How We Helped a 15-Location Chiropractic Group Scale Financial Operations, Navigate Multi-

When a healthcare organization begins to scale across state lines, the financial demands quickly
evolve from simple bookkeeping to complex, multi-entity management, real estate
optimization, and tax strategy.
That was exactly the case for a 15-location chiropractic group operating across several U.S.
states when they partnered with Solutions Group Accounting Firm (SGAF).
With clinic acquisitions underway, nonprofit entities forming, and owned real estate holdings
growing, they needed a proactive, strategic finance partner—not just a tax preparer.
 
The Challenge: Disconnected Financial Systems and Untapped Tax Opportunities
The group had strong patient volume and expanding geographic reach—but their financial
infrastructure was holding them back.

Key challenges included:
  • No standardized accounting or reporting system across 15 locations
  • Multi-state operations with unclear compliance on state tax rules
  • Real estate entities with no depreciation strategy
  • New nonprofits with uncertain IRS compliance
  • Limited internal staff training on financial processes
  • No centralized tools for bill pay, expense management, or approval workflows
Without a scalable system or proactive financial oversight, their leadership team was flying blind
on performance—and leaving serious tax savings on the table.
 
Our Solution: Scalable Finance Infrastructure and Strategic Tax Advisory
SGAF engaged with the chiropractic group as their outsourced finance and advisory team,
leading a full transformation across their accounting, tax, and operational finance processes.

Multi-State Tax Compliance and Structuring
We reviewed and aligned their entity structures across states, ensuring compliance with nexus
laws, sales tax, state income tax filings, and reporting obligations. We implemented best
practices for allocating income and expenses across jurisdictions and advised on withholding for
nonresident owners.

Site-Level Class Coding for Location-Specific Visibility
To prepare for growth and improve financial reporting, we trained their in-house team on
QuickBooks Online class coding by site. This gave management clear, segmented financials for
each clinic—paving the way for smart decision-making at the location level.

In-House Staff Training for Bookkeeping Consistency
SGAF worked directly with their internal finance staff to standardize bookkeeping practices
across locations, reduce error rates, and implement monthly close procedures. Our coaching
improved internal capacity and laid the groundwork for sustainable scaling.

Systems Implementation: Bill.com and Divvy
We implemented Bill.com to streamline vendor payments and approval workflows and rolled
out Divvy to manage employee card spend with built-in class tracking by location. This allowed
for real-time expense coding, better spend controls, and seamless integration into the books.

Real Estate Tax Optimization via Cost Segregation
The group owned multiple buildings used in their practice. SGAF conducted cost segregation
studies on five properties, unlocking significant bonus depreciation and real estate tax savings.

Nonprofit Formation and IRS Compliance
We supported the creation and launch of two separately structured 501(c)(3) nonprofit entities,
handling state registrations, EINs, and successful IRS Form 1023 filings—ensuring compliance
with charitable contribution rules and unrelated business income tax (UBIT) risks.

M&A and Business Disposition Advisory
We advised the group on several clinic acquisitions and divestitures, supporting deal
structuring, tax allocation planning, and post-closing accounting setup.

The Result: Over $300,000 in Tax Savings and a Scalable Financial Foundation
With SGAF’s partnership, the chiropractic group achieved:
  • More than $300,000 in first-year tax savings from cost segregation, entity optimization, and proactive planning
  • Fully compliant multi-state tax filings and clarified entity structures
  • Unified, location-level financial reporting using class tracking
  • A trained internal finance team and standardized monthly close procedures
  • Automated workflows via Bill.com and Divvy, reducing manual inefficiencies
  • Successful formation of two nonprofit organizations aligned with their mission
The group’s leadership now meets with SGAF on a quarterly basis for tax planning, business
strategy, and financial performance reviews—transforming what was once a fragmented back
office into a unified, scalable finance operation.

Build a Financial System That Grows with Your Healthcare Business
At SGAF, we help healthcare and chiropractic groups grow with confidence. From entity
structuring and tax planning to real estate optimization and financial system design, we act as
your full-service financial department.
Avoid costly mistakes. Maximize your tax position. Build a scalable infrastructure for growth.

