Cornerstone Community Health Clinic

Words in [brackets] are blanks you fill in with your own details when you adopt this sample in Supreme Plan AI.

Executive Summary

Cornerstone Community Health Clinic will be a primary care clinic on the east side of our city in Tennessee, serving adults and children who are uninsured, underinsured or on Medicaid. We provide affordable office visits, preventive care, chronic disease management and referrals to specialists, so every person in our community has access to a doctor whatever their ability to pay.

Why this fits. Many residents near us have no regular doctor. Emergency rooms are their only option for routine care, which is costly for patients and for the health system. A clinic with sliding-scale fees, extended hours including Saturdays and care in English and Spanish can serve patients that other practices do not reach. Medicaid and sliding-scale fees pay for visits, and grants and community partners help bridge the first years.

This is a regulated, capital-heavy business. We plan carefully for licenses, equipment and the time it takes to build a patient panel.

Here is what our numbers show. In Year 1 we plan about 3,800 patient visits (roughly 73 a week), paid through sliding-scale fees and Medicaid. That brings in sales of $380,000, growing to $1,239,952 by Year 5. We expect a loss of about $68,500 in Year 1, a profit of about $39,200 in Year 2, a profit of about $39,100 in Year 3 and a profit of about $115,200 by Year 5. Physician and staff pay and the clinic build-out and equipment paid for before the first visit are our largest costs, and the plan counts all of them.

We need $435,000 in total. Of that, $185,000 is startup costs (exam room build-out, exam tables and diagnostic and lab equipment, health record and telehealth systems, furniture, signs, permits and opening supplies), and the rest is cash for the first months. I am putting in $35,000 of my own savings, raising $250,000 from grants and community investors and asking for a $150,000 SBA 7(a) loan.

I am Dr. Marcus Reid, a family physician and the owner and medical director. These numbers are estimates based on the assumptions listed at the end of this plan, not promises.

Company Description

Cornerstone Community Health Clinic will be a limited liability company (LLC) in Tennessee, owned by Dr. Marcus Reid. We will lease about 3,500 square feet on the east side of the city with four exam rooms, a small lab, a waiting room and a reception area.

What we believe. Every person in our community should have a doctor, and cost should never be the reason someone goes without care.

What we offer:
- Primary care visits for adults and children, with same-week appointments.
- Preventive care: physicals, immunizations, cancer screenings and well-child visits.
- Chronic disease management for diabetes, high blood pressure and asthma.
- A sliding fee scale based on household income and family size.
- Community health workers who help patients keep appointments and find other help.
- Care in English and Spanish and extended hours including Saturdays.

What we are required to do, and what we do not do. We hold the state licenses a clinic needs, enroll as a Medicaid provider, follow every privacy and billing rule and keep malpractice insurance. We do not promise any health result and we call 911 for any emergency. We confirm every rule and requirement with the state, Medicaid and our healthcare attorney before we open.

Where things stand today. The plan, the fee scale and the budget are written. The next steps are the lease, the licenses and the first hospital and laboratory agreements.

Problem & Opportunity

Many residents near us have no regular doctor. The target area has about one primary care physician for every 3,800 residents, more than double the national shortage threshold, and about 28 percent of adults have no health insurance.

Patients who cannot see a doctor delay care. They use the emergency room for problems that a primary care doctor could handle at lower cost. Preventable emergency room visits cost the regional health system millions of dollars a year.

Medicaid patients face a different problem. Many practices are not accepting new Medicaid patients or have long waits. Language barriers and travel add to the difficulty.

The result is sicker patients, higher costs and families who feel the health system is not for them.

Products & Services

Cornerstone Community Health Clinic will address the shortage by placing an affordable, full-service primary care practice in the neighborhood.

What we will provide:
1. Sliding-scale primary care. Fees range from $20 to $120 per visit based on household income and family size, so no patient pays more than they can afford.
2. Chronic disease management. A care team helps patients with diabetes, hypertension and asthma track conditions, take medicines and reach their goals.
3. Preventive care. Annual physicals, immunizations, cancer screenings and well-child visits.
4. Same-day and next-day appointments. No one should wait weeks to see a doctor.
5. Community health workers. Neighbors who help patients keep appointments, understand instructions and find food, housing and benefits help.
6. Language access. Care and materials in English and Spanish.
7. Referrals. Relationships with specialists and the hospital for patients who need more.

Why patients stay. They find a doctor who knows them and a team that helps.

Market Analysis

Who we serve. Uninsured and underinsured adults and children, Medicaid patients who cannot find a primary care doctor, working adults without employer health insurance and Spanish-speaking residents who have avoided care because of language.

How we sized the market. The target zip code has a population of about 42,000. We are not counting on all of them. Year 1 plans about 3,800 visits, roughly 73 a week, which is a small share of the visits needed by residents who do not have a regular doctor. Replace this estimate with your own count of residents, uninsured households and current providers in your area.

