Little Steps Pediatric Therapy

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

Executive Summary

Little Steps Pediatric Therapy is a clinic in South Carolina that provides occupational, speech-language and physical therapy for children from infancy through age 18. We plan a bright clinic of about 2,500 square feet with a sensory gym, treatment rooms and a waiting area where parents can stay. Therapists work with each child and family on goals such as feeding, handwriting, speech, motor skills and attention, and we run small groups for social skills and early movement.

Many children wait months for therapy. Pediatricians and schools identify delays, and families find that clinics are full and the nearest opening is far away. Early help changes how a child learns and plays. A clinic with open appointments, warm therapists and clear communication fills a real need.

Here is what our numbers show. We expect about 3,600 therapy sessions, 260 evaluations and 1,200 group class visits in Year 1, which brings in sales of $529,300, growing to $1,786,642 by Year 5. Our payers are mostly insurers and Medicaid, who pay weeks after the visit, and approvals take months, so we plan carefully for cash. We expect a loss of about $88,600 in Year 1 while we build our caseload and complete payer credentialing, then a profit from Year 2 ($58,100), growing to about $254,500 by Year 5.

We need $340,000 in total. Of that, $159,200 is startup costs (the sensory gym and therapy equipment, the build-out, records and billing systems, credentialing and setup) and the rest is cash to cover the first months while payers pay. I am putting in $80,000 of my own money, and I am asking for a $260,000 SBA loan.

I am Dr. Priya Nair, an occupational therapist with a clinical doctorate and 12 years of experience in pediatric therapy, including five years as a clinic director. These numbers are estimates based on the assumptions listed at the end of this plan, not promises.

Company Description

Little Steps Pediatric Therapy is a small, independently owned pediatric therapy clinic in South Carolina, planned as a limited liability company (LLC). We will lease about 2,500 square feet in a medical and retail building near pediatricians, with parking and an entrance that is easy for strollers and wheelchairs.

Our mission. To help children grow, learn and play with confidence by giving families timely, kind and effective therapy.

What we believe. Therapy works best when families are partners. We set goals with parents, explain what we do and why, give simple practice at home and celebrate progress. We make the clinic a place children want to come.

What we offer:
- Occupational therapy. Help with fine motor skills, handwriting, feeding, sensory processing, self-care and play.
- Speech-language therapy. Help with speech sounds, language, stuttering and social communication.
- Physical therapy. Help with motor milestones, balance, strength and coordination.
- Evaluations. A full assessment with a written report that families can share with schools and doctors.
- Group classes. Small groups for social skills, early movement and handwriting.

Who we serve. Children from birth to 18 and their families, with referrals from pediatricians, schools and early intervention programs.

What we do not do. We do not diagnose medical conditions, prescribe medicines or promise specific outcomes. We refer families to specialists when needed.

How we are run. I am the owner and clinical director and treat children. Contracted and employed therapists are paid per session, which is counted in the cost of each session. A clinic coordinator and biller and a part-time front desk assistant run the office, and therapy assistants join as the caseload grows. A small advisory group of a pediatrician, a school psychologist and a parent tells us what is working.

Where things stand today. We have a lease option, equipment quotes, letters of interest from five pediatric practices and two schools and a waiting list of 34 families. Before we begin, our attorney will review the lease, consent forms and privacy policy, and we will begin payer credentialing.

Problem & Opportunity

Children who need therapy often wait. Pediatricians refer children for delays in speech, movement and learning, and many clinics have waiting lists of months. For young children, those months matter, because the early years are when therapy has the most effect. Schools offer therapy, usually limited to what a child needs to access education.

The system is hard for families. Insurance rules, prior authorizations and limits on visits confuse parents. Medicaid reimbursement for therapy is low in many states, so clinics limit how many children they take. Families without transportation or flexible jobs find it hard to attend weekly sessions.

Therapists are in short supply, and many leave clinics for schools or hospitals because of pay and burnout. A clinic that pays well, supports its therapists and treats families respectfully can attract them.

For a new clinic, the barriers are the cost of equipment, the months needed to credential with each insurer and the long wait for payment. A clinic can see children for weeks before it is paid.

We want to be clear about what we know and do not know. Demand for pediatric therapy is strong and growing. We will use the most recent numbers from the census, the state and the school districts for our area in our final plan and will not overstate them. We do not know how fast credentialing will go, which is why our plan assumes a loss in Year 1 and a lot of cash to cover the payer delay.

Products & Services

Little Steps will give children timely therapy in a welcoming clinic, with clear goals and strong communication with families.

How it works, step by step:
1. Referral and intake. A family or a doctor calls, and our coordinator checks insurance and schedules an evaluation, usually within two weeks.
2. Evaluation. A licensed therapist assesses the child, talks with the family and writes a report with goals.
3. Treatment plan. We set goals with the family, choose a schedule and explain the plan in plain language.
4. Therapy. A child comes once or twice a week for 45 to 60 minutes in the sensory gym or a treatment room, and parents can watch or join.
5. Home practice. We give simple activities for home and check in with parents each visit.
6. Groups. Small groups for social skills, handwriting and early movement run after school and in summer.
7. Communication. We send progress notes to doctors and schools, with the family's consent, and review goals every three months.
8. Quality. We track wait times, attendance, goals met and family satisfaction.

