and Equipping Your Chiropractic Facility Guide Guidel.pdf ·...

Planning and Equipping Your

Chiropractic Facility Guide

Welcome to the ScripHessco Planning and Equipping your Chiropractic Facility Guide ScripHessco is pleased to present our “Planning and Equipping your Chiropractic Facility Guide” to help assist you in opening your chiropractic office. Whether you are opening your first office or opening satellite offices, this hands on workbook lets you apply your expertise with some guidance from a company that’s been in the chiropractic business for more than 40 years. This guide was designed to provide a chiropractor with guidance in selecting the right equipment for their new clinic or remodeling their current facility. In addition the booklet will assist you in determining the best layout for your situation and the equipment you have selected. The booklet includes the following:

1. Facility Planning – In this section we will walk you through the different rooms in your office including treatment, X-Ray suite, physical therapy and exercise/rehab room. We will list the equipment and approximate sizes of the equipment so you can use our planning grids to layout the room.

2. E-Z Quick Quote Form – If you don’t have much time just fill out the E-Z Quick Quote form and let us put together a list for you. We will quote specific brands/models when indicated. If you are not sure then we will quote the most popular equipment in that category.

3. Financing Guide – Some info on financing your office along with a form for sending in to receive a lease quote on the package you have chosen.

Need Help? When you decide on your facility plan or would like to discuss your equipment needs, please contact ScripHessco at 1-800-237-5652. One of our equipment specialists will be happy to assist your with your needs. Where to Find Equipment and Supplies All chiropractic equipment and supplies listed in this guide can be found in the ScripHessco Catalog for Healthcare Professionals. To request the latest catalog, call toll-free: 1-800-747- 3488.

How to Use This Guide

Facility Planning Detailed Instruction

1. Review the equipment lists under the room categories that are specific to your needs. 2. Refer to the ScripHessco catalog for additional information on your product choices. 3. Design your facility rooms on the planning grid(s) by outlining the room, making sure you use the correct room

dimensions before laying out the equipment. Be sure to include doorways, storage areas, electrical outlets and other built-in features (for example sinks, cabinets, desks etc.). Exact window location is important in your X-Ray suite. Use scissors to cutout the equipment and then use a tape or a glue stick to place on the grid.

4. Make several copies of the planning grids so you can experiment with different layouts. Each square of the planning grid is equal to 12” and the equipment cutouts are to scale with this grid. For equipment or items that there is no cutout for simply use a felt tip marker to black out the appropriate sized area.

5. The major equipment has average sizes provided. For sizes on specific equipment please refer to your ScripHessco catalog. For X-Ray suite call 877-717-2225 provided to consult with an X-Ray specialist for planning that room.

6. Anytime during your process please feel free to call your ScripHessco equipment specialist at 800-237-5652 to help with the process.

E-Z Quick Quote Detailed Instruction

1. Go through each room checking off the desired equipment you want quoted. In the treatment table section you will choose from a category, a type and the options desired. You may choose all in each column that apply. i.e. You may want a refurbished hylo so check both the hylo and the refurbished boxes.

2. When you want a specific make and model of equipment make note of that in the space required. 3. Use your ScripHessco catalog as a reference. 4. There are ScripHessco reps available for consultation on the equipment. Check the ScripHessco catalog for the

contact information for the rep in your area or just call 800-237-5652 to talk directly to an equipment specialist. For X-Ray call our national X-Ray manager at 877-717-2225. He will be able to help you to choose the best equipment for your situation. He will also help design and draw up your X-Ray room and help with leading requirements, electrical, plumbing specs, etc.

5. Fill out the entire contact form as best you can. 6. Fax the completed form to 866-590-5822. We will complete and fax, email or mail a completed quote.

Financing Guide Detailed Instruction

1. Read through the leasing information and feel free to call your Bankers Leasing Rep with any questions concerning the benefits of leasing or conventional financing.

2. If you choose to lease your equipment fill out the information form and fax it to 866-590-5822. 3. If you questions on financing call Bankers Leasing at 800-247-8136.