Where patients come from.
- Hospital emergency room staff and discharge planners.
- The county health department and school nurses.
- Churches and community organizations.
- Patients who tell a neighbor.

Who else benefits. Families gain steady care. Hospitals gain fewer avoidable emergency visits. Employers gain healthier workers.

Competitive Landscape

What patients can do today:

1. Hospital emergency rooms. Open to anyone, expensive and not built for ongoing care.
2. Urgent care clinics. Convenient, with high costs for patients without insurance and no continuity.
3. Other primary care practices. Many are full, do not accept Medicaid or are far from the neighborhood.
4. Federally qualified health centers. Strong programs, often with long waits and limited hours.
5. Free clinics. Valuable and limited in hours and services.

Where we fit. Cornerstone offers a full-service practice in the neighborhood with sliding-scale fees, Medicaid acceptance, extended hours and care in English and Spanish. We will not try to replace the hospital or the health centers. We will work with them and fill the gaps they leave.

Marketing & Sales Strategy

How patients will find us.

Before opening:
- Meet hospital care management teams and emergency room social workers to set up a referral path.
- Present at community meetings: churches, neighborhood associations and school parent nights.
- Distribute bilingual flyers at laundromats, grocery stores and faith communities.
- List the clinic with 211, the county health department and the Medicaid enrollment office.

After opening:
- A bilingual front desk and a community health worker who calls new patients.
- A Google Business Profile and honest reviews from patients.
- Health fairs and screening days in trusted places.
- Partnerships with schools and employers.
- Reminders and follow-up so patients keep appointments.

What we will measure. How patients found us, new patients each month, no-show rate and how many patients return.

Operations Plan

How the clinic will run.

Hours. Weekday daytime hours, two evenings a week and Saturday mornings, adjusted as demand shows.

Staffing in Year 1. Dr. Reid sees patients and directs the clinic. A medical assistant, two community health workers and a front desk and billing coordinator work with him. A nurse practitioner joins in Year 2. Pay for each role is listed at the end of this plan.

Records and billing. An electronic health record keeps charts, orders and billing in one place. We submit claims promptly, track receivables weekly and apply the sliding fee scale fairly.

Quality and safety. We follow infection control rules, calibrate and maintain equipment, keep a written emergency plan and call 911 for emergencies. We review charts for quality and respond to patient complaints.

Privacy. We follow federal and state privacy rules, limit access to patient information and train every staff member.

Referrals. We keep agreements with a hospital, a laboratory and specialists so patients can get tests and specialty care.

Management & Organization

The people who will run Cornerstone Community Health Clinic.

Dr. Marcus Reid, owner and medical director. A board-certified family physician, he sees patients, leads clinical quality, compliance and hiring and manages relationships with the hospital and the health department. (Replace this paragraph with your own background.)

Nurse practitioner (from Year 2). Sees patients under the state's practice rules and follows the clinic's protocols.

Medical assistant. Rooms patients, takes vital signs, assists with procedures and manages supplies.

Community health workers. Reach out to patients, help them keep appointments and connect them with food, housing and benefits. They are not clinicians and do not diagnose or treat.

Front desk and billing coordinator. Schedules visits, checks coverage, handles sliding-scale paperwork and submits claims.

Outside advisors. A healthcare attorney, an accountant who knows medical billing, a malpractice insurance broker and a free mentor from SCORE or the Small Business Development Center.

Staff pay in this plan is a full year per person: physician / Medical Director $185,000; nurse Practitioner $110,000; medical Assistant $38,000; community Health Worker $34,000; front Desk / Billing Coordinator $42,000. Replace them with the pay you can offer where you live.

Milestones Narrative

Our goals and when we plan to reach them.
- Before opening (6 to 9 months ahead): sign the lease, build and equip the exam rooms, get the state licenses and the Medicaid provider enrollment, install the health record system, hire the first staff and sign agreements with the hospital and a laboratory.
- Year 1: about 3,800 patient visits, a physician, a medical assistant, two community health workers and a front desk coordinator; $380,000 in sales and a loss of about $68,500.
- Year 2: about 6,019 patient visits with a nurse practitioner added; $619,957 in sales and a profit of about $39,200.
- Year 3: about 8,396 patient visits and a second physician and a larger team; $889,976 in sales and a profit of about $39,100.
- Year 4: about 10,092 patient visits and a second nurse practitioner; $1,100,028 in sales and a profit of about $68,700.
- Year 5: about 11,071 patient visits and a plan for a second clinic or for federal health center status; $1,239,952 in sales and a profit of about $115,200.
Growth depends on winning and keeping customers, so treat the later years as goals, not promises.

What we check every week: patient visits, new patients, no-show rate, share of visits on sliding scale and Medicaid, claims billed and paid, wait times, staff hours and cash in the bank.

