Veterinary Law Blog

9 Items to Consider When Contemplating the Sale of Your Veterinary Practice

October 27, 2021

For many veterinary practice owners, aspirations of selling your practice may be tempered by the unknowns of the acquisition process. Even when the circumstances of a potential sale are ideal, unfamiliarity with the market and sale procedures can lead to hesitancy. While timidity toward the unknown is certainly justifiable, owners should not let it stop them from becoming a participant in the rapidly growing market for veterinary practice acquisitions. While each veterinary practice sale is unique in its own right, there are also a number of procedural commonalities that appear in nearly every deal. Getting familiar with these steps and procedures may help shed some light on the selling process and relieve the effects of the acquisition unknowns:

Deciding to Sell: Behind every veterinary practice sale is the practice owner’s “Why”. The end goal for a successful veterinary practice owner is to one day sell their practice for a lucrative price and start their next chapter. For some, that next phase is complete retirement. For others, it might mean stepping away from a managerial role to focus solely on medicine, carving out more free personal time or sharing the responsibilities with a partner. Whatever the motivation may be, every sale of a practice begins with an owner’s decision to sell. 

Valuing the Practice: An owner must have a general understanding of the monetary value of their practice prior to initiating the sales process. This valuation establishes reasonable expectations of return prior to entering the acquisition market and sets a pricing standard for potential buyers.   Several key factors that are helpful in determining your practice’s value include  the practice itself, equipment, and current and potential revenue. Potential buyers will also consider gross revenue, profit and loss statements, net operating income, EBITDA (earnings before interest, taxes, depreciation, and amortization), profit margins, a good location, room to expand, a long-lasting, efficient staff, a practice owner who will stick around and great client retention.

Finding a Buyer: There are many ways in which a practice owner may come across a suitable buyer. In some cases, the buyer may be a partner or associate veterinarian in the practice. In others you may have considered selling to a corporate consolidator.   Selling to a corporate consolidator can be an excellent way for some owners to get their equity out now, with the ability to still work as a DVM for a few years after the sale.    Three things that just about every corporate consolidator is looking for in a practice – high gross revenue, profitability and location.   Knowing your options when it comes to selling your practice is a must.  Consider engaging an experienced practice broker who can help you form the best plan for you and the best plan for your practice.

Negotiate the Deal: Once a suitable buyer has been located, it is time to determine the terms of sale. What does the purchase price look like? Will the owner receive all cash at closing?   How long will the owner have to work after the sale? Are there any ownership opportunities for my associates? Should I sell or hold the real estate? What will the terms of my lease look like?    There are many moving parts that need to be negotiated before the transaction can be consummated.  

Letter of Intent: The letter of intent (LOI) is the preliminary agreement of the acquisition process which contains such salient terms as the purchase price, how the purchase price will be paid at closing, when the deal will close, the owner’s opportunity to reinvest in the buyer, the owner’s post-closing employment terms, and the terms involving the real estate. While the LOI is not a legally binding contract, it is typically used to establish both the essential terms of the transaction and the commitment of the parties to move toward a successful closing.

Due Diligence: This is the process of “looking under the hood” of the practice; the buyer will conduct an extremely detailed accounting of the assets, records, inventory, and financial standing of the veterinary practice. By conducting due diligence, the buyer is ensuring that the practice to be purchased is worth the price to be paid. For this process, the parties will want to involve industry specific accountants and legal counsel, as the closing of the deal and the purchase price to be paid is naturally contingent upon buyer’s satisfaction of the due diligence outcome.

Contracting Stage: The “Purchase Agreement” is one of the most important pieces of the entire transaction. This agreement, prepared and negotiated through each party’s respective legal counsel, will encompass the essence of the acquisition and obligations of both buyer and seller in successfully closing the transaction.

Pre-Closing Contingencies: Between the execution of the LOI and the agreed-upon closing date, both the buyer and the seller will be contractually obligated to perform a number of actions prior to the closing. These obligations may include the obtaining financing, disclosure of all practice operations, execution of employment documents and various certificates, etc. Each party’s respective legal team will be significantly involved in facilitating the drafting of documents and ensuring the satisfaction of deadlines and contingencies during this period.

Closing: The “Closing Date” is the day that the veterinary practice transaction is solidified; the seller is paid the purchase price, the buyer acquires ownership to the practice, and transaction is complete! Keep in mind that with modern technologies, a successful closing is typically accomplished electronically – gone are the days of the in person closing. The closing date marks the end of the acquisition process, and a new beginning for each party, especially for the owner who moves one step closer towards retirement.

Attorney: Peter Tanella
Related Practice: Veterinary Law
Category: Real Estate

When Should Veterinarians Consider Forming a Management Services Organization?