FACILITY PLANNING

WAITING ROOM A typical sized waiting room of 6 chairs is normally sufficient but if you are planning on a high volume practice you may need more. Make sure you leave room in waiting room area for, at least, one product display. Typically one rack of pillows plus either a shelving unit or just the use of the counter space is sufficient. This is a must. Offering quality products to your patients will solidify your position as their healthcare provider, increase patient referrals and add revenue to your office. There are no negatives. RECEPTION/INSURANCE/FILING AREA Openness for this area works the best and is most efficient. The open space provides a friendly, inviting atmosphere. Your front desk CA should have a clear view of the waiting area so they can greet each patient. Within a few feet any direction your front office CA will have access to the telephone, computer, fax, filing area, copier, appointment book and any other tools they may need. Make sure there is a fairly large countertop area for the patient to sign in and sufficient space for literature and retail countertop displays for smaller retail product offerings.

DOCTOR’S PRIVATE OFFICE A Private doctor’s office is probably a necessity but do not devote much room to it. You don’t need a huge private impressive office with a big desk. The private office is your workroom rather than a place to impress patients. The patients are better served if you put your money into treatment equipment and in to the consultation/exam area where you spend the majority of the time with them on their visit.

Product Product # Source Average Dimensions

Waiting Room Chairs – N/A at ScripHessco (see local office supply) N/A N/A 20”L x 20”W End Tables – N/A at ScripHessco (see local office supply) N/A N/A 24”L x 24”W Literature Rack Various Scrip Catalog 78”L x 22”W Plants – N/A at ScripHessco (see local office supply) N/A N/A 18”L x 18”W

Retail Product Display Various Scrip Catalog 72”L x 28”W x 18” D


Doctor’s Desk – N/A at ScripHessco (see local office supply) N/A N/A Various Doctor’s Chair – N/A at ScripHessco (see local office supply) N/A N/A 22”L x 22”W Side Chair – N/A at ScripHessco (see local office supply) N/A N/A 20”L x 20”W Bookcase/Storage – N/A at ScripHessco (see local office supply) N/A N/A 12”L x 36”W


Desk – N/A at ScripHessco (see local office supply) N/A N/A Various Filing Cabinet – N/A at ScripHessco (see local office supply) N/A N/A Various Copier/Stand – N/A at ScripHessco (see local office supply) N/A N/A Various Storage – N/A at ScripHessco (see local office supply) N/A N/A Various

TREATMENT ROOM(S)

In the treatment/adjusting room(s) you should strive for efficiency and energy conservation. The best way to accomplish this is to not have to move the patient. Choose a table, if at all possible, that will fulfill all of your needs. For instance, if you use a drop technique and a low force technique then an elevation/drop table might work fine for both. You perform the low force technique at the higher level and the drop technique at a lower height. This is also ideal for elderly or handicapped patients or if you have two doctors that adjust in the same room that are different heights. In addition the table should qualify for a 50% Handicapped Access Credit because of the elevation feature. When looking for an adjusting table the biggest mistake is getting oversold. Models and options are endless. To avoid paying for features you don’t need first spend some time and write out the features you need. If you don’t know their name just describe what you need to accomplish. You dictate the options to the salesperson and let them give you the models that fit those specs. Unnecessary table features cost more, complicate things and may provide more opportunity for service problems in the future. One way to save money is to purchase a refurbished table instead of a new one. But be careful when purchasing used tables. All refurbished tables are used but not all used tables are refurbished. Refurbished tables can provide equal or near equal quality at a 40-60% savings over new. Used tables are sold as is versus refurbished which are stripped down to the base and rebuilt to your specifications. New covers are installed in your choice of colors. A good refurbished table will look and perform like a new table.

PHYSICAL THERAPY/REHAB EQUIPMENT SUITE

Product – See Current ScripHessco Catalog for Page# Product # Source Average Dimensions

HyLo Adjusting Table – Operates from standing position to flat position making it easier for an injured patient to be adjusted.

Various Scrip Catalog 84”L x 22”W

Elevation Table – Starts at low position and can be elevated to higher levels allowing different height doctors using different techniques to work on the same table. Also allows a severely injured or handicapped patient to easily get on the table.


Flexion Table – Pelvic section of the table flexes downward for manipulation of the low back.


