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 · SPECIMEN
ENGAGEMENT: GROWTH RETAINER · YEAR 2
PERIOD: JUNE 1 — JUNE 30, 2026 · 21 CLINIC DAYS
PREPARED: JULY 6, 2026 · 4TH BUSINESS DAY AFTER CLOSE
BASIS: MODIFIED CASH · TIED OUT WITH CONTROLLER JUL 2
DISTRIBUTION: BOARD · CFO · CEO · PRACTICE ADMINISTRATOR

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 (first completed visit)	239	235	▲ 1.7%	176	▲ 35.8%	PMS · feeds 4000
Gross production	$1.61M	$1.56M	▲ 3.2%	$1.29M	▲ 24.8%	PMS · pre-GL
Contractual adjustments	$192K · 11.9%	≤ 12.5%	▲ ok	13.4%	▼ 1.5 pt	4100
Collections (net patient revenue)	$1.35M	$1.31M	▲ 3.1%	$1.08M	▲ 25.0%	4000
Collection rate (of net production)	95.2%	95.0%	▲ 0.2 pt	93.8%	▲ 1.4 pt	4000 ÷ (PMS − 4100)
Growth spend, fully loaded	$59.2K	$60.0K	▼ 1.3%	$54.9K	▲ 7.8%	6200 + 6210 + 6020ᵃ
Fully-loaded CAC	$238	≤ $240	▲ ok	$312	▼ 23.7%	see appendix
90-day production per new patient	$698	$650	▲ 7.4%	$612	▲ 14.1%	PMS cohort · feeds 4000
Payer mix — FFS / cash share of production	27%	26%	▲ 1 pt	22%	▲ 5 pt	shrinks 4100
No-show rate	12.4%	≤ 12.0%	▲ 0.4 pt — miss	16.8%	▼ 4.4 pt	unbilled chair-hrs
Answer rate, front desk (staffed hours)	88%	90%	▼ 2 pt — miss	74%	▲ 14 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 $38.4K; we report the loaded figure because the loaded figure is what the P&L absorbs.

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

ATTRIBUTED GROSS PRODUCTION

$342.4K

care performed for attributed patients

LESS CONTRACTUAL ADJ.

−$40.7K

payer write-downs · GL 4100

ATTRIBUTED NET REVENUE

$301.7K

= 22.3% of the 4000 line

RECONCILES TO LINE

4000 — PATIENT REVENUE

variance to PMS < 1% · rule: PMS wins

READ THIS PAGE IN ONE LINE

Demand is ahead of plan and 24% cheaper to buy than at baseline. The two misses — no-shows and answer rate — are operations, not marketing, and both have named fixes with 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 · SPECIMEN

LOADED SPEND ALLOCATES RETAINER, TOOLING & LABOR PRO-RATA TO MEDIA · CAC DENOMINATOR = COMPLETED FIRST VISITS, NOT LEADS
CHANNEL	MEDIA $	LOADED $	NEW PATIENTS	CAC (LOADED)	FIRST-VISIT PROD.	PAYBACK ᵇ
Paid search	$16.8K	$25.9K	85	$305	$35.0K	2.1 mo
Paid social	$9.6K	$14.8K	41	$361	$16.9K	2.5 mo
Local SEO + profile listings	$4.2K	$6.5K	58	$112	$23.9K	0.8 mo
Referral program	$2.1K	$3.2K	26	$123	$10.7K	0.9 mo
Direct mail (test — decision Aug 15)	$4.2K	$6.5K	12	$540	$4.9K	3.8 mo
Unattributed / walk-in ᶜ	—	—	17	—	$7.0K	—
TOTAL — NEW-PATIENT ACQUISITION	$36.9K	$56.9K	239	$238	$98.4K	1.7 mo

REACTIVATION — REPORTED SEPARATELY. RETURNING PATIENTS ARE NOT "ACQUIRED" AND ARE EXCLUDED FROM CAC BY DEFINITION
PROGRAM	MEDIA $	LOADED $	PATIENTS REACTIVATED	COST / REACTIVATION	FIRST-VISIT PROD.
Dormant-patient email + SMS (18 mo+)	$1.5K	$2.3K	31	$74	$9.6K

ᵇ Payback = CAC ÷ average monthly contribution margin per new patient in the first 90 days ($698 production × 62% contribution ÷ 3 ≈ $144/mo). Definitions and GL mapping in the appendix, p.6.
ᶜ 17 patients (7%) could not be attributed after call-tracking and PMS referral-source reconciliation. They stay in the CAC denominator — we charge ourselves for them rather than flattering the blended number.

