executive summary for homecare

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Executive Summary Wheatland Health Services offers a unique combination of premier home health care and community-based social services to Southeastern Kansas. Market research indicates that there is a significant need for quality home health care and social services within this region and we believe that by employing competent and well-educated staff and providing them with organized and responsive management, we can become the home health care/social service agency of choice in Southeastern Kansas. Wheatland Health Services will be created as a Kansas Limited Liability Company based in Wilson County, owned by its principal investors and principal operators. The initial office will be established in quality office space on Main Street in Neodesha, Kansas, which is the heart of Southeastern Kansas. Neodesha is also home to a hospital facility and a renowned Wound Center, which will serve as referral bases for our agency. Consumers of our services will be those individuals and families in need of home health care and/or social services. These patients are usually referred by other health care professionals such as physicians, attorneys, insurance companies and health care facilities. Our agency has already developed an excellent reputation with many of these professionals, through the work of our Clinical Director, who has been providing home health care services through another agency for the past three years, and through the presentations we have made to the community via marketing tools and personal interactions. Our agency must be licensed by the State of Kansas and our services reimbursed by Medicare, Medicaid and other private insurance carriers. The process for licensure and insurance certification has already been initiated and we are well on our way to meeting the regulations and guidelines for providing home health care and social services to patients in Southeastern Kansas.

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Example Proposal for Homecare

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Executive SummaryWheatland Health Services offers a unique combination of premier home health care and community-based social services to Southeastern Kansas. Market research indicates that there is a significant need for quality home health care and social services within this region and we believe that by employing competent and well-educated staff and providing them with organized and responsive management, we can become the home health care/social service agency of choice in Southeastern Kansas. Wheatland Health Services will be created as a Kansas Limited Liability Company based in Wilson County, owned by its principal investors and principal operators. The initial office will be established in quality office space on Main Street in Neodesha, Kansas, which is the heart of Southeastern Kansas. Neodesha is also home to a hospitalfacility and a renowned Wound Center, which will serve as referral bases forour agency. Consumers of our services will be those individuals and families in need of home health care and/or social services.These patients are usually referred by other health care professionals such as physicians, attorneys, insurance companies and health care facilities. Our agency has already developed an excellent reputationwith many of these professionals, through the work of our Clinical Director, who has been providing home health care services through another agency for the past three years, and through the presentations we have made to the community via marketing tools and personal interactions. Our agency must be licensed by the State of Kansas and our servicesreimbursed by Medicare, Medicaid and other private insurance carriers. The process for licensure andinsurance certification has already beeninitiated and we arewell on our way to meeting the regulations and guidelines for providing home health care and social servicesto patients inSoutheastern Kansas. There are currently only three other home health care agencies that serve Southeastern Kansas. One is a satellite operation based out of a larger regional hospitalin Bartlesville, Oklahoma. Kellene Walker currently manages this agency's operation there, and due to the lack of interest the parent organization has demonstrated in this satelliteagency, we believe that upon her transfer to Wheatland Health Services that agency will close its Wilson County operation. The other home health care agencies currently operating in our area do not offer services to all four of our target Counties; they also do not offer the unique blend of home health care and social services which Wheatland Health Services will be providing.All pricing will be set according to Medicare, Medicaid and other insurance regulation so pricing is not a major factor of consideration. Sales estimates project healthy revenues in the first year and modest increases through year three.WHSis incorporated as a partnership. The primary founder, Elizabeth Patzer, MSW/PA,is a social worker and public administrator with prior experience in operating a social service agency.The partnership will include a second, non-managing partner, M. Brad Patzer, who will help with initial start-up funding and retain a minority equity stake. Wheatland Health Services will be managed by Beth Patzer and Kellene Walker, our Clinical Director.The company plans on taking ondebt in the form of a five-year loan, and has no plans for additional debt as growth will be financed mainly through cash flow.Our planincludes assumptions of100% sales on credit, and sufficient cash on-hand at start-up to prevent any problems with cash flow.1.1 Objectives 125 Home Health Care patients served by the end of first year. 12 Personal Injury Case Management Clients served by the end of first year. Respectable gross sales by the end of first year. 80% of Customer Satisfaction Surveys returned indicating satisfaction with services.