Stationary Drop Table – Sections of the table drop to perform

specific adjusting techniques. Various Scrip Catalog 78”L x 22”W

Flat Treatment Tables Various Scrip Catalog 72”L x 28”W

Specialty Table – Table used with a specific technique. i.e. Activator methods, side posture, upper cervical Various Scrip Catalog Various

Doctor’s Stool Various Scrip Catalog 18” Round


Muscle Stimulator/Ultrasound Combo – Provides electrical muscle stimulation in combination with ultrasound deep heat therapy.

Various Scrip Catalog 12”D x 18”W

Muscle Stimulator – Provides electrical muscle stimulation through single or multiple channels.

Various Scrip Catalog 12”D x 12” W

Ultrasound – Provides deep tissue heat. Various Scrip Catalog 12”D x 12”W Low Level Laser Therapy Various Scrip Catalog 12”D x 18”W Heating Unit for Hot Therapy – moist heat therapy Various Scrip Catalog Various

Flat Treatment Tables – For Therapy/Exam Various Scrip Catalog 72”L x 24”W

Mobile Treatment Cart Various Scrip Catalog 18”D x 24”W Intersegmental Traction Table – Provides traction of the spine through lift and separation via mobile roller system that travels up and down the spine.


Traction Table – Provides long axis traction via traction system that includes table, traction head and traction harness


If you plan on making physical therapy and rehab a significant portion of your practice then a therapy suite will be needed. A therapy suite consists of a large open room which is normally partitioned using therapy curtains. If you want to use physical therapy on a limited basis you may do it in the treatment rooms using a mobile treatment cart to take the equipment from room to room or purchase separate units, some of which may be mounted to the wall, in each room. This may slow down the flow and limit the number of patients you can see in a day. Rehab may be done efficiently using low tech bands and tubing in conjunction with exercise balls, stability trainers, weight cuffs etc. Decompression/traction tables provide an excellent therapy that provides a proven method of treatment. Do not be oversold by many of the super expensive decompression tables on the market. MASSAGE THERAPY ROOM Massage can be a great compliment to your chiropractic business. Room size for an efficient massage room needs to provide 2 ½’ to 3’ of room around the massage table for the therapists to work. This would dictate a room size of 8’ to 9’ wide by 11’ to 12’ feet long. This room may also be used for physical therapy, exam or acupuncture. X-RAY ROOM

Spinal Decompression Table – Provides spinal decompression through precise, smooth traction.


Exercise and Rehab Units – Utilizes various hardware coupled with exercise tubing and attachments to allow various exercises to be performed in a small area at a reasonable cost

Various Scrip Catalog Approx. 4’ x 6’ area.

Treadmill Various Scrip Catalog 74”L x 36”W Exercise Bike Various Scrip Catalog 63”L x 27”W Elliptical Various Scrip Catalog 78”L x 26”W Rower 849 0331 Scrip Catalog 76”L x 20”W Stretch Partner 849 0019 Scrip Catalog 48”L x 37”W Total Gym 849 0417 Scrip Catalog 122”L x 24”W Low Tech Rehab – exercise balls, stability trainers, weight cuffs, medicine balls, etc.

Various Scrip Catalog Various

Therapy Curtains and Track 880 0021, 880 0022

Scrip Catalog Various


X-Ray Machine (traditional) – Standard Frequency, High Frequency, Single or Three Phase X-Ray Machine.

Various Scrip Catalog Call for Assistance

X-Ray Processor – Processes X-Ray film. Various Scrip Catalog 33”L x 24”W Digital CR X-Ray – Pictures are processed without the use of a processor and are stored digitally on your computer. CR Digital systems utilize a traditional X-Ray to take the pictures then the information is transferred to computer using plates. No processor is needed.


Digital DR X-Ray – Dr digital X-Ray skips the plated transfer process and the X-Ray image goes directly to the computer. Image acquisition is quicker than with CR.



