1. PREMIERE
CONCIERGE
SERVICES
Business
Plan
Fall
2015
Caroline
Foscue,
Catherine
Pelto,
Jay
Spafford,
Savanna
Williams,
Haley
Wright
Providing
excellence
in
patient-‐centered
care,
based
on
a
foundation
of
knowledge,
innovation,
and
ethical
values.
2.
2
TABLE
OF
CONTENTS
Executive
Summary
4
Strategic
Planning
6
About
Premiere
Concierge
Services
7
Environmental
Analysis
7
Office
Layout
11
Marketing
17
Services
Offered
18
Distribution
of
Services
21
Promotion
of
Services
22
Differential
Statement
24
Geographic
and
Economic
Demographics
24
Organization
and
Design
26
Legal
Entity
27
Employment
Positions
28
Governance
of
Organization
28
Coordination
of
Work
30
Organizational
Chart
32
Staffing
33
Recruitment
and
Retaining
35
Contract
Work
36
Staffing
Issues
39
Performance
Evaluation
40
Member
Satisfaction
41
Benefits
Package
42
Disciplinary
Procedures
42
Termination
42
Regulatory
Compliance
43
HIPAA
Compliance
44
Drug
Testing
and
background
check
Policy
45
Regulatory
Compliance
Policies
45
Finance
and
Accounting
46
Initial
Funding
47
Financial
Statements
for
Fiscal
Years
1
and
2
49
Financial
Specifications
51
Technology
53
Desired
System
Functionality
54
Acceptable
Systems
54
3.
3
Staff
Training
Plan
57
Security
and
Data
Backup
Plan
58
Technology
and
Equipment
59
Works
Cited
63
Appendix
A:
Marketing
67
Explanation
of
services
68
Alabama
High
School
Athletic
Association
Physical
Evaluation
Form
73
Appendix
B:
Staffing
75
Staff
Member
Performance
Evaluation
Form
80
Premiere
Concierge
Services:
Member
Satisfaction
83
Staff
Member
Handbook
85
Appendix
C:
Regulatory
Compliance
95
HIPAA
Compliance
and
Confidentiality
Statement
96
Privacy
Policy
97
Employee
Drug
Testing
Policy
100
Employee
Random
Drug
Testing
Policy
106
Employee
Background
Check
Policy
109
Equal
Employment
Opportunity
and
Harassment
Policy
111
Occupational
Safety
and
Health
Program
113
ADA/ADAA
Policy
118
Appendix
D:
Finance
and
Accounting
121
Appendix
E:
Furniture
and
Fixtures
129
Appendix
F:
Technology
and
Equipment
136
4.
4
EXECUTIVE
SUMMARY
Concierge
medicine
is
a
relatively
new
and
upcoming
form
of
providing
care
to
patients.
A
patient
pays
an
annual
fee
or
retainer
for
all
or
most
services
that
the
primary
care
physician
would
provide.
Additionally,
the
physician
gives
more
in
depth
care
and
attention
to
each
of
his
or
her
patients
in
comparison
to
the
fifteen-‐
minute
office
visit
that
has
become
so
standard.
Concierge
medicine
allows
a
physician
to
go
back
to
a
more
traditional
way
of
providing
healthcare
to
patients,
by
building
relationships
in
order
to
make
an
overall
positive
impact
on
their
health
and
not
just
treat
a
disease
or
illness.
The
increase
in
the
aging
Baby
Boomer
population
calls
for
more
health
care
and
services.
We
believe
a
concierge
medical
facility
would
be
beneficial
to
Mobile
and
Baldwin
county
residents
who
are
retirees
or
have
dependent
children.
When
it
comes
to
our
marketing
ventures,
our
unique
services
such
as
our
wellness
plans
and
house
calls
will
help
us
stand
out
among
various
primary
care
providers
who
are
unable
to
take
the
extra
time
and
effort
to
exceed
a
patient’s
expectations.
Also,
we
hold
importance
in
being
involved
in
and
giving
to
our
community
by
supporting
local
schools
and
organizations
and
hope
we
gain
positive
attention
as
a
result
of
those
efforts.
Premiere
Concierge
Services
will
be
a
small
LLC
organization,
employing
two
physicians,
a
practice
manager,
and
two
registered
nurses.
We
believe
starting
small
and
providing
the
best
possible
care
to
our
members
should
be
how
we
make
our
biggest
impact
before
potentially
expanding
in
the
future.
Having
a
team-‐like
atmosphere
in
the
office
is
at
the
utmost
importance
to
ensure
both
our
staff
and
members
are
trusting
and
satisfied.
Our
practice
will
not
submit
insurance
claims
or
accept
insurance.
All
revenue
will
be
generated
by
the
various
levels
of
membership
tiers.
Under
the
assumption
our
practice
will
not
begin
generating
revenue
for
the
first
sixty
days
of
business,
we
must
generate
enough
sources
of
cash
to
cover
operating
expenses
for
that
period,
in
5.
5
addition
to
leasehold
improvements,
technology,
and
furniture.
We
will
receive
two
loans
from
BBVA
Compass
and
Wells
Fargo
to
finance
the
leasehold
improvements,
technology,
and
furniture.
Our
two
physicians
will
finance
the
remainder
of
our
operating
expenses
and
starts
up
costs
at
varying
rates.
Premiere
Concierge
Services
desires
to
obtain
practice
management
and
electronic
medical
record
systems
that
will
tailor
to
our
concierge
practice
needs.
We
also
see
this
investment
as
one
that
will
simplify
processes,
be
user-‐friendly
for
both
our
staff
and
members,
and
protect
our
members'
privacy.
We
hope
implementing
such
systems
will
enable
our
practice
to
provide
the
personalized
care
we
promise
to
give
out
members.
Additionally,
because
concierge
medicine
boasts
on
the
idea
that
the
medical
staff
is
available
to
care
for
members
anytime
of
the
day,
it
is
vital
our
physicians
are
equipped
with
phones
and
other
technology
that
is
mobile
and
can
be
taken
to
someone's
home.
The
care
provided
in
one's
home
should
be
of
no
less
quality
as
the
care
provided
in
our
office.
The
use
of
information
systems
and
technology
will
help
carry
out
the
unique
components
of
our
concierge
practice.
Our
hope
in
creating
Premiere
Concierge
Services
is
to
give
physicians
the
opportunity
to
care
for
their
patients
in
an
unhurried
and
relaxed
environment
to
help
foster
a
true
sense
of
understanding
and
trust.
Focusing
on
the
individual
as
a
whole
to
develop
long
term
goals
and
plans
is
at
the
forefront
in
becoming
our
members’
partner
for
health
and
well-‐being
7.
7
ABOUT
PREMIERE
CONCIERGE
SERVICES
MISSION
STATEMENT
We
strive
to
provide
our
members
with
more
than
just
healthcare.
Our
goal
is
to
modernize
the
traditional
house
call
by
going
above
and
beyond
what
the
traditional
primary
care
practice
offers.
Our
holistic,
proactive
approach
to
healthcare
addresses
your
physical,
mental
and
emotional
well-‐being
through
one-‐on-‐one
counseling
and
comprehensive
diagnostic
testing.
MOTTO
Providing
excellence
in
patient-‐centered
care,
built
on
a
foundation
of
knowledge,
innovation,
and
ethical
values.
STRATEGIC
GOALS
§ To
create
a
service-‐based
company
whose
primary
goal
is
to
exceed
customers'
expectations.
§ To
establish
a
partnership
between
PCS
and
at
least
two
of
the
top
10
local
companies
§ To
develop
a
sustainable
home
business,
surviving
off
of
its
own
cash
flow.
§ To
become
the
concierge
practice
of
choice
for
Mobile
and
Baldwin
counties.
§ To
have
a
prominent
and
positive
presence
in
the
local
community.
ENVIRONMENTAL
ANALYSIS
We
would
like
to
enter
a
target
market
of
upper
middle
class
residents
in
the
Mobile
and
Baldwin
counties,
specifically
retirees
and
families
with
dependent
children.
The
average
household
income
in
both
Mobile
and
Baldwin
counties
are
in
the
top
twenty
highest
incomes
in
the
state.
