DenQAIPatient-centered ownership

Build pathway · Startup control system

Finish the project with enough freedom and cash to care for patients.

A startup is a care model, facility plan, site, lease, construction project, equipment handoff, payer process, staffing plan, operating launch, and household commitment. Keep them in one review without collapsing them into a “go” score.

Open the local workbenchDownload the guided Excel workbookLearn the buildout method

Before you enter numbers

Know the question, gather the records, and choose how deep to go.

You are deciding whether the care model, site, complete budget, cash, and opening plan can survive the next commitment without consuming the reserves needed after opening.

First useful review
30–45 minutes for the capital and reserve review
What you receive
Complete project cost, remaining contingency, pending exposure, opening working capital, funding gap, and open safety checks
1

Gather these first

  • Patient-care model, planned hours, rooms, team, procedures, and referral assumptions
  • Site and lease terms, issued plans, utility and building-system findings
  • Comparable contractor bids, equipment and technology quotes, and financing sources
  • Approved and pending changes, opening expenses, working capital, and household reserve
2

Guided review

Start here if you are learning the decision or do not have every record yet.

  • Define the care model and the space it actually requires
  • Enter the five budget groups, project sources, contingency, and protected reserves
  • Read the cash-to-open result before comparing detailed bids or changes
3

Detailed review

Use this after the first result, or with advisers and stronger records.

  • Compare bids on one scope and expose allowances and exclusions
  • Track each change and each opening dependency separately
  • Clear site, lease, design, team, liability, and readiness checks with the right reviewers
Your output order
  1. Read and print the plain-language result on this page.
  2. Download the Excel decision workbook when one is available.
  3. Save a DenQAI project file if you want to reopen your inputs.
  4. Use raw CSV only for advanced data work.

Complete fictional example

A $1,500,000 five-budget base does not answer whether the practice is ready to build or open.

The loaded example preserves $92,000 of construction contingency after approved changes, then separately exposes opening working capital, pending exposure, household reserve, bid-scope documentation, site safety checks, and twelve dependencies.

Project sources$1,775,000

Entered commitments—not an approval

Opening working capital$155,000

After protected project uses

Pending change exposure$41,000

Draft plus pending direct and downstream cost

Open safety checks19

Documentation, bids, dependencies, practice reserve, and household reserve

All figures are fictional and deliberately incomplete. They are not cost-per-square-foot benchmarks, lender terms, market forecasts, construction advice, or a recommended startup budget.

Local startup control file · Model v1.0.0

Protect the care model and the opening reserve in the same record.

The workbench does not approve a site, lease, plan, bid, contract, loan, code interpretation, or opening. It makes the project dependencies, assumptions, limits of the available evidence, and reserve consequences visible.

Data boundary

No patient, employee, credential, private quote, or unredacted contract records belong here.

Use coded project labels and short local locators. Nothing is uploaded or saved by DenQAI. Your values remain in this browser tab until you export a file you control.

Local export available

No common direct-identifier pattern detected. Pattern screening cannot certify confidentiality or de-identification.

01 · Owner mandate

Define what the facility must protect before drawing rooms.

A floorplan is an operating model with walls. Debt service is not a clinical design brief.

02 · Operating program

Translate care into actual opening and stabilized capacity.

Rough in inexpensive future infrastructure only when each deferred room has a written utilization, staffing, cash, and access trigger.

Decision Summary · 03 · Capital and protected reserves

Construction completion is not the capital requirement.

Site and lease, professional services, construction, equipment and opening inventory, and pre-opening operations are separate. Contingency, practice working capital, and household reserve remain visible.

Project uses

Committed sources

Owner reserve contract

Opening working capital = committed sources − five-budget base − the larger of planned contingency or approved change cost. The pending case also reserves draft and pending change exposure. These are user-entered scenarios, not construction estimates or financing commitments.

04 · Comparable bid bridge

The lowest quoted total may contain the largest unanswered scope.

Reconcile each proposal to one issued package. The adjusted total below adds entered allowance exposure and owner-budgeted exclusions; it does not decide bidder quality or contract risk.

BID-A
$797,000
BID-B
$839,000
BID-C
$806,000
Use the row-level common-scope matrix.

Compare inclusion, exclusion, allowance, alternate, owner-supplied, ambiguity, and no-response across demolition, partitions, millwork, dental utilities, electrical, HVAC, low voltage, life safety, permits, testing, training, and closeout.