1.2 Keys to Success Professional quality of services offered Reliability -- being available through on-call, and adequate staffing Effective collaboration with other community professionals (physicians, hospitals, and other organizations)1.3 MissionOur values are simple. Wheatland Health Services strives to offer excellent and affordable home health care and community-based social services to individuals and families of Southeastern Kansas. It is our goal to employ competent, caring, and well-trained individuals who are responsive to the needs of our patients, their families, and the communities we serve. Each staff member will meet the State of Kansas educational and training requirements for the services they provide. We encourage and support continued education of each service provider. In turn, our agency will provide staff with competitive compensation, an inviting work environment, and knowledgeable, trustworthy management and direction.Company SummaryWheatland Health Services is anew Home Health and Social Service agency in its start-up stages. Our agencywill be located in the heart of Southeastern Kansas andwill provide the following services to patients and clients from Neodesha, Wilson, Montgomery and LabetteCounties- all within a ninety mile radius of our offices: Skilled Nursing Nursing Aide Social Work Occupational, Physical, and Speech Therapy Personal Injury Case Management2.1 Company OwnershipWheatland Health Servicesis a limited liability company owned and operated by Elizabeth G. Patzer, MSW/MPA and Marlon B. Patzer, M.S./M.Ed.2.2 Start-up SummaryWheatland Health Services is in its start-up stage, and consequently there are start-up costs and funding issues to address. The Start-Up Table, below, indicates in detail those costs which include the following: BUSINESS DEVELOPMENT RENTAL EXPENSE OFFICE EQUIPMENT OFFICE SUPPLIES NURSING SUPPLIESThe table also demonstrates Assets needed for start-up and addresses potential funding sources which are to include cash investments made by each Owner, as well as a five-year 8% loanwhich will be needed in order to cover start-up costs.

Start-up Requirements

Start-up Expenses

BUSINESS DEVELOPMENT$0

Attorney Fees - Setting Up Limited Liability Company$875

State of Kansas Home Health Agency License$100

Medisoft Billing Program plus Support$5,000

Professional Liability Insurance$3,000

*Assuming 25% down of $12,000.00$0

Workman's Comp Insurance Deposit$500

Premises and Content Insurance Deposit$300

*Assuming 25% down of $1200.00$0

Contract Retainer with PT/OT/ST$500

Inserted Row$0

RENTAL EXPENSE$0

Office Upgrades (Carpet and Paint)$3,000

Deposit plus First$400

*Assuming $200.00/Month$0

Phone Set Up (Excluding Phones)$250

Utilities Deposit$150

Post Office Box$26

Inserted Row$0

OFFICE EQUIPMENT$0

2 Computers (Fully Loaded)$3,000

4-in-1 Printer/Fax/Copier/Scanner$750

QuickBooks Pro$300

Phones$200

Pager$50

Inserted Row$0

OFFICE SUPPLIES$0

Stationary$200

Business Cards$150

Brochures$200

Other Misc. Office Supplies$450

Computer$0

NURSING SUPPLIES$2,500

Total Start-up Expenses$21,901

Start-up Assets

Cash Required$44,599

Other Current Assets$3,500

Long-term Assets$0

Total Assets$48,099

Total Requirements$70,000

Start-up Funding

Start-up Expenses to Fund$21,901

Start-up Assets to Fund$48,099

Total Funding Required$70,000

Assets

Non-cash Assets from Start-up$3,500

Cash Requirements from Start-up$44,599

Additional Cash Raised$0

Cash Balance on Starting Date$44,599

Total Assets$48,099

Liabilities and Capital

Liabilities

Current Borrowing$0

Long-term Liabilities$50,000

Accounts Payable (Outstanding Bills)$0

Other Current Liabilities (interest-free)$0

Total Liabilities$50,000

Capital

Planned Investment

Elizabeth Patzer$20,000

Investor$0

Additional Investment Requirement$0

Total Planned Investment$20,000

Loss at Start-up (Start-up Expenses)($21,901)

Total Capital($1,901)