The
following
tables
display
the
population,
median
household
income,
average
housing
value,
and
average
age
for
the
cities
in
which
we
believe
the
majority
of
our
services
will
be
rendered:
8.
8
The
Fairhope
area
is
notably
one
of
the
premiere
retirement
locations
in
the
state.
We
expect
that
a
large
portion
of
our
patients
will
be
of
retirement
age,
so
the
retirement
population
in
the
Fairhope
area
would
be
beneficial.
The
Fairhope
community
is
highly
family-‐oriented,
as
can
be
determined
by
the
vast
number
of
quality
public
and
private
K-‐12
academic
institutions
in
the
area.
There
is
market
share
to
be
gained
due
to
the
fact
that
we
will
be
acquiring
the
only
exist
concierge
physician
in
the
area.
She
previously
performed
concierge
medicine
in
addition
to
her
existing
primary
care
physician
role.
There
has
never
been
a
true
concierge
practice
in
the
area.
The
sheer
lack
of
competition
would
warrant
an
easy
entry
into
the
market
as
there
are
currently
few
barriers
to
entry.
Daphne,
23,633
Fairhope,
16,385
Spanish
Fort,
7,629
Mobile,
194,899
Population
$54,706
$71,899
$62,197
$36,150
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Daphne Fairhope Spanish
Fort
Mobile
Median
Household
Income
$178,826
$197,099 $206,544
$119,300
$0
$50,000
$100,000
$150,000
$200,000
$250,000
Daphne Fairhope Spanish
Fort
Mobile
Average
Housing
Value
37
44
40
36
0
10
20
30
40
50
Daphne Fairhope Spanish
Fort Mobile
Average
Age
10.
10
LOCATION
ADVANTAGES
• We
will
be
acquiring
the
only
existing
concierge
physician
in
the
area,
eliminating
competition
• Locating
the
office
in
Daphne
will
lower
property
price
compared
to
Fairhope
while
still
maintaining
access
to
to
all
four
target
cities
• Can
service
the
Daphne,
Fairhope,
Spanish
Fort,
and
high-‐income
areas
of
Mobile
• Physicians
already
have
privileges
at
the
Mobile
Infirmary
Health
Network
(Thomas
Hospital)
LOCATION
DISADVANTAGES
• Entering
a
new
market,
which
adds
risk,
higher
marketing
costs,
and
other
challenges
• Acquiring
patients
who
have
preexisting
relationships
with
local
physicians
• Lack
of
knowledge
of
concierge
medicine
as
a
practice
within
the
community
• Large
geographical
location
to
service
11.
11
OFFICE
LAYOUT
We
would
like
our
waiting
room
and
lobby
area
to
have
a
very
comfortable
and
warm
feel
to
it,
similar
to
a
living
room.
Because
our
practice
specializes
in
home
visits,
we
want
our
members
to
feel
as
though
they
are
in
their
own
home
when
they
enter
our
office.
Members
will
enter
the
waiting
room
and
lobby
area
where
they
will
be
greeted
by
our
receptionist.
In
the
event
their
physician
is
not
immediately
available,
the
member
will
be
invited
to
wait
on
one
of
our
comfortable
seating
options
and
offered
a
beverage
and
a
selection
of
magazines.
Our
beverage
station
will
consist
of
a
self-‐
service
Keurig
connected
to
a
water
line
so
that
we
do
not
have
to
worry
about
refilling
the
machine.
There
will
be
a
selection
of
single-‐serve
coffee
pods.
There
will
also
be
carafes
of
chilled,
filtered
water
with
a
variety
of
sliced
fruits.
We
will
offer
light
refreshments
at
the
beverage
station
such
as
fresh
fruit
and
small
whole
grain
pastries.
We
will
have
gas-‐powered,
electric
fireplace
which
will
be
lit
during
the
colder
months
to
add
to
the
homey
feel.
Our
color
scheme
consists
of
light
blues,
greens,
and
greys,
which
we
have
found
to
be
inviting
and
not
overwhelming.
Our
intention
is
for
the
space
to
feel
warm
and
inviting,
but
not
overly
bold
and
harsh.
The
office
will
have
two
care
suites,
with
each
consisting
of
a
consultative
and
exam
room.
In
the
exam
room
there
will
be
a
comfortable
exam
table,
physician’s
stool,
and
an
additional
chair
for
family
members.
On
the
exam
side,
visual
information
display
and
storage
coexist,
making
the
most
of
space
and
encouraging
shared
understanding
with
information
access.
The
consultative
room
will
have
a
couch
for
the
member
and
a
swivel
seating
for
the
doctors,
to
be
able
to
maintain
eye
contact.
There
will
be
a
two-‐monitor
visual
display
to
increase
the
ability
for
the
patient
and
doctor
to
understand
the
full
picture
of
the
health
context.
Both
sides
of
the
care
suite
will
include
room
for
families
to
participate
in
learning
and
decision
making.
16.
16
LEASE,
BUY,
OR
PURCHASE
DECISION
Leasing
office
space
in
a
local
office
building
or
complex
is
the
best
option
for
our
practice.
It
is
preferable
that
we
do
not
buy
or
build
our
location
because
our
office
space
needs
are
not
overly
complex
compared
to
the
average
business.
We
will
perform
minimal
procedures
in
the
physical
office,
so
there
is
no
need
to
many
patient
rooms.
Additionally,
leasing
will
allow
our
business
to
have
more
capital
in
its
infancy
stages.
The
more
capital
we
have
in
the
beginning
the
better
our
chances
are
of
success.
Leasing
removes
the
complication
of
being
tied
to
an
office
space
that
we
own
through
buying
or
building
it
in
the
event
that
our
business
is
unsuccessful.
Maintenance
issues
in
our
facility
will
also
be
covered
in
our
lease
and
be
an
advantage
to
us
to
where
we
do
not
have
to
outsource
this.
Finally,
if
we
choose
to
expand
our
practice
in
the
future,
it
is
easier
to
do
so
by
waiting
until
the
termination
of
the
lease
and
relocating
to
a
new
location
rather
than
renovating
or
adding
onto
a
bought
or
built
property.
18.
18
SERVICES
OFFERED
OUR
UNIQUE
SERVICES
Comprehensive
Physicals
Upon
a
member’s
first
visit
to
the
office
their
personal
physician
will
meet
with
the
new
member
for
an
hour
and
a
half
in
order
to
provide
them
with
a
comprehensive
physical.
Unlike
a
traditional
primary
care
practice,
the
physician
will
take
the
extra
time
to
get
to
know
the
member,
their
lifestyle
and
their
current
health.
Each
physician
will
go
through
the
member’s
medical
history,
check
their
vital
signs,
perform
a
heart
exam,
lung
exam,
head
and
neck
exam,
abdominal
exam,
and
neurological
exam
(see
Appendix
A
for
descriptions).
Through
the
comprehensive
physical
we
hope
to
gain
an
in-‐depth
knowledge
of
each
member’s
medical
history
and
their
chronic
medical
needs,
if
any
exist.
Additionally,
testing
may
include:
a
complete
blood
count,
urine
analysis,
body
composition
test,
nutritional
assessment,
exercise
counseling,
heart
screening,
and
stroke
screening
(see
Appendix
A
for
descriptions).
Our
practice
aims
to
know
members
as
a
whole
person,
rather
than
as
a
faceless
name
on
a
chart.
Wellness
Plan
Each
member’s
physician
will
develop
a
wellness
plan
tailored
to
their
unique
health
goals
and
lifestyle
based
on
their
comprehensive
physical.
The
physician
will
support
their
patient
along
the
way
to
living
a
healthier
and
more
vibrant
life.
Some
of
our
areas
of
focus
include,
heart
health,
diabetes
prevention,
sleep,
emotional
well-‐
being,
sexual
health,
and
weight
management.
Personalized
Grocery
Shopping
A
service
we
will
provide
to
our
most
committed
members
is
personalized
grocery
shopping
trips.
One
of
our
Registered
Nurses
will
go
with
members
to
the
grocery
store
in
order
to
help
them
select
healthier
foods
to
19.
