It was 1998 when I first heard the gentle knocking of sleep therapy opportunity. Seven years later, that opportunity is banging down the door.

In 1998, I started with a staff respiratory therapist (RT) to develop a sleep apnea program that tracked compliance. Along with the one RT, we had just four other staff members. Nobody really focused on sleep in our area (Perry County), so we had an obvious advantage.

I crunched the numbers and found undeniable profit potential in continuous positive airway pressure (CPAP) and bilevel positive airway pressure treatment. Competitive bidding was just a theory back in 1998, but even then I did not want to put myself in a situation where I or my employees depended on Medicare to stay in business. Today, we have cut our dependence on Medicare to just 30% of revenue.

A Great Sleep Program
First, we developed custom software to track compliance. Second, we made educating our patients a top priority. Education begins at setup, which takes an average of 35 to 45 minutes, and continues with phone follow-up and Internet follow-up. Third, we develop patient programs all the time. For example, our Friends and Family program awarded a free CPAP mask and tubing to every patient who referred a new CPAP customer to us.

A focused marketing program is another key ingredient. My key salesperson spends 90% of her time at sleep laboratories. At least every 2 weeks, you need something new and exciting to show the laboratories. We work with almost 20 different laboratories, and we have started educating primary care physicians about sleep issues. We work with sleep laboratories not only to build our business, but also theirs.

We will customize our program for any sleep laboratory. For example, some laboratories want certain reports on a quarterly basis. We do help physicians track patient compliance so they can better manage their patient’s condition.

• Work with manufacturers and build strong relationships. Many manufacturers offer training and support, so take advantage of it.
• It is a cliche, but it is true: Put your customers first. Every-thing you do should in some way benefit your customer. If it does not, it probably is not worth the time and energy.
• Offer many products and seek out the latest technology.
• Get input from patients, physicians, and sleep laboratory staff members about ways that you can improve.

No matter how good your sleep program is, it will never succeed without good employees. I have eight RTs and one CPAP technician on staff. You must have staff members who believe in your vision and love to practice sleep. All our therapists focus only on sleep. We train all staff members every 2 months. On the sales side, the love of sleep is just as important.

Physician Reporting
We report detailed clinical data and compliance data to the patient’s sleep laboratory and primary care physician. At any time, the physician can look in his patients’ charts and see the progress they are making. We have detailed quarterly reports that show all patients’ compliance year to date for each sleep laboratory.

We consider 5 hours or more of average use per night to be a compliant patient (above the industry’s 4-hour standard). We set our threshold for patient compliance at 80%. If a patient is not compliant, our quarterly report shows the physician what we are doing to help the patient to become compliant.

We Stress Communication
All staff members should know what is going on even if it does not directly affect what they do day to day. Staff members are visited weekly by the operations manager who educates them on important issues.

A formal monthly operations evaluation is done at each location, which includes chart reviews, inventory evaluations, vehicle inspections, and an overall check. The director of respiratory therapy also performs a monthly evaluation at each location to ensure our sleep apnea program is using proper follow-through. Only through strong communication can you identify areas to improve and create a great working environment.

That positive attitude will rub off on your patients. Of course, not all patients are excited about their therapy at first, but that does not mean they cannot change. We want our customers to be excited about new mask technology, or the new machine that is smaller and easier to travel with. It is all about communication and education of our customers.

Setup for Success
Our locations are set up similar to a doctor’s office with a front reception area and patient rooms. We have one location in a class A office building on the second floor, one location in a strip mall, and two other stores with a more traditional setup. Even there, we still have specific areas for sleep, which include private fitting rooms.

We encourage appointments, and like a physician’s office, we have set appointments for customers with specific therapists each day. We accept walk-ins anytime. About half of our setups are done at the office, while the other half take place in the patient’s home. One full-time employee is designated to call all our patients on a routine basis.

The Future Looks Sleepy
I am always looking at other communities that may have a need for my type of company. If you are looking to expand or invest heavily in sleep, consider the demographics. You need an area that has enough sleep laboratory beds to support you. You also must know the third-party carriers. Who are the big payors and what do they pay for CPAP, bilevel, supplies, and services? DP

Todd Cressler is the owner of CressCare Medical, with four Pennsylvania locations and corporate offices. He can be reached via e-mail: todd@cresscaremedical.com.