activity and had no
exercise within the past month (“COPD among adults in Rhode Island”, 2018). Both of these issues can be improved with
pulmonary rehabilitation programs. Those with musculoskeletal conditions are an even larger part of the potential target market.
In fact, those with musculoskeletal conditions comprise the majority of outpatient visits to physical therapists (Carter & Rizzo,
2007). With roughly twenty percent of the population reportedly suffering from a musculoskeletal condition, the amount of
potential patients is vast (Carter & Rizzo, 2007).
14
Being able to effectively penetrate this market and continue to remain successful and relevant can be difficult for
some businesses, but Richmond Rehab would not appear to have this concern. Most short-term rehabilitation clinics are in
fact smaller, not owned by large chains (LaRosa, 2019). Additionally, of those large chains, only twenty-one percent of the
market utilized their services over smaller, independent clinics (LaRosa, 2019). Therefore, there is not concern that
Richmond Rehab will not be well received due to not being a part of any major chain. Due to the selected location,
Richmond Rehabilitation will be serving a currently underserved, but well populated, area, as there are over one hundred
and twenty-six thousand residents of Washington County, the county we will be located in (“Washington County, Rhode
Island”, 2018). This area currently has very few rehabilitation center options, with the southern and western parts of the
county especially limited on their options, as they currently have to drive even further to one of the very few locations
available anywhere near their homes.
15
With increasing awareness of the efficacy of pulmonary rehabilitation programs, it is a wonder why there are not
more of them offered. It is also a wonder why only two to five percent of people who would benefit from these programs
are currently utilizing them (Alison & McKeough, 2014). The answer is the issue faced by many: these programs are not
only fairly new, but are commonly only offered in metropolitan centers where there is easy access to fully-equipped gyms
in which to perform the exercises (Alison & McKeough, 2014). Therefore, despite its more rural location, by having a
fully-equipped gym on site, Richmond Rehabilitation will be able to attract many patients from the area and surrounding
communities who were previously largely unable to participate in these programs.
16
By offering more than just one type of rehabilitation service, we will be able to create a true center for those
seeking rehabilitation services. Not only will this create continuous and plentiful business, it will be helpful and
convenient for patients. Additionally, it will allow for more opportunities for patients of all different types and ages to
recommend our facility, as word of mouth and reviews on the internet are both great ways to attract new customers when
they are in need of our services. By receiving recommendations from patients of all different ages and with all different
needs, we can build trust within the community which will help promote business in the long-term.
It can be difficult to predict the success of any business. However, understanding the target market, potential for
market growth, and so forth is vital when creating a successful business plan. When his research has been done and
information has been compiled, as has been done for Richmond Rehab, the ability to see the potential for a company’s
success is increased tremendously. Based on the information collected, Richmond Rehabilitation has great potential to be
a success and a staple in the community for many, many years.
17
MARKET ANALYSIS REFERENCES
LaRosa, J. (2019, July 1). U.S. Physical Therapy Clinics Constitute a Growing $34 Billion Industry. In Market Research. Retrieved from
https://blog.marketresearch.com/u.s.-physical-therapy-clinics-constitute-a-growing-34-billion-industry
Who uses short-term rehab? (2017). In Knute Nelson. Retrieved from https://www.knutenelson.org/lifestyle-options/short-term-rehab
Rehabilitation after major trauma (2018). In Victoria State Government. Retrieved from
https://www.betterhealth.vic.gov.au/health/servicesandsupport/rehabilitation-after-a-major-trauma-incident
Michel D. Landry, Laurita M. Hack, Elizabeth Coulson, Janet Freburger, Michael P. Johnson, Richard Katz, Joanne Kerwin, Megan H. Smith,
Henry C. “Bud” Wessman, Diana G. Venskus, Patricia L. Sinnott, Marc Goldstein, Workforce Projections 2010–2020: Annual
Supply and Demand Forecasting Models for Physical Therapists Across the United States, Physical Therapy, Volume 96, Issue 1, 1
January 2016, Pages 71–80, https://doi.org/10.2522/ptj.20150010
Washington County, Rhode Island (2018, July 1). In United States Census Bureau. Retrieved from
https://www.census.gov/quickfacts/washingtoncountyrhodeisland
Alison, J. A., & McKeough, Z. J. (2014). Pulmonary rehabilitation for COPD: are programs with minimal exercise equipment
effective?. Journal of thoracic disease, 6(11), 1606–1614. doi:10.3978/j.issn.2072-1439.2014.07.45
COPD among adults in Rhode Island (2018, June 6). In CDC. Retrieved from https://www.google.com/url?
sa=t&source=web&rct=j&url=https://www.cdc.gov/copd/maps/docs/pdf/RI_COPDFactSheet.pdf&ve
d=2ahUKEwiBi_yR74HmAhUynOAKHSShCiAQFjAAegQIBRAB&usg=AOvVaw0ov9wjbljNrMZELc0B0aXU
Carter, S., & Rizzo, J. (2007, May 1). Use of Outpatient Physical Therapy Services by People With Musculoskeletal Conditions. Physical
Therapy, 87(5). doi:https://doi.org/10.2522/ptj.20050218 18
ORGANIZATIONAL STRUCTURE OF
RICHMOND REHABILITATION
19
Before any new business can open its doors, a multitude of decisions need to be carefully made. These decisions include more than just
where to physically build the facility, or even what the business will offer. Other highly important details include what positions will be needed,
how they will work together, and what they will do. For Richmond Rehab, a few different types of people will be needed, and a certain
organizational structure will be followed to ensure the business will run as efficiently as possible.
20
Understanding who is necessary for a facility to properly function is a highly important part of starting a new business. The CEO is the
head of the company, as is in most companies, and will be hands-on with the operations of the facility until it grows larger, offering the
opportunity to hire a facility head and allowing the CEO to step back and work more indirectly for the company. The CEO is currently going to
be responsible for overseeing overall operations, presenting information to the Advisory Board, and managing company resources. The two
people directly below the CEO are the Clinical and Non-Clinical Administrators. The Clinical Administrator will oversee operations related to
medical services including keeping policies updated and ensuring operations are within guidelines as required by law. The Non-Clinical
Administrator will oversee all operations not directly related to patient care, including finances, insurance, and public relations. Both
administrators will report directly to the CEO when necessary.