19
fulfill
the
weight
management
aspect
of
their
wellness
plan.
If
a
physician
suggests
a
diet
plan
(vegan,
paleo,
etc.)
for
their
member,
the
Registered
Nurse
will
help
the
patient
to
find
the
foods
that
fit
within
their
plan.
House
Calls
Our
practice
seeks
to
personalize
care
to
fit
the
member’s
needs,
one
way
in
which
we
do
this
is
through
convenient
house
calls.
Following
our
member’s
comprehensive
physical
they
have
the
option
to
elect
for
at
home
services
rather
than
traveling
to
our
office.
The
member’s
physician
can
provide
them
with
any
service
that
can
be
performed
in
the
home
without
the
use
of
our
in-‐office
medical
equipment.
Similarly,
once
our
practice
has
established
relationships
with
local
companies
we
hope
to
offer
in-‐office
visits.
The
companies
can
opt
for
discounted
membership
fees
for
their
employees
and
our
practice
will
come
in
for
the
day
and
give
employees
their
comprehensive
physicals.
This
allows
busy
employees
to
avoid
having
to
take
time
out
of
their
day
to
travel
to
our
office.
OUR
FREQUENT
SERVICES
Office
Visits
The
office
visit
is
one
of
our
member’s
most
frequent
reasons
for
coming
in.
The
office
visit
can
greatly
range
in
complexity
from
a
minimal
risk
problem,
such
as
an
insect
bite
or
cold,
to
a
high
complexity
problem
like
the
exacerbation
of
one
or
more
chronic
illnesses.
Management
for
office
visit
problems
can
range
from
superficial
dressings
to
emergency
surgery.
20.
20
Vaccinations
Some
of
the
most
common
types
of
vaccination
we
plan
to
provide
to
our
members
are:
• Influenza
• Measles,
Mumps,
Rubella
(MMR)
• Measles,
Mumps,
Rubella,
Varicella
(MMRV)
• Meningococcal
• Pneumococcal
• Varicella
(Chickenpox)
• And
Zoster
(Shingles)
School
Physicals
The
school
physical
helps
determine
whether
it
is
safe
for
a
member
to
participate
in
a
particular
sport.
The
Alabama
High
School
Athletic
Association
requires
the
physical
prior
to
the
beginning
of
the
season
and
has
specific
requirements
(see
Appendix
A
for
requirements).
The
medical
history
portion
can
be
filled
out
by
a
parent
but
should
be
reviewed
by
a
medical
professional.
The
pre-‐participation
physical
evaluation
portion
of
the
physical
is
fairly
standard
and
in
line
with
the
exams
described
in
the
comprehensive
physical.
PRICING
OF
SERVICES
The
pricing
of
all
services
that
a
member
may
need
will
be
included
in
the
annual
membership
fee
they
pay
to
our
practice.
There
are
three
levels
of
membership
that
new
members
can
buy
into.
The
top
level
of
membership
for
our
most
committed
members
is
the
platinum
level,
this
includes
all
of
our
unique
services
such
as,
the
comprehensive
physical,
wellness
plan,
personalized
grocery
shopping,
and
house
calls.
Additionally,
platinum
members
will
have
access
to
a
spa
and
fitness
center
in
Daphne.
We
will
partner
with
the
spa
and
fitness
center
in
order
to
receive
discounted
services
for
our
members.
The
annual
price
for
our
platinum
level
membership
is
$1,750.
Our
second
level
of
membership,
the
gold
level
includes
the
comprehensive
physical,
wellness
plan,
and
house
calls.
The
annual
price
for
our
gold
level
membership
is
$1,500.
Our
third
level
of
membership,
the
silver
level
includes
the
comprehensive
physical
and
wellness
plan.
The
annual
price
for
our
silver
level
membership
is
$1,200.
Additionally,
all
members
at
every
membership
level
will
have
access
to
their
physician’s
cell
phone
numbers
to
easily
text
or
call
them
with
their
medical
concerns.
21.
21
Our
practice
understands
the
bulk
of
our
clientele
will
come
from
two
groups,
affluent
individuals
who
do
not
want
to
bother
with
their
limiting
insurance,
who
want
the
extra
attention,
and
personalized
services
our
practice
can
offer.
Additionally,
the
other
group
we
plan
to
serve,
the
chronically
sick
who
realize
our
services
can
be
less
expensive,
comparatively,
for
how
often
they
must
come
in
contact
with
the
health
care
system.
Our
goal
is
to
balance
these
two
groups
so
our
practice
is
still
profitable.
We
recommend
that
all
of
our
new
members
wait
until
their
insurance
runs
out
and
instead
purchase
a
high-‐deductible
health
plan
(HDHP),
which
can
be
used
in
the
case
of
catastrophic
emergencies.
DISTRIBUTION
OF
SERVICES
Our
practice’s
distribution
of
services
has
been
broken
up
per
physician.
In
our
first
year
we
plan
to
have
400
members
per
physician.
Annually
we
plan
to
see
each
member
for
their
comprehensive
physical
and
wellness
plan.
Our
most
common
service,
the
office
visit
is
based
upon
how
many
patients
the
non-‐concierge
primary
care
physician
would
see
annually,
however,
we
will
see
less
than
a
quarter
of
the
typical
PCP.
The
distribution
of
house
calls,
one
of
our
unique
services,
is
based
off
the
office
visits
as
it
will
be
used
in
substitution
of
the
office
visit
for
some
of
our
members.
Vaccinations
and
school
physicals
are
also
based
off
the
distribution
of
office
visits
for
the
typical
PCP.
Service Per(day Per(week Per(month Per(year
Comprehensive,Physicals 1 7 28 400
Wellness,Plans 1 7 28 400
House,Calls 2 14 56 672
Office,Visits 5 27 108 1,296
Vaccinations 5 35 140 1,680
School,Physicals 5 20 20,,,,,,,,,,,,,,,,
Distribution(of(Services(per(Physician
22.
22
PROMOTION
OF
SERVICES
REFERRALS
Our
practice
sees
referrals
from
existing
members
as
a
crucial
means
for
attracting
new
members.
In
order
to
keep
word-‐of-‐mouth
consistently
positive,
we
will
make
sure
each
member
receives
care
personalized
to
their
needs
and
wants.
If
a
member
does
not
feel
their
needs
and
wants
have
been
met,
our
practice
will
reach
out
to
the
member
to
make
sure
any
problems
are
resolved.
MARKETING
For
our
internet
marketing
needs
our
practice
will
be
outsourcing,
the
company
we
will
outsource
to
is
A-‐Factor
Marketing.
They
will
meet
with
us
about
our
practice’s
vision
for
the
website
and
Facebook
page,
strategize
what
will
be
best
for
our
practice,
then
they
will
create
and
execute
our
website
and
Facebook
page.
They
also
will
be
available
to
help
maintain
the
website
and
Facebook
page,
and
make
changes
whenever
needed.
Additionally,
for
our
Facebook
page,
A-‐Factor
will
post
meaningful
articles
and
health
facts
to
increase
page
views.
A-‐Factor
Marketing
will
charge
$4,000
in
the
first
year
and
$2,000
in
subsequent
years
for
the
making
and
maintaining
of
our
website
and
Facebook
page,
when
we
plan
to
make
the
website
active.
ADVERTISING
Brochures
Our
practice
plans
to
consistently
print
and
distribute
brochures
advertising
our
practice,
some
of
our
unique
services,
our
office
hours
and
location,
links
to
our
website
and
Facebook
page,
and
our
office
phone
number.
We
will
strategically
distribute
our
brochures
at
local
churches,
schools,
health
food
stores,
upscale
gyms,
and
country
clubs.
By
distributing
to
these
specific
locations
we
hope
to
make
contact
with
the
specific
clientele
that
desire
our
practice’s
personalized
care.
23.
23
School
Athletics
Sponsorship
Our
practice
is
donating
$1,000
to
each
of
the
following
schools:
Daphne
High
School
athletics,
Fairhope
High
School
athletics,
Spanish
Fort
High
School
athletics,
McGill-‐Toolen
Catholic
High
School
athletics,
and
St.
Paul’s
Episcopal
High
School
athletics.