Total Capital and Liabilities$48,099

Total Funding $70,000

ServicesWheatland Health Services offers premier home health care that includes skilled nursing, nursing aide, social work, occupational therapy, speech therapy, and physical therapy. We also provide personal injury case management services which include assessment, planning, resource linkage, reporting and professional services (court testimony, etc.).Market Analysis SummaryThe consumer base for Wheatland Health Services (Home Health Care Services) will be patients referred by physicians, health care facilities and other health care professionals. The majority of these patients will be covered by Medicare with a smaller portion being insured by Kansas Medicaid or other private insurance carriers. The consumer base for the Personal Injury Case Management component of our business will be those individuals who have been injured either on the job or in another type of accident. These referrals will come from attorneys seeking case management services for their clients or from insurance companies who are requesting assistance in mitigating the injuries and loss the client suffers.4.1 Market SegmentationThe population base in Southeastern Kansas is aging, and more individuals are opting to stay in their own homes longer and return home following hospitalization, rather than proceeding to a nursing home. Our primary market segment includes those patients -- typically in an older age bracket-- who requirehealth care services by home health nursing staff. These patients may also require other home health services, such as social work, in order to access needed community resources. Our secondary market will be those individuals who have suffered a personal injury and require case management services to assist them in addressing medical, financial, and employment issues.

4.2 Target Market Segment StrategyBecause our agency specializes in home health care and community-based social services, we will focus on those market segments where we know our services are most needed. Focusing on those market segments that require only home-based services will greatly decrease overhead, since additional office space will not be required.4.3 Service Business AnalysisWheatland Health Services is a combined Home Health Care and Social Service Agency serving a four-county region in Southeastern Kansas. Home health care and social services are typically utilized by individuals and families, with service referrals coming most often from other professionals (i.e. physicians, hospitals, attorneys,etc.). There are currently three other Home Health Agencies serving the same area, but we are unique in that we plan to offer community-based social services as well as home health care. 4.3.1 Competition and Buying PatternsThe key factor considered by both consumers and referring professionals when purchasing home health care is trust in the professional reputation, reliability and quality of services provided by the home health Agency. Pricing of home health servicesdoes not usually influence consumers' choices, as most home health services are reimbursed by Medicare, Medicaid, and private insurance companies, and reimbursement rates are set by those entities. Pricing of personal injury case management services is a more important factor, as these services are paid for as negotiated on a case-by-case basisat an hourly rate. When pricing personal injury case management services, we will explain to the client that we estimate the total number of hours needed to complete services liberally, rather than bidding low and then exceeding the anticipated total bid price for services. Consumers of both home health care services and personal injury case management services rarely compare service providers directly.Usually they follow word-of-mouth recommendations, especially when those recommendations come from their physicians. Perhaps the most important elementfor assessing competition in the Home Health and Social Service fields ishow to persuadeother professionals to repeatedly refer their clients to our agency for services. As our agency demonstrates outstanding patient care, current and pertinent qualification of service providers, and professional organization and business management, we believe that we will be able to capture the majority of the home health care and personal injury case management market in our designated region.

Strategy and Implementation SummaryWheatland Health Services will focus on four counties within southeastern Kansas. Within this geographical area we will target two specific programs: home health care personal injury case managementWithin each area, we have two target markets: the actual client, and the regional physicians, health care facilities, attorneys and insurance companies who refer them to our services.5.1 Competitive EdgeWe start with a competitive edge: There are currently only three home health care agencies serving southeastern Kansas; Kellene Walker, our Clinical Director, has been employed with one of them for three years and has learned many of the day-to-day administrative functions that make a home health care agency successful. Ms. Walker has built a reputation for outstanding customer service, and it is our belief that her reputation willhelp to build a strong client base even before our start-up date. Wheatland Health Services will also stand out in integrating community-based social services, such as Personal Injury Case Management, with our more traditional home health care. This broader base will allow us to accessadditional clientele and payor bases, adding to our financial stability. This integration also leaves room in the long-term for the addition of other social services, such as Family Counseling, Psycho-Educational Services, and Mental Health Case Management.5.2 Marketing StrategyMarketing our service-oriented business requires establishing a reputation for expertise and excellence. It starts with our known contacts who are in positions to recommend us and make referrals to us, and continues with long-term efforts to develop recognition among other professionals within the health care and social service fields. We will develop and maintain a database of our contacts in the field. Ms. Walker is already well-known to physicians, other nurses and hospital facilities in our market area, and will work to maintain those relationships throughout our start-up process. Ms. Patzer will make initial contacts in the community as she establishes the business entity and provider status with Medicare, Medicaid, private insurance companies and local attorneys. She will then join Ms. Walker in an effort to introduce Wheatland Health Services to area professionals who are potential referral sources. Our communications will be professional, as will our marketing tools such as brochures, business cards, and advertisements.5.3 Sales StrategySales in our businessmeans quality patient service and utmost satisfaction fromreferring physicians and health care facilities. It is perpetual business. One doesn't sell home health care and personal injury case management;rather one sells excellent care, availability, andeffective interpersonal relationships. In a service industry, growth can mean loss of quality control, which in turnleads to client dissatisfaction. The services we provide should always reflect the mission and oversightof management. We want our clientsto know that the quality of service they receive will be excellent, regardless of the individual service provider performing the service. We will therefore avoid the temptation to broaden the scope of our services too quickly. Rather, wewill focus our immediate attentions on making the services we offer of the highest possible quality. Only when those services are well-established and grounded in excellence will we consider expanding our service base.5.3.1 Sales ForecastAnnual sales reflect a conservative average of 125 new Home Health Care patients for the first year with amodest increase per year thereafter. This figure is based on the number of patients currently being seen by an existing home health care agency in Southeastern Kansas. Research indicates that this agency is a satellite office of a larger regional organization and investment in the satellite office has been minimal. We believethat with a greaterinvestment in marketing, employee relations, and customer service this client base can grow significantly. The projected annualfigures for Personal Injury Case Management salesarerelatively low, as this portion of the business will initially be secondary to the Home Health Care Services. However, we project ajumped upannual growth after the first year, asmarket analysis indicates there is a significantneed for these services. As theHome Health Care portion of the business stabilizesmanagement will focus growth efforts on the Personal Injury Case Management program.