21
Below the two administrators are the five department managers. These consist of the Physical Therapy Manager, Pulmonary
Rehabilitation Manager, Speech Therapy Manager, Occupational Therapy Manager, and Nursing Manager. All department managers are
responsible for overseeing day to day operations of their department, handling their department’s scheduling, leading educational in-services to
their department employees, and briefly stepping in and performing the job duties of their employees if an unforeseen circumstance occurs,
such as an employee becoming injured on the job during the work day when another qualified employee is unable to come in to work for them.
All managers will report the clinical matters of their department to the Clinical Administrator, and the non-clinical matters of their department
to the Non-Clinical Administrator. Last but not least, the employees of each department are responsible for creating programs for their patients
and helping care for them through their sessions. These include physical therapists, respiratory therapists, speech therapists, occupational
therapists, and nurses, all reporting to their respective managers. It is of note that although the initial idea for this facility was to also employ
food and environmental service staff, the idea for the facility has shifted to a purely outpatient facility that will not house a fully staffed
cafeteria or environmental services department. Instead, there will be vending machines available and a crew will be hired to fully clean the
facility after hours once a week, or whenever an incident occurs where it is deemed necessary that professionals come and clear the mess. When
every employee has their job and understands their roles, the whole operation can run smoothly and efficiently.
22
It is important that every type of business have a form of organization and structure. Richmond Rehabilitation will generally
follow a vertical, or sometimes referred to as a hierarchal, structure. In this type of structure, everyone will have someone to whom they
directly report to, such as a manager or administrator who oversees what they do (“Reporting Relationships…”, 2017). However, the
five department managers will follow more of a matrix structure. In this type, the department managers will have two different people
to whom they must report, depending on the nature of what is being discussed or reported. The vertical structure is well known and well
understood, so the chance of confusion concerning who one should report to is greatly diminished. The matrix style structure for the
department managers to the administrators is to help keep the job duties of the administrators fairly even and also split in a way that
makes logical sense. When certain situations concern both aspects, the two administrators can converse. The facility will follow this
structure in order to best support the goal of simplicity and efficacy.
23
Another necessary component of a new business is deciding who will comprise the Advisory Board. Richmond Rehabilitation’s Advisory
Board will consist of local professionals. There will be a financial advisor, a marketing advisor, a legal advisor, and a human resources advisor. It is
important that these be local professionals, as they will best understand the culture where Richmond Rehabilitation is located, and generally of the
whole state as well. The financial advisor will be responsible for providing information to guide the CEO to the best financial decisions, including
those regarding matters such as investments and stocks. The marketing advisor will provide the CEO with information on how to best market the
facility at that time. It is important to understand that marketing strategies may very well change every few months or years depending on technology
or new groups Richmond Rehabilitation wishes to attract. The legal advisor will help provide guidance on legal matters, such as liability or any
lawsuits that could potentially arise, whether it be from patients, employees, or others. The human resources advisor will be responsible for providing
the CEO with plans for improving relations between management and employees if problems should arise, as well as advice for pursing any
employee investigation, should it become necessary. The Advisory Board will meet every quarter the first two years, and then twice a year thereafter.
24
Positions and job duties must be created and well thought-out before a business can begin to function. There are often
many moving parts that people do not consider, which is why taking the time to map out the organization structure is highly
effective. It is also why it is important to flesh out the description of what each employee will be responsible for doing.
Because starting a new company requires a lot of attention to many different areas, this type of planning and upkeep is vital
to running smoothly and staying successful.
25
ORGANIZATION OF RICHMOND
REHABILITATION
26
ORGANIZATIONAL STRUCTURE
REFERENCE
Reporting Relationships: The Structure Leads the Way (2017, June 29). In Organimi. Retrieved from
https://www.organimi.com/reporting- relationships-structure-leads-way/
27
PRODUCTS AND SERVICES
28
Though it may seem simple to open a business of any kind, it is not. This is especially true when it comes to health care. The new health
care business must be well thought out, including the things that seem obvious, such as the type, or types, or services that will be provided. One
must consider who will be working there, what type of equipment must be purchased, and more. Additionally, it is wise for any business owner to
consider where the business can grow next.
Richmond Rehabilitation center is an outpatient, short-term, rehabilitation center that provides physical therapy, occupational therapy,
speech therapy, pulmonary rehabilitation, and nursing services. These are commonly needed services in a currently underserved, yet decently
populated, area. Richmond Rehabilitation will not be selling any products. One reason for not selling any type of physical product is because
many patients already have different types of equipment that they need, such as exercise or resistance bands, bolsters, and so forth. Additionally,
now with the widespread access to and convenience of the internet, many to most patients will opt to purchase their new equipment online where
they are likely to be able to find the items cheaper than we would be able to offer in-house. In fact, about sixty-five percent of online healthcare
equipment sales are from consumers, not businesses (Brohan, 2018). Not only it is often cheaper for patients to buy equipment online, they are
more likely to find the exact brand or even color that they want, whereas they would be realistically quite limited when purchasing at the facility.
29
Though Richmond Rehabilitation does not offer new services, it does offer a wide range of services in a currently underserved area. The
benefit to starting this business in this area is that there is a decent sized population that currently has to travel well into or nearby the capitol
city to be able to receive most of these services. By opening up our rehabilitation center in this area, we will be able to serve Richmond and
surrounding communities in a way that is not only top quality but is much more convenient for the patients. Another way that Richmond Rehab
will have an advantage over competitors is because it will have a fully equipped gym in which patients can practice a wide range of therapies.
Many places out in more rural areas do not have these fully equipped gyms, which is why many patients will be more incline to go to
Richmond Rehab, as they will have access to more without having to travel more. The geographical location also offers another benefit, as it is
close to halfway between a community hospital and the largest hospital in Rhode Island. This helps because many people who need rehab
services are those who have had surgery or had injuries that sent them to the hospital. Being closer to two hospitals as opposed to just one helps
provide a greater number of potential patients.
