Case Study
Southern Sky Recovery

How C4 Consulting Transformed an Ambitious Start-Up into a Successful Treatment Center.

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How C4 Consulting Helped Southern Sky

Southern Sky’s Chief Executive Officer, Nathan Shepard, retained C4 Consulting to provide licensing and accreditation services, operational efficiency consulting, human capital management, clinical services and programming support, vendor selection and management, marketing, sales and business development expertise, financial consulting including billing, insurance contracting, and revenue cycle management consulting.

An ongoing, twenty-five (25) hour retainer per month allowed C4 Consulting to dispatch multiple experts, holding over one hundred (100) years of combined direct experience in behavioral healthcare to collaborate and support Southern Sky’s vision and growth from a pre-launch start up to profitable.


Key Impact – Business Optimization

11 months from licensing to profitability

Average Daily Census Optimization

250% – ADC Growth (Jan ’23 to Sept ’23)

Business Optimization Stats*

$138,000 – Cost Savings

48% – Increase in Successful Completions

84% – PHP Attendance Rates

80% – IOP Attendance Rates

Marketing and Sales Optimization*

30% Increase- Sales Inquiries

27% Increase – Pre-Admission Assessments

54% Increase – Admissions

Admissions Optimization Stats*

3% Increase – Inquiries to Assessments

37% Increase – Assessments to Admission

19% Increase – Close Rate (Inquiries to Admissions)

*All data points exhibited are: 7 Months Pre-C4 Engagement vs. 7 Months Post-C4 Engagement

Since July of 2022, Southern Sky has strived to provide a continuum of high-integrity outpatient care, addiction and co-occurring treatment services to its community.

  • Partial Hospitalization Programming
  • Intensive Outpatient Programming
  • Outpatient Programming
  • Veterans Addiction Treatment Program
  • Outpatient Detox Services
  • Medication Assisted Therapy
the plan

How C4 Consulting Helped Southern Sky

Southern Sky Recovery and it’s Chief Executive Officer and Founder, Nathan Shepard, after several discussions with various consulting firms, including C4 Consulting, decided to go with another consultant to help him prepare to launch the premier outpatient program in Bluffton, South Carolina,
in late 2021.

By early 2022, still in a pre-launch phase, Nathan had quickly realized that he needed a trusted ally and consulting partner who had the depth and breadth of knowledge and experience to help him achieve his dream. He subsequently discontinued services with the previous consulting firm, while
hiring C4 Consulting.

As Southern Sky continues to grow to this day, their relationship with the C4 Consulting team has become an integral part of their expansion strategy and success story.

Dive deeper into this remarkable case study as Nathan Shepard, the Chief Executive Officer, gives a first-hand account as to why Southern Sky chose C4 Consulting for the job and how C4 Consulting transformed Southern Sky Recovery into the thriving treatment center it is today.

The collaboration through the end of 2022 created the foundational elements which included re-design and integration of all policy and procedure manuals, licensing, and JCAHO, accreditation, set up Southern Sky to begin optimizing the business for growth.

The optimization of the organizational culture, operational efficiencies, the focus on getting the right people into the right seats on the bus (human capital management and recruiting), ongoing re-design of and development of the EMR, performance improvement including data collection and reporting, vendor selection for a new digital marketing company, and the development of the Ambulatory Withdrawal Management Program established such a solid infrastructure heading into 2023 fully prepared for aggressive growth.

The timeline

C4's Initial Engagement and Functions

April 2022

  • C4 Consulting’s initial contact and strategic plan development with Nathan Shepard to
    assist with the transition from the existing contracted consulting company.

May 2022

  • Execution of 25 hour a month retainer contract.
  • Redesign of policy book for compliance with South Carolina Licensing
  • Implementation of:
    • Health and Safety and EOC policies and procedures
    • Medication policy design along with establishing pathways for Medication component of care including hiring, training and establishing procedures and protocols for nurse practitioners.
    • Design and training related to EMR implementation
  • Functioning as a remote CEO to single owner operator

June 2022

  • Ongoing preparation and design for Licensing and Joint Commission survey
    scheduled for July.
  • Development of the Performance Improvement process as well as the designing and establishing the training platform (Relias) to meet accreditation (and licensing) requirements.
  • Onsite visit to facilitate South Carolina Licensing Board inspection – completed in a day and licensing granted as the surveyor left the building.

July 2022

  • Onsite visit for preparation and management of the Joint Commission survey.
  • Survey completed with 7 citations (average for new outpatient programs is 14).


the next steps

Licensed and Accredited, Now What?

August 2022

  • Hiring – nurse practitioner, counselors, peers.
  • Partnering with CEO in recruitment – screening, interviewing, orientation (re)design and training.
    • *This is an ongoing process for Southern Sky.

Fall 2022

  • Ongoing training and hiring. Assisted with training for new business development FTE.
  • Ongoing redesign and development of EMR
  • Performance Improvement initiative design, data collection and reporting.
  • Development and launch of Ambulatory Withdrawal Management Program
  • Peer development work
  • Recruitment – interviewing and training/coaching new Clinical Director
  • Assisting with changing digital media management company – recruitment, interview/vetting, execution.
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We've Optimized Our Operations, Now What?

Q1 2023

  • Ongoing business development and financial work.
  • Extensive collaboration with the Director of Business Development
  • Development of an actionable and metric based Marketing and Sales Strategy.
  • Ongoing consultation and vendor management with new digital management company
  • Data management related to census and attendance – reporting monthly with Clinical Director
  • Financial support relating to new billing company (vetting, interviewing)
  • Functioning as coach/executive colleague for support and perspective.

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the results

Holistic Business Optimization Key Impacts

“Their insights have been invaluable on the clinical front, ensuring