Massage Table Clinical – Non-portable tables Various Scrip Catalog 73”L x 30”W Massage Table Portable Various Scrip Catalog 73”L x 30”W Massage Chair Various Scrip Catalog 30”L x 20”W Therapy Stool Various Scrip Catalog 18” Round Massage Units Various Scrip Catalog 78”L x 26”W

First of all make sure you contact your ScripHessco X-Ray equipment specialist before you sign a lease on a space. The X-Ray suite will have specific electrical, plumbing and size requirements that may not be available in the space. Electrical and plumbing can be very expensive if it is not readily available. Room requirements are typically about a 10’ x 10’ or 8’ x 12’ room but your rep will help you design that space. There are many choices when purchasing X-Ray equipment. New versus used? Traditional versus digital? In some cases standard frequency X-Ray will still do what you want it to do and fit into your budget a little better. When looking used the “if it looks too good to be true then it probably is too good to be true” principle is true in most cases. There are a lot of good used systems available that can save you money but purchasing the wrong unit will just cost you more in the end. Another factor is to make sure that the unit you purchase now can be upgradable to digital in the future. You want to make sure you don’t have to dispose of the unit you purchased and by all new when it is time to upgrade. There are reasonable upgrade packages available that can be added to your existing system, if you have the right system. You want to make sure your room is designed to accommodate a digital system, if you decide to upgrade in the future. If you can afford it then going digital from the beginning is great, but if you can’t, you want to be able to do it in the future without disposing of your system or moving to a new location because your current one isn’t large enough. Call 877-717-2225 to speak to a X-Ray specialist who can assist you with the type of equipment you need and help with room design.

These are just a few examples of traditional X-Ray designs. Please call 877-717-2225 to speak to an X-Ray specialist that can assist you in designing a X-Ray suite to

fit your specific needs.

Equipment Cut-outs – Cut out shape and place in the appropriate room to get an idea for the layout of the room. Sizes are to scale but may vary slightly with actual equipment dimensions. For products that do not have cutouts simply color in the area with the correct dimensions.

84” x 22” HyLo Table

78” x 22” Flexion Table, Stationary Drop table

72’ x 24” PT/Exam Table, Elevation Table

78” x 28” Intersegmental Traction

72” x 30” Massage Table – Clinical and Portable

107” x 28” Traction/Decompression Table

18” Round Stool 18” x 24” Mobile Treatment Cart 20” x 20” Waiting Room Chair, Side Chair or Dr’s Chair

24” x 24” End Table

28” x 18” Retail Display 30” x 20” Massage Chair

Example of a Room Layout

THERAPY CURTAIN GRID

Draw the room then draw the curtains on the grid. Add the written dimensions to each segment. Although a corner will curve draw them at right angles on the grid. Leave a space where you do not want them to be a solid curtain

Ceiling Height: __________ Color (see catalog): ________________

Mesh Desired (for light and air flow, suggested): YES NO

E-Z Quick Quote Fill out the E-Z Quote sheet and we will send you a complete quote with financing options. We will quote used or refurbished options when available in addition to the prices for the new equipment. Use your latest ScripHessco catalog to help you choose the best equipment for your office. Items listed below that are underlined are items that ScripHessco cannot provide.

Fax Completed Quote to 1-866-590-5822. Call 1-800-237-5652 with any questions.

WAITING ROOM

Notes on Waiting Room Equipment and Supplies (list additional equipment and supplies for the treatment room desired)

PERSONAL INFORMATION

Applicant’s Name:

Street Address:

City, State, Zip:

Phone: Cell: Fax: E-mail:

BUSINESS INFORMATION

Business Legal Name: Projected Start Up Date:

Business Address:

City, State, Zip:

Business Phone: Business Fax:

Waiting Room Chairs Brochures Plants

End Tables Artwork for the walls Clock

Coat/Hat Rack Retail Pillow Display

Magazine Rack Shelving Unit for Retail Product

Literature/Brochure Rack Retail Product – list below out of catalog

RECEPTION/INUSRANCE/FILING AREA Notes on Reception Room Equipment and Supplies (list additional equipment and supplies for the treatment room desired)

DOCTOR’S PRIVATE OFFICE

Notes on Doctor’s Office Equipment and Supplies (list additional equipment and supplies for the treatment room desired)