Each
of
these
schools
made
our
practice
“Preferred
Sponsors”
for
their
booster
club.
For
our
donations
these
schools
will
put
up
banners
displaying
the
Premiere
Concierge
Services’
logo
and
contact
information
on
their
football
field,
baseball
field,
softball
field,
and
in
their
basketball
gym.
The
baseball,
softball,
and
basketball
advertisements
will
begin
in
the
spring
of
2016
and
football
will
begin
in
the
fall
of
2016.
Club
Soccer
Sponsorships
Our
practice
is
donating
$2,500
to
the
US
Youth
Soccer
program.
We
plan
to
sponsor
one
boy’s
team
and
one
girl’s
team
in
Daphne,
Fairhope,
Spanish
Fort,
in
addition
to,
two
boy’s
teams
and
two
girl’s
teams
in
Mobile.
Each
team
will
receive
a
donation
of
$250.
For
our
donations
these
teams
will
wear
the
Premiere
Concierge
Services’
logo
on
their
jerseys.
Type Cost Frequency/per/Year Total/Expense
Brochures 2,000.00$.. 4 8,000.00$.....
School.Athletics.Sponsorship 5,000.00$.. 1 5,000.00$.....
Club.Soccer.Sponsorship 2,500.00$.. 1 2,500.00$.....
Total 15,500.00$///
Advertising/Budget
For/Year/Ending/December/31,/2016
Type Cost Frequency/per/Year Total/Expense
Brochures 1,000.00$.. 4 4,000.00$.....
School.Athletics.Sponsorship 5,000.00$.. 1 5,000.00$.....
Club.Soccer.Sponsorship 2,500.00$.. 1 2,500.00$.....
Total 11,500.00$//
Advertising/Budget
For/Year/Ending/December/31,/2017
24.
24
DIFFERENTIAL
STATEMENT
Our
practice
can
not
be
compared
to
others
in
the
area.
While
we
offer
similar
services
to
a
primary
care
provider,
our
goal
is
to
go
above
and
beyond
our
member’s
expectations.
Our
holistic,
proactive
approach
to
healthcare
addresses
our
member’s
physical,
mental
and
emotional
well-‐being
through
one-‐on-‐one
counseling
and
comprehensive
diagnostic
testing.
Unlike
the
traditional
primary
care
provider
who
sees
2,000
patients
or
more,
our
practice
purposefully
limits
our
physician’s
patient
load
to
600
in
order
to
better
serve
and
personalize
each
member’s
care.
In
the
first
year
we
hope
to
keep
our
practice
relatively
small
at
400
patients
per
physician
and
growing
to
about
500
in
the
second
year.
.
In
addition,
by
limiting
the
number
of
patients
our
physicians
see,
better
quality
of
care
and
a
more
productive
work
environment
will
be
focused
towards
our
members.
As
mentioned
in
our
pricing
of
services,
our
practice
includes
all
services
provided
in
the
annual
membership
fee
so
our
members
and
physicians
will
not
have
to
deal
with
the
hassle
of
their
insurance
or
Medicare.
Our
practice
will
be
all
self-‐pay
in
order
to
ensure
that
our
member’s
have
the
freedom
to
see
their
physician
as
frequently
as
they
desire.
GEOGRAPHIC
AND
ECONOMIC
DEMOGRAPHICS
Our
physicians
will
cover
Mobile
and
Baldwin
counties
specifically
Daphne,
Fairhope,
Spanish
Fort,
and
Mobile.
We
hope
to
service
most
of
Mobile,
even
if
our
members
live
further
from
our
office
we
have
the
flexibility
to
travel
to
them
in
order
to
provide
care.
Our
physicians
have
admitting
privileges
at
Thomas
Hospital,
which
is
most
convenient
for
the
bulk
of
our
members,
as
well
as,
the
closest
to
our
office.
The
average
age
for
Daphne,
Fairhope,
Spanish
Fort,
and
Mobile
are
37,
44,
40,
and
36
respectively.
As
well,
the
Fairhope
area
is
known
as
one
of
the
premiere
retirement
locations
in
the
state.
This
age
is
ideal
for
our
25.
25
services,
we
are
targeting
older
adults
and
families
who
have
the
income
for
our
services
which
consist
of
out-‐
of-‐pocket
payments.
Also,
older
adults
and
retirees
need
more
access
to
their
physician
and
our
concierge
practice
aims
to
be
with
our
members
as
much
as
they
need.
The
Average
Household
Income
for
Daphne,
Fairhope,
Spanish
Fort,
and
Mobile
is
$178,826,
$197,099,
$206,544,
and
$119,300
respectively.
Our
members
are
required
to
pay
a
yearly
membership
fee
for
our
services
to
ensure
adequate
time
and
availability
for
each
patient.
Due
to
the
yearly
membership
fee
we
expect
most
of
our
patients
to
have
a
higher
income,
which
the
area
in
where
we
plan
to
enter
can
support
based
on
the
data
previously
mentioned.
27.
27
LEGAL
ENTITY
Premiere
Concierge
Services
will
operate
as
a
Limited
Liability
Company
(LLC).
A
LLC
is
defined
as
liability
of
a
company’s
owners
for
nothing
more
than
the
capital
they
have
invested
in
the
business.
A
LLC
is
a
legal
structure
that
combines
the
limited
liability
component
that
corporations
have
while
having
the
flexibility
and
tax
benefits
of
a
partnership.
Advantages
to
operating
as
a
LLC
include:
• Owner(s)
have
protection
of
their
assets
in
the
case
of
lawsuits
against
the
business.
No
member
of
the
LLC
can
be
held
personally
liable
for
any
debts
of
the
company.
• Pass-‐through
taxation,
which
allows
the
income
of
the
business
to
be
respected
as
the
income
of
the
owner.
This
allows
the
LLC
to
avoid
double
taxation
since
only
the
owner
is
taxed
on
the
revenue.
• Owner(s)
is
self-‐employed
and
can
maintain
control
over
the
business
operations.
• Limited
compliance
requirements
and
small
costs/paperwork
to
set
up
(compared
to
corporation
start-‐
up
costs)
While
there
is
great
advantage
in
forming
a
LLC,
there
are
some
potential
drawbacks
as
well.
Some
of
these
disadvantages
include:
• Limited
Life:
The
life
of
the
company
is
limited
to
the
life
of
the
owners.
• Hard
to
raise
capital:
LLCs
do
not
have
the
ability
to
issue
stocks
like
corporations
can.
This
can
make
it
hard
to
raise
capital
if
it
is
needed
by
the
organization.
• New
Structure:
LLC’s
are
a
new
model
to
operate
a
business
as.
Because
of
this,
some
laws
and
regulations
are
still
transitioning.
Also,
since
it
is
a
newer
form
of
business,
if
the
LLC
organization
goes
to
court,
it
may
not
be
as
well
recognized
as
a
corporation
or
partnership
would
be.
NOTE:
A
$300
LLC
startup
fee
is
shown
as
a
“Professional
Services”
expense
on
the
income
statement.
28.
28
EMPLOYMENT
POSITIONS
Premiere
Concierge
Services’
staff
will
include
two
physicians,
two
Registered
Nurses,
and
a
Practice
Manager.
The
physicians
are
full-‐time
and
will
practice
within
our
office
as
well
as
our
members’
homes
for
house
calls.
Both
physicians
will
be
owners
of
PCS.
One
physician
will
be
appointed
as
the
Director
of
Medicine,
serving
as
the
lead
for
the
organization.
The
Registered
Nurses
will
work
part-‐time
during
the
weekdays,
switching
between
Monday/Wednesday/Friday
and
Tuesday/Thursday
shifts.
The
weekends
will
be
determined
according
to
appointment
times
and
availability.
The
Practice
Manager
will
work
full-‐time
within
our
office.
The
Practice
Manager
will
be
responsible
for
all
bookkeeping
and
reception
duties
including
but
not
limited
to:
management,
marketing,
finance,
taking
phone
calls,
and
checking
members
in
at
the
office.
GOVERNANCE
OF
ORGANIZATION
GOVERNING
STRUCTURE
Premiere
Concierge
Services
will
be
governed
exclusively
in-‐house.
