Why a med spa needs one engagement, not four vendors
In most aesthetics practices the money is handled by four people who never talk to each other: a bookkeeper who records what hits the bank, a payroll service that pays what the commission spreadsheet says, a preparer who sees the file in March, and the owner, who reconciles the POS to nothing. The result is predictable. Packages booked as revenue in the month they are sold. Neurotoxin and filler expensed in the month the shipment arrives. Commissions paid on package sales, then paid again when the treatment is redeemed. Retail sales tax filed from a POS report nobody mapped.
Med Spa Core puts the five pieces under one person because, in a med spa, they are one system. The package liability on the balance sheet decides when revenue is earned and when it is taxed. The provider production report drives both the commission accrual and the payroll register. The tax code on a retail serum in the POS decides what goes on the sales tax return. If the bookkeeping is wrong, the payroll is wrong, the sales tax is wrong and the tax return is wrong, in that order. Jenny Gao, CPA, EA, reviews every close and prepares the return from the same numbers.
What a month looks like
Core runs on a calendar, not on when someone gets to it. The close lands by the 10th business day because sales tax returns, estimated payments and payroll decisions all wait on it.
| When | What happens | What you see |
|---|---|---|
| Business days 1–3 | Bank, card, merchant and loan feeds reconciled in QuickBooks Online; POS sales-by-category, outstanding-balance and provider production reports pulled | One email with the handful of transactions we need you to identify |
| Business days 4–7 | Package, membership and gift-card rollforward tied to the POS; injectable and retail counts reconciled and cost of goods sold booked; commission accrual built from production and tied to payroll | Nothing yet — this is the work a bank-feed bookkeeper skips |
| Business days 8–10 | Balance sheet reviewed and signed off; P&L by service line, KPI sheet and rollforward issued; sales tax payable reconciled to the POS tax report | The report pack, with a short note on what moved and why |
| By the 20th | Retail sales tax returns filed in each state; payroll tax deposits and quarterly filings checked against the ledger | Filing confirmations |
| Each quarter | Tax projection from closed books; estimates recalculated; owner salary, device purchases and distributions reviewed | A one-page projection and the payment vouchers |
| October–December | Year-end planning: equipment timing under Section 179 and bonus depreciation, owner compensation, retirement contributions, 1099 vendor review | A written year-end plan with dates |
An illustrative month
An illustration, not a client. A single-location practice in Florida runs two injectors and one aesthetician and does about $1.8 million a year. In October the POS shows $160,000 collected before sales tax and tips. Of that, $40,000 was package and membership sales for treatments not yet delivered, and $35,000 of earlier packages was redeemed. The practice received $30,000 of neurotoxin and filler and used $21,000. Commissions earned on October production were $38,000, paid in the first November payroll. Retail skincare was $12,000 of the $160,000.
Cash-basis books call October a $160,000 revenue month, expense the full $30,000 of product, and show the $38,000 of commissions in November. Core books it the way the practice actually operated: $155,000 of revenue ($160,000 collected, less $40,000 sold but not yet delivered, plus $35,000 redeemed), $21,000 of product cost with $9,000 still in the refrigerator, $38,000 of commission accrued in October, and a package liability that grew by $5,000. Gross margin by service line is now a real number. The $12,000 of retail carries Florida sales tax at 6% plus the county surtax; the $143,000 of treatments does not. The January estimated payment is calculated from that P&L, not from the bank balance.
Who Core fits
Core is built for single- or two-location practices doing roughly $500,000 to $5 million a year — typically one to four injectors, memberships or packages, real inventory, W-2 providers and an owner who still signs off on the numbers. It also fits funded practices about to open, where the chart of accounts, POS mapping and payroll are built before the first sale; see accounting setup for a new med spa.
Practices past about $1 million with two or more locations, or with an MSO alongside a professional entity, usually need more than Core: a controller who owns the intercompany settlement, a CFO who runs the 13-week cash forecast, or a tax director who plans the management fee. Those are scoped after a diagnostic as fractional leadership engagements, and Core remains the base either way. Our guide to who a med spa needs, and when draws the line in more detail.
What Core does not include
Core is accounting, tax, sales tax and payroll coordination. It is not an audit, review or compilation; Balance Partners does not provide attest services. Payroll runs stay with Gusto, ADP, Paychex or QuickBooks Payroll — we coordinate and reconcile, we do not process. Bills are approved and paid by you unless the cash flow and bill pay scope is added, and even then every payment carries your authorization. Prior months that need rebuilding are a separate one-time fixed project, quoted after the diagnostic, so the monthly fee is never inflated to pay for history. And we work only with practice owners: no white-label, overflow or subcontracted work for other accounting firms, and no referral fees in either direction.