Computer Appointment Book Filing Folders - Regular

Software HCFA Insurance Forms Labels

Printer Filing Cabinet – Regular Files CPT Code Book

Telephone Filing Cabinet – X-Ray Files Garbage Can

Copier Pegboard/Ledger Card System

Sign In Form Filing Envelopes – X-Ray

Desk Garbage Can Doctor’s Chair

Computer Clock Side Chair

Printer Artwork for the Wall

Telephone Book Shelf

TREATMENT ROOM(S) Check the box of the equipment you want quoted. If you know exactly what table you want just write out the description complete with options. i.e. Lloyd Galaxy HyLo with manual drops. If you don’t know the model or brand, check type of table and options desired and we will provide several alternatives. There can be more than one option in each category. i.e. auto flexion and manual drops or hylo and refurbished. There are blank spaces to write in options not listed. Table 1 Description _________________________________________________________________________

________________________________________________________________________________ Table 2 Description _________________________________________________________________________

________________________________________________________________________________ Table 3 Description _________________________________________________________________________

________________________________________________________________________________

Table Category Table Type Table Options

Stationary Manual Drop Table Cervical Drop

HyLo Auto Drop Table Thoracic Drop

Elevation Manual Flexion Table Lumbar Drop

Refurbished Auto Flexion Table Pelvic Drop

Activator Table Chest Breakaway













Miscellaneous Treatment Room Equipment and Supplies

Notes on Treatment Room Equipment and Supplies (list additional equipment and supplies for the treatment room desired) EXAM/DIAGNOSTIC Check the box of the equipment you want quoted. Notes on Exam/Diagnostic Room Equipment and Supplies (list additional equipment and supplies for the exam/diagnostic room desired)

Flat Exam Table Blood Pressure Unit Goniometer

Elevation/Exam Table Stethescope Tuning Forks

Diagnostic Set Dynamometer – Grip Strength Thermometer

Scale Neurological Hammer

Inclinometer Pinwheel

Folding Wall Desk Doctor’s Stool Tepper Wedge for Anteriorities

Activator Adjusting Instrument Germicidal Cleaner Posters

Spine Model Hand Sanitizer Vinyl or Latex Gloves Gloves Pelvic Blocks Headrest Paper – rolls Biofreeze

Block Board Headrest Paper – 12 x 12 squares

PHYSICAL THERAPY SUITE If you know exactly what equipment you want just write out the description. i.e. Chattanooga XT 2 channel combination. If you don’t know an exact model or brand, check the equipment desired and indicate quantity. There are blank spaces to write in options not listed. Treatment/Exam Tables Description ________________________________________________________________________________ Electrotherapy Unit Description ___________________________________________________________________________________________________________ Other ___________________________________________________________________________________________________________

Miscellaneous Physical Therapy Suite Equipment and Supplies Notes on Physical Therapy Suite Equipment and Supplies (list additional equipment and supplies for the treatment room desired)

Treatment/Exam Tables Electrotherapy Units Other

Rectangular Exam/PT Table 2 Channel/4 Pad Muscle Stim Only Traction Table

Contour Bench 4 Channel/8 Pad Muscle Stim Only Decompression Table

Contour Bench w/tilt head 2 Channel Combo Stim and Ultrasound Hydrocollator – Hot Packs

Elevation Table 4 Channel Combo Stim and Ultrasound Intersegmental Traction Table

Laser Therapy Stool

Diathermy

Cart(s) Paraffin Bath Kinesio Tape

Reusable Electrodes Headrest Paper – 12 x 12 squares Therapy Curtains (draw on planning grid)

Ultrasound Gel Gowns Biofreeze

Ultrasound Lotion Posters

Velcro Nylatex Wraps Germicidal Cleaner

Cold Packs Hand Sanitizer

Lotion/Gel Warmer Leg Bolster(s)

Hot Pack Covers Neck Bolster(s)

X-RAY SUITE Check the box of the equipment you want quoted. You may have more than one check mark in each column.

