CHART № 610-M · GROUP FILE

CONFIDENTIALBOARD DISTRIBUTION ONLY

Monthly
Board Pack

CFO / BOARD-READY · PERIOD CLOSE · JUNE 2026

"The document your board reads without us in the room."
Every number in this pack reconciles to a line on the income statement. Where it can't, it isn't in the pack.

PATIENT OF RECORD: GROUP · 12 LOCATIONS (11 AT BASELINE) · SPECIMEN
ENGAGEMENT: GROWTH RETAINER · MONTH 11
PERIOD: JUNE 1 — JUNE 30, 2026 · 21 CLINIC DAYS
PREPARED: JULY 7, 2026 · 4TH BUSINESS DAY AFTER CLOSE
BASIS: MODIFIED CASH · TIED OUT WITH CONTROLLER JUL 2
DISTRIBUTION: BOARD · CFO · CEO · PRACTICE ADMINISTRATOR

Month vitals — vs plan, vs baseline p.2
Channel economics — spend, patients, cost per patient, payback p.3
Capacity — open chair-hours vs demand routed p.4
Assessment & plan — next 30 days p.5
Appendix — metric definitions in CFO terms p.6

FORM 610-M · MONTHLY BOARD PACK · PAGE 1 OF 6illustrative data — specimen

01 · Month Vitals — vs Plan, vs Baseline JUN '26 · GROUP · 12 LOCATIONS (11 AT BASELINE) · SPECIMEN

BASELINE = TRAILING 6-MONTH AVERAGE IMMEDIATELY PRECEDING ENGAGEMENT START · MISSES PRINTED IN RED, NOT FOOTNOTED
VITAL	JUN '26	PLAN	Δ PLAN	BASELINE	Δ BASE	P&L / SOURCE LINE
New patients — same-store (11 loc)	249	244	▲ 2.0%	213	▲ 16.9%	PMS · feeds 4000
New patients — all-in (12 loc incl. Parkway) ᵉ	267	262	▲ 1.9%	213	▲ 25.4%	PMS · feeds 4000
Gross production — same-store	$1.35M	$1.34M	▲ 0.7%	$1.29M	▲ 4.7%	PMS · pre-GL
Gross production — all-in	$1.44M	$1.44M	▲ ok	$1.29M	▲ 11.6%	PMS · pre-GL
Contractual adjustments	$204K · 14.2%	≤ 13.5%	▲ 0.7 pt — miss	13.4%	▲ 0.8 pt — worse	4100
Collections — same-store	$1.075M	$1.068M	▲ 0.7%	$1.03M	▲ 4.4%	4000
Collections — all-in	$1.147M	$1.145M	▲ ok	$1.03M	▲ 11.4%	4000
Collection rate (of net production)	92.8%	92.5%	▲ 0.3 pt	92.2%	▲ 0.6 pt	4000 ÷ (PMS − 4100)
Growth spend, fully loaded	$69.4K	$70.0K	▼ 0.9%	$54.9K	▲ 26.4%	6200 + 6210 + 6020ᵃ
Cost per new patient — same-store ᵈ	$216	≤ $225	▲ ok	$246	▼ 12.2%	see appendix
Cost per new patient — all-in ᵈ	$251	≤ $245	▲ 2.4% — miss	$246	▲ 2.0% — worse	see appendix
90-day production per new patient	$588	$620	▼ 5.2% — miss	$612	▼ 3.9% — worse	PMS cohort · feeds 4000
Case acceptance (presented → scheduled)	41%	45%	▼ 4 pt — miss	43%	▼ 2 pt — worse	PMS tx plans · feeds 4000
Payer mix — FFS / cash share of production	34%	37%	▼ 3 pt — miss	36%	▼ 2 pt — worse	shrinks 4100
Broken appointments (no-show + late cancel)	19.8%	≤ 19.0%	▲ 0.8 pt — miss	22.4%	▼ 2.6 pt	unbilled chair-hrs
Answer rate, front desk (all lines, all hours — frozen Day-0 basis) ᵍ	82%	84%	▼ 2 pt — miss	78%	▲ 4 pt	call tracking · feeds 4000