March 12, 2020

A Management Services Organization Adds a Layer of Structural Complexity to a Veterinary Practice but Offers Non-Veterinarians and Even Family Members the Opportunity to Reap the Financial Rewards

Veterinarians, investors and executives who want to form a management services organization (MSO) often do so without fully exploring the reasons. One revolutionary change in the veterinary industry over the last decade was heightened interest in MSOs, which resulted in a lot of newer market entrants, including, but not limited to, private equity.

The problem for private equity and any other potential investor is that in most states, they cannot own the veterinary practice because it is not a professional entity. The only entity that private equity or any other investor can typically own is the MSO.

What Is an MSO?

At its most basic level, an MSO is a legal entity that is separate and distinct from a veterinary practice and that provides certain administrative or management services. In most states, a veterinary practice must be owned and controlled by one or more licensed veterinarians. Some states require those veterinary owners to be licensed in the state, while others will accept equivalent licensure from another state.

Some states allow non-veterinarians to own the practice directly, so long as patient care decisions are ultimately made by licensed individuals. In states where practice ownership is restricted, non-veterinarians may own the MSO instead. These non-veterinarians can be investors, lenders, members of management, trusts, or friends and family investors. These individuals may own the MSO alongside one or more of the licensed veterinarians.

Such flexibility permits the practice’s veterinary owners, for example, to have family members partially or completely own the MSO so that they can indirectly enjoy the financial rewards of the practices. Alternatively, the veterinary owners might want to expand or purchase additional practices but do not want to assume additional debt liability. The MSO can be owned by non-veterinary investors as a means of providing capital for funding practice expansion. The profits that these non-veterinary investors realize from their ownership of the MSO, and the value of this business entity at the time of a sale, are, in effect, the return on investment for these non-veterinary investors.

Back-Office Support

Involvement of the MSO in the veterinary practice and services provided will vary based on the goals of the parties as well as the applicable state regulations governing these arrangements and the corporate practice of veterinary medicine.

An MSO may be involved in almost every non-clinical aspect of the business and offer a full suite of administrative and management services, including billing and collections, IT support, human resources, professional management, payor contracting services, financial accounting, and benchmarking. On the other hand, an MSO may contract to provide a smaller subset of services in a fee-for-service model. The MSO can provide overall management and administration, all support services, facilities, staffing, equipment and supplies — essentially everything the practice needs to operate except for the actual veterinary care.

The MSO’s goal is to free veterinarians from the burden of operating the practice as a business, leaving them to focus on patient care and growing the practice. The MSO accomplishes these goals by hiring the support staff (office and clinical) and leasing them to the practice. In a practice acquisition, the MSO will typically purchase all of the selling practice’s equipment, both office and clinical. In a de novo scenario, the MSO purchases or leases all the new equipment. In both situations, the MSO will then lease the equipment to the practice. The MSO thereby assumes all the financial and all other obligations and responsibilities for the equipment, including its maintenance, repair and replacement.

Similarly, the MSO assumes responsibility for the purchasing and adequately supplying the practice with all required office and clinical supplies. Further, the MSO can assume the building lease, including payment of rent and all other landlord relations, and then sublease the office to the practice. If the practice owns the real estate, then the MSO can either act as the property manager or the MSO can own the real estate and lease the premises to the practice.

The operational advantages of the MSO can be summarized as economy of scale, greater efficiency and availability of a higher level of services. The economy of scale and enhanced efficiency is realized through the MSO’s providing of services for any number of practices with administration of their overall business operations, including human resources and centralized billing and collections, increased purchasing power, and the ability to negotiate lower rates on employment-related insurances such as health coverage and workers’ compensation.

The relationship between the MSO and practice is contractual. The MSO will typically enter into a long-term agreement to provide all the services and other items described above in exchange for a management fee. Because the relationship is contractual, it affords the parties involved great flexibility in what the MSO will provide to the practice and the ability to change the mix of services and other items as the relationship and business progress.

Savings and Additional Costs

Creating an MSO does not by itself create any real value attractive to investors. The value is in being able to deliver efficient processes, standardization and professional business management in a way that is scalable across multiple locations. Additionally, creating an MSO comes with some cost, such as legal and accounting fees, and adds a layer of structural complexity. Most importantly, the MSO and its arrangement with the practice will need to be structured to comply with the state’s corporate practice of veterinary medicine restrictions and federal and state fraud and abuse laws.

Additional structural complexity comes at a cost. Whereas operating out of a single professional entity as a veterinary practice is relatively straightforward, operating an MSO with one or multiple levels of management and submanagement can create headaches. Investors, management and clinicians will need to be taught the vagaries of a somewhat esoteric legal structure.

Finally, moving from a single-practice structure to an MSO can limit flexibility in structuring a sale or acquisiion. Specifically, in creating an MSO, the parties might inadvertently create issues around concepts like subchapter S elections, depreciation recapture and taxes.


This story was originally published in todaysveterinarybusiness.com

Attorney: Peter Tanella
Related Practice: Veterinary Law
Category: Partnership Agreements