30
Our facility and services are not just for one specific group, as Richmond Rehabilitation will serve pediatric patients all the way up to
geriatric patients. This helps to ensure that nearly all members of the community will be able to see and use Richmond Rehab as an option for
their rehabilitation needs. To be specific, however, Richmond Rehabilitation will target those in need of orthopedic, cardiopulmonary, and
neurological physical therapy, gerontology and physical occupational therapy, speech therapy to be able to speak again after loss of muscle
strength or motor control, and pulmonary rehabilitation to focuses on exercise, activities of daily living, breathing techniques, and respiratory
medication education. Though some are age specific, many of these types of therapies are utilized by patients young and old, so patients of
nearly all ages will be part of the target market.
31
In order to deliver high quality rehabilitation services, there are many qualified professionals that are needed. All of those hired to work at Richmond
Rehabilitation will be required to meet all state and federal requirements as far as certifications and education are concerned. We will be hiring physical
therapists, occupational therapists, speech therapists, respiratory therapists, and nurses. As far as equipment is concerned, there will need to be a fair amount
in order to best serve the various types of patients we will have. For example, we will have exercise balls, resistance bands, stationary bikes, treadmills, a
stair climber, treatment tables, ultrasound, various types of bolsters, kinesiotherapy tape, weights, gait belts, padded exercise mats, interactive tablets with
special communication software, flashcards, and more. These are of course in addition to more basic pieces of equipment such as chairs, tables, first aid kits,
educational charts concerning anatomy, and so forth. The health care professionals will provide their own smaller personal pieces of equipment such as
stethoscopes and pulse oximeters, as is common practice in many health care facilities. Richmond Rehabilitation will also have oxygen tanks on hand at all
times, so the collection of empty tanks and drop off of full tanks will be arranged with a local home care company with which we will contract. This will be
especially helpful for those in pulmonary rehabilitation in the event that their oxygen tank runs out in the middle of their session. As there is more money
available, more equipment will be purchased, including new types of equipment as well as additional equipment that we already have, based on need. One
thing to note is that much of the equipment can be used for multiple types of therapies. For example, treadmills, resistance bands, and more can be used for
physical therapy, occupational therapy, and pulmonary rehabilitation programs.
32
Though Richmond rehabilitation will offer a wide range of services from the start, one service that is a goal to provide in the future in
order to be more competitive would be aquatic therapies. Though this is a type of physical therapy- a service already planned to be offered by
Richmond Rehabilitation- it is practiced in the water and is helpful for patients who cannot practice regular physical therapy for various
reasons. Aquatic therapy requires special pools specifically designed for therapy, including extra handrails and so forth (UPMS Sports
Medicine, 2015). Having one of these pools installed requires significant time and funds that Richmond Rehabilitation does not have at this
time, but that we hope to have in the future.
Understanding every aspect of what a business is and what the business plans to be in the future is an important step before opening the
doors to a new operation. This process of planning out the details includes all types of things, from big to small, current needs to future goals. A
new business owner should be well aware of the major, immediate components, such as who to hire, where to open the facility, and what
services will be offered. However, a business owner should also be well aware and thinking of things that may not seem pressing at this time,
such as the future of the business and how it may expand. Like with many other things, planning is an essential part to setting up for success.
33
PRODUCTS AND SERVICES
REFERENCES
Brohan, M. (2018, December 24). More consumers take to the web to shop for medical supplies.
In Digital Commerce 360. Retrieved from https://www.digitalcommerce360.com/2018/12/24/moreconsumers-
take-to-the-web-to- shop-for-medical-supplies/
UPMC Sports Medicine. (2015, August 25). What Is Aquatic Physical Therapy?. In UPMC Health Beat.
Retrieved from https://share.upmc.com/2015/08/what-is-aquatic-physical-therapy-mm07/
34
MARKETING STRATEGIES
35
Marketing and advertising are key to building a successful business. People will often not hear about a business if marketing is minimal.
This is why advertising is important, especially in the beginning when many people do not know about the business. Richmond Rehabilitation
will utilize social media, radio, newspaper, and fliers to reach potential customers.
36
Social media has become one of the most important tools for a company to use to make its name known. Instagram is one of the most popular
social media sites with over one billion people using it every month (Newberry, 2019). Instagram is not only fun, but extremely helpful for
businesses, as nearly two hundred million Instagram users visit at least one business profile every day (Newberry, 2019). Additionally, one-third of
the most viewed Instagram stories are from business who are utilizing the platform to promote their products and services (Newberry, 2019). By
creating an ad for Instagram, Richmond Rehabilitation will be able to reach a large amount of the local population who may want to utilize our
services, or will be able to easily forward the ad to someone they know who may want to utilize our services, thereby help spread the word. This
Instagram ad will utilize the option to include multiple photos that users can swipe through, showing pictures of the brand new, fully equipped
facility, as well as some of the professionally dressed and smiling staff. The photos will show that Richmond Rehabilitation is new, up to date, and
friendly so that people will be impressed and then interested to click on the link to our website and investigate further. The description beneath the
photos will read: “Richmond Rehabilitation is a brand new, fully equipped rehabilitation facility in Richmond, Rhode Island. We cater to all ages and
are always accepting new patients. Let us help you on your journey to recovery! Click the link to find out more.” The ad will be posted one week
before our doors open and will stay running for four months. After the first four months, the ad will be taken down and the effectiveness of the ad
will be evaluated based on data such as how many people viewed the ad, how many people interacted with the ad, and how many views Richmond
Rehabilitation’s website had during the run of the ad. If it proves successful, a similar but updated ad will be created and posted. 37
Richmond Rehabilitation will also utilize the radio for marketing purposes. Though not as new and flashy as social media, radio advertisements are
still the most cost-effective way to advertise to potential customers (Theisen, 2019). Because anybody can, and plenty of people do, listen to the radio, a
wide range of potential patients can hear the ad. The ad will mention briefly the services that we offer, the fact that we have a fully equipped, state of the
art facility, and highly trained staff. The ad will also mention that we can help people of all ages. A point will be made that Richmond Rehab is located
conveniently in Richmond, not all the way in the city. This will get more potential patients interested as they will likely be interested in a facility that is
located much closer than the facility they already use or were thinking about using. Lastly, the ad will mention where we are located, our website
address, and what our phone number is.
