Before AHA does anything inside a practice, both sides agree — in writing — on three things: what authority we hold, what is in scope, and what conditions end the engagement. Turnaround work fails on ambiguity. The charter removes it.
Which operational decisions AHA makes, which the owners keep, and which require both. Temporary authority is what makes an operator effective — and written boundaries are what make temporary authority safe. Clinical decisions always remain with physicians.
What the engagement covers, and — just as deliberately — what it does not. Bounded scope is how urgency stays productive instead of metastasizing into an engagement without edges.
What must be true for the engagement to end: which systems are installed, which roles are filled and performing, which numbers are stable. Exit is defined at the start, when everyone is clear-eyed — not negotiated at the end.
If we hold authority and the practice doesn’t stabilize, there is no one else to point at. The charter makes our accountability enforceable rather than rhetorical. That is the arrangement working as intended.
Engagements move through four phases. The pace varies with the practice’s condition; the sequence doesn’t.
A structured assessment of the practice’s cash position, operations, and governance — built from the practice’s own data and the people who run it. The output is a shared, written understanding of what is actually wrong, the order it must be addressed in, and what stability will look like for this practice.
Cash brought under visibility and control. Critical operational failures triaged. Stalled decisions made. Stabilization favors reversible speed over elegant design — the practice needs a floor before it needs an architecture.
The management rhythm, reporting, role structure, and governance practices the practice will run itself. People are trained into the systems, not just handed them. This phase converts the recovery from an event into a capability.
Authority transfers back on schedule and our involvement tapers by plan. The engagement ends as chartered — with the option of Ongoing Maintenance if the practice wants a periodic outside check on its own numbers.
Each charter’s specific terms — decision rights, thresholds, timelines, and commercial arrangements — are set with each practice, in private, where they belong. We publish the structure rather than the template because the discipline is the point: no AHA engagement begins without one.
All four service lines run under this structure. A maintenance relationship gets a lighter charter than a turnaround — but it gets one.
A first conversation obligates nothing. If a structured assessment makes sense, we’ll say so. If it doesn’t, we’ll say that too.
Or reach John Austin directly: admin@austinhealthadvisory.com