Why this approach is strong. Short waits, a warm environment and partnering with families improve attendance and results.

Market Analysis

Who we serve: children from birth to 18 with developmental, speech, motor or sensory needs and their families.

Our primary group is children referred by pediatricians and schools. We will use the most recent numbers from the census and the state for children with developmental needs in our area in our final plan. Our secondary group is schools and early intervention programs that need outside providers.

How we sized our plan. We plan about 3,600 therapy sessions in Year 1 (about 75 a week on average), 260 evaluations and 1,200 group class visits, growing to 10,800 sessions (about 225 a week), 680 evaluations and 4,200 group visits by Year 5. Our Year 1 rates are about $116 per session (a blend across payers), $245 per evaluation and $40 per group visit, rising about 3% a year.

Demand data. A waiting list of 34 families and letters of interest from five pediatric practices and two schools cover about a third of Year 1 sessions. We do not count on any one referral source.

We do not take every child. We refer children whose needs are beyond our scope to other providers.

Competitive Landscape

Other options for families, and what makes us different.

- Hospital outpatient therapy clinics. They are trusted and often have long waits. We offer shorter waits and a smaller, friendlier setting.
- Other private pediatric clinics. Some are excellent and full. We compete on access and communication.
- School-based therapy. It serves students' educational needs. We offer more intensive and flexible outpatient care.
- Early intervention programs. They serve infants and toddlers. We work with them and take referrals.
- Telehealth. It helps some families. We offer in-person care and a sensory gym.

What makes us different.
- Appointments within two weeks.
- A sensory gym and warm, child-friendly setting.
- Families as partners, with clear goals and reports.
- Fair pay for therapists, which helps us keep them.

What we do not claim. We are new. Established clinics have long referral relationships. We plan to earn trust one family at a time.

Marketing & Sales Strategy

How we will reach families and referral sources.

Referral sources. We will meet pediatricians, nurse practitioners, school counselors, early intervention coordinators and developmental specialists, bring them a one-page referral form and offer tours. We do not pay for referrals.

Families. A friendly website with clear information, a Google business listing and reviews, parent workshops at libraries and preschools and a text line for questions.

Schools and preschools. Screening nights, teacher workshops and partnerships.

Payers. We will complete credentialing with the main insurers and Medicaid plans and accept self-pay with a sliding scale for a small number of families.

Pricing. About $116 per session (blended across payers), $245 per evaluation and $40 per group visit in Year 1.

Operations Plan

How the business will run.

Setup (the 4 to 6 months before the first session). We will form the LLC, sign the lease, build out the clinic, install the sensory gym, buy records and billing systems, apply for payer credentialing, hire and onboard therapists, write policies and buy insurance. Payer approval can take two to four months, so we plan the first months with cash and self-pay.

The clinic. About 2,500 square feet with a sensory gym, three treatment rooms, a group room, a waiting area and staff space. Rent is $4,583 a month in the plan.

Staffing. In Year 1: I serve as owner and clinical director and treat children. Therapists are paid per session, which is counted in the cost of each session (about $63 per session in Year 1). A clinic coordinator and biller and a part-time front desk assistant run the office. A therapy assistant joins in Year 2, and we add assistants and therapists as the caseload grows.

Billing. We bill insurers and Medicaid through a billing service. About 14% of annual sales is owed to us at any time, because payers pay about 50 days after the visit.

Safety and privacy. All staff pass background checks and training in child safety, infection control and privacy. We keep records securely and share information only with consent.

Insurance. We carry professional and general liability, abuse and molestation, property and workers' compensation insurance. Insurance is about $9,000 a year in Year 1.

Management & Organization

The people who will run Little Steps.

Dr. Priya Nair, owner and clinical director. A licensed occupational therapist with a clinical doctorate and 12 years in pediatric therapy, including five years as a clinic director. She leads clinical quality, hiring, referrals and finance and treats children. (Replace this paragraph with your own background.)

Therapists (paid per session). Occupational, speech-language and physical therapists who evaluate and treat.

Clinic coordinator and biller. Schedules, verifies insurance and manages billing.

Front desk assistant (part-time). Welcomes families and keeps the clinic running.

Therapy assistant (from Year 2). Works with therapists on sessions and groups.

Outside advisors. A pediatrician, an attorney, an accountant, an 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: owner and clinical director $75,000, clinic coordinator and biller $40,000, part-time front desk assistant $24,000 and therapy assistant $38,000. Therapist pay is counted in the cost of each session. Replace them with the pay you can offer where you live.