The
Director
of
Medicine
will
serve
as
the
ultimate
decision-‐maker
when
a
collective
decision
cannot
be
made.
The
second
physician
at
the
practice
and
the
Practice
Manager
will
answer
to
the
Director
of
Medicine.
However,
the
Director
of
Medicine,
Practice
Manager,
and
physician
will
work
together
to
make
decisions
that
are
best
for
our
members
and
practice.
The
Director
of
Medicine
and
the
other
physician
will
both
be
owners
of
Premiere
Concierge
Medicine,
so
it
is
important
that
their
inputs
are
integrated
into
the
practice.
The
Practice
Manager
will
serve
as
the
champion
for
the
business
aspects
of
the
practice
such
as
management,
finance,
and
other
administrative
duties.
The
Director
of
Medicine
will
work
closely
with
our
Practice
Manager
to
bridge
the
gap
between
clinical
and
clerical
operations.
While
the
Director
of
Medicine
is
the
main
leader
for
Premiere
Concierge
Medicine,
it
is
important
that
our
Practice
Manager,
who
is
highly
involved
in
the
day-‐to-‐day
business
operations,
be
in
contact
to
ensure
the
practice
is
running
smoothly
as
a
whole.
The
Practice
Manager
will
deal
directly
with
employee
conduct
29.
29
issues
in
order
to
allow
the
Director
of
Medicine
give
most
of
his
or
her
attention
to
providing
medical
care
to
our
members.
LEADERSHIP
STYLE
The
Director
of
Medicine
should
have
a
high
concern
for
production
when
it
comes
to
his
or
her
leadership
style.
Our
main
objective
is
to
provide
excellence
in
high-‐quality,
patient-‐centered
care.
Thus,
the
mission
of
our
facility
should
always
be
at
the
forefront
of
our
Director
of
Medicine’s
leadership
to
ensure
the
level
of
care
provided
is
what
our
member
expects
and
needs.
Our
overall
hope
is
the
Director
of
Medicine
will
have
the
confidence
to
stand
alone
and
lead
PCS
as
a
startup
health
organization,
the
courage
to
make
tough
decisions
that
are
in
the
best
interest
of
the
practice
and
our
members,
and
the
compassion
to
listen
to
the
needs
of
others
in
order
to
create
a
family-‐like
atmosphere
with
other
staff
and
our
members.
RETENTION
While
the
focus
will
be
on
the
quality
of
services
and
care
we
provide,
we
do
intend
to
emphasize
on
the
importance
of
having
lasting
employment
among
our
staff.
Our
goal
is
for
our
employees
to
build
relationships
with
our
members.
A
trusting
and
friendly
connection
between
physician
and
patient
is
vital
because
of
our
desire
to
care
for
our
members’
physical,
mental,
and
emotional
well-‐being.
PCS
believes
our
members
will
benefit
from
having
the
same
care
team
throughout
their
membership
in
order
to
get
to
know
them
both
professionally
and
personally
and
feel
comfortable
inviting
them
into
their
homes.
Overall,
the
desire
of
PCS
is
to
create
a
family-‐type
atmosphere
between
the
staff
themselves
and
the
staff
and
members.
The
Director
of
Medicine’s
leadership
effectiveness
in
concern
with
the
retention
of
the
other
staff
members
will
rely
on
his
or
her
genuine
and
charismatic
personality.
While
this
will
only
come
naturally,
the
goal
is
that
PCS
have
a
character
that
encourages
and
uplifts
the
staff
in
order
to
have
satisfaction
within
the
organization.
For
30.
30
instance,
gatherings
during
the
holiday
season
as
well
as
occasional
parties,
outings,
and
other
social
events
will
help
connect
staff
members
outside
the
office,
hopefully
creating
a
more
harmonious
work
environment.
COORDINATION
OF
WORK
HOURS
OF
OPERATION
Our
office
will
be
open
to
walk-‐ins
and
appointments
Monday
through
Friday.
Saturdays
and
Sundays
will
be
reserved
exclusively
for
appointments.
• Monday
-‐
Friday:
8:00am-‐5:00pm
• Saturday
-‐
Sunday:
10:00am-‐3:00pm
(appointments
only)
• Closed
for
the
following
holidays:
o New
Year’s
Day
o Memorial
Day
o Independence
Day
o Labor
Day
o Thanksgiving
Day
o Christmas
Day
BUSINESS
MEETINGS
Staff
meetings
will
be
scheduled
every
Tuesday,
but
may
be
cancelled
if
deemed
unnecessary
for
the
week.
Every
employee
is
required
to
attend
all
meetings.
If
an
employee
must
miss
a
staff
meeting,
he
or
she
is
required
to
notify
the
Practice
Manager
with
his
or
her
excuse
or
reason.
Patient
walk-‐ins
to
the
office
will
be
excused
during
the
course
of
the
meeting
time.
Staff
meetings
will
occur
during
lunch
hour
unless
otherwise
noted.
Appointments
will
not
be
scheduled
30
minutes
before
or
after
the
scheduled
staff
meeting
time
to
help
31.
31
ensure
staff
attendance.
Lunch
will
be
catered
to
all
staff
members
for
meetings
occurring
during
lunch
hour.
Staff
is
expected
to
be
flexible
with
meeting
changes
or
adjustments.
CONFLICT
RESOLUTION
Conflict
happens
in
every
organization
no
matter
the
size
or
organization
structure.
Our
goal
for
Premiere
Concierge
Services
is
that
our
staff
become
very
much
of
a
team,
respecting
and
encouraging
one
another.
If
conflict
occurs
during
operating
hours,
our
staff
is
expected
to
try
to
resolve
the
issue
themselves
first,
then
seek
help
from
our
Practice
Manager.
With
such
a
small
team,
it
is
imperative
that
our
staff
works
together
to
provide
the
highest
quality
of
care
our
members
expect.
Conflict
in
an
office
the
size
of
PCS
can
easily
be
spread
to
other
areas
of
the
practice
and
potentially
affect
that
quality
of
care.
It
is
important
to
prevent
that
spread
as
quickly
as
possible
so
our
members
do
not
suspect
a
lack
of
camaraderie.
If
a
staff
member
speaks
with
the
Practice
Manager
about
the
issue
and
it
still
does
not
get
resolved,
the
staff
member(s)
will
be
subject
to
sanctions
as
listed
in
the
employee
handbook,
which
is
displayed
in
Appendix
B.
32.
32
ORGANIZATIONAL
CHART
The
Director
of
Medicine
is
the
leader
of
PCS.
The
other
physician
and
the
Practice
Manager
will
answer
to
the
Director
of
Medicine.
However,
they
will
collaborate
with
the
Director
of
Medicine
to
make
decisions
on
large,
important
matters
concerning
the
practice.
The
two
Registered
Nurses
answer
to
the
physician
and
Director
of
Medicine.
Since
the
Registered
Nurses
will
be
employed
part-‐time,
they
will
be
responsible
for
working
with
both
physicians
and
answering
to
both
during
their
scheduled
work
hours.
If
one
physician
is
out
on
a
house
call,
the
Registered
Nurse
on
duty
will
answer
first
to
the
physician
that
is
currently
in-‐office.
Director
of
Medicine
Physician
Registered
Nurse
Registered
Nurse
Practice
Manager
34.
34
At
Premiere
Concierge
Services
having
a
staff
that
portrays
great
work
ethic,
respect,
honestly,
positive
attitude
and
integrity
is
significant.
A
top
priority
for
our
staff
is
for
them
to
appreciate
the
way
a
concierge
practice
functions.
We
want
our
staff
to
be
dedicated
to
create
a
relationship
with
the
members,
while
giving
them
the
top
care
needed.
Premiere
Concierge
Services
plans
to
have
staff
positions
of
a
Director
of
Medicine,
physician,
two
Registered
Nurses,
and
a
Practice
Manager.
See
Appendix
B
for
the
job
descriptions
in
detail.
