1. ALL THE TREATMENT IS DONE
You can run an unscheduled or untreated treatment plan report that should give you an idea of treatment on the books. You can also look at the number of true active patients and compare that to the annual collections to see if there is potential treatment. If annual collections are $500,000 and there are 1,500 active patients, there's a good chance there's work to be done. If annual collections are $500,000 and there are 400 active patients, start asking questions
2. OVERPAID STAFF
Annual staff salaries typically run around 20 to 25% of the annual collections. When you get up to the 35 to 40% area, you are in for some bad news for the staff. An older practice with long tenured staff may have dental assistants who get annual salary increases and now their making $30/hr.The same with hygienists. Or, they are receiving an incredible benefit package of health insurance, retirement plan, gym memberships etc.,This can be cured, but if you plan on keeping the staff, be prepared for a discussion on reducing benefits and/or pay.
3. OUT OF CONTROL COLLECTIONS
You can typically tell how good of a job the front desk is doing by looking at the accounts receivable balances. The total amount should not be above 125% of your monthly collections (adjusted for insurance discounts). The insurance aging report should be pretty clean with only small dollar amounts in any of the aging buckets. If the aging balance is too high, or the insurance aging is high, you will either need to retrain the front desk, or hire a replacement in the future.
4. SECRETIVE SELLER
If you are asking for reports or questions from the seller and they are giving you run around answers, you may want to think about moving on. If the tax returns do not match to the annual collections reports, something funny is going on. You should expect straight and quick answers, unless the seller is away on vacation or overly busy.
5. EQUIPMENT NOT WORKING
I am surprised how buyers don't have someone go through and make sure all of the equipment isn't working. You would hate to go in on your first day and have equipment not functioning. The equipment supply companies will typically come out at no charge and go through your equipment to make sure it's working. If it looks old and in disrepair, it will give you a good peace of mind to have it checked out.
All of these red flags can be fixed, so they are not deal breakers. But, if you do run across any of these red flags, be sure to have your team of experts, CPA, consultant, equipment rep, etc., dig a little deeper and make sure you are getting what you think you are getting.
-Rod Johnston, MBA. CMA