ᵃ Fully-loaded growth spend = media (GL 6200) + agency retainer (6200) + tracking & tooling (6210) + the attributed share of internal coordinator labor (6020). Media alone was $43.6K; we report the loaded figure because the loaded figure is what the P&L absorbs.
ᵈ Dentistry publishes no acquisition-cost benchmark — the ADA Health Policy Institute's expense tables aggregate all practice expenses and never separate advertising. This figure is the group's own, rebuilt from its own GL, and is comparable to its own plan and its own baseline. It is not comparable to an industry number, because there isn't one.
ᵉ The group ran 11 locations at baseline. Parkway — 11 opened March '26, inside the engagement. Same-store rows cover the 11 sites that existed at Day 0 and are the rows that measure our work; all-in rows include Parkway and are reported so the board sees the whole P&L. We do not blend them, and we do not present the all-in number as growth.
ᵍ Answer rate is reported on the definition frozen at Day 0: answered by a human in four rings ÷ all calls on all lines, after-hours counted unanswered — a voicemail is a patient who didn't book. The desk's own operating number is narrower: 88% during staffed hours in June, against a Day-0 staffed-hours restatement of 83%. Both bases give the same move, about four and a half points. Setting the 88% staffed-hours reading beside the 78% all-hours baseline would print a ten-point gain that neither basis supports — ten points of definition, not of work — so this pack no longer prints it. Full disclosure of the definition mismatch and both readings: Form 247-P §02②.

MARKETING → P&L RECONCILIATION · JUNE · SIGNED OFF BY CONTROLLER JUL 2

ATTRIBUTED GROSS PRODUCTION

$270.0K

care performed for attributed patients

LESS CONTRACTUAL ADJ.

−$38.3K

payer write-downs · GL 4100

ATTRIBUTED COLLECTIONS

$231.7K

= 20.2% of the 4000 line

RECONCILES TO LINE

4000 — PATIENT REVENUE

variance to PMS < 1% · rule: PMS wins

READ THIS PAGE IN ONE LINE

Acquisition worked and the economics of what it acquired got slightly worse. Same-store new patients are up 16.9% and cost 12% less to buy; the patients arriving are more insured and less established than the ones already on the books, so payer mix, case acceptance and 90-day production per patient all moved against us. That trade is the mechanism, not a surprise — but it is a real cost and it is printed in the same size type as the wins. Five vitals regressed this month. Named fixes and dates on page 5.

FORM 610-M · MONTHLY BOARD PACK · PAGE 2 OF 6illustrative data — specimen

02 · Channel Economics — What a Patient Costs, By Source JUN '26 · GROUP · 12 LOCATIONS (11 AT BASELINE) · SPECIMEN

LOADED SPEND ALLOCATES RETAINER, TOOLING & LABOR PRO-RATA TO MEDIA · DENOMINATOR = COMPLETED FIRST VISITS, NOT LEADS · NO INDUSTRY ACQUISITION-COST BENCHMARK EXISTS IN DENTISTRY, SO NONE IS SHOWN
CHANNEL	MEDIA $	LOADED $	NEW PATIENTS	COST / NP (LOADED)	FIRST-VISIT PROD.	PAYBACK ᵇ
Paid search	$15.5K	$24.6K	92	$267	$34.0K	2.2 mo
Paid social	$8.8K	$14.0K	43	$326	$14.6K	2.7 mo
Local SEO + profile listings	$4.0K	$6.4K	65	$98	$25.7K	0.8 mo
Referral program	$2.0K	$3.2K	29	$110	$12.2K	0.9 mo
Direct mail (test — decision Aug 15)	$3.5K	$5.6K	11	$509	$3.3K	4.2 mo
Unattributed / walk-in ᶜ	—	—	9	—	$3.2K	—
SUBTOTAL — SAME-STORE (11 LOCATIONS)	$33.8K	$53.8K	249	$216	$93.0K	1.8 mo
Parkway — 11 (opened Mar '26) · all channels ᶠ	$8.3K	$13.2K	18	$733	$5.8K	6.0 mo
TOTAL — NEW-PATIENT ACQUISITION, ALL-IN	$42.1K	$67.0K	267	$251	$98.8K	2.1 mo

REACTIVATION — REPORTED SEPARATELY. RETURNING PATIENTS ARE NOT "ACQUIRED" AND ARE EXCLUDED FROM COST PER NEW PATIENT BY DEFINITION
PROGRAM	MEDIA $	LOADED $	PATIENTS REACTIVATED	COST / REACTIVATION	RETURN-VISIT PROD.
Dormant-patient recall — email + SMS (18 mo+)	$1.5K	$2.4K	34	$71	$11.7K

