Buying a chiropractic or therapy practice in Southwest Florida

• Referrals from many sources, so losing one orthopedic group or one family doctor doesn't empty the schedule.
• Patients who finish their plans of care, with few cancellations and no-shows.
• A mix of payers, without heavy dependence on auto insurance claims.
• Several clinicians treating patients, not just the owner, and therapists who have stayed for years.
• Documentation that clearly supports why each visit was needed, which is what auditors look for.
• For cash and membership businesses: a steady membership base with low monthly cancellations.
• A front desk that checks benefits before the first visit, so patients aren't surprised by bills and the practice isn't chasing unpaid balances.
• Equipment that fits the work, such as treatment tables and exercise space, in good repair.

If the practice treats car accident patients, find out how much revenue comes from PIP. Florida's no-fault law pays only when care starts within 14 days of the accident. It pays less when no emergency medical condition is found, pays only certain kinds of providers, and excludes massage and acupuncture. Auto insurers can also dispute or audit these claims, so ask for the history.

Have someone review a sample of charts to make sure the plans of care and visit notes support the billing. Each clinician has to be approved by each insurer individually (credentialing), so ask how long it will take to add new clinicians under your ownership. Check for prepaid packages and memberships you'll have to honor. If doctors who send patients own any part of the practice, that raises referral law questions, since Florida's Patient Self-Referral Act covers physical, occupational and speech therapy. Offices with x-ray machines register them with the Department of Health. If you buy the assets, you register the machines within 30 days and before using them; if you buy the company, you report the changes within 30 days (rule 64E-5.511).

• Where do most new patients come from, and which referral sources have grown or faded lately?
• How many visits does a typical patient complete, and how often do patients stop coming early?
• What share of your work involves auto accident or workers' compensation claims?
• How many of the clinicians are employees, and how long have they been with you?
• Do you sell prepaid packages or memberships, and how many visits are still owed?
• Have any health or auto insurers audited your claims or asked for money back?
• How do you see your own role after a sale, and would you keep treating patients for a while?

This region covers Lee, Collier, Charlotte, Sarasota and Manatee counties on the Gulf coast and Hendry, Glades and DeSoto inland: Fort Myers, Cape Coral, Naples, Bonita Springs, Punta Gorda, Port Charlotte, Sarasota, Venice, Bradenton, LaBelle, Clewiston, Moore Haven and Arcadia. The coastal economy runs on people who choose to live or spend the winter here: retirees, seasonal residents, and the construction, real estate, health care, financial and home services that follow them. Tourism, golf and boating add to it.

Inland, the economy is agricultural: sugarcane around Clewiston, citrus, cattle and vegetables, with Immokalee in Collier County a center for farm work. The building trades, pool, landscaping and pest control companies, property managers, medical and dental practices, and marine businesses tend to do well along the coast.

This is one of Florida's most seasonal markets. From roughly January through April, restaurants, shops and service companies run at full speed. Summers are slower, so look at monthly revenue, not only the yearly total. The coast has taken two major hurricanes in recent years: Ian came ashore at Cayo Costa in Lee County in September 2022, and Milton at Siesta Key in Sarasota County in October 2024. Rebuilding brought a wave of work for contractors that won't last forever, so ask how much recent revenue came from storm repairs. Insurance costs and flood zones weigh on every property.

Housing costs near the coast make hiring hard, especially around Naples. New communities east of Interstate 75 in Lee, Collier, Charlotte and Manatee keep service companies busy.