Miscellaneous X-Ray Suite Equipment and Supplies Notes on X-Ray Room Equipment and Supplies (list additional equipment and supplies for the exam/diagnostic room desired)

Fold up Wall Desk ID Imprinter L/R Marker Set

Exam Gowns Blank Form ID Cards Safelight 14 x 36 Cassette and Screen Printed ID Cards Filtration System

14 x 17 Cassette and Screen Safelight

10 x 12 Cassette and Screen View Box

8 x 10 Cassette and Screen Marking Pencils

X-Ray Film Film Storage Bin

X-Ray Chemicals Lead Shield with Window

X-Ray Category X-Ray Type Processor

New Standard Frequency Standard Plumbing

Used High Frequency Closed Loop No Plumbing Needed

14 x 17 CR Digital

14 x 36 DR Digital

Benefits of Leasing

Finance 100% of Equipment Costs – no upfront or out-of-pocket expense Pays for Itself – use of the equipment adds value to your business and ultimately your bottom line Conserves Working Capital – use someone else's money to get the equipment you need Preserves Existing Line of Credit for other operational uses No Advanced Payments Lower Monthly Payments – Allocate your funds over time with a fixed rate Flexible Payments Schedules and Lease Terms Provides protection against obsolescence and enables you to upgrade your equipment NO Pre-payment Penalties

Questions to ask Your Lessor

Does the Lessor require advanced payments or security deposit? Does the quoted payment include all applicable taxes? Are the end of lease options clearly defined? Can I get a separate document explaining the purchase option? What are the terms regarding the return of the equipment once the term is up? Does the lease automatically renew?

If you have any questions concerning leasing call Bankers Leasing at 800-247-8136.

Bankers Leasing Company 10052 Justin Drive, Suite A, Urbandale, IA 50323 (515) 334-0880 (515) 334-0892 Fax (800) 247-8136 (800) 342-6855 Fax

FOR BLC USE ONLY

Taken _____________________________

Review ____________________________

Review ____________________________

Decision ___________________________

This application is true and correct, and is given to obtain credit from Bankers Leasing Company, Urbandale, Iowa or its designee, assigns or potential assigns for the purpose of extending credit to the applicant. My Signature on this application authorizes all bank and trade references to release relevant information for the purpose of obtaining credit. Signature: __________________________________________________ Date: ________________

BUSINESS INFORMATION

Business Legal Name: Contact:

Business Address:

City, State, Zip:

Country: State of Incorporation: Years in Business: Tax ID #:

Business Telephone: Business Fax:

E-mail Address: Web Address:

Business Type: ____ C. Corporation ____ S. Corporation ____ LLC ____ Partnership ____ Sole Proprietor

PERSONAL INFORMATION

Applicant’s Name: Social Security Number:

Street Address:

City, State, Zip: Telephone:

Co-Applicant Name: Co-Applicant Social Security Number:

Business Type: ____ DC ____ PT ____ MD ____ DDS ____ Pharm. D. ____ Other (Please Specify)

FINANCIAL INFORMATION

Bank: Account Number(s):

Bank Address: City: State: Zip:

Telephone: Bank Contact and Phone Number:

EQUIPMENT INFORMATION

Equipment: Cost:

Supplier of Equipment:

Salesperson: Telephone:

Lease Terms: _________ 10% Purchase Option _________ $1.00 Buyout Option

Term Requested: ______ 12 ______ 24 ______ 36 ______ 48 ______ 60

NOTES

Section 44

Disabled Access Credit

Form 8826

Disabled access credit is for eligible small businesses that elect to apply a credit against income tax of 50% of the amount of the eligible expenditure for the tax year that is over $250.00 and not more than $10,250.00. Thus the maximum amount of the

credit is $5,000.00.

The term “eligible access expenditures” means amounts paid or incurred by an eligible small business for the purpose of enabling such eligible small business to comply with applicable requirements under the Americans with Disabilities Act of

1990. Elevation tables and hylo tables typically qualify for this credit. Always check with your accountant concerning the application of this credit.

Form 8826 is the correct IRS form for this tax credit (see attached). Refer to tax code section 44 for more detailed information.

Section 179

Special Depreciation Rule

Under Section 179, up to $139,000 of the cost of new equipment and software purchased by the taxpayer is completely

deductible in the year it is placed in service.

For example, if a doctor purchases $100,000 worth of equipment in the year 2012 the doctor would be able to take a full deduction on their 2012 tax return. Assuming they are in a 39% tax bracket it would reduce the tax due on their personal or

corporate tax return by $39,000.

See www.section179.org for more information concerning the Section 179 deduction.

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