Schedule a Strategy Call with Our Healthcare Advisory Team Today

Tax Mitigation Strategies for High Net Worth Individuals​

High-net-worth individuals face unique tax challenges that require sophisticated strategies to minimize tax liabilities. According to the Tax Policy Center, the top 1% of earners in the U.S. pay an effective federal tax rate of over 25%, making proactive tax planning essential. Engaging in strategies like charitable giving, tax-efficient investments, and income splitting can significantly reduce this burden.

For instance, donating appreciated assets instead of cash allows you to avoid capital gains taxes while receiving a charitable deduction for the full market value of the asset. Additionally, investing in municipal bonds can provide tax-free income, while utilizing retirement planning tools like Roth IRAs can create tax-deferred or tax-free growth opportunities. Trusts, such as Grantor Retained Annuity Trusts (GRATs) and Irrevocable Life Insurance Trusts (ILITs), are also powerful tools for wealth transfer and estate tax reduction.

Additional strategies include hiring children in your business, which allows you to shift income to a lower tax bracket. Wages paid up to the standard deduction ($14,600 in 2023) are tax-free for the child, and the business can deduct these wages as an expense. This strategy can fund college savings, 529 plans, or a Roth IRA for the child, building wealth tax-efficiently. Another advanced concept is utilizing the Qualified Business Income (QBI) Deduction, which allows eligible pass-through business owners to deduct up to 20% of their qualified business income, significantly reducing the effective tax rate on business profits.

Our team works closely with high-net-worth clients to develop tailored tax plans that not only minimize current liabilities but also ensure long-term wealth preservation. By integrating sophisticated tax strategies into your financial plan, you can navigate complex tax laws and keep more of your hard-earned wealth. A proactive approach can result in significant savings, helping you maintain your financial legacy for future generations.

Quarterly Tax Planning: A Proactive Approach to Tax Planning​

Quarterly tax planning is essential for staying on top of your tax obligations and avoiding surprises at year-end. Regularly reviewing your financials and tax strategy allows you to make adjustments throughout the year, ensuring you’re taking advantage of available deductions and credits. It also helps you forecast your tax liability, so you can set aside funds for tax payments and avoid penalties.

Effective quarterly planning includes strategies like optimizing retirement contributions, such as through a Solo 401(k) plan. A Solo 401(k) allows business owners and self-employed individuals to maximize retirement savings with contributions up to $58,000 per participant (or $64,500 for those 50 and older). These contributions are tax-deferred, reducing taxable income and growing tax-free until withdrawal. Additionally, maximizing Health Savings Account (HSA) contributions provides a triple tax advantage, allowing for tax-deductible contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses.

Our quarterly tax planning meetings help clients proactively manage their tax situation, from estimating quarterly payments to adjusting withholding and planning for major expenses. By staying engaged with your tax strategy year-round, you can take advantage of opportunities such as Section 179 expensing, cost segregation studies, and R&D tax credits to reduce your tax burden. This proactive approach can help you achieve greater financial success and peace of mind.

Accurate Financial Statements: Your Key to Maximizing Tax Deductions​

Accurate financial statements are more than just numbers—they’re a powerful tool for maximizing tax deductions and minimizing your tax liability. With precise records, you can identify deductible expenses such as business travel, equipment purchases, and employee benefits. Inaccurate or incomplete financial statements can lead to missed deductions and costly errors. By investing in professional bookkeeping, you ensure that every transaction is accurately recorded, giving you the data needed for effective tax planning.

The importance of accurate financial statements extends to implementing specific tax planning strategies. For example, tracking business mileage accurately can result in substantial tax savings, especially if driving is a significant part of your business. Reimbursing business-related miles at the IRS standard rate (67 cents per mile) provides a tax-free benefit while allowing the business to claim a deduction.

In addition, properly categorizing expenses allows for maximizing deductions in areas like business education and charitable donations. Investing in continuing education related to your business can be tax-deductible, enhancing your skills and ultimately increasing profitability while lowering taxable income. Similarly, charitable contributions that meet IRS guidelines can reduce your taxable income. You can also maximize deductions by donating appreciated assets or household items.

The cost of bookkeeping is generally more than offset by the tax savings achieved through precise deductions. This means that accurate financial management isn’t just about compliance—it’s a strategic approach to enhancing your business’s profitability and financial health.