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

solutions on June 17, 2025

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