The third form of marketing that Richmond Rehabilitation will use is newspaper ads. Despite the rise of social media, there are still a lot of people
who read the newspaper. This form of advertisement can benefit Richmond Rehabilitation by being a rather inexpensive way to reach a lot of people,
many of whom may be older and may be more likely to need some of the services that we offer. Additionally, advertising in a local paper ensures that
people who live in the area will be the ones seeing the ad. These are part of our target market, as they would be more likely to see the appeal in a
rehabilitation center that is within their community.
38
The fourth form of marketing that Richmond Rehabilitation will utilize is fliers. These fliers will be placed in offices where we
have connections or partnerships, such as with acupuncturists, massage therapists, and doctors. The fliers will show pictures much like
the pictures posted on our Instagram ad that show our brand-new facility and friendly staff. The flier will list the services we offer, our
location, hours, website, and phone number. Fliers are physical things that people can take with them or give to people they know who
might be interested in our services. By placing them in places such as acupuncture, massage, or doctors’ offices, we will be able to more
likely reach our target market, as people seeking help from these places often need other forms of help as well to stay healthy and active.
Additionally, when people find our flier in a place that they already use and trust, they will likely feel as though we are also a place they
can trust.
Marketing is an important part of starting any new business. This is why taking advantage of multiple forms of advertising is
important. Advertisements need to tell your potential customers who you are, what you do, and why they should choose you. By taking
advantage of multiple forms of media to spread the word about our business, Richmond Rehabilitation is sure to reach a wide range of
potential customers.
39
MARKETING STRATEGY REFERENCES
Newberry, C. (2019, October 22). 37 Instagram Stats That Matter to Marketers in 2020. In Hootsuite.
Retrieved from https://blog.hootsuite.com/instagram-statistics/
Theisen, S. (2019, January 25). RADIO IS STILL THE TOP MEDIUM FOR ADVERTISING
EFFECTIVENESS. In Leighton Broadcasting. Retrieved from
https://blog.leightonbroadcasting.com/blog/radio-advertising-effectivness
40
EXAMPLE FLIER
41
42
BUDGET SPREADSHEET
43
BUDGET
44
BUDGET REFERENCES
Cost vs reward of opening a medical private practice (n.d.). In Doctorly. Retrieved from http://doctorly.org/cost-vs-reward-of-opening-amedical-
private-practice/
Coverage Options (n.d.). In Blue Cross MA. Retrieved from http://www.bluecrossma.com/bluelinks-for-employers/plans-products/municipaloptions/
coverage-options.html
Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (216-RICR-10-05-2) (n.d.).
In Rhode Island Department of State. Retrieved from https://rules.sos.ri.gov/regulations/part/216-10-05-2
Griffiths, Phillips, Davies, Burr, & Campbell. (2001, October 1). Cost effectiveness of an outpatient multidisciplinary pulmonary rehabilitation
programme. Thorax, 56(10).
Miller, S. (2019, August 20). Employers’ Health Costs Could Rise 6% in 2020. In SHRM. Retrieved from
https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/2020-large-employer-health-costs-expected-to-rise.aspx
Outpatient therapy costs (n.d.). In Medicare Interactive. Retrieved from https://www.medicareinteractive.org/get-answers/medicare-coveredservices/
rehabilitation-therapy-services/outpatient-therapy-costs
Pulmonary rehabilitation programs (n.d.). In Medicare.gov. Retrieved from https://www.medicare.gov/coverage/pulmonary-rehabilitationprograms
Rhode Island workers’ compensation law (n.d.). In Insureon. Retrieved from https://www.insureon.com/small-business-insurance/workerscompensation/
rhode-island
Speech-language pathology services (n.d.). In Medicare.gov. Retrieved from https://www.medicare.gov/coverage/speech-language-pathologyservices
Update on Pulmonary Rehab CPT Codes (2015, July 9). In AARC. Retrieved from http://www.aarc.org/medicare-payment-pulmonary-rehabgets-
boost-2015/
Washington County, Rhode Island (2018). In Census Reporter. Retrieved from https://censusreporter.org/profiles/05000US44009-washingtoncounty-
ri/
45
BUDGET SUMMARY
46
Richmond Rehabilitation is a new outpatient rehab located in Richmond, Rhode Island. Richmond Rehab is serving all of southern
Rhode Island. Richmond Rehab offers physical therapy, occupational therapy, speech therapy, and pulmonary rehabilitation services. In order to
help get started with employee salaries, purchasing equipment, purchasing licenses, and so forth, Richmond Rehabilitation is requesting a loan
of $350,000.
47
Extensive time and effort had been put into determining reasonable estimates for patient volume, revenue, and costs for the business.
First to discuss is the assumption of revenue. We have had a modest approach to our expected revenue, as having greater revenue than expected
is a far better situation to be in than less than expected. It is estimated that in general, about fifty percent of patients use Medicare, forty percent
use Blue Cross Blue Shield, and ten percent continually pay out of pocket. The out of pocket payments will be greater in the first months of the
year before many patients have reached their deductible. The next assumption is on patient volume. It is estimated that in the beginning,
Richmond Rehabilitation will be booked for eight physical therapy sessions a day Monday through Friday, and five on Saturdays. For
occupational therapy, seven sessions a day Monday through Friday, and four on Saturday. For speech therapy, six sessions a day Monday
through Friday, and three on Saturday. Finally, for the pulmonary rehabilitation program, it is estimated that we will have six sessions
scheduled per day Monday through Friday, and three on Saturday. These numbers are largely based off of the population of Washington County
(including age, average income, and location) as well as our hours of operation. After researching average costs for these services, the expected
revenue based on these volumes has been listed on the spreadsheet. It is very possible that as the business grows and becomes more wellknown
and trusted, these volumes will grow.
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Another assumption that has been made is the cost of the facility in which we will be located. After researching the approximate sized
facility needed and comparing this to the cost of other available commercial spaces in the area based on price per square foot, the rent price was
determined. This rent price may in fact be a little higher than what it will actually be, and in the coming years we will work towards purchasing a
facility so as to have this rent cost no longer be a part of the monthly expenses. Additionally, the monthly fee for being able to use the EPIC
system has been included in these estimates, as well as the upfront cost of purchasing the package to train employees on how to use it. Other
smaller assumptions that have been made are things such as maintenance and repair fees, as it is impossible to know exactly how many times a
snow plow company will need to be hired in order to plow the parking lot of the rehabilitation center after a snow storm, as there is no way to
predict exactly how many large storms there will be in any given month. Educated assumptions have been made and will hopefully be accurate or
even larger than what the actual costs end up being. All in all, however, these are smaller costs, and will not make or break the overall budget for
Richmond Rehabilitation.
