Medical Spa Operating Agreement: What You Need

A medical spa operating agreement is the internal governance document for LLCs or partnerships running a med spa. This agreement is separate from your medical director agreement and governs how the business entity operates.

Why You Need an Operating Agreement

An operating agreement serves several critical functions:

  • Defines ownership percentages and capital contributions
  • Establishes management structure and decision-making authority
  • Protects your business structure and limited liability
  • Prevents disputes between owners
  • Addresses CPOM compliance requirements

Many states require operating agreements for LLCs, but even if not required, having one protects all parties.

Key Components for Med Spa Operating Agreements

Business Structure and Ownership

Define the fundamental structure:

  • Entity type (LLC, partnership, etc.)
  • Member or partner names and ownership percentages
  • Capital contributions from each owner
  • Additional capital call procedures

Management Structure

Specify who manages the business:

  • Manager-managed vs. member-managed structure
  • Decision-making authority and voting rights
  • Day-to-day operational control
  • Major decision approval requirements

CPOM Compliance Provisions

Critical for med spas owned by non-physicians:

  • Reference to medical director agreement
  • Prohibition on interfering with medical decisions
  • Separation of business and medical operations
  • Compliance with state corporate practice laws

Financial Provisions

Detail money matters:

  • Profit and loss distribution
  • Draw and distribution schedules
  • Accounting and record-keeping requirements
  • Tax treatment and allocations
  • Banking and financial controls

Member Duties and Restrictions

Define what members can and cannot do:

  • Time commitments and involvement levels
  • Competing business restrictions
  • Confidentiality obligations
  • Non-solicitation provisions

Transfer and Buy-Sell Provisions

Address ownership changes:

  • Restrictions on transferring ownership
  • Right of first refusal procedures
  • Buy-sell triggers (death, disability, etc.)
  • Valuation methods for ownership interests
  • Drag-along and tag-along rights

Dispute Resolution

Establish how conflicts will be handled:

  • Mediation requirements
  • Arbitration procedures
  • Governing law and jurisdiction
  • Attorney fee provisions

Dissolution and Winding Up

Plan for potential business ending:

  • Events triggering dissolution
  • Winding up procedures
  • Asset distribution priorities
  • Final accounting requirements

Special Considerations for Med Spas

MSO Structure Operating Agreements

If you're operating as an MSO:

  • Reference to management services agreement with PC
  • Scope of MSO vs. medical practice activities
  • Financial arrangement limits
  • Independence protections for physician PC

Multi-Location Provisions

For med spas with multiple locations:

  • How new locations are added
  • Allocation of expenses and profits by location
  • Local management authority
  • Expansion approval procedures

Equipment and Intellectual Property

Address ownership of:

  • Medical and aesthetic equipment
  • Trade names and branding
  • Marketing materials and patient lists
  • Proprietary protocols and procedures

CPOM Pitfalls in Operating Agreements

Avoid these common mistakes:

Giving Non-Physicians Medical Authority

Your operating agreement should not:

  • Give non-physician owners authority over medical decisions
  • Allow business managers to override physician judgment
  • Create incentives that pressure medical decision-making

Inadequate Separation in MSO Structures

Must clearly separate:

  • MSO business operations
  • Physician PC medical practice
  • Financial arrangements between entities
  • Decision-making authority for each

Missing Required State Provisions

Some states require specific language about:

  • Professional liability and malpractice
  • Physician supervision and oversight
  • Scope of practice limitations
  • Licensing and regulatory compliance

When to Update Your Operating Agreement

Review and amend your agreement when:

  • Adding or removing members
  • Changing management structure
  • Expanding to new locations
  • Adding new service lines
  • State regulations change
  • Business valuations significantly change

Getting Professional Help

Have these professionals review your operating agreement:

  • Healthcare Attorney: Ensure CPOM compliance
  • Business Attorney: Protect business interests
  • Tax Professional: Optimize tax treatment
  • Valuation Expert: For buy-sell provisions

The cost of proper legal review is minimal compared to the cost of disputes or compliance violations.

Learn more in our complete Med Spa Compliance Guide, including MSO structures and medical director requirements.

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