Cirrus Blog

White Paper: Veterinary Practice Expansion Guide to Growth

Is your production potential limited by the size of your current veterinary office?
It sounds like you may be ready to expand your clinic and grow your business.
Expanding a veterinary practice is an important decision that involves countless, time-sensitive moving parts. For over 20 years, Cirrus Consulting Group has been helping doctors safely and thoughtfully prepare for their office expansion projects. Use our guide to prepare for your new business venture, armed with the knowledge critical to take your business operations to the next level.
STEP 1: Define Objectives & Create the Plan
Is your potential for revenue capped by the size of your current facility? Strategically thinking about why you need to expand will help define your goals and execute a plan of action.

STEP 2: Analyze the Terms in Your Current Veterinary Office Lease
After outlining your goals, it’s time to analyze the details in your current clinic lease to ensure they will allow you to carry out your expansion plans without obstacles. Contact the veterinary office leasing experts at Cirrus Consulting Group to help you with this important step. A leasing expert will help you review and decipher the complex language within the lease to ensure you are fully protected when you approach your landlord with your plans.

Important Considerations in Your Current Lease:

Putting together a team of capable and trusted professionals is critical to a smooth and successful expansion project. Assemble a reliable team of financial advisors, office designers, builder/contractors and contact your equipment suppliers and technology specialists at Henry Schein Animal Health.
STEP 4: Review and Negotiate the Offer to Lease for the New Space
Once you’ve gotten the go-ahead on the additional space from your landlord, you’ll be presented with either a lease agreement, Offer to […]

Customer Case Study: Dr. Nora C., DDS | Charlotte, NC

Dr. Nora C. is a late-career prosthodontist who’s been practicing in the same dental office in Charlotte, NC for several years. With her dental office lease just 6 months from its expiry date, she was contemplating relocating the practice to a property that would be more suitable to support her plans for a gradual transition over the next 5-6 years.
The Problem
After a lengthy search, the doctor found the ideal location for her practice, and was presented with the landlord’s standard office lease agreement for the new space. The doctor’s primary concerns were to make certain that the relocation go smoothly, to mitigate any potential risks with the new lease, and to minimize any negative impact on her patients, all the while ensuring that both her investment and estate would be protected.

Dr. C’s Henry Schein consultant introduced her to Cirrus Consulting Group, the dental office lease negotiation experts, to review her existing lease for costly surrender provisions and critical dates that might impact her relocation, as well as the new lease proposed by the landlord. Cirrus began by assessing her personal and practice goals, and then developed a strategy to help guide her through a safe relocation.
The Challenge
Upon reviewing Dr. C’s proposed new lease agreement, Cirrus uncovered various issues that could be detrimental to her eventual transition out of dentistry, including an “Assignment” clause that would leave her personally responsible for the practice’s debt after transitioning, and the landlord’s right to collect a significant portion of her practice sale proceeds.

Dr. C. was looking for her new lease agreement to provide her with the following:

The Solution
Cirrus collaborated with Dr. C. to clarify her transition goals, and then guided her through their eight-step strategic lease negotiation process, achieving […]

Henry Schein Associate Spotlight – Joe Middleton, FSC

“Since recommending Cirrus for the lease negotiation for their new location, the relationship with my doctors has reached a new level of trust. Since then, they have ordered over $160K in equipment and technology for their new location!”

Joe Middleton, FSC | Frederick, MD

Meeting the Needs of My Dental Clients

I worked as a Trainer/Dental Sales Representative for the last 20+ years with Warner Lambert, Pfizer Consumer Health, Johnson & Johnson and Ora Pharma. These were all great experiences, but I felt the need to further my growth and work with a company that offered ALL of the tools a dentist needs to be successful.

Fortunately for me, I was offered an FSC position with Henry Schein Dental about 8 years ago, and it was just what I was looking for! Walking into dental practices armed with the HS Connections Wheel and knowing that whatever the specific needs of each dental practice were, that I could help them meet their needs, was, and continues to be, an amazing feeling! One of the pieces of our Wheel that I had some great success with lately was our “Business Solutions” component, specifically, working with our outstanding partners at Cirrus Consulting Group, the dental office lease negotiation experts.

One Wrong Word in the Dental Office Lease Can Make or Break a Practice Sale

Recently, one of my best customers, Virginia Dental Solutions in Reston VA, was being forced by their landlord company to move from their current location of 25+ years to a new location by the end of 2017. The doctors there are excellent dentists, but have very little experience with office leases. Initially, they were just going to have a lawyer “look over” their new lease and make sure everything […]

Consent in a Veterinary Office Lease: Why it’s Important

Are you selling your clinic? Installing new signage? Remodeling your veterinary office? Planning to bring in an associate or vet tech?
What do all of these actions have in common? Each of them will likely require your landlord’s consent as a condition in your veterinary office lease agreement.
Standard of Consent in the Veterinary Office Lease
Consent, in and of itself, is fairly common and a very reasonable provision in the typical veterinary office lease agreement. However, what most veterinarians don’t realize is that the standard of consent set forth by the landlord in the lease can be very problematic and restrictive to the clinic. Quite often, the element of consent is contractually defined in the lease, requiring the consent “not to be unreasonably withheld”.