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This budget comes with some limitations, too, however. These limitations include what we are able to receive as credit limit for our
business credit cards so that we may continue to make necessary purchases until we do begin to make a profit, which is predicted to occur
towards the end of the second year. Additionally, unexpected changes may occur, which could help or hurt our revenue. For example, it is
always possible that Medicare could reintroduce the previous cap that they had placed on outpatient therapies, which was recently removed. If
this happened, our revenue could decrease. There is also the more positive possibility that Blue Cross Blue Shield could decide to lower the out
of pocket cost for therapies, as it currently stands generally at twenty five dollars for physical therapy and occupational therapy, and fifteen
dollars for speech therapy. While these out of pocket costs to the patient are already very low, if they were to become lower, it could encourage
some patients to come for an extra session every month, thereby increasing revenue. There are seemingly endless possibilities of things that
could change and thereby effect our revenue, though we are currently not concerned that any of these changes are on the horizon.
Richmond Rehabilitation is bringing comprehensive care to southern Rhode Island. By offering many services, including physical
therapy, occupational therapy, speech therapy, and a pulmonary rehabilitation program, Richmond Rehab will be able to serve a wide variety of
patients. Though getting a business started is generally not an easy task, extensive research has been done to help ensure Richmond Rehab is off
to a good start, with well trained employees, a well-sized facility, high quality equipment, and more. A loan of $350,000 is just what Richmond
Rehab needs to help get started.
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APPROVALS
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Starting a new business can be very exciting. The anticipation to open the doors, start making money, and sharing a product or service with the
community can be a great motivator to getting things done quickly. However, during this rush it is important not to forget there are regulations that
must be abided by and licenses that must be obtained. Before opening any business, especially one in healthcare, it is important to review and obtain
all necessary permits, licenses, and permissions to ensure the business is operating within the law.
Before creating any business, it is crucial to understand the requirements set forth by the state in which the business will be operating to ensure
compliance. In Rhode Island, there are a couple things that one needs to be aware of when opening an outpatient rehabilitation facility. One major
requirement is that the facility receives a license to operate from the State of Rhode Island Department of Health (“Rehabilitation Center, Outpatient”,
n.d.). Before a license to operate an outpatient rehabilitation center will be issued, a few approvals must be granted, as are described later. Another
requirement is that the town in which the business will operate, Richmond in this case, must be contacted to register the name and address of the
business (“Rhode Island Business Portal”, n.d.). Additionally, it is required that a business application and registration be filed with the State of
Rhode Island Division of Taxation (“Rhode Island Business Portal”, n.d.).
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It is also important to note the state requires all of the direct patient care employees hired by Richmond Rehabilitation must have licenses to
work. This includes physical therapists, occupational therapists, speech therapists, respiratory therapists, and nurses. All of these healthcare workers
must have their own professional licenses to work in Rhode Island, which are issued by the State of Rhode Island Department of Health (“What We
License”, n.d.). Being granted one of these licenses is contingent upon their achievement of national standards, which varies depending on the field.
It is highly important that all approvals be received before starting a business. Before Rhode Island’s Department of Health will issue a license, a
Certificate of Need is required (“Chapter 40…”, 2018). To receive approval and be granted a Certificate of Need, a formal application must be
submitted that includes information such as a brief description of the facility, the nature of new services provided, the proposed location, proposed
cost to open the facility, demonstration of public need, and more, along with a fee (“Chapter 40…”, 2018). The health services council will review
the application, and ultimate approval will be granted by the state agency. Some stipulations to receiving approval include the apparent need for these
services as well as affordability for the people of the state (“Title 23 Health and Safety Chapter…”, n.d.). Receiving this approval is of tantamount
importance. Without it, a license cannot be granted, and without a license, the business cannot legally operate in the state of Rhode Island.
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It is a worthwhile endeavor considering what will happen and what the next step should be if proper permits, licenses, and accreditation
are not achieved. It is the goal of Richmond Rehabilitation to receive accreditation from the American Association for Accreditation of
Ambulatory Surgery Facilities, which provides accreditation for physical, occupational, and speech rehabilitation centers (American
Association for Accreditation of Ambulatory Surgery Facilities, 2017). The AAAASF RA/OPT Medicare Accreditation Program sets high
national standards for patient care and safety; therefore, receiving accreditation from the association would help newer patients feel more
confident in coming to the facility for treatment. The goal is to create more business for Richmond Rehab. Additionally, accreditation from the
AAAASF has been federally recognized for those facilities that wish to participate in Medicare programs for outpatient physical and speech
therapy (“CMS Announces AAAASF’s Continued Recognition…”, 2019). This would therefore help to not only build trust within the
community, but it would also serve as a means to participate in Medicare programs. If Richmond Rehab does not receive accreditation from the
AAAASF, it is not going to mean that the business cannot operate, but it will mean that substantial effort and attention to detail will need to be
made in the coming months and years to ensure that accreditation is eventually achieved to prove the high quality of services provided. This
will help create more trust and in turn more business from the community.
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In some cases, state permits and licenses may not be required if a facility has federal accreditation. The Joint Commission is an
independent, not-for-profit organization, the United States’ oldest and largest accrediting body in health care (“Facts about the Joint
Commission “, 2020). Many states recognize and rely upon Joint Commission accreditation and certification when conducting their own
quality oversight activities, and in some cases, if a facility has received recognition of accreditation from the Joint Commission, a statespecific
license may not be required (“State Recognition”, 2020). In Rhode Island, according to the Joint Commission, this currently
applies to about nine different types of organizations but does not apply to outpatient physical, occupational, speech, or pulmonary
rehabilitation programs (“State Recognition”, 2020). Therefore, state licensure and permits are still required in Rhode Island for these
types of facilities. Additionally, accreditation from the AAAASF may be federally recognized and therefore allow a facility to participate
in physical and speech therapy Medicare programs, but all applicants operating in states that require a license must have state license to
even apply (“Learn how to become accredited…”, n.d.). Therefore, in the state of Rhode Island, a state license is still required.
