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How to Launch an Aquatic Therapy Practice
A 25-Step Plan for Aquatic Entrepreneurs


You've read every article on the benefits of aquatic therapy. You've surreptitiously ordered books from on water-based exercise. You just came back from an incredible seminar on Watsu® — or Halliwick or Ai Chi. There's one problem. Your facility hasn't got a pool.

For all intents and purposes, you're a closet aquatic therapy provider. Well, today's the day. It's time to launch your own aquatic therapy facility (or add a pool to an existing practice). This 25-step process will help you get organized and stay focused along the way.

Step 1. Hypothesize the need for a new aquatic therapy pool or facility in your area.
Order the Training Manual "How to Successfully Launch an Aquatic Therapy Practice".

Step 2: Begin to determine sources for the financing.
Begin discussions with funding sources. Do you intend to raise money for this construction from existing business capital, a commercial loan or from alternative sources (such as grants, private philanthropic organizations or the community)? If you intend to seek financial assistance, you will need professional help to complete a grant application or business plan which is lucid, functional, and, most importantly, plausible.

Step 3: Hire a functional design consultant.
Hire a functional design consultant to assist you in "mapping out" the community needs that your prospective pool will meet. This step cannot be overlooked as it will determine everything from the necessary shape and water temperature of your pool to the availability of referral sources and patient populations. Your architect's hands will be tied until this functional description is created and the time spent in this stage is critical to prevent later complications. You may contact the Aquatic Resources Network via phone (715) 248-7258 or fax (715) 248-3065 to hire our functional design consultant or to find an alternative consultant.

Step 4: Examine other pools.
Study the strengths and weaknesses of aquatic therapy facilities in your area; these are your geographic competitors. Study the strengths and weaknesses of facilities which have similar missions and clientele to your intended site; these are worthy of emulation. Seach for facilities with similar missions, locations or populations to your proposed facility. This service is free to members. A search fee may be required for more extensive searches or multiple requests.

Step 5: Determine if you will purchase a prefabricated pool or have your pool custom-designed.
1. If you intend to purchase a prefabricated pool, request materials from prefabricated pool manufacturers to help you make a decision about the right purchase. Some of the manufacturers are listed below:

  • Adolph Kiefer & Associates — 800/323-4071; 847/872-8866
  • Aqua Motion — 800/423-9090; 303/530-7946
  • Arjo, Inc — 800/323-1245; 630/967-0360
  • Aquatic Therapy Systems — 800/220-1287; 610/940-1435
  • Endless Pools — 800/732-8660; 610/497-5470
  • FERNO-Ille — 800/733-3766; 937/382-1451
  • Hydro-Worx — 800/753-9633; 717/948-2000
  • Med-Fit System, Inc. — 800/831-7665; 760-723-9618
  • Spectrum Pool Products — 800/776-5309
  • SwimEx Aquatic Therapy Systems— 800/877-7946; 401/245-1200
  • Therapeutic Systems Inc. — 800/777-1870
  • Wave Length — 877/850-1973

Even if you intend to purchase a prefab pool, it is helpful to seek assistance from a functional design consultant (see Step 1). Such assistance will ensure that any pool your purchase will meet the needs of your clientele (e.g. entry methods, dressing rooms, water temperature), referral sources, and colleagues.

2. If you intend to have your pool custom-designed, it is critical that you first consult with two types of specialists prior to hiring an architect or construction team:

  • An architectural design consultant. An architectural design consultant will ensure that your proposed facility will meet all codes and will function appropriately as a commercial therapeutic pool, not as a standard swimming pool or backyard pool. See Step 7 for more details.
  • A functional design consultant. A functional design consultant will aid you in creating a functional business plan and will ensure that your pool design is consistent with your intended program requirements and specifications. See Step 3 for more details.

Note: these consultants do not need to live near you; in fact, they rarely will. But they will help you shape your ideas into a workable pool design.

