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How to Start a Residential Treatment Center.

Residential treatment centers are a crucial part of the continuum of care in the cure of substance use disorders. With the increase in the amount of addiction-related deaths, there is a real need for more high quality residential treatment centers. But is now the right time for you to open your own? Let Ascension help you make that decision and guide you through the process.






 Feasibility and Market Analysis
 Business and Organizational Structure
 Full Support for Starting a Center


Ascension provides start-up consulting services for individuals, business partnerships, hospitals and institutions interested in developing residential treatment centers. 

Our proven track record supporting program development efforts focuses on two main goals:

1. Providing the highest quality of care
2. Creating a sustainable and financially viable business model

Ascension guides its clients and partners from the research and planning phase through opening the doors of your facility. With an accelerated development process, smooth opening and a solid operating model, we help you start making a significant positive impact on community health in your area.


Some of the Residential Treatment Centers we have developed:

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Have you hit a roadblock during the development of your residential treatment center? We can help.


Residential Treatment Center Feasibility and Market Analysis

During the first phase, we will conduct a feasibility study and market analysis to determine the most desirable location for the residential treatment center, type of program (clinical or peer-driven, insurance-based or cash pay, considering commercial insurance vs Medicaid), target populations, competition and state and local regulations / code. A thorough analysis by our team of experts during this phase is crucial to establishing a successful program. There are many treatment programs in existence and more coming to market; it is imperative to know what is in your area, what is coming to your area and how you will differentiate yourself, better serve the population and establish a long-term financially viable facility.

Residential Treatment Center Business and Organizational Structure



During Phase Two, we begin by developing a budget based on the owners’ / entities’ desires and financial tolerability. Start-up capital is usually comprised of cash and financing activities, with a goal of recuperating capital contributions through operating activities in the first couple of years. We will also assist the owners with setting up the appropriate business structure and will further investigate the regulations and code specific to the state your facility will be operated in, which will translate through all phases of development.



We will assist in the application for a behavioral health license if one is not already possessed by the entity. We will guide the application process, including best practice recommendations for communicating with state licensure bodies to alert them of the plans for the new facility. Support will be provided if there is a need to file for a Certificate Of Need (CON) or exemption.

We will work with you to complete all licensure applications, ensure receipt of CON or exemption and keep the state aware of all plans as we move forward to meet all applicable state codes (health, life, fire and safety). The clinical program of the residential treatment center will be intentionally designed to meet the licensing and regulatory requirements as well as the goals for treating guests of the center.

Proforma Financial Analysis

Proforma Financial Analysis

Ascension will simultaneously begin developing a draft proforma financial analysis, which will include:

  • Staffing model and salaries
  • Revenue stream projections & reimbursement rates
  • Operational expenses
  • Property lease vs buy analysis
  • Analysis of the target number of patient beds to meet the financial goals

The proforma financials will be refined throughout the development period as we recognize actual expenses, negotiate rates with various insurers, establish staff salaries, etc.

Full Support for Starting a Residential Treatment Center

The third phase of development of the residential treatment center will coincide with the following:

  • Purchasing, constructing or leasing
  • Programming
  • Program materials
  • Staffing
  • Marketing
  • Grant funding
  • Research

Ascension also has partnerships with leading industry firms specializing in logo design, branding and marketing services (website development, marketing strategy, SEO, PPC, social media, etc.). These partnerships equate to significantly reduced rates due to existing synergies and makes Ascension a one-stop-shop for full business startup support.

Purchasing, Constructing or Leasing

Purchasing, Constructing or Leasing

During Phase Three, we will execute on our facility (property) decision made in Phase Two to either lease or purchase / build a facility. Should the owner wish to build the facility, Ascension offers property development services through our partner organization with more than 30 years in the commercial real estate development business. In previous engagements, we have purchased the land, hired the architects, engineers, commercial builders and fully managed the construction of the treatment center from start to finish. We will borrow the money and finance the project so you don’t have a large capital expense at project order. Should the owner choose to lease, build themselves or utilize existing space, Ascension will assist the architect and general construction contractor in the design and build of the facility and environment.