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Accreditation site visits are sometimes announced while other times they are not. The benefit to making announced visits is that the administration
and staff have time to review and properly prepare to ensure that their facility will receive or have their accreditation renewed. The benefit to
unannounced visits, however, is that those visiting the facility can see how it operates every day when it is not actively preparing for someone to visit
and determine accreditation status. Unplanned visits are sometimes seen as the better way because then the administration and employees must always
work to follow the rules and uphold standards because they never know when someone will be showing up to see how the facility is operating.
While it may seem at first that starting a new business is simply a matter of having an idea, renting a space, and hiring some employees, there is a lot
more to it than that. Starting a new business first requires extensive research to understand what types of permits and licenses must be obtained before
the business can open and begin operation. Often these permissions must be renewed annually or every few years. Ensuring that a business is
continually operating within the law and is in compliance with all federal and state regulations should be at the top of the owner’s list of priorities.
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APPROVALS REFERENCES
American Association for Accreditation of Ambulatory Surgery Facilities. (2017, September 8). Rehabilitation Agency / Outpatient Physical Therapy Standards and
Checklists Manual. In AAAASF. Retrieved from https://www.aaaasf.org/docs/default-source/accreditation/standards/standards-manual-and-checklist-v2- 2-
(opt).pdf?sfvrsn=32
Chapter 40 – Professional Licensing and Facility Regulation (2018, November 4). In State of Rhode Island Department of Health. Retrieved from https://risos-apaproduction-
public.s3.amazonaws.com/DOH/REG_10204_20181015083150.pdf
CMS Announces AAAASF’s Continued Recognition As An Accrediting Organization For Its Outpatient Physical Therapy And Speech Language Pathology Services
Accreditation Program (2019, April 1). In AAAASF. Retrieved from https://www.aaaasf.org/cms-announces-aaaasfs-continued-recognition-as-an- accreditingorganization-
2/
Facts about the Joint Commission (2020). In The Joint Commission. Retrieved from https://www.jointcommission.org/en/about-us/facts-about-the-joint-commission/
Learn how to become accredited through one of our Medicare Programs (n.d.). In AAAASF. Retrieved from https://www.aaaasf.org/programs/medicare-programs/
Rehabilitation Center, Outpatient (n.d.). In State of Rhode Island Department of Health. Retrieved from https://health.ri.gov/licenses/detail.php?id=201
Rhode Island Business Portal (n.d.). In Rhode Island Department of State. Retrieved from https://www.ri.gov/SOS/businessassistant/wizard/business_types/show/
1df5f50d81e49f76ef6c783a16f5b5e9650cd264/39f25d236abf83f457643cae74756 ea2afa7f4f4
State Recognition (2020). In The Joint Commission. Retrieved from https://www.jointcommission.org/en/accreditation-and-certification/state- recognition/

f:_Facet_State=[Rhode%20Island]

Title 23 Health and Safety Chapter 23-15 Determination of Need for New Health-Care Equipment and New Institutional Health Services Section 23-15-4 (n.d.). In State
of Rhode Island General Assembly. Retrieved from http://webserver.rilin.state.ri.us/Statutes/TITLE23/23-15/23-15-4.HTM
What We License (n.d.). In State of Rhode Island Department of Health. Retrieved from https://health.ri.gov/licenses/detail.php?id=201
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MANAGER INTERVIEWS
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Before beginning to work in any particular field for the first time, it is wise to get a little insight on to what to expect and how
things work. This is helpful because it is not always easy to accurately predict what things will be like once one gets into the field. One
way to help combat this issue is to interview those who already work in the field. For this reason, I have interviewed two people already
in the health care field who were able to provide insight into the financial and administrative operations of health care organizations.
The first person that I interviewed was Stephen Fife, who may be reached at sfife@capefearvalley.com or 910-862-5149. Mr. Fife
is the Director of Finance at Bladen Healthcare. I interviewed Mr. Fife on December 5th and asked him some questions regarding the
financial operations of his health care facility. I first asked Mr. Fife to describe his role within the facility, to which he answered that he
is part of the administration, receives monthly financial information, and works with the health information accounting, and payroll
departments. Mr. Fife also mentioned that he is also works on the annual budget, does the final check on financial statements before
they go to their corporate office, and manages day to day financials and meeting volumes targets and expense control.
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Getting into more specific questions, I next asked Mr. Fife how many people are involved in the financial process, and if he could briefly
explain the roles of each person involved. Mr. Fife said that on a broad scale, the revenue cycle for hospital involves lots of people, starting with
nurses scanning supplies for charges, coders who review charts to code accounts and put appropriate charges, and billers who make sure claims
are accurate and go out on time. He then was more specific and said that closing financial statements involve their senior accountant, there is
one payroll analysist, a senior accountant and payroll accountant do ledger statements, and patient financial staff to track accounts receivable. In
general, he said that the large revenue cycle involves fifty to sixty people, whereas the financial closing statements involve about five to six
people.
I next asked Mr. Fife how he formulates the budget for his facility on a monthly and annual basis. Mr. Fife replied that once a year they
look at the prior to project expenses, go through every detail to see if they expect to spend that much again, and then forecast new expenditures
for operating budget. Once expenses are done, they then forecast volumes for things such as daily patient volumes, ED visits, outpatient clinic
visits, and so forth. He says they try to determine what they can expect from all of the revenue generating procedure departments. Then, they
look at cash collections and what percentage of insurance companies have paid. Expenses should not exceed revenue, cash collected should
cover annual expenditures, and if the bottom line is not where it should be, expenses must be cut. On monthly basis, he says that if volume is
not where it should be, he looks for what variable expenses can be cut, staff they can flex, or which discretionary expenses can be held off on.
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For my fourth question, I asked Mr. Fife what he thinks will have the greatest effect on his organization’s margins in the upcoming
year, and why. I also asked if he believed that this is a concern specific to his organization or if he believes this is generally felt nationally.