Step 6: Construct a business plan and functional design description.
With your functional design consultant (see Step 3), construct a comprehensive business plan including a functional design description of the proposed facility or pool. This is the most important preliminary step. This business plan should include, at the least, the following:

1. Business Description, including:

  • Overall Description
  • Specific Purposes
  • History
2. Marketing Strategy, including:
  • Information and Research Strategy
  • Organization and Management
  • Management Objectives

3. Market Definition, including:

  • Customer Description
  • Customer Base

4. Market Growth

5. Competition, including:

  • Identification
  • Strengths and Weaknesses

6. Marketing Plan, including:

  • Overview
  • Marketing Objectives
  • Marketing Strategy

7. Sales

8. Production Plan, including:

  • Facility Requirements
  • Equipment Requirements

9. Operating Plan

10. Organization Structure & Labor Requirements

11. Business Advisors

12. Financial Plan Summary, including:

  • Income and Expense
  • Cash Flow
  • Assets and Liabilities (Balance Sheet)

13. Sources of Funds

14. Biographies of Principals

Step 7: Hire an architectural design consultant and obtain pertinent codes and standards.
Hire the architectural design consultant. The consultant should be involved with construction and should communicate with the architect and engineer. Order your state's administrative code on swimming pool construction and design (typically can be obtained via the Department of Health). Each state calls this code something different (Pool Codes, Sanitation Codes, Swimming Pool Rules, etc.).The National Recreation and Parks Association has just released an excellent resource which gives an overview of state codes and regulations for swimming pool construction (see below under Johnson K).

If you choose not to hire a consultant (not recommended), you will need to obtain resources which pertain to your proposed construction or installation. It is very important to note that the codes for a swimming pool and the codes for a special use or therapy pool can be very different.

Below, find an incomplete list of helpful resources:

American Public Health Association. Public Swimming Pool Recommended Regulations for Design and Construction, Operation and Maintenance, most recent ed. American Public Health Association, Washington, D.C..

Centers for Disease Control. Swimming Pools: Safety and Disease Control Through Proper Design and Operation, most recent ed. US Department of Health and Human Services, Public Health Service, Atlanta, GA: 88-8319.

Council for National Cooperation in Aquatics. Swimming Pools: A Guide to their Planning, Design and Operation, most recent ed. Champaign, IL: Human Kinetics.

Griffiths T. The Complete Swimming Pool Reference, most recent ed. Hoffman Estates, IL: NRPA Aquatic Publications Catalog.

Johnson K. The Encyclopedia of Aquatic Codes & Standards. Hoffman Estates, IL: National Recreation and Park Association; 2000.

Moschetti M. Facility design. In: Ruoti RG, Morris DW, Cole AJ (eds). Aquatic Rehabilitation for Health Professionals. Philadelphia, PA: Lippincott-Raven: 1997: 355-374.

Thomas, D.G. Swimming Pool Operators Handbook, most current ed. National Swimming Pool Foundation: Washington, D.C.

U.S. Department of Health, Education and Welfare. Swimming Pools, Safety and Disease Control Through Proper Design and Operation, Publication No. (CDC) 77-8319, most recent ed. Centers for Disease Control, Public Health Service: Atlanta, GA.

Step 8: Promote the financing in earnest.
Do you intend to raise money for this construction from existing business capital, a commercial loan or from alternative sources (such as grants, private philanthropic organizations or the community)? It is often necessary to commit a full-time person as a fund-raiser if money is to be obtained from outside sources. If you intend to seek financial assistance, you will need a grant application or business plan which is lucid, functional, and, most importantly, plausible. Although it is tempting to try to create such a document internally, it is not usually worthwhile to do so. Contact the Aquatic Resources Network via phone (715) 248-7258 or fax (715) 248-3065 to hire our grant proposal consultant or to find an alternative resource.

Step 9: Select an architect.
Select a local architect who has experience in at least two, and preferably many, similar projects. Ensure that the architect has designed plans for therapeutic pools and not just swimming or recreational pools as these require dramatically different designs.

Step 10: Select a site.
Select a site based on the advice of the consultants and architect. If you have already committed to a site or if you are planning to add the pool to an existing site, have your functional and architectural design consultants ensure that your choice is appropriate for your needs. It's better to know now whether that site you've already chosen will yield the results you seek.

Step 11: Commission preliminary construction designs and cost estimates.
Commission the architect to make preliminary drawings and cost estimates.