Funding Request

How much we need and how we will use it. Total we are raising: $435,000.

How we got that number. The Funding Need Calculator in this plan adds up three things:
- Startup costs of $185,000, listed item by item in the Startup Costs section: $65,000 for exam room buildout and renovation, $12,000 for medical exam tables (4), $14,000 for diagnostic equipment (EKG, pulse ox, otoscopes, sphygmomanometers), $16,000 for lab equipment (centrifuge, point-of-care testing), $8,000 for autoclave / sterilizer, $18,000 for electronic health records - setup and Year 1 license, $10,000 for telehealth equipment and software, $12,000 for waiting room furniture and reception desk, $4,000 for signage (exterior and interior), $4,000 for pre-opening outreach and printed materials (bilingual), $7,000 for licenses, permits, and legal fees, $10,000 for initial medical supplies and medications, $5,000 for insurance - first year premium (malpractice and general liability).
- The cash the business uses before it breaks even, about $98,500. Medicaid and other payers pay weeks after a visit, and the first months have few patients, so the clinic spends cash on pay and rent before enough visits arrive.
- A cash cushion of about $101,900: three months of Year 1 operating costs.
- Together, the cash used before break even and the cushion come to about $200,400, and the three pieces add up to about $385,400, rounded up to the nearest $500: $385,500.
We are raising $49,500 more than that, $435,000 in all, to cover a slower first year than planned and payer delays. With this funding, the lowest year-end cash balance is about $254,000, at the end of Year 3.

Where the money comes from:
- My own money: $35,000.
- Grants and community investors: $250,000.
- SBA 7(a) loan: $150,000.

Kind of funding we are looking for. An SBA 7(a) loan from a lender that finances healthcare businesses, together with grants and community investors, backed by my own savings and the clinic equipment as collateral.

How we will pay it back. We expect a loss of about $68,500 in Year 1, a profit of about $39,200 in Year 2, a profit of about $39,100 in Year 3, a profit of about $68,700 in Year 4 and a profit of about $115,200 in Year 5. With this funding, the business has money in the bank at the end of every year of the plan. Our loan is the SBA 7(a) loan at 10.5% over 10 years, $2,024 a month. That payment is already included in our cash flow. We chose these as cautious planning rates; ask the lender for the real rates, which may be lower or higher.

What we are offering the lender: the clinic's equipment and my personal guarantee.

A smaller first step, if needed. If we cannot raise the full amount right away, we can start smaller and grow into this plan:
- Phase 1: open with two exam rooms and one provider, defer the lab equipment and telehealth and use a reference laboratory, which lowers the startup costs and the loan.
- Phase 2: once the patient panel grows, add the other exam rooms, the lab equipment, the nurse practitioner and the telehealth program and follow this plan.
To plan the smaller start, make a copy of this plan (use Duplicate) and lower the numbers to match.

All numbers in this plan are estimates. We will update them as real results come in.

Appendix Notes

Documents to attach before you send this plan:

- Your resume and a personal financial statement (a list of what you own and what you owe; lenders usually provide a form).
- Business registration papers and your EIN (your business tax number from the IRS, free at irs.gov).
- Your medical license, board certification and Drug Enforcement Administration registration or plan to obtain it.
- Your state facility licenses, Medicaid provider enrollment and clinical laboratory certificate applications.
- The lease or a letter of intent from the landlord.
- Quotes for the build-out, equipment and health record system.
- Your sliding-scale fee policy, privacy policy and emergency plan.
- Letters of support from the hospital, health department and community organizations.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Patient Visits (sliding scale and Medicaid): about $100 in Year 1, rising to $112; about $4 in direct costs, rising to $5; about 3,800 in Year 1, growing to 11,071.
- A patient visit is one visit paid by sliding-scale fees or Medicaid at an average of about $100 in Year 1, so about 3,800 visits is roughly 73 visits a week. About 15 percent of a year's billings is still waiting to be paid at the end of the year.
- Prices rise about 3% a year.
- Equipment ($50,000 in Year 1) covers exam tables, diagnostic and laboratory equipment, a sterilizer, telehealth equipment and waiting room and reception furnishings, and later years ($5,000, $8,000, $8,000 and $10,000) replace and add equipment.
- Pay (a full year, per person): physician / Medical Director $185,000; nurse Practitioner $110,000; medical Assistant $38,000; community Health Worker $34,000; front Desk / Billing Coordinator $42,000.
- Other yearly costs in Year 1: rent and Utilities $36,000, eHR, Software and Technology $16,000, malpractice and General Liability Insurance $14,500, marketing and Community Outreach $8,000. These grow between 3% and 5% a year.
- Customers and payers pay about 55 days after service, so at the end of Year 1 about $57,000 is still owed to us. Income tax at 21%.
- Every dollar amount is an estimate. Replace them with your own quotes and research.

Startup Costs