Milestones Narrative

Our goals and when we plan to reach them.
- Before opening (4 to 6 months ahead): sign up at least 30 waiting families, get letters of interest from at least 4 referral sources, submit payer credentialing, get equipment and lender quotes, form the LLC, get an EIN and open a business bank account. Sign the lease only after the lender's commitment is in hand.
- Year 1: about 3,600 therapy sessions, 260 evaluations and 1,200 group visits; $529,300 in sales and a loss of about $88,600.
- Year 2: about 6,400 therapy sessions and the first profit; $969,539 in sales and a profit of about $58,100.
- Year 3: about 8,400 therapy sessions; $1,309,869 in sales and a profit of about $146,600.
- Year 4: about 9,800 therapy sessions; $1,574,332 in sales and a profit of about $216,500.
- Year 5: about 10,800 therapy sessions; $1,786,642 in sales and a profit of about $254,500.
Growth depends on winning and keeping customers, so treat the later years as goals, not promises.

What we check every week: sessions per week, wait time to evaluation, cancellations, days to get paid, therapist turnover, family satisfaction and cash in the bank.

Funding Request

How much we need and how we will use it. Total we are raising: $340,000.

How we got that number. The Funding Need Calculator in this plan adds up three things:
- Startup costs of $159,200, listed item by item in the Startup Costs section: $62,000 for sensory gym and treatment room equipment: swings, climbing, balance and fine motor tools; $18,000 for therapy furniture, toys, assessments and speech materials; $12,000 for electronic health record, billing system, computers and phones; $38,000 for clinic build-out: treatment rooms, a waiting area, safety flooring and a sensory room; $9,200 for lease security deposit and first month of rent; $3,000 for business license, payer credentialing and enrollment fees; $5,000 for attorney and accountant: consent forms, privacy policies and setup; $6,000 for sign, brochures for referral sources and a website; $6,000 for staff background checks, training and the first insurance payments.
- The cash the business uses before it breaks even, about $89,346: because payers pay about 50 days after the visit and credentialing takes months.
- A cash cushion of about $68,750: three months of Year 1 operating costs.
- Together that comes to about $317,296, rounded up to the nearest $500: $317,500.
We are raising $22,500 more than that, $340,000 in all, to cover the loan payments and the extra cash the early years take. With this funding, the lowest year-end cash balance is about $44,000, at the end of Year 1.

Where the money comes from:
- My own money: $80,000.
- SBA 7(a) loan for startup and working capital: $260,000.

Kind of funding we are looking for. An SBA 7(a) loan through a bank or community lender, plus our own equity. Lenders for a therapy clinic look at the owner's experience, the referral letters, the credentialing plan and a cash plan for the payer delay.

How we will pay it back. We expect a loss of about $88,600 in Year 1 and a profit of about $58,100 in Year 2, then a profit of about $146,600 in Year 3, a profit of about $216,500 in Year 4 and a profit of about $254,500 by Year 5. With this funding, the business has money in the bank at the end of every year of the plan. The loan is planned at sba 7(a) loan for startup and working capital at 12.75% over 10 years, about $3,844 a month. That is about $3,844 a month in all, and it 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: a personal guarantee, a lien on the equipment and business assets and the signed lease.

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: start with a smaller space and self-pay and school contracts while credentialing is pending.
- Phase 2: once you are credentialed with the main payers, add therapists 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, license and certifications.
- 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).
- The lease or lease option and a floor plan.
- Equipment quotes.
- Your payer credentialing applications.
- Insurance quotes or proof of insurance.
- Letters of interest from referral sources and your waiting list.
- Your consent and privacy forms.
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):
- Therapy Sessions (OT, Speech and PT, blended): about $116 in Year 1, rising to $131; about $63.00 in direct costs, rising to $72.29; about 3,600 in Year 1, growing to 10,800.
- Evaluations: about $245 in Year 1, rising to $276; about $118.00 in direct costs, rising to $135.41; about 260 in Year 1, growing to 680.
- Group Classes (per child-session): about $40.00 in Year 1, rising to $45.02; about $17.00 in direct costs, rising to $19.51; about 1,200 in Year 1, growing to 4,200.
- Therapy sessions about $116 in Year 1 (a blend of payers) with about $63 in therapist pay and supplies; evaluations about $245 with about $118; group visits about $40 with about $17, rising about 3% to 3.5% a year.
- Pay (a full year, per person): owner and clinical director (occupational therapist) $75,000; clinic coordinator and biller $40,000; front desk (part-time) $24,000; therapy assistant $38,000.
- Other yearly costs in Year 1: clinic lease $55,000, utilities $7,000, professional liability, property and general insurance $9,000, billing service and electronic health record fees $21,000, marketing and referral outreach $8,000, equipment maintenance $3,000, accounting and legal $6,000, therapy supplies $9,000, licenses, credentialing and continuing education $4,000, payroll taxes and benefits (staff) $14,000. These grow between 3% and 12% a year.
- Startup costs and equipment ($159,200 in Year 1, then $4,000, $4,000, $5,000, $5,000) are spread evenly over five years in the plan's books.
- Customers and payers pay about 51 days after service. Income tax at 21%.
- Every dollar amount is an estimate. Replace them with your own quotes and research.

Startup Costs