Step 12: Compromise.
After the drawings and estimates are completed, meet with the architect and both pool consultants (this can be accomplished via conference calls, Internet conferences or fax) to reconcile realism with idealism. Compromise until costs meet funding restrictions.

Step 13: Commission construction plans and working documents.
Commission the architect to draw construction plans and working documents. Ensure that the architect provides your pool consultants access to all plans in order to provide assistance.

Step 14: Submit plans to health commissioner for review and approval.
Submit plans for swimming pool construction to the commissioner of health for review and approval. To determine exactly what is required by your state, examine your Department of Health's Administrative Code. Once a plan is approved by the Commissioner, typically no modification affecting the safety and sanitation features of the pool can be made without prior written approval of the Commissioner.

Step 15: Submit plans for bidding to contractors.
Submit plans for bidding to contractors. Ensure that any contractors you consider has constructed at least two therapeutic pools (not swimming pools) similar to yours.

Step 16: Oversee construction.
Oversee construction or installation. Insist that the pool consultants be made aware of any changes proposed by the contractors in order to make comments prior to such changes being authorized.

Step 17: Create policies and procedures manual.
Create a policies and procedures manual including job descriptions and training standards for all staff to be employed. Contact the Aquatic Resources Network via phone (715) 248-7258 or fax (715) 248-3065 to hire our P&P ghost writer or to find an alternative resource.

Step 18: Determine programming.
Determine programming, scheduling, and equipment needs for intended aquatic therapy programming. Note that you should have already determined what type of populations you will serve before the pool was constructed (see Step 3). Otherwise, you will be limited to offering what your newly-built pool will allow.

Step 19: Find aquatic therapy staff.
Hire employees or contract with therapists interested in leasing space in the pool once constructed. Decide if you want the pool staffed by therapists, fitness instructors, adapted aquatics instructors, etc. (Note: this will be based on the type of intervention you intend to provide; see Step 6).

Step 20: Execute marketing strategies.
Plan and execute a marketing and public relations campaign to launch your program (Note: this should begin at least six to nine months prior to the grand opening of your new pool or facility).

Step 21: Have pool inspected.
After the pool is built, the commissioner and any local jurisdiction which regulates pool use must inspect the facility to determine compliance.

Step 22: Train staff.
Train staff by bringing a CME educator to do site-specific training. Contact the Aquatic Resources Network via phone (715) 248-7258 or fax (715) 248-3065 to find an appropriate CME educator.

Step 23: Open facility or pool.

Step 24: Justify aquatic therapy treatment to payers and referring professionals.
Contact the Aquatic Resources Network via phone (715) 248-7258 or fax (715) 248-3065 to purchase Prove It! Justifiable Aquatic Therapy or to get information on an upcoming seminar on the same topic.

Step 25: Train staff again.
Once the facility or pool has been open for six months to a year, staff will have a much better idea of their educational needs. See Step 22.

Learn More on this Topic
The above information was excerpted from the Aquatic Resources Network conference "How to Successfully Launch an Aquatic Therapy Practice: A Strategic Planning Workshop for Entrepreneurs".

To obtain the powerful Training Manual "How to Successfully Launch an Aquatic Therapy Practice", click here or call ARN at (715) 248-7258 to request information by phone.


The information presented in this article is meant to be a summary and educational in nature. It is not meant to serve as a substitute for legal advice.

Author Bio
Andrea Poteat Salzman, MS, PT is the owner of two businesses, the Aquatic Resources Network and Concepts in Physical Therapy. She has received both the prestiguous Aquatic Therapy Professional of the Year Award (Aquatic Therapy and Rehabilitation Institute) and the Tsunami Aquatic Therapy Award.

Salzman is well-regarded within the industry as:

  • Editor-in-Chief of an aquatic therapy trade journal and newsletter;
  • Author of over a dozen publications, including the soon-to-be-released Evidence-Based Aquatic Therapy textbook;
  • Freelance author and columnist;
  • Aquatic therapy seminar instructor;
  • Adjunct faculty and research advisor, St. Catherine Physical Therapy Program, Minneapolis, MN;
  • Immediate past manager of therapeutic aquatics, St. Paul Ramsey Medical Center, St. Paul, MN;
  • Researcher and grant recipient examining aquatic exercise vs. land-based exercise.

She may be reached via e-mail at


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