Download bid-scope matrix

05 · Site and project safety checks

A favorable capital result cannot resolve missing authority, an unsafe plan, or an unreviewed contract.

“Reviewed with limits” requires a direct project document and a named reviewer. It is not the same as approved, compliant, or guaranteed.

01 · Permitted use and authorityReviewed with limits
02 · Lease and site economicsRequested
03 · Accessibility and local codeRequested
04 · Utilities and building systemsRequested
05 · Clinical flow and infection preventionRequested
06 · Bid scope and construction contractRequested
07 · Financing and reserveReviewed with limits
08 · Opening readinessRequested

06 · Formal change control

Every field change draws from reserve, schedule, or operating intent.

Direct price is not the whole change. Capture downstream work, delay, owner, record, and operating consequence before approval.

CO-001
CO-002
CO-003
CO-004

07 · Opening dependency map

Completed tasks matter only when they unblock safe opening.

Lease, plans, permit, financing, contractor, utilities, equipment, technology, credentialing, staffing, occupancy, and opening are one critical path.

01

Site control

02

Lease and work letter

03

Operating program and plans

04

Permit and local approvals

05

Financing and sources

06

Construction and inspections

07

Equipment delivery and acceptance

08

Technology, phones, and security

09

Payer enrollment and credentialing

10

Hiring, policies, and training

11

Occupancy and closeout

12

Controlled opening

19unresolved safety checks
  1. Lease and site economics: direct record and named reviewer have not reached reviewed-with-limits status.
  2. Accessibility and local code: direct record and named reviewer have not reached reviewed-with-limits status.
  3. Utilities and building systems: direct record and named reviewer have not reached reviewed-with-limits status.
  4. Clinical flow and infection prevention: direct record and named reviewer have not reached reviewed-with-limits status.
  5. Bid scope and construction contract: direct record and named reviewer have not reached reviewed-with-limits status.
  6. Opening readiness: direct record and named reviewer have not reached reviewed-with-limits status.
  7. Lease and work letter: dependency is not complete with an owner and supporting document.
  8. Operating program and plans: dependency is not complete with an owner and supporting document.
  9. Permit and local approvals: dependency is not complete with an owner and supporting document.
  10. Construction and inspections: dependency is not complete with an owner and supporting document.
  11. Equipment delivery and acceptance: dependency is not complete with an owner and supporting document.
  12. Technology, phones, and security: dependency is not complete with an owner and supporting document.
  13. Payer enrollment and credentialing: dependency is not complete with an owner and supporting document.
  14. Hiring, policies, and training: dependency is not complete with an owner and supporting document.
  15. Occupancy and closeout: dependency is not complete with an owner and supporting document.
  16. Controlled opening: dependency is not complete with an owner and supporting document.
  17. Fictional Bid B: proposal scope has not been reviewed against a common bid package.
  18. Fictional Bid C: proposal scope has not been reviewed against a common bid package.
  19. Opening working capital is below the owner mandate after approved project commitments and protected contingency.

Save or share your review

Start with the readable Excel workbook or printable review.

The workbook includes instructions, examples, units, formulas, questions, and a data dictionary. Save the DenQAI project file only if you want to reopen these exact inputs here. Nothing is uploaded.

Download startup workbook (Excel)
Advanced data exports

These CSV files are raw row-and-column data for advisers or analysts. They are not the recommended reading format.

Fictional example loaded. Replace every assumption with direct project records.

For any reopened project file, confirm the source period, supporting documents, reviewer roles, and model version before relying on the result.

Continue the evidence chain

The buildout record is not the market case or the 48-month cash model.

Local Market Evidence Builder

Prove the city, trade area, patient segment, provider capacity, payer, staffing, and site context before programming demand.

Open →Six-path ownership comparison

Compare startup with employment, acquisition, modernization, succession, and affiliation on one ten-year contract.

Open →First 48 Months

Roll practice and household cash separately after opening and expose the additional capital required to preserve each floor.

Open →Delay Cost Clock

Price rent, interest, payroll, storage, rework, and unrecovered contribution when opening slips.

Open →Revenue-cycle control

After opening, follow production to bank-cleared cash, classify exceptions, pay owner clinical labor, and preserve the operating reserve.

Open →