The
staff
positions
are
described
below:
• Director
of
Medicine:
a
physician
who
will
be
responsible
for
the
roles
of
the
physician
position,
and
will
serve
as
a
leader
to
the
medical
aspects
of
Premiere
Concierge
Services
• Physician:
responsible
for
spending
time
with
the
members
to
develop
a
relationship
with
them
and
treat
them
with
top
care,
while
providing
house
calls
to
members
and
working
at
the
office.
• Registered
Nurse:
responsible
for
escorting
members
to
room,
recording
members’
history,
taking
vitals
and
assisting
medical
staff
members
when
needed
• Practice
Manager:
responsible
for
information
management,
project
management,
human
resources
roles,
marketing
roles,
answering
phone
calls
and
all
operations
of
the
organization
These
positions
will
have
various
responsibilities
explained
in
the
job
descriptions
with
different
work
schedules.
The
Director
of
Medicine
and
physician
will
be
working
all
operation
hours
on
Monday
through
Friday,
with
appointments
on
Saturday
and
Sunday
and
be
available
at
all
times
to
their
members
on
a
daily
basis.
The
Registered
Nurses
will
work
part-‐time
during
the
weekdays,
switching
between
Monday/Wednesday/Friday
and
Tuesday/Thursday
shifts.
The
weekends
will
be
determined
according
to
appointment
times
and
availability.
The
Practice
Manager
will
only
be
working
Monday
through
Friday.
See
the
following
table
for
staffing
salaries.
35.
35
Because
we
are
operating
under
the
assumption
that
it
will
take
60
days
to
begin
bringing
in
patient
revenue,
the
Director
of
Medicine
and
physician
will
not
be
earning
a
salary
during
that
60-‐day
period.
Their
salary
will
begin
in
March
2016.
The
Practice
Manager
will
be
salaried
starting
in
January
2016
as
he
or
she
will
not
be
a
part
owner
and
will
be
integral
in
the
practices
formative
months.
The
Registered
Nurses
will
begin
working
for
PCS
in
March
2016
and
will
begin
receiving
salary
in
that
month.
RECRUITMENT
AND
RETAINING
At
Premiere
Concierge
Service
we
will
strive
to
recruit
the
most
qualified
staff
members.
To
be
able
to
recruit
the
top
staff
members,
we
plan
to
market
to
professionals
who
desire
to
be
apart
of
a
concierge
practice.
The
concierge
service
has
many
benefits
to
the
staff
members,
and
we
believe
this
is
an
advantage
to
us
to
recruit
the
top
staff
members.
For
the
medical
staff
members,
the
biggest
asset
is
that
he
or
she
is
able
to
practice
traditional
medicine
again,
and
is
able
to
build
relationships
with
their
members.
We
plan
to
strictly
use
our
minimum
requirements
of
each
position
to
hire
our
staff,
and
seek
candidates
with
experience
in
their
position.
Our
practice
wants
to
recruit
staff
members
who
exhibit
traits
of
a
positive
attitude,
strong
work
ethic
and
professionalism.
Premiere
Concierge
Services
will
also
select
staff
members
who
will
represent
and
up
hold
our
Position #(Required Salary Total(Salaries Employment(Expense((30%) Total(Expense
Director(of(Medicine 1 180,000$((((((((((((( 118,000$(((((((((((((((( 35,400$(((((((((((((((((((((((((((((((((((( 153,400$((((((((((((((((
Physician 1 170,000$((((((((((((( 108,000$(((((((((((((((( 32,400$(((((((((((((((((((((((((((((((((((( 140,400$((((((((((((((((
Registered(Nurse 2 60,000$(((((((((((((((( 120,000$(((((((((((((((( 36,000$(((((((((((((((((((((((((((((((((((( 156,000$((((((((((((((((
Practice(Manager 1 75,000$(((((((((((((((( 75,000$(((((((((((((((((( 22,500$(((((((((((((((((((((((((((((((((((( 97,500$((((((((((((((((((
Totals( 5 485,000$((((((((((((( 421,000$(((((((((((((((( 126,300$(((((((((((((((((((((((((((((((( 547,300$((((((((((((((((
Per(Month(Expense: 45,608.33$((((((((((((
Per(Week(Expense:( 10,525.00$((((((((((((
Year(1(Salaries 472,333$((((((((((((((((
Year(2(Salaries 547,300$((((((((((((((((
Salaries(Budget
36.
36
mission.
We
plan
to
recruit
our
staff
members
through
referrals
and
an
application
process
done
by
the
Director
of
Medicine
and
Practice
Manager.
At
Premiere
Concierge
Services
we
plan
on
retaining
our
high
quality
staff
members
through
bonuses
when
we
see
a
staff
member
needs
to
be
rewarded
for
their
work,
and
through
our
comprehensive
benefits
packages
which
will
be
explained
later.
We
want
our
staff
to
know
they
are
appreciated
at
our
practice
and
we
want
to
help
them
realize
this
by
rewarding
them
frequently
for
their
dedication
to
our
practice.
It
is
important
to
keep
our
staff
because
of
the
relationships
he
or
she
has
formed
with
their
members.
With
having
a
small
practice,
and
not
many
staff
members
we
hope
the
relationships
will
help
retain
the
staff.
We
plan
to
promote
monthly
contests
that
will
help
better
our
practice,
motivate
our
staff,
and
reward
our
staff
that
achieves
great
results
of
the
contest.
Premiere
Concierge
Services
plans
to
make
a
significant
investment
in
our
staff
members
and
we
hope
our
staff
members
don’t
see
their
salary
as
their
only
compensation,
but
all
of
their
benefits
to
work
at
a
concierge
practice
also.
CONTRACT
WORK
Premiere
Concierge
Services
plans
to
be
a
small
organization,
as
we
will
only
have
five
salaried
staff
members.
Rather
than
hiring
additional
staff
members,
we
have
decided
to
outsource
cleaning
services,
grounds
keeping,
lab
services,
shredding
service
and
website
developer.
CLEANING
SERVICES
We
will
be
contracting
cleaning
services
out
to
Office
Pride
Mobile,
who
will
come
once
every
weekend
to
clean
the
office.
They
will
come
after
office
hours
to
avoid
distractions
to
staff
members
and
members.
Registered
Nurses
will
be
in
charge
of
keeping
exam
rooms
sanitized
and
clean
on
daily
basis,
as
Office
Pride
Mobile
will
only
come
once
per
week.
37.
37
Office
Pride
Mobile
9340
Sevenhills
Curve
Mobile,
AL
36695
(251)
473-‐9244
$350
per
month
GROUNDS
KEEPING
Although
we
are
leasing
our
space,
Premiere
Concierge
Services
is
responsible
for
grounds
keeping
issues.
Maximum
Landscape,
Inc.
will
come
once
per
week
to
do
maintenance
to
our
small
yard.
In
the
winter
months
(October
–
March)
they
will
come
every
other
week.
The
yard
maintenance
that
Southern
Pride
Lawn
Care
will
provide
is:
mowing,
clearing
leaves,
planting
and
maintaining
flowers,
and
trimming
bushes.
Maximum
Landscape,
INC.
P.O.
Box
850754
Mobile,
AL
36685
(251)
633-‐6657
$300
per
month
LAB
SERVICES
We
plan
to
outsource
all
of
our
lab
work.
However,
our
EHR
system
we
have
chosen
eMedicalFusion’s
software
allows
for
bi-‐directional
lab
integration.
The
lab
integration
feature
is
compatible
with
Quest
and
Labcorp
labs.
Premiere
Concierge
Services
will
use
Solstas
/
Quest
Diagnostics
in
Fairhope,
Alabama
for
lab
needs.
Solstas
/
Quest
Diagnostics
811A
Fairhope
Ave.
Fairhope,
Al
36532
(251)
990-‐2011
38.
38
SHREDDING
SERVICE
Our
practice
will
be
use
a
shredding
service
to
comply
with
HIPAA
and
maintain
patient
confidentiality.
Mobile
Shredding
Service
will
come
to
our
practice
on
a
biweekly
basis
to
collect
documents
that
need
to
be
shredded.
They
will
be
taken
to
a
shredding
facility
and
our
practice
will
be
presented
with
a
certificate
of
destruction
for
compliance
records.
This
outsourcing
service
will
cost
$120
per
month.