5.4 MilestonesThe accompanying table lists important program milestones, with dates and managers in charge, and budgets for each. The milestone schedule indicates our emphasis on planning for implementation. What the table doesn't show is the commitment behind it. Our business plan includes complete provisions for plan-vs.-actual analysis, and we will hold monthly follow-up meetings to discuss the variance and course corrections.

Management SummaryWheatland Health Services' initial team will consist ofone Administrative Director, one Clinical Director,three employees and a contracted agency to fulfill the need for Physical Therapists, Occupational Therapists, and Speech Therapists. Initially, both managers will also provide direct service. Elizabeth Patzer is a licensed social worker and will provide all social work services during the start-up stage of the business. She will also provide all administrative direction and will perform most of the administrative functions with assistance from an Administrative Assistant. Kellene Walker is a registered nurse and has experience as a Skilled Nurse and Director of Nursing for a Home Health Agency. She will also provide direct nursing services during the initial stages of the business, as well as supervising the nursing staff. As the need for service providers grows, both managers will assume primary roles in management and willdelegate direct service to employees. Wheatland Health Services has no current management or personnel gaps; our plan provides for hiring service providers only as growth demands. Job descriptions have been written for each position and we will develop anemployeehandbook prior to our StartDate.

6.1 Personnel PlanThe following is an explanation of personnel needs, costs, and benefits as listed in the Personnel table. The projections for the next three years are based onminimal growth in client base and therefore no resulting impact on payroll due to increased hours of service. A cost of living increase is noted for all employees but does not impact the Administrative Director asshe is the owner of the business and will realize increase through profit gains. Administrative Director -- This position will be held by the agency owner. The Administrative Director will also assume all Social Work hours of service during the initial stages of the venture as those hours are projected to be minimal. It is assumed that as need for Social Work hours increases a second Social Worker will be hired. *Owner's compensation will be made in the form of a draw and will not include payroll taxes, cost of insurance, etc., as these costs will be assumed by the owner; these after-tax expenses can be found in the detailed Profit and Loss table.

Clinical Director -- This position will be held by Kellene Walker, who has prior experience as Clinical Director for a home health care agency in Southeastern Kansas. Ms. Walker's compensation will be in the form of a salary, based for the first year on $1000/week. It has been agreed that at the end of each calendar year Ms. Walker shall be entitled toa TBApercent of the company's netprofits (less taxes and interest expense). The company will pay employer portion of payroll taxes for Ms. Walker and will allow for 4 weeks of paid personal leave per year and 11 paid holidays, but benefits will not include medical insurance, retirement or other fringe benefits. The Clinical Director will also assume the majority of Skilled Nursing hours of service during the initial stages of the venture as that will be her primary role. As the need for additional Skilled Nursing hours increases, additional Skilled Nurses will be hired.