Many commercial office lease agreements include language similar to the following:

“The Tenant shall not _________, without prior consent of the Landlord, such consent not to be unreasonably withheld.”

The question of reasonableness is one of fact, and is determined by the circumstances at hand, including the commercial realities of the marketplace and the economic impact on the party being asked to consent. Reasonableness should not be confused with what may seem fair. It is also not necessary for the opposing party to have to prove that their refusal to consent was justified; only that it was reasonable under the circumstances. The onus will generally be placed on the veterinary tenant to prove that the landlord’s refusal to consent was unreasonable.

To that end, consent language can be quite problematic for a veterinarian who is planning to sell their clinic, bring in associates, or even try to sublease some of their space to another animal health practitioner, and here’s why:

The Importance of Negotiating “Consent” in […]

Consent and Reasonableness in the Dental Office Lease: Why it’s Important

Are you selling your practice? Installing new signage? Remodeling your dental office? Planning to bring in an associate?
What do all of these actions have in common? Each of them will likely require your landlord’s consent as a condition in your dental office lease agreement.
Standard of Consent in the Dental Office Lease
Consent, in and of itself, is fairly common and a very reasonable provision in the typical dental office lease agreement. However, what most dentists don’t realize is that the standard of consent set forth by the landlord in the lease can be very problematic and restrictive to the practice. Quite often, the element of consent is contractually defined in the lease, requiring the consent “not to be unreasonably withheld”.

Many commercial office lease agreements include language similar to the following:

“The Tenant shall not _________, without prior consent of the Landlord, such consent not to be unreasonably withheld.”

The question of reasonableness is one of fact, and is determined by the circumstances at hand, including the commercial realities of the marketplace and the economic impact on the party being asked to consent. Reasonableness should not be confused with what may seem fair. It is also not necessary for the opposing party to have to prove that their refusal to consent was justified; only that it was reasonable under the circumstances. The onus will generally be placed on the dental tenant to prove that the landlord’s refusal to consent was unreasonable.

To that end, consent language can be quite problematic for a doctor planning to sell their practice, bring in associates, or even try to sublease some of their space to another dental practitioner, and here’s why:

The Importance of Negotiating “Consent” in Your Dental Office Lease
Whenever landlord consent […]

Customer Case Study: Dr. Raymond N., DVM | Jacksonville, FL

Husband and wife team Dr. Raymond N., DVM, and Mrs. N. were opening their first animal hospital in Jacksonville, FL. With the help of a real estate broker, they had selected two potential sites for their new hospital.
The Problem
A veterinary tenant and their space requirements are quite different than that of a typical retail or office tenant, requiring terms specific to an animal hospital’s needs.

The real estate broker, although helpful in space-finding and incredibly knowledgeable about the commercial real estate market, did not specialize in representing veterinary tenants in lease negotiations. As a result, negotiations with the landlords did not go as planned, and the couple walked away from the prospective locations feeling discouraged, frustrated, and continued on their search.
The Challenge
The couple’s Henry Schein Animal Health (HSAH) supply partner, Joelle Craig, understood the stressful, lengthy, and expensive process of opening a new clinic. She referred them to HSAH’s exclusive real estate and lease negotiation partners at Cirrus Consulting Group to aid in selecting the space and negotiating a healthy lease.

Cirrus worked collaboratively with the broker to find a suitable location that fit the couple’s space requirements, and then focused on reviewing and negotiating the details of the lease agreement.

Dr. N. and Mrs. N. were looking for the new lease to provide them with the following:

The Solution
By incorporating their strategic and proven office lease negotiation process consisting of market research, a practice needs analysis, and a thorough lease review, Cirrus was able to achieve the following key “wins” for the couple in their negotiations:

“Within two months, Cirrus was able to secure the new lease on our hospital with excellent amendments that will ensure my practice runs smoothly and that I will be able to transition […]

Ten Tips for Monitoring Dental Embezzlement

Prevention of embezzlement is impossible, but, detection of embezzlement is fairly easy if you go about it the right way.  Here are ten tips, written by embezzlement expert, David Harris, CEO of Prosperident, that take very little time and can make your practice much less vulnerable to embezzlement:

Daily:

1. Print reports yourself: This prevents the possibility of a staff member using “selective reporting” in the information that they give you.

2. Review and initial day sheets. Retain for three years or more. You may need these someday if embezzlement is suspected.

Monthly:

3. Review entry log (alarm system). Staff members coming to the dental office at unusual times is often a symptom of embezzlement.  Taking five minutes to review this information from your alarm company is one of the best time investments you can make in detecting embezzlement.

4. Review AR listings and compare with previous months. Make sure that balances are “aging” properly in the reports, and ensure that suitable collection action is being taken on older accounts.

