A Delaware MSO holds investor equity and employs all non-clinical staff. A Georgia Clinical Entity holds CMS enrollment and employs clinicians. The two are linked by an arm's-length Management Services Agreement. MSO has zero clinical authority.
The MSO employs all non-clinical roles under the Delaware C-Corp. Leadership scales with clinic expansion — 5 named roles at Y1 launch to 12+ named roles by Y3, plus an additional staffing buffer (10% Y1–Y2 · 15% Y3). All W-2 roles carry a 25% benefits load. Merit increases: 1.5% Y2 · 2.5% Y3 · 3.0% Y4–Y5. Roles highlighted in gold are new additions for the selected year.
Each clinic runs its own independent stage clock driven by member count — not by calendar year. Clinical Entity (GA LLC) employs NPs and LPNs. Remote MD is a 1099 retainer. One Driver is present at every active clinic from Day 1. Stage advances trigger mandatory hiring. Roles highlighted in green are new additions for the selected stage.
Clinics open sequentially by FFS member density. Each runs an independent 18-month ramp. Habersham is the flagship — densest FFS market in the portfolio (5,066 FFS members) and first to advance through stages.
All figures reflect the v4 financial model. Clinic headcount shown as total portfolio positions (EOY) — not per-clinic averages. Every active clinic has at minimum 1 NP + 1 LPN + 1 Driver from Day 1. Clinic benefits load is staged (18% Y1 → 25% Y5). MSO benefits flat at 25%.
| Role / Category | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 |
|---|---|---|---|---|---|
| CLINIC HEADCOUNT & COST · Total Portfolio · Stage-Driven by Member Count | |||||
| Active Clinics (by end of year) | 3 | 6 | 10 | 10 | 10 |
| NPs / APRNs — 2nd NP triggers at 650 members (S3) | 3 | 9 | 16 | 19 | 19 |
| LPNs — LPN #2 added concurrent with NP #2 | 3 | 9 | 16 | 19 | 19 |
| Care Coordinators — PT at S1, FT at S2, 2nd CC at S3/S4 | 3 | 9 | 16 | 19 | 19 |
| Admin / Front Desk — PT starts at S2, FT at S3/S4 | 1 | 5 | 8 | 10 | 10 |
| Drivers — 1 per active clinic from Day 1, W-2, $45K | 3 | 6 | 10 | 10 | 10 |
| Remote MD — 1099 retainer per clinic · no benefits load | 3 | 6 | 10 | 10 | 10 |
| Total Clinic W-2 Headcount | 13 | 38 | 66 | 77 | 77 |
| Benefits load on W-2 clinic staff | 18% | 19.75% | 21.5% | 23.25% | 25% |
| Total Clinic Staff Cost (loaded) | $836K | $3,061K | $5,884K | $8,963K | $9,477K |
| MSO HEADCOUNT & COST · Central Leadership · 25% Benefits All Years | |||||
| Executive (CEO + CFO Y2 + CMO Y3) | 1 | 2 | 3 | 3 | 3 |
| Growth & Market Dev (CGO Y1 + VP/Community Y2) | 1 | 3 | 3 | 3 | 3 |
| Operations (COO Y1 + Ops Coord + Regional Mgr Y3) | 1 | 1 | 3–4 | 3–4 | 3–4 |
| Technology & Compliance (CIO Y1 + Legal/Comp Y2) | 1 + frac. | 2 | 2–3 | 2–3 | 2–3 |
| Revenue Cycle & Billing (Billing I → III Y3) | 1 | 2 | 3 | 3 | 3 |
| Additional Staffing Buffer | 10% of Y1 | 10% of cumul. | 15% of cumul. | Merit only | Merit only |
| v4 Operational Budget Addition | — | — | +$300K | Carried fwd | Carried fwd |
| Merit increases (all MSO staff) | Base | +1.5% | +2.5% | +3.0% | +3.0% |
| Total MSO Staff Cost (loaded, 25%) | $1,400K | $2,382K | $3,291K | $3,390K | $3,492K |
| PORTFOLIO TOTAL STAFFING (CLINIC + MSO COMBINED) | |||||
| Total Staff Cost · All Roles | $2,236K | $5,443K | $9,175K | $12,353K | $12,968K |
| Notes | Clinic benefits load stages 18%→25% Y1–Y5. MSO flat 25%. All staff merit: 1.5% Y2 · 2.5% Y3 · 3.0% Y4/Y5. +15% clinic headcount Y4/Y5 as early clinics advance to S3/S4. MD is 1099 — no benefits load. | ||||
All non-clinical staff. 25% benefits load all years. Merit increases: +1.5% Y2 · +2.5% Y3 · +3.0% Y4–Y5. Gold nodes = new addition for that year. Dashed nodes = 1099 advisor / contractor.
Y4: $3,390K · Y5: $3,492K · +3.0% merit annually. No new headcount.
Each clinic runs its own stage clock driven by member count. Charts show expected stage per year for a typical clinic. Remote MD is always a 1099 retainer. Teal nodes = new addition at this stage.