Due Diligence Checklist for Buying a Medical Practice

Due Diligence Checklist for Buying a Medical Practice

Due Diligence Checklist for Buying a Medical Practice


Purchasing a medical practice can be a career-defining decision that offers both exciting opportunities and potential challenges. To ensure that you make a well-informed investment and avoid unexpected issues down the road, conducting thorough due diligence is essential. In this blog post, we will provide a comprehensive due diligence checklist for buying a medical practice. This checklist will help you navigate the complex process of acquiring a medical practice while mitigating risks and maximizing the potential for a successful transition.

1. Financial Due Diligence

One of the most critical aspects of due diligence when buying a medical practice is evaluating its financial health. A comprehensive financial analysis should include:

Financial Statements: Review the practice’s financial statements for the past three to five years, including balance sheets, income statements, and cash flow statements. Look for any red flags, such as declining revenues, increasing expenses, or unusual financial trends.

Accounts Receivable: Analyze the practice’s accounts receivable to determine the collection rate, outstanding balances, and any potential issues with unpaid invoices.

Tax Returns: Examine the practice’s tax returns to verify the accuracy of reported income and identify any tax liabilities or audits.

Contracts and Liabilities: Review all contracts, agreements, and liabilities, such as leases, loans, and vendor contracts, to understand the financial obligations of the practice.

Reimbursement Rates: Investigate the practice’s reimbursement rates from payers and insurance providers to assess the stability of income streams.

Employee Compensation: Examine the compensation agreements and benefits offered to employees to ensure they are competitive and align with industry standards.

A thorough financial due diligence process will provide a clear picture of the practice’s financial stability and potential for growth.

2. Legal and Regulatory Compliance

Ensuring legal and regulatory compliance is crucial when buying a medical practice to avoid potential liabilities and legal issues. The following areas should be included in your due diligence:

Licenses and Certifications: Verify that the practice holds all required licenses and certifications to operate legally in the relevant jurisdiction. Check for any pending disciplinary actions or compliance violations.

HIPAA Compliance: Assess the practice’s compliance with the Health Insurance Portability and Accountability Act (HIPAA) to protect patient confidentiality and avoid potential penalties.

Contracts and Agreements: Review all contracts, including employment agreements, non-compete agreements, and vendor contracts, to identify any restrictive terms that could impact the purchase.

Litigation History: Investigate the practice’s litigation history, including malpractice claims, lawsuits, or disputes with employees, to assess potential legal liabilities.

Medicare/Medicaid Compliance: Ensure that the practice is in compliance with Medicare and Medicaid billing regulations to avoid fraudulent billing issues.

Environmental Compliance: If the practice owns the property where it operates, evaluate any environmental liabilities or contamination issues that may exist.

Addressing legal and regulatory compliance during due diligence is essential to avoid surprises and potential legal consequences post-acquisition.

3. Operational Due Diligence

Operational due diligence assesses the day-to-day functioning of the medical practice, ensuring that it is efficient and aligned with your goals. Key aspects of operational due diligence include:

Patient Base: Examine the practice’s patient demographics, referral sources, and patient retention rates to assess the stability and growth potential of the patient base.

Staffing and Employee Satisfaction: Evaluate the practice’s staffing levels, roles, and employee satisfaction to determine if there are any personnel challenges that need to be addressed.

Technology and Equipment: Assess the condition and functionality of medical equipment, electronic health record systems, and other technology infrastructure to determine potential upgrade or maintenance costs.

Practice Management: Review the practice’s management and administrative processes to identify any inefficiencies or areas for improvement.

Workflow Analysis: Analyze patient flow, appointment scheduling, and billing processes to identify opportunities to enhance operational efficiency.

Operational due diligence provides insights into the day-to-day operations of the practice and helps identify areas where improvements may be needed.

4. Patient and Referral Relationships

The patient and referral relationships of the medical practice are critical assets that should be carefully examined during due diligence. Consider the following:

Patient Records: Ensure that patient records are well-organized, compliant with legal requirements, and easily transferrable to the new owner.

Provider Relationships: Evaluate the relationships between the practice’s healthcare providers and assess their willingness to stay on after the acquisition.

Referral Sources: Identify the practice’s referral sources and assess the strength of these relationships, as they can impact patient volume.

Non-Compete Agreements: Review any existing non-compete agreements with healthcare providers to understand their potential impact on the acquisition.

Understanding patient and referral relationships is vital for maintaining continuity of care and ensuring a smooth transition.

5. Real Estate and Facility Considerations

If the medical practice includes real estate or operates in a specific facility, it’s essential to evaluate the property and facility-related factors:

Lease or Property Ownership: Determine whether the practice leases or owns the property and evaluate the terms and conditions of the lease or ownership agreement.

Zoning and Permits: Confirm that the property is appropriately zoned for medical use and that all necessary permits are in place.

Condition Assessment: Conduct a thorough inspection of the facility to identify any needed repairs, renovations, or compliance issues.

Utility and Maintenance Costs: Assess utility costs, maintenance expenses, and any outstanding facility-related liabilities.

Real estate and facility considerations are critical to ensure that the practice’s physical assets align with your long-term goals and investment strategy.


Purchasing a medical practice is a significant undertaking with numerous complexities, but thorough due diligence is your key to making a successful and informed investment. By following this comprehensive checklist and working with experienced professionals, you can assess the financial, legal, operational, patient, and real estate aspects of the practice thoroughly. At Real Estate Law Corporation, our team of attorneys specializes in healthcare and real estate law and can provide expert guidance throughout the due diligence process. With careful diligence, you can embark on your journey to acquire a medical practice with confidence, knowing that you have minimized risks and positioned yourself for a prosperous future in healthcare.

Whether you’re a property owner, investor, or business owner, Real Estate Law Corporation™ is your trusted partner on the path to legal success. Contact us today to embark on a journey of exceptional legal support. Our team of seasoned attorneys brings decades of experience to every case, demonstrating a profound understanding of real estate law, transactions, litigation, business intricacies, and estate planning. With a proven record of success, our portfolio is adorned with numerous landmark cases that stand as a testament to our dedication, expertise, and commitment to achieving favorable outcomes for our clients.