ᵇ Payback = loaded cost per new patient ÷ average monthly contribution margin per new patient in the first 90 days ($588 production × 62% contribution ÷ 3 ≈ $122/mo). Payback lengthened from 2.0 to 2.1 months against baseline: production per patient fell faster than cost per patient did. Definitions and GL mapping in the appendix, p.6.
ᶜ 9 patients (3.4%) could not be attributed after call-tracking and PMS referral-source reconciliation. They stay in the denominator — we charge ourselves for them rather than flattering the blended number.
ᶠ Parkway opened March '26 and is four months into a ramp. Its cost per new patient is 3.4× the same-store figure and its payback is 6.0 months. This is what a de novo site costs in a catchment carrying no brand recognition, and it is shown on its own line rather than averaged into the group — averaging it in would hide both the ramp and the same-store result.

WHERE THE NEXT DOLLAR GOES

Local SEO and referral are the cheapest patients we buy — but both are near saturation at current footprint. Paid search carries scale at an acceptable $267. Direct mail is on notice: one more drop with new list + offer; if the loaded cost per new patient isn't under $400 by the Aug 15 read, the $3.5K/mo goes back to paid search. Parkway keeps its budget through the ramp on an explicit clock, not on optimism: if cost per new patient there is not under $450 by the December close, the site moves to organic and referral only. No channel keeps budget on narrative. Only on payback.

FORM 610-M · MONTHLY BOARD PACK · PAGE 3 OF 6illustrative data — specimen

03 · Capacity — Open Chair-Hours vs Demand Routed JUN '26 · 21 CLINIC DAYS · GROUP · 12 LOCATIONS · SPECIMEN

MARKETING IS THROTTLED WHERE CHAIRS ARE FULL AND ROUTED WHERE THEY SIT OPEN · UTILIZATION = BOOKED-AND-KEPT HOURS ÷ AVAILABLE · INTERNAL INSTRUMENT — NO DENTAL UTILIZATION BENCHMARK IS PUBLISHED
POD	CHAIR-HRS AVAIL.	UTILIZED	UTIL. %	OPEN HRS	NP HRS ROUTED	ACTION
Central — 01	672	618	92%	54	52	THROTTLE SPEND · WAITLIST
Midtown — 02	504	398	79%	106	34	HOLD
Westlake — 03	672	571	85%	101	44	HOLD
North — 04	672	632	94%	40	58	THROTTLE SPEND · HYGIENE HIRE
Hillcrest — 05	504	393	78%	111	33	HOLD
Round Rock — 06	672	545	81%	127	39	HOLD
Lakeline — 07	672	578	86%	94	47	HOLD
South — 08	504	368	73%	136	30	ROUTE +
Riverside — 09	672	410	61%	262	26	FIX DESK FIRST · THEN ROUTE +
Cedar Park — 10	504	358	71%	146	31	ROUTE +
Parkway — 11 (opened Mar '26)	672	390	58%	282	41	RAMP · ROUTE +30%
Uptown — 12	504	373	74%	131	30	HOLD
GROUP	7,224	5,634	78%	1,590	465	—

WHY THE BOARD SHOULD CARE ABOUT CHAIR-HOURS

At June's realized rate of ~$219 of net production per utilized chair-hour, the group's 1,590 open hours represent roughly $350K/mo of latent net production that requires no new spend to serve — only demand routed to the right pods and a front desk that answers. Read that as a ceiling, not a plan: it assumes the recovered hours produce at the group average, and the pods holding the open hours are the ones producing below it. That is why we throttle ads at Central and North (94% utilization; more spend there buys waitlist, not production) and point the same dollars at South, Cedar Park, and Parkway. Riverside's 262 open hours are gated on the desk fix, not on marketing: demand we route there today leaks at the phone.

FORM 610-M · MONTHLY BOARD PACK · PAGE 4 OF 6illustrative data — specimen

04 · Assessment & Plan — Next 30 Days SOAP FORMAT · JUN '26 · GROUP · 12 LOCATIONS (11 AT BASELINE) · SPECIMEN

SSUBJECTIVE — WHAT OPERATORS REPORTED

Riverside administrator reports two front-desk departures in five weeks; afternoons frequently single-staffed.
North reports hygiene fully booked 3 weeks out; associate dentist requesting an added Saturday.
Parkway (opened March) reports the team "ready for more volume than we're getting."