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 $305. Direct mail is on notice: one more drop with new list + offer; if CAC isn't under $400 by the Aug 15 read, the $4.2K/mo goes back to paid search. 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
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 ~$252 of net production per utilized chair-hour, the group's 1,590 open hours represent roughly $400K/mo of latent net revenue that requires no new spend to serve — only demand routed to the right pods and a front desk that answers. That is why we throttle ads at Central and North (94% utilization; more spend there buys waitlist, not revenue) 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 · 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

239 new patients (+35.8% vs baseline) at $238 fully-loaded CAC (−23.7% vs baseline); collections $1.35M, +3.1% vs plan.
Misses: answer rate 88% (plan 90%) — driven almost entirely by Riverside at 81%; no-shows 12.4% (plan ≤12%).
Utilization spread now runs 58–94% across pods; group open chair-hours ≈ $400K/mo of latent net revenue.

AASSESSMENT

The demand engine is no longer the constraint. Patient acquisition is ahead of plan, cheaper than baseline by a quarter, and reconciling cleanly to the 4000 line. The binding constraint has moved inside the building: phone coverage at one pod and chair capacity at two others now cap revenue before marketing does. This is the correct problem to have in year 2, and it is cheaper to fix than demand was to build — a desk hire costs less per recovered patient than any channel on page 3. Direct mail is the one demand-side experiment underperforming; it gets one disciplined iteration, not a quiet renewal.

PPLAN — NEXT 30 DAYS · OWNER · DATE

Riverside desk: overflow call routing to Central live, temp coverage placed, permanent hire posted. Target answer rate ≥ 90% 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
Deposit-policy pilot at the 3 pods with no-shows >14%. 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 CAC ≤ $400.AGENCY · AUG 15 READ
Membership-plan promotion to push FFS/cash mix toward 29% — 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 actually performed in the period, before any payer discount. Not an income-statement number — it is the top of the bridge to one. We never present production as revenue.

BRIDGES TO 4000
VIA 4100

Contractual adjustmentsWRITE-DOWNS

The difference between fee schedule and contracted payer rates, written down at posting. Tracked as a % of gross production; payer-mix shift is the main lever that moves it.

GL 4100

Collections / net patient revenueTHE REVENUE LINE

Cash collected from patients and payers in the period. The group reports on a modified cash basis, so collections are the 4000 line. Every revenue claim in this pack reconciles here; where marketing attribution and the PMS disagree, the PMS wins.

GL 4000

Collection rateREALIZATION

Collections ÷ net production (gross production − contractual adjustments), trailing. Distinguishes a demand problem from a billing problem — marketing gets no credit for revenue the billing office fails to collect.

4000 ÷ (PMS − 4100)

Fully-loaded CACNO FLATTERING DENOMINATORS

(Media spend + agency retainer + tracking/tooling + attributed share of internal coordinator labor) ÷ new patients who completed a first visit. Not leads, not bookings, not calls. Reactivation spend and reactivated patients are excluded on both sides of the fraction. Unattributed new patients stay in the denominator.

(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 who returns. Conflating them inflates growth and deflates CAC; we report them on separate tables.

PMS PATIENT FLAG

Payback (months)WHEN A PATIENT TURNS PROFITABLE

CAC ÷ average monthly contribution margin per new patient across the first 90 days. Contribution = production × (1 − direct clinical cost %) from the client's own GL, currently 62%. This is margin payback, not revenue payback.

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

Payer mixFFS / PPO / OTHER

Share of gross production by payer class. FFS/cash production carries no 4100 write-down, so a point of mix shift raises the 4000 line with zero change in patient volume — which is why it appears on the vitals page, not buried here.

MOVES 4100 → 4000

No-show rate & answer rateOPERATIONS VITALS

No-show: kept appointments missed without 24-hour notice ÷ scheduled. Answer rate: calls answered by a human within four rings during staffed hours (call-tracking log). Neither is a GL line; both gate whether paid demand ever reaches one. They ship because they price the leak between spend and revenue.

UNBILLED CHAIR-HRS
UPSTREAM OF 4000

Baseline & attribution rulesHOW WE KEEP SCORE HONESTLY

Baseline = the 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 referral-source field; the controller signs the tie-out. A metric that cannot trace to the P&L or the PMS does not ship in this pack.

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

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CONTENTS

Monthly
Board Pack