Jill Toliver, FNP and Gretchen Moen, PNP Owners, Nurse Practitioners Mendota Health, Eagan, MN

How did you finance your start up and how do you maintain your finances?

The idea has been in the works for the past five years. Gretchen wanted to have a clinic for both women and children, based on her experience in the pediatric clinic where sick parents would bring in sick children and were unable to seek care for themselves. She knew of a few other nurse practitioner run clinics in the area and felt that it would be a natural step to create a nurse practitioner owned clinic.

After finding there was a need and a desire for the type of practice in mind, Gretchen hired Health Care Management, Inc. a firm specializing in launching healthcare businesses, health care billing and health care administration, to assist with securing finances, payer contracts, credentialing, equipment and other resources needed to build a practice.

Our consultant also found out that it would be necessary to "sell" the idea for our NP-run clinic here in Minnesota, as it is an innovative idea, and there were not any other current NP practices in the state that they could find.

As the result, we also hired a public relations/marketing person who is currently developing a logo and contacting newspapers. We hope to sell their "story", rather than simply purchasing advertisements. The clinic will also have a web site at http://www.mendotahealth.com. The clinic will also be hosting an Open House which will be a “family fun night” on December 12 with activities for the entire family. Ideas for activities include: a book fair/reading with a children’s author, hot air ballon rides, and reindeer.

The consulting firm, HealthCare Management Resources, helped us determine the amount of financing needed and also made the contacts with the banks. Some personal income was needed, especially during the research phase. Each owner/shareholder paid a nominal sum for their initial shares. There was also a large investment of sweat equity by each of the owners. The biggest asset, the business's Accounts Receivable (the potential of earning) secures the loan. The building is under a renewable 10-year lease, which incorporates the build out cost, which is tax beneficial to Mendota Health. All building expenses are included in the lease except for telephone and electrical charges. The equipment loan is termed within 2 months of startup with the operating loan terming at the end of the first year.

We wanted and found staff that supported the idea of the NP owned and managed clinic. Space issues were based on the number of providers per day and required support staff. Much of the equipment was secured through donations and "finds" by the owners, purchases at discount stores, and buying used/refurbished medical equipment. The owners worked with 4 major equipment and supply businesses to secure the right equipment for the intended services. The computers, copiers, telephones, printers, and other business technology were either leased or purchased new. Billing issues focused generally on developing a charge document that fit pediatric,women, and family specialties. The bulk of the billing responsibilities are outsourced. Administration is also outsourced but day-to-day office management is part of the owner's responsibility at start-up. Eventually we would like to have an office manager.