Mr. Fife replied that he thinks whatever the state decides to do with Medicaid will have the biggest effect. He said that value-based care
and managed care population affect them the most because it is paid from the government. He said that they are shifting from a volumebased
payment environment to quality-based environment. Right now, they want a lot of patients in the hospital because they are paid every
day they’re in, but moving forward they need to keep people healthy and out of the hospital, which is good for people, but tough if they cut
rural hospital payments too fast. Mr. Fife felt that the value-based care shift is felt nationally but that each state is different on how they
control their Medicaid.
I moved forward by asking Mr. Fife what is important for me to know about starting up a business and month to month operational
finances. Mr. Fife said that in terms of individual physician clinics, it is important to know the patient population and payer mix, be
conservative with capital expenditures and expenses, achieve sustainable growth, and do not hire too many people that you cannot afford to
hire. He suggested putting one doctor and one nurse practitioner in a clinic, and then move them around based on how busy they are. He
said that a business should grow conservatively.
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Next, I asked what he believes is generally one of the most common mistakes made in new businesses, specifically in health care,
that causes it to fail financially. Mr. Fife said that often people can put too much on a provider and it becomes more than they can handle.
One thing he sees is that growing too quickly and offering too many services is not always a good thing. He suggests figuring out what
you are good at and perfecting that. He suggests sticking to higher earning services that one is good at and referring out lower paying
services that pay less.
Next, I wanted to know that if I have a start-up loan amount of up to $500,000, how he would best utilize it. His reply what that
businesses need capitol. He said to invest capitol. He said that $500,000 is not a lot for many health care businesses, so focus on
spending only what you can, otherwise you cannot sustain operations to meet payroll. With only $500,000 he suggests leasing space
instead of buying a practice. Mr. Fife also said to make sure capital expenditures do not exceed what is needed to make it operational for
at least a year. He also mentioned that it typically is at least three months before one is credentialed with Medicare and Medicaid, so there
may not be payments from them for the first few months. There will be copays, but they are typically not enough to sustain business.
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Lastly, I wanted to know if Mr. Fife felt that the seemingly constant implementation of new technology in healthcare has hindered many
organization’s financial situations, and if yes, how so. He said that he thinks it does sometimes. He said that technology is good because it allows health
care workers to keep people healthier for longer. Mr. Fife said in his facility most recently it has affected them when their x-ray machines went from
cassette to digital readers. He feels that digital technology in this area is better, but that Medicare and Medicaid take down reimbursement five percent a
year if it is not purchased. Mr. Fife said that their hospitals are completely digital, but not in their two outpatient clinics. Unfortunately, he said, it is
$300,000 to upgrade their machines, so they have to decide if it is worth having ten percent taken from Medicare. When they upgraded to the EPIC
system, it cost about one hundred million dollars. This technology is great, but generally non-affiliated organizations cannot afford it.
After asking my last question, I thanked Mr. Fife for his time and hung up the phone. I felt that overall my interview with Mr. Fife taught me that
managing the finances of a health care institution is often more difficult than I would have liked to think that it is. Dealing with Medicare and Medicaid
almost seems like a cruel game in some ways, and I wish that it would not be that way. I have also found that it is more involved on a day to day basis
than I previously thought that it was. I suppose my previous thoughts were that finances were looked over just occasionally, which is how hospitals (and
other businesses) so often end up in debt, because they were not managing things on a daily and monthly basis. However, I now see all of the various
parts that play into creating a budget for a health care facility and that it requires a lot of daily work and is not always easy and simple to manage.
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The second person I interviewed was Christine Gadbois. Ms. Gadbois may be reached at
CGadbois@carelinkcollaborative.org, or at 401-654-4021. I interviewed Ms. Gadbois on December 9th and asked
questions regarding her administrative role. Ms. Gadbois stated that she is the CEO of CareLink and that she therefore
holds many roles within the organization, which she would go on to discuss further in other questions within the interview.
I next asked Ms. Gadbois to explain to me the managerial operations of her healthcare organization. She described
her role as broad and yet also very involved. She said that she has oversight of all aspects of the organization. Ms. Gadbois
went on to say that this includes everything from financial matters to overseeing new program development, interacting
with the Board of Directors, insurance, state regulations and licensing, and that she is ultimately responsible for clinical
care and quality.
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Next, I asked Ms. Gadbois what some of the biggest decisions are that she makes on a daily basis. Ms. Gadbois replied that
day to day decisions around staff and supporting staff are the most important, including how they are paying and recruiting staff.
She said this also involves figuring out how to best deal with HR issues, making critical decisions to make sure that staff can
deliver proper care, as well as seeing that HR is functioning properly and ensuring that administrators are on top of finances. She
also mentioned that collaborating with the Board is critical to evaluate how the organization is fitting into the landscape: are there
new opportunities or directions in which the organization can go?
Next, I wanted to ask Ms. Gadbois what some of the biggest challenges are that she faces on a regular basis in her work.
Ms. Gadbois answered that, as a nonprofit, the biggest challenge is finances. Trying to capture the best reimbursement is
sometimes difficult. She also said that keeping that point in mind, it is also sometimes a challenge to maintain the highest quality
while under constraints of limited funding.
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Having the opportunity to speak to someone who runs a nonprofit, I wanted to know what she feels is different from
running a nonprofit versus a for profit organization or facility. Ms. Gadbois answered that for-profit organizations have many
of the same funding challenges. However, her nonprofit has a partnership with Board of Directors and that the Board
members often have different perspectives with which course of action is the best. She explained that being the senior leader
in a nonprofit means figuring out how to be best responsive to the Board and still maintain the organization’s mission.
My next question to Ms. Gadbois concerned what she does to advertise or market her organization for growth within
your community, and also how involved she is in that process as the CEO. Ms. Gadbois started by answering that she is pretty
involved. She said that CareLink is fairly small, so she gets to be pretty involved. Ms. Gadbois then went on to say that they
do not advertise in a lot of traditional ways such as with billboards or TV ads. Instead, CareLink’s advertising is through
professionals. Essentially, she said, it is networking more than just advertising, which is accomplished through things such as
conferences and making sure website is up to date.
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Next, I asked what she felt would be important for one to know from an administrative perspective when starting up and growing a healthcare
business. Ms. Gadbois answered that it is most important to understand the market. Understanding the market is important so that your facility or
organization is providing a service people actually want to buy. Is the market already saturated? What is your value? She said that it is necessary to
articulate that your organization is something the market needs, and why.
