Subscription revenue, multi-state telehealth nexus, inventory for compounded products, and entity design for clinics growing online.
Peptide and telehealth clinics sell across state lines from day one, bill on subscriptions, and buy compounded products from pharmacies in other states. The result is a business whose income, inventory and nexus footprint look nothing like the local practice its entity was copied from.
The plan starts with the structure: a management company and the professional entity or entities the telehealth rules require in each state, with the fee arrangement documented. Then revenue: memberships and prepaid protocols recognized in the right period, not when the card runs. Then the state footprint: where patients are, where providers are and where the products ship from decide income and sales tax obligations. And then the owner: compensation, a retirement plan and the structure a buyer will want.
We work with your healthcare and telehealth counsel, review the entity chart, the merchant statements and three years of returns, and write the plan with the elections and filings on a calendar.
What we typically see: Patients in thirty states and returns filed in one. Membership revenue booked on the card date. Compounded product expensed on receipt. A single LLC doing the work of an MSO and a professional entity.
Each one is modeled against your numbers and written into the blueprint with the documentation it needs.
We were filing in one state with patients in twenty-eight. Mapping the footprint first was the difference between planning and cleanup.
Possibly income tax, sales tax or both, depending on each state's thresholds and how the services and products are characterized. The plan maps the footprint and the filings.
Over the period the service is delivered, subject to the tax rules for advance payments. Booking it on the card date overstates income in a growing clinic.
Product sold or dispensed to patients is generally inventory, so the year-end stock is not deducted yet. Supplies consumed in service delivery are treated differently. We set the policy and the count.
Usually through a management services organization alongside a physician-owned professional entity, subject to each state's rules. The tax structure is built on what your counsel confirms.
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