5. Review the modified transactions report (the name varies with the type of practice management software you are using). This is a much smaller report than the “audit log” (which can run to thousands of pages per month), and is often a place where certain types of embezzlement transactions can be seen.

6. Have bank and credit card statements sent to your house instead of your dental office. This prevents employee tampering.

7. Use Prosperident’s Monthly Monitoring Spreadsheet (ask for it at requests@dentalembezzlement.com) to reconcile daily reporting with monthly reporting and deposits.

As needed:

8. Use the Embezzlement Risk Assessment Questionnaire.

9. Instill mandatory vacations and cross training for all staff. Everyone from your office should be gone for at least two consecutive weeks per year, and this needs to be done when […]

Buying a Family Practice in Ontario

Important Questions and Issues to Consider:

Benefits to Purchasing a FHO Practice:

It is the ideal time to purchase an established FHO practice; however, it’s important to consider the substantial time, commitment and costs involved. Although there is an initial upfront cost, the long-term benefits far outweigh the short-term investment, such as:

While the FHO model is the most popular payment model within family medicine, it can also be the most complicated. It is critical to your practice’s success, if you decide to use the FHO payment model, to ensure you are familiar with the “ins and outs” of practicing and optimizing a FHO practice from day one. Contact Cirrus to learn more about running a FHO practice.
Considerations in the Medical Office Lease:

As a physician looking to acquire a medical practice, it is also important to take proactive measures to ensure you are protected from potentially dangerous language in the medical office lease. Be sure to dig deep, and ask the selling physician about their lease obligations. One key question to ask is whether the office lease will be assigned to you, or, will you have to sign a new lease?

Evaluate important lease terms such as economics, critical dates, and any details and risks hidden throughout. Some significant lease terms include:

It is recommended to have the lease professionally reviewed before moving forward with your new practice venture. This will help ensure you are protected, while also providing the flexibility to continue to run and grow your clinic. The best way to do this is by seeking help from a healthcare leasing expert such as Cirrus Consulting Group for a professional, and thorough review of the details of your office lease.
Click here to download the white paper.
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Are You Overpaying for Your Clinic’s Operating Costs?

Visibility and Audit Rights

Before you sign your veterinary office lease, it’s important to ensure that you have the “right to review and/or audit statements and invoices for all operating costs” negotiated into the agreement. This will ensure that you have the ability to take prudent steps to protect your clinic from unreasonable or hidden charges set forth by the landlord. If you have the right to see exactly what is being charged, it is less likely that you will be billed for something completely unreasonable.

In a Net lease, operating costs are expenses associated with the landlord’s day-to-day maintenance and operation of the property. Your landlord should keep track of all operating costs, and at the end of the fiscal year, provide you with a detailed statement of the actual expenses. As a tenant of a commercial property, you should insist on having the reasonable right to verify, audit, and where applicable, contest any charges that have been passed on by your landlord. Veterinarians who have not secured such provisions in their office lease may find that they are vulnerable and exposed to unscrupulous landlords.

Exclusions

It is customary for a tenant to cover their proportionate share of charges relating to the maintenance of the building, common areas, insurance, and various taxes; however, some landlords take advantage of their tenant’s lack of knowledge as to what are reasonable pass through costs.

What charges are unreasonable for the landlord to pass along to a veterinary tenant?

Retroactive Billing

It’s not uncommon for a veterinarian to receive notice from their landlord communicating that they were not billed correctly for a certain expense, dating back several years. Without proper preventive language negotiated into your veterinary office, situations like this can result in many […]

Are You Overpaying for Your Practice’s Operating Costs?

Visibility and Audit Rights

Before you sign your dental office lease, it’s important to ensure that you have the “right to review and/or audit statements and invoices for all operating costs” negotiated into the agreement. This will ensure that you have the ability to take prudent steps to protect your practice from unreasonable or hidden charges set forth by the landlord. If you have the right to see exactly what is being charged, it is less likely that you will be billed for something completely unreasonable.

In a Net lease, operating costs are expenses associated with the landlord’s day-to-day maintenance and operation of the property. Your landlord should keep track of all operating costs, and at the end of the fiscal year, provide you with a detailed statement of the actual expenses. As a tenant of a commercial property, you should insist on having the reasonable right to verify, audit, and where applicable, contest any charges that have been passed on by your landlord. Dentists who have not secured such provisions in their office lease may find that they are vulnerable and exposed to unscrupulous landlords.

Exclusions

It is customary for a tenant to cover their proportionate share of charges relating to the maintenance of the building, common areas, insurance, and various taxes; however, some landlords take advantage of their tenant’s lack of knowledge as to what are reasonable pass through costs.

What charges are unreasonable for the landlord to pass along to a dental tenant?

Retroactive Billing

It’s not uncommon for a dentist to receive notice from their landlord communicating that they were not billed correctly for a certain expense, dating back several years. Without proper preventive language negotiated into your dental office, situations like this can result in many unforeseeable future […]