OOBJECTIVE — WHAT THE NUMBERS SAY

What moved for us: 249 same-store new patients (+16.9% vs baseline) at $216 fully-loaded cost per new patient on the group's own ledger (−12.2%); same-store collections $1.075M, +4.4% vs baseline; broken appointments 22.4% → 19.8%; answer rate 78% → 82% on the frozen all-hours definition, ▲ 4 pt (83% → 88% during staffed hours — same move, other basis; note ᵍ, p.2).
What moved against us — five vitals: case acceptance 43% → 41%; payer mix (FFS/cash) 36% → 34%; contractual adjustments 13.4% → 14.2%; 90-day production per new patient $612 → $588; all-in cost per new patient $246 → $251. Payback lengthened 2.0 → 2.1 months.
Misses vs plan: answer rate 82% (plan 84% — both all-hours), the shortfall concentrated at Riverside, 81% staffed / 75% all-hours on that desk's own daypart split; broken appointments 19.8% (plan ≤19%); case acceptance 41% (plan 45%); payer mix 34% (plan 37%).
Utilization spread now runs 58–94% across pods; group open chair-hours ≈ $350K/mo of latent net production at the group's realized rate — a ceiling, not a forecast.

AASSESSMENT

Acquisition is working and it is not free. Same-store new patients are up 16.9% at 12% lower cost, and the group crossed from the band where 38.8% of practices sit (under 20 new patients per location per month) into the one above it. But the patients we bought are not the patients already on the books: a larger share of first visits are unestablished and insured, so case acceptance fell two points, FFS/cash mix fell two points, the 4100 write-down line rose, and production per new patient fell 3.9%. Five vitals regressed. That trade is the predicted mechanism, not an accident — volume and acceptance pull against each other, and this month volume won — but the board should read it as the real price of the volume rather than as noise. Net of it, the same-store increment annualises to roughly $540K of collections against $175K of program cost, which clears; it clears by less than the headline volume number implies.

The binding constraint has moved inside the building: phone coverage at one pod and chair capacity at two others now cap collections before marketing does. That is the correct problem to have in month 11 and is cheaper to fix than demand was to build. Direct mail is the one demand-side experiment underperforming; it gets one disciplined iteration, not a quiet renewal. Parkway is on a ramp clock, not a pass.

PPLAN — NEXT 30 DAYS · OWNER · DATE

Riverside desk: overflow call routing to Central live, temp coverage placed, permanent hire posted. Target answer rate ≥ 90% staffed hours — ≥ 84% all-hours, the basis this pack reports — at the July close.AGENCY + ADMIN · JUL 22
Shift $6K/mo of paid-search budget from Central + North geos to South, Cedar Park, Parkway. No net spend increase.AGENCY · JUL 18
Case-acceptance and payer-mix regression: pull the June first-visit cohort and split presented-vs-scheduled by established / unestablished and by plan. If the fall is entirely mix, we say so and stop treating it as a coaching problem; if it is not, it goes to the treatment-conversation program.AGENCY + CLINICAL DIR · JUL 29
Deposit-policy pilot at the 3 pods with broken-appointment rates >20%. Drafted; goes live only on CEO sign-off.CEO DECISION · JUL 24
Direct mail: one redesigned drop (new list, new offer). Kill-or-scale decision at loaded cost per new patient ≤ $400.AGENCY · AUG 15 READ
Membership-plan promotion to push FFS/cash mix toward 41% — every point of mix shrinks the 4100 write-down line with zero added volume.AGENCY + ADMIN · JUL 31
Q3 plan drafted with CFO; baseline refresh and capacity-weighted spend targets on the table before the next pack.AGENCY + CFO · AUG 5

FORM 610-M · MONTHLY BOARD PACK · PAGE 5 OF 6illustrative data — specimen

05 · Appendix — Every Metric, In CFO Terms DEFINITIONS · GL MAPPING · SPECIMEN CHART OF ACCOUNTS

Gross productionPMS · PRE-GL

Fee-schedule value of care performed in the period, before payer discount. Not revenue — the top of the bridge to it.