Administrative Assistant -- This position is based on 30 hours per week reimbursed, at $12.00 per hour. Initially there will be no benefits attached to this position except forfour weeks of paid personal leave and 11 paid holidays to be used at the discretion of the employee with prior notification to the Administrator.

Skilled Nurse -- This position will be paid $18.50 per hour for direct service hours. The total reimbursement as shown in the Personnel Table is calculated on 1040 hours per full year. In addition, the Skilled Nurse will be paid $408 per month for On-Call Hours served. On-Call Hours are figured at $1.50/hr. x 16 hrs x 5 days + $1.75/hr x 24 hours x 2 days x 2 weeks/month. There will be no benefits attached to this position other than 2 weeks of paid personal leave and 5.5 paid holidays per year, as this is a part-time position.

Nurse's Aide -- This position will be paid $10.00 per hour for direct service hours. The total reimbursement as shown on the Personnel Table is calculated on 1040 hours per year. There will be no benefits attached to this position other than 2 weeks of paid personal leave and 5.5 paid holidays per year, as this is a part-time position.

Social Worker -- This position will be paid $18.50 per hour for direct service hours. The total reimbursement as shown in the Personnel Table is calculated on 520 hours per year. There will be no benefits attached to this position initially until the need for more hours of service is realized.We will also contract for other therapeutical services, as described below. These contracted expenses can be found in the Profit and Loss table. Physical Therapist/Occupational Therapist/Speech Therapist -- These positions will be contracted at a rate of $30.00 per hour. The total reimbursement is based on 650 hours per year.There will be no benefits attached to these positions, as they are contracted on a fee-for-service reimbursement basis only.

Financial PlanWe want to finance growth mainly through cash flow. We recognize that this means we will have to grow more slowly than we might like. The most important factorfor our financial plan is collection of receivables.Our home health care services will bereimbursed primarily by Medicare, Medicaid, and other private insurances. History indicates that these payors are sometimes slow to reimburse and receivables can get hung up in the automated payment system if not tracked closely. As we broaden our scope of services to include a larger payor base, these lags incollection of receivables will have less impact on cash flow. Our figures are based onstart-up capital as shown in the Start-up and Start-up Funding tables; wewill consider an additional loan if needed.7.1 Important AssumptionsThe General Assumptions table, below, shows our important (and conservative) annual assumptions concerning interest rates, tax rates, and personnel burden. In addition: 1. We assume a strong economy, without major recession. 2. We assume, of course, that there are no significant unforeseen changes in thefederal policy that dictates Medicare and Medicaid reimbursement of Home Health Care Services.

7.2 Break-even AnalysisThe Break-even Analysis below is based on monthly fixed costs and an Average Per UnitVariable Cost. This assumption about cost of sales may at first look low, but in our service-based business, payroll is included with other operating expenses in our fixed monthly amounts,so the variable costs relate to the only other cost of service provided: mileage to and from service locations. At these levels,we need to bill and collect the amount shownbelowper monthto cover ourper month costs. We don't really expect to reach break-even until a few months into the business operation.

7.3 Projected Profit and LossOur projected profit and loss is shown in the following table, with sales increasingthroughout thethree years of the plan, and profits are notable even for the start-up phase of this business. per monthWe are projecting growth and total annual sales very conservatively, with high projected expenses. Our cost of sales isrelatively low, as this is a service agency and the primary costs involved in providing the services are those related to payroll. The costs of sales reflects the costof mileage reimbursement to employees,becausethe services we provide are home- and community-based and require travel to and from service locations. The Profit and Loss table also contains our expenses for independently contracted physical, occupational and speech therapists, as well as the owner's and Clinical Director's after-tax draws.

7.4 Projected Cash FlowThe following cash flow projections show the annual amounts only.Collection ofaccounts receivable from our sales on creditwill greatly affect our cash flow. Cash flow projections are critical to our success. The monthly cash flow is shown in the illustration, with one bar representing the cash flow per month, and the other the monthly cash balance. The annual cash flow figures are included here and the more important detailed monthly numbers are included in the appendix.

7.5 Projected Balance SheetThe balance sheet in the following table shows managed but sufficient growth of net worth, and a sufficiently healthy financial position. The monthly estimates are included in the appendix.

7.6 Business RatiosThe following table shows the projected businesses ratios, and a comparison of our ratios with standards for the home health care industry (SIC code 8082.000). We expect to maintain healthy ratios for profitability, risk, and return.