We work with practice owners across Nashville, Brentwood, Franklin, Murfreesboro and the wider Middle Tennessee market.
Nashville is the headquarters city of the healthcare services industry. The groups acquiring dental, veterinary and optometry practices, the private-equity firms behind them, and the lenders financing the transactions are largely based here or run their deal teams here. Practice owners in Middle Tennessee are approached earlier and more often than owners almost anywhere else.
That changes what the numbers have to be ready for. An owner who has never considered selling still needs a normalized earnings figure, because the first serious conversation usually arrives unannounced and the practices that negotiate well are the ones whose books already tell a clean story.
What that means for the numbers.
- Normalized owner earnings, kept currentNot assembled the month a letter of intent arrives. Owner compensation set to market, capital spending on a depreciation schedule, deferred revenue released as care is delivered.
- Growth capital and the second locationMiddle Tennessee is adding population faster than most metros. Expansion decisions here are frequent, and they are financing decisions before they are clinical ones.
- Rising occupancy costCommercial rent in Nashville and the inner suburbs has moved sharply. Occupancy as a percentage of collections deserves closer attention than the national benchmarks assume.
- No state income tax, which changes entity mathTennessee has no personal income tax on wages, which alters the owner compensation and entity questions relative to most states.
- A labour market competing with hospital systemsYou hire clinical and administrative staff against one of the densest concentrations of healthcare employers in the country.
What a CFO engagement covers here
Accurate books closed on an agreed date, a monthly conversation about what the numbers mean, and the analysis behind hiring, expansion and eventual transfer.
What changes in this market is urgency. Owners here field acquisition interest sooner and more often, and the gap between a practice with clean normalized earnings and one without is measured in multiple rather than in bookkeeping tidiness.
Frequently asked.
Do you work with practices outside Nashville?
Yes. The firm works with practice owners nationally. Nashville is where we are based and where a meaningful share of our conversations start.
Can you meet in person?
For practices in Middle Tennessee, yes. Most of the monthly work happens remotely regardless, because it runs on your accounting file and practice management reporting.
Do you help with an acquisition offer?
We build the owner-earnings picture a buyer will diligence and tell you what the practice looks like from their side of the table. Brokerage stays with your broker.
General information for practice owners, not accounting, tax, legal, valuation or investment advice for your situation. MedPraxis CFO is not a CPA firm, a registered investment adviser, or a business broker. Talk to your own CPA, attorney or adviser before acting on anything here.