BRIDGES TO 4000
VIA 4100

Contractual adjustmentsWRITE-DOWNS

Gap between fee schedule and contracted payer rates, written down at posting. Tracked as % of gross production; payer mix moves it.

GL 4100

Collections / net patient revenueTHE REVENUE LINE

Cash collected from patients and payers. On a modified cash basis it is the 4000 line; if attribution and the PMS disagree, the PMS wins.

GL 4000

Collection rateREALIZATION

Collections ÷ net production (gross − contractuals), trailing. Marketing gets no credit for revenue the billing office fails to collect.

4000 ÷ (PMS − 4100)

Fully-loaded cost per new patientNO FLATTERING DENOMINATORS · NO INDUSTRY COMPARATOR

(Media + agency retainer + tracking/tooling + attributed coordinator labor) ÷ new patients who completed a first visit — not leads, not bookings, not calls. Reactivation is excluded both sides; unattributed new patients stay in the denominator. Read it against your own baseline only: dentistry publishes no acquisition-cost benchmark. ADA HPI never separates advertising, no PMS publisher reports one — an "industry CAC" for a dental group does not exist.

(6200 + 6210 + 6020ᵃ)
÷ FIRST VISITS

New patient vs reactivationMUTUALLY EXCLUSIVE

New patient: first completed visit ever with the group. Reactivation: a patient dormant 18+ months returning through recall. Conflating them inflates growth and deflates cost per new patient.

PMS PATIENT FLAG

Payback (months)WHEN A PATIENT TURNS PROFITABLE

Loaded cost per new patient ÷ average monthly contribution margin per new patient over the first 90 days. Contribution = production × (1 − direct clinical cost %) from the client's GL, 62%. Margin payback, not revenue.

COST / NP ÷ [(90-DAY PROD × 62%) ÷ 3]
5000-SERIES COSTS

Case acceptancePRESENTED → SCHEDULED

Treatment dollars presented that are scheduled within 30 days. Same-day counts at presentation; unscheduled carries forward, never written off. The only conversion metric here with a published distribution — average 45%, top decile 75% (Henry Schein One, 2026 Catalyst Index).

PMS TX PLANS
UPSTREAM OF 4000

Payer mixFFS / PPO / OTHER

Share of gross production by payer class. FFS/cash carries no 4100 write-down, so a point of mix shift raises 4000 with no volume change.

MOVES 4100 → 4000

Broken appointments & answer rateOPERATIONS VITALS

Broken appointment: appointments missed or cancelled inside 24 hours ÷ scheduled. Combined, not split — locations coded them inconsistently, and the only published dental figure (6.9% no-show + 12.9% cancellation, 8,500+ practices) compares only combined, at 19.8%. Answer rate: calls answered by a human in four rings ÷ all calls on all lines, after-hours counted unanswered — the definition frozen at Day 0 in Form 247-B, and the only basis on which this pack differences current against baseline. The staffed-hours reading is a second, narrower instrument the desk manages to day to day; it is printed in note ᵍ on p.2 and is never subtracted from an all-hours figure, in either direction. Internal, no published benchmark — the ceiling is our own best desk.

UNBILLED CHAIR-HRS
UPSTREAM OF 4000

Baseline & attribution rulesHOW WE KEEP SCORE HONESTLY

Baseline = trailing 6-month average immediately preceding engagement start, frozen at kickoff. Attribution = call tracking + form source, last non-direct touch, reconciled monthly to the PMS; the controller signs the tie-out. Nothing untraceable to the P&L or PMS ships. Same-store vs all-in: the baseline covers the 11 locations open at Day 0. Any site opened during the engagement is reported on its own line and never blended into a growth rate — a group that adds a location and reports the total as growth is measuring its construction schedule, not its marketing. Regressions: vitals that move against the client are printed in the table at the same weight as the ones that move for it. A pack with no regressions in it has not been read.

CONTROLLER
SIGN-OFF MONTHLY

ᵃ Specimen chart of accounts: 4000 Patient Revenue · 4100 Contractual Adjustments · 5000-series Direct Clinical Costs · 6020 Salaries & Wages (attributed share) · 6200 Marketing & Agency · 6210 Software & Tracking. Mapped to the client's actual chart of accounts at kickoff.

FORM 610-M · MONTHLY BOARD PACK · PAGE 6 OF 6illustrative data — specimen

MonthlyBoard Pack

CONTENTS

Monthly
Board Pack