My question for Ms. Gadbois concerned what she sees as one of the most common mistakes that administrators of new health care business
make, and what she suggests as the best way to avoid this issue. Ms. Gadbois said that it is sort of the same idea. She expanded on this by saying
that folks think there is an unmet need. However, she went on to say, there really there are other factors that had not been taken into account, such as
current supply of that product or service and demand for it. In turn, these factors impact the viability of their new service or product.
I was then curious to know how Ms. Gadbois feels about health care administration versus administration in other fields. I ask her what she
believes makes a successful administrator in health care in comparison to other fields and if it different in any particular way. Ms. Gadbois said that
she actually has not worked in other fields. However, she said that she but imagines it is much the same. To be a good administrator, one needs to be
flexible and really know their product and service.
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Lastly, I wanted to ask Ms. Gadbois, when hiring or electing new administrators, how important it is to her that they have experience
working in the area they now oversee. Ms. Gadbois answered by saying that front line experience is important. She said it is about
knowing the business. If they have front line experience, they know what staff needs and wants are. They will also know what team
members are going to face. She then mentioned that there is also something to be said for credibility, including how much weight do their
opinions will carry based on what other perceive about them.
After hanging up the phone with Ms. Gadbois, I had a lot to think about. It was very interesting to better understand the perspective
of a CEO. I had never spoken to a CEO before. There is so much to consider when running a business, including things that I think might
be easy to overlook. For example, running a business may become overwhelming and trying to find the right people for each job may
become difficult. At some point, it might be easy to say that experience does not matter so much, so long as they have the right degree to
qualify for the position. It is important, however, that they have experience, as this allows the new administrator to provide a front-line
perspective as well as have respect and credibility with their new employees. Funding also poses a big problem and trying to balance
funding while still providing quality care can be tricky but is necessary.
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When comparing the two interviews, it is interesting to see how funding seemed to be one of the most common topics of discussion. Especially
when it came to discussing problems that the organizations and facilities face, funding was the biggest topic. Being able to receive adequate and timely
payments, especially from Medicare and Medicaid, seems to create a struggle and sort of balancing act that all types of administrators must be very
aware of and work around. It is somewhat sad to know how tightly providing quality health care is to money, but it is. It appears as though it would be
almost impossible to work at any administrative level in health care and not be thinking about money almost every single day. One difference,
however, was that the financial manager is focused solely on money, while the CEO has to focus on money but also focus on other issues such as HR
issues and pleasing the Board. While this may seem obvious and be expected, it is still a lot for both to take on and have to work on every day.
Overall, these interviews have been helpful in regard to my project. These interviews have opened my eyes a little to see that, while advertising and
having a good business model is extremely important, money is just as important. Without adequate funding or a meticulously planned budget, a
business is unlikely to get off of the ground. It is difficult to try and run a business only thinking about money of course, but it has become clear that
money needs to be considered in essentially every single decision that is made, especially in the beginning when funds are typically especially tight.
This has helped me realize that hiring as many people in the start as I would actually want to hire might prove unrealistic and having quite as large of a
facility as I would like right from the start might not be exactly attainable. It may be, but it also might not, and really either way, careful budgeting is
going to be the biggest key to determine success or failure of my planned business. 69
It is not always easy to know what one is getting oneself into when entering a new field. There are always things
that come up that were not planned for that can cause problems. There are also almost always going to be things that an
inexperienced person will think are important, but in turn, do not require as much focus as once thought. Understanding
the things that have generally caused the ultimate downfall or success of other business and getting insight from those
currently in the field is extremely important before starting a new business endeavor.
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EMPLOYEE QUALITIES AND
RETENTION
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I would want my employees to be hard working. I know this seems kind of obvious, but I am a hard worker and I always try to do the best job I can at work,
so I would expect the same from my employees so that our facility may form a good reputation in the community. I would also want my employees to be
humble, especially when they are new. If people are not humble and cannot admit when they do not know how to do something, it can result in improper
treatment and distrust among employees. I want confident and intelligent employees, but nobody knows everything, and I do not want to have employees who
think they never have anything more to learn. Lastly, I would want my employees to have good time management skills so that appointments are not constantly
running behind and causing upset for the other patient.
It kinds of goes hand in hand with me wanting humble employees, but I would not want employees who are cocky because it can lead to frustration and
distrust amongst employees. This is a small facility and we do not need people to be too tense to work well together. I would also not want employees who are
extremely shy or introverted. The reason for this is because they will need to be working closely with many different patients, most of whom will require a lot
of encouragement and energy to put in the effort they need to get the best results from their therapies. Lastly, I would not want employees who lie. This seems
obvious, but I do not want employees who lie about how their patients are doing, how sessions went, or even about things like why they are calling out sick.
This is a small facility and people lying will only lead to tension, distrust, aggravation, and potentially poor patient care.
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The first strategy I would use to help retain employees would be to create an atmosphere of trust. I would work hard to remind employees
that asking for help when they are doing something new or unfamiliar is okay. Work environments that make employees feel scared to ask
managers and fellow employees for help when they need it and instead feel they must always just “fend for themselves” just breed tension,
frustration, and possibly high turnover. The next strategy I would use is flexibility. I know that in one of my previous jobs, a manager told me that
the number one reason employees give in their exit interview about their favorite part of the job is the flexibility it offered. I want my employees
to know that it is okay if they switch shifts with each other if they need to, as long as someone is there to do the work. I want my employees to
understand that I know they are human, and while I do expect them to come to work and put in good work, I also know that life happens and it is
ok to ask if you need something to be adjusted. It may not always be possible, but every effort will be made to accommodate what they need. The
last strategy would be by making sure that there is always an easy, anonymous way for employees to submit questions, complaints, concerns, and
so forth. Employees should not fear retaliation just because they have a concern or are unsure of a policy, etc. Employees should feel as though
they have a convenient, helpful way to get their questions answered or to be able to report unethical activity within the facility. I do not want my
employees feeling like when something they feel is not right is happening that they can do nothing about it and have to just let it happen around
them. Hopefully this will give them a sense of responsibility and a way to contribute to keeping the facility safe, well-respected, and honest.
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