Mobile
Shredding
Service
107
Saint
Francis
St.
Mobile,
AL
36602
(251)
345-‐6250
$120
per
month
WEBSITE
DEVELOPER
Because
we
do
not
have
designated
Information
Technology
or
social
media
staff
members,
we
plan
to
contract
with
a
website
developer.
A-‐Factor
Marketing
will
meet
with
the
Practice
Manager
about
our
organization’s
vision
for
the
website,
strategize
what
will
be
best
for
our
organization,
create
our
website,
and
execute
it.
They
will
be
available
to
help
maintain
the
website
and
make
changes
whenever
needed.
A-‐Factor
Marketing
will
also
provide
our
Internet
marketing,
including
maintaining
our
Facebook
page
with
a
combined
fee.
A-‐Factor
Marketing
will
charge
$4,000
in
January
2016
to
start
up
the
website,
and
$2,000
each
subsequent
year
for
maintenance
and
Internet
marketing
fees.
A-‐Factor
Marketing
4318
Downtowner
Loop
N.
Building
D.
Mobile,
Al
36609
(251)
285-‐1576
39.
39
STAFFING
ISSUES
THEFT
Theft
of
any
sort
will
not
be
tolerated
and
can
lead
to
immediate
termination
of
a
staff
member.
Theft
includes,
but
is
not
limited
to,
office
supplies,
money,
medicines,
phone
service,
time,
inappropriate
use
of
the
computer,
and
stealing
from
co-‐workers.
Theft
will
not
be
tolerated
at
Premiere
Concierge
Services.
If
this
is
problem
at
our
practice,
the
Practice
Manager
has
the
right
to
terminate
the
staff
member
immediately.
SHIFT
TRADING
The
only
staff
members
who
may
trade
shifts
are
the
two
Registered
Nurse
positions.
All
other
positions
may
not
trade
shifts,
due
to
having
only
one
staff
member
to
fill
their
position.
A
shift
trade
request
must
be
done
one
week
in
advance
and
be
approved
and
signed
by
both
staff
members
and
the
Director
of
Medicine.
The
Practice
Manager
will
document
all
requests
and
approved
requests
for
shift
trading.
If
a
staff
member
becomes
ill
suddenly,
the
Practice
Manager
is
in
charge
of
finding
a
replacement
or
fulfilling
the
staff
member’s
duties
during
his
or
her
illness.
Shift
trading
and
time-‐off
request
procedures
are
explained
in
the
staff
member
handbook
in
Appendix
B.
TARDINESS
Tardiness
is
not
acceptable
at
Premiere
Concierge
Services
and
could
be
considered
grounds
for
termination.
In
order
for
our
practice
to
run
smoothly,
it
is
essential
that
staff
members
are
on
time
and
maintain
regular
attendance.
Staff
members
are
expected
to
be
in
the
office
and
settled
before
the
practice
opens.
If
a
staff
member
must
be
late,
they
should
inform
the
Practice
Manager
as
soon
as
possible.
At
the
end
of
each
workweek,
all
late
arrivals
and
early
departures
will
be
totaled.
For
each
accumulated
six
minutes
that
the
staff
member
is
late,
or
leaves
early,
he
or
she
loses
one-‐tenth
of
an
hour
of
pay.
40.
40
USE
OF
OFFICE
COMPUTERS
The
use
of
office
computers
for
personal
use
is
prohibited.
Office
computers
should
be
used
for
only
medical
or
office
reasons.
Each
computer
will
be
password
protected
and
the
password
will
only
be
known
by
the
staff
member
who
uses
the
computer
This
password
will
be
changed
each
month.
Each
staff
member
with
an
office
computer
is
expected
to
demonstrate
caution
and
care
to
ensure
confidentiality
of
information
stored
on
the
computers.
Staff
should
not
install
any
software
on
computers
unless
the
Practice
Manager
approves
it.
If
a
staff
member
does
not
comply
with
these
rules,
the
Practice
Manager
will
inform
them
of
the
disciplinary
procedure.
USE
OF
CELL
PHONES
See
Employee
Handbook
in
Appendix
B.
INSUBORDINATION
At
Premiere
Concierge
Services
all
staff
members
are
expected
to
treat
their
co-‐workers
with
top
respect.
Disrespect
and
resisting
authority
will
not
be
tolerated.
The
act
of
scheming
to
go
above
the
Practice
Manager
and
Director
of
Medicine
may
result
in
the
Practice
Manager
enforcing
disciplinary
procedures
or
immediate
termination.
PERFORMANCE
EVALUATION
Premiere
Concierge
Services
will
evaluate
our
staff
members
every
six
months
by
the
Practice
Manager.
After
the
evaluation
done
the
Practice
Manager
will
have
a
meeting
with
the
staff
member
about
the
evaluation.
See
Appendix
B
for
more
details
and
the
performance
evaluation
form.
41.
41
MEMBER
SATISFACTION
At
Premiere
Concierge
Services,
our
first
priority
is
our
members.
We
want
our
members
to
feel
that
the
extra
fees
associated
with
concierge
medicine
are
valuable.
Our
physicians
will
spend
at
the
least
thirty
minutes
with
each
member
during
their
appointments.
This
time
should
be
used
to
make
the
member
feel
knowledgeable
about
their
health,
treat
them
with
quality
care,
and
develop
a
patient-‐physician
relationship.
Time
spent
with
members
should
develop
high
member
satisfaction.
Members
will
receive
a
member
satisfaction
survey
after
each
visit
to
Premiere
Concierge
Services
to
help
better
our
practice.
The
survey
will
be
handed
to
the
members
in
a
pre-‐stamped
envelope
so
it
will
not
be
an
inconvenience
to
fill
out.
At
Premiere
Concierge
Services
we
will
rely
on
the
surveys
to
measure
member
satisfaction.
Feedback
from
our
members
is
important.
Their
appointment,
our
staff,
communication
with
their
provider,
and
overall
satisfaction
will
be
topics
included
in
our
member
satisfaction
survey.
The
survey
will
only
ask
for
the
member’s
age,
gender,
provider’s
name,
not
their
name.
The
Practice
Manager
will
review
all
completed
and
returned
surveys
and
analyze
the
results
in
an
Excel
worksheet.
The
survey
results
will
be
discussed
in
the
first
week
of
every
month
in
staff
meetings.
During
these
meetings
it
will
be
encouraged
to
discuss
how
to
improve
areas
which
are
lower
in
satisfaction.
Incentives
can
be
made
by
the
Practice
Manager
to
motivate
staff
members
to
improve
survey
results.
The
Practice
Manager
will
be
in
charge
of
a
monthly
email
newsletter
to
our
members
updating
them
about
Premiere
Concierge
Services
to
keep
members
feeling
informed
about
our
practice.
This
newsletter
will
include
a
member
satisfaction
survey
to
make
it
convenient
for
members
to
submit
one
at
any
time.
It
will
also
be
available
on
our
website
to
be
filled
out
electronically.
See
Appendix
B
for
the
member
satisfaction
survey.
42.
42
BENEFITS
PACKAGE
See
Employee
Handbook
in
Appendix
B.
DISCIPLINARY
PROCEDURES
Staff
members
have
the
responsibility
to
execute
their
job,
while
following
the
practices
policies
and
procedures.
Any
staff
member
who
does
not
follow
them
will
receive
notice
by
the
disciplinary
procedures,
that
the
Practice
Manager
will
follow.
See
Employee
Handbook
in
Appendix
B
for
the
disciplinary
steps.
TERMINATION
All
employment
with
Premiere
Concierge
Services
is
“at
will”
employment.
A
staff
member
can
terminate
his
or
her
employment
at
anytime
or
Premiere
Concierge
Services
can
terminate
the
staff
member’s
employment
at
anytime.
Staff
members
are
not
hired
for
a
specific
duration.
See
Employee
Handbook
in
Appendix
B
for
explanation.
44.
44
HIPAA
COMPLIANCE
The
role
of
compliance
officer
will
be
assigned
to
the
Practice
Manager.
The
compliance
officer
will
be
responsible
for
ensuring
all
business
practices
and
procedures
are
HIPAA
compliant.
He
or
she
will
be
required
to
complete
a
HIPAA
compliance
training
program
developed
by
Thomas
Reuters
Risk
Management
Solutions.
Topics
covered
in
this
45-‐minute
course
include:
What
is
HIPAA?
Who
is
subject
to
HIPAA?
Protected
Health
Information
(PHI)
HIPAA
Privacy
Notice
of
Privacy
Practices
Reasonable
Safeguards
Using
PHI
for
Marketing
HIPAA
Security
Administrative
Safeguards
Physical
Safeguards
Technical
Safeguards
Handling
PHI
Security
Breach
PHI
Rights
of
Individuals
Enforcement
of
HIPAA
Upon
passing
the
course
and
receiving
his
or
her
HIPAA
compliance
certification,
the
compliance
officer
will
be
responsible
for
ensuring
all
employees
are
trained
in
HIPAA
compliance.
The
compliance
officer
may
elect
to
train
employees
by
utilizing
the
Thomas
Reuters
training
program,
resources
from
the
Department
of
Health
and
Human
Services,
or
a
combination.
All
employees
must
receive
training
within
five
days
of
beginning
work.
If
they
are
not
trained
within
the
five-‐day
time
frame,
they
will
not
be
permitted
to
return
to
work
until
they
have
been
trained.
All
employees
must
read,
understand,
and
acknowledge
the
Employee
Confidentiality
Agreement
(Appendix
C)
prior
to
their
first
day
of
work.
All
new
patients
will
be
distributed
a
copy
of
our
Privacy
Policy
(Appendix
C)
prior
to
the
rendering
of
any
services.
45.
45
DRUG
TESTING
AND
BACKGROUND
CHECK
POLICY
See
Appendix
C
for
Employee
Drug
Testing,
Random
Drug
Testing,
and
Background
Check
policies.
Third-‐party
provider
for
background
checks
and
drug
testing:
IntelliCorp
216-‐450-‐5300
info@intellicorp.net
$70
per
employee
per
year;
factored
into
employee
expenses
at
30%
of
the
employee’s
base
salary
REGULATORY
COMPLIANCE
POLICIES
See
Appendix
C
for
our
Equal
Employment
Opportunity
and
Harassment,
Occupational
Safety
and
Health,
and
Americans
with
Disabilities
Act
policies.
NOTE:
All
policies
are
modeled
after
suggestions
from
the
Society
for
Human
Resource
Management,
Department
of
Health
and
Human
Services,
and
the
Occupational
Safety
and
Health
Administration.
48.
48
Under
the
assumption
that
PCS
will
not
begin
generating
revenue
for
the
first
60
days
of
operation,
our
calculated
start-‐up
costs
(uses
of
cash)
are
$239,823.
We
would
like
to
generate
enough
sources
of
cash
that
will
allow
for
net
cash
to
be
10%
greater
than
break-‐even.
To
do
so,
our
sources
of
cash
must
equal
$295,954.
We
will
finance
this
amount
through
the
following:
Because
we
will
not
be
generating
revenue
in
our
first
60
days,
principal
payments
on
both
the
BBVA
and
Wells
Fargo
loans
will
not
begin
until
March
2016.
Only
interest
will
be
charged
in
the
first
60
days.
BBVA
charges
3.50%
interest
over
the
5-‐year
loan
term.
Wells
Fargo
charges
4.20%
interest
over
the
7-‐year
lease
term.
Because
the
Director
of
Medicine
will
be
earning
approximately
10%
more
salary,
he
or
she
must
buy-‐in
for
a
greater
percentage
than
the
physician.
The
remaining
needed
contributed
capital
after
loan
proceeds
of
$148,078
will
be
financed
55%
by
the
Director
of
Medicine
($81,443)
and
45%
by
the
physician
($66,635).
PCS
does
not
submit
claims
to
insurance
companies.
All
of
our
revenue
is
generated
through
the
$1,200,
$1,500,
and
$1,750
annual
membership
fees,
billed
monthly
and
due
at
the
first
of
each
month.
Leasehold)Improvements)
(BBVA) 125,000.00$(
Loan(Proceeds 85% 106,250.00$((
Contributed(Capital 15% 18,750.00$((((
Furniture,)Fixtures,)Tech.,)&)Equipment)
(Wells)Fargo) 48,972.23$((((
Loan(Proceeds 85% 41,626.40$((((
Contributed(Capital 15% 7,345.83$((((((
Operating)Costs 121,981.81$(
Contributed(Capital 100% 121,981.81$((
Total)Initial)Funding 295,954.04$(
Initial)Funding
51.
51
FINANCIAL
SPECIFICATIONS
All
additional
financial
reports
can
be
found
in
Appendix
D.
Below
are
explanations
of
various
expenses
and
start-‐up
costs
for
clarification
of
the
information
in
the
reports.
• As
explained
in
Staffing,
the
Director
of
Medicine
and
physician
will
not
earn
salary
in
the
first
60
days
of
operation.
The
Practice
Manager
will
be
salaried
in
that
time
period.
The
Registered
Nurses
will
not
begin
working
for
PCS
and
receiving
salary
until
March
2016.
For
these
reasons
the
2016
salaries
will
be
lower
than
2017.
• Leasehold
improvements
have
been
depreciated
using
the
straight-‐line
method
over
the
5-‐year
life
of
the
lease.
• Technology
and
equipment
have
been
depreciated
using
the
straight-‐line
method
over
an
expected
7-‐
year
life
assuming
a
salvage
value
of
20%
of
purchase
price.
Items
which
have
previously
stored
protected
health
information
and
bio-‐hazardous
materials
will
not
be
resold.
• Furniture
and
fixtures
have
been
depreciated
using
the
straight-‐line
method
over
an
expected
7-‐year
life
assuming
a
salvage
value
of
15%
of
purchase
price.
• We
will
be
leasing
a
2,200
square
foot
space
at
a
rate
of
$14.40
per
square
foot
for
a
total
of
$31,680.00
per
year.
The
lease
term
is
for
five
years
and
can
be
renewed
at
the
finality
of
the
lease.
• We
have
worked
with
Timothy
J.
Spafford
of
Architecture
and
Design,
Inc.
to
draw
up
the
office
layout
plans
(shown
in
Strategic
Planning).
His
fee
is
$15,000
and
is
recorded
as
a
professional
service
expense.
• Our
contractor,
Vance
McCown
of
Vance
McCown
Construction
company,
estimates
the
renovations
to
our
space
as
per
our
desired
layout
will
cost
$125,000.
This
is
recorded
as
a
capital
expenditure
on
the
Initial
Facility
and
Operating
Costs
report.
52.
52
• Our
interior
designer,
Sarah
Wallstedt,
will
handle
all
design-‐related
tasks
including
selecting
furniture
and
décor.
Her
fee
is
$5,000
and
is
recorded
as
a
professional
service
expense.
• PCS
will
use
Verizon
Wireless’s
small
business
resources
for
our
mobile
device,
landline,
internet,
and
cable
needs.
These
needs
are
discussed
in
the
subsequent
Technology
portion
of
the
business
plan.
These
costs
reported
as
“Cable,
Phone,
and
Internet”
expenses
as
well
as
in
our
technology
budget.
• We
have
a
contract
with
A-‐Factor
Marketing,
a
web
developer,
to
construct
our
website.
A-‐Factor
will
also
manage
our
internet
presence
through
managing
the
website
in
addition
to
a
Facebook
page.
This
information
is
included
in
the
Marketing
section.
There
is
a
first
year
fee
of
$4,000
and
$2,000
in
each
subsequent
year.
• We
will
carry
malpractice
insurance
on
each
of
our
physicians.
The
premium
is
$9,000
per
physician.
• Our
facility
will
be
covered
by
at
Business
Owner’s
policy
from
Geico
at
$3,000
per
year
to
protect
PCS
against
accidents,
lawsuits,
etc.
• ADT
will
provide
us
with
a
small
business
security
system
at
a
fee
of
$200
for
the
system
and
installation
in
addition
to
$40
per
month.
Specifics
about
the
system
can
be
found
in
the
Technology
section.