Ascension assists clients in developing the treatment model that will best serve the trade area. Ascension has implemented the following disciplines into various treatment programming in the past engagements: 

Developed a comprehensive business plan that sets the entity up for success

  • 12-step facilitation model
  • Group therapy
  • Cognitive Behavioral Therapy (CBT)
  • Rational Emotive Therapy (RET)
  • Dialectical Behavioral Therapy (DBT)
  • Systemic family counseling
  • Mindfulness therapy
  • Mindfulness Based Stress Reduction (MBSR)
  • Yoga and meditation
  • Humanistic and existential psychology
  • Motivational Interviewing (MI)
  • Multi-cultural counseling and awareness
  • Social integration
  • Contingency Management
  • Adaptive Information Processing (AIP)
  • Trauma informed care
  • And Medication Assisted Treatment (MAT)

Ascension understands that addiction recovery is not a one size fits all approach, and we will be developing a program that provides a menu of evidence-based practice.

program materials

Program Materials

Ascension offers expertise and support to simplify and accelerate development of program materials, policy and procedure manuals and design of the patient’s daily schedule and curriculum. We have experience establishing Electronic Medical Records (EMR) systems and can help you with a recommendation based on the size and scope of the proposed residential treatment center. Ascension will assist in developing other program materials such as the mission statement, code of conduct, employee handbook and referral package for potential patients. Ascension offers material resources and best practices to guide in the development of policies and procedures manuals specific to licensure requirements of the state where the facility will be located.



Our team will guide you through best practices for staff recruiting, interviewing, selection and training. We can advise on compensation for practitioners and other staff to ensure that they work within the overall budget. The staff may be comprised of addiction specialists, psychiatrists, psychologists, LPCs, LCSWs and non-clinical staff to include chemical dependency technicians / peer recovery coaches and volunteers. The staff will be the fabric of the center’s community and must be well versed in its mission.



Ascension’s industry leading marketing partners offer logo design and marketing of residential treatment facilities to assist with the branding and marketing of the new program. We work with the logo designer and marketing agency to develop a brand and image consistent with the goals developed in the previous phases. Marketing efforts are led by the agency and guided by Ascension. Ascension assists in the creation of a website and marketing materials by providing a draft of mutually agreeable content for the website and marketing materials.

Together, Ascension and our partner agency present an overall strategic marketing effort to reach appropriate audiences for building and maintaining patient census.

grant funding

Grant Funding

Ascension will assist you in researching applicable grants that can support the treatment center. We can also assist you with grant writing and execution of the grants if received. Ascension has assisted our partners in the search of grants, application process, narrative writing, budget creation and writing of the budget justification for various grants totaling millions of dollars for substance use disorder treatment, both state and federal, and participates in the execution of the grant, project management, final analysis and dissemination of final outcomes.



Ascension will assist in establishing a research component to the center to document evidence-based practices and outcomes. This research will be used to publish articles in popular media and journals, which will lend itself to the credibility of the center as a world-class treatment facility. Data and outcomes will be analyzed to ensure that your program is reaching its specific objectives and goals. The data we collect will also be used to justify further state and federal grant funding.

open the doors!

Prepare to Open the Doors

At the end of Phase Three, you will have completed the following efforts in preparation to open your doors and begin to change lives in your region:

  • Developed a comprehensive business plan that sets the entity up for success
  • Developed a world-class clinical program
  • Established a licensed and credentialed facility that reflects the mission of the program
  • Contracts established with all desired payers / insurers
  • Created a robust website and marketing strategy
  • Hired an experienced and well-trained team
  • Grand opening

Ongoing Support

Ascension usually stays on and consults through an initial period of operation to help the owner ensure operational excellence and is then available for consultation on an as-needed basis. 

Value of a Partnership

Developing a treatment facility can provide many challenges. It can take months of planning to execute effectively, and mistakes or missteps can be costly. These mistakes can end up cost tens to hundreds of thousands of dollars in lost revenue, and can even delay the opening of your facility. 

From feasibility analysis and site selection, to program development and staffing, to marketing planning and community relations, our team has the experience and capabilities to effectively launch your new endeavor and build a healthier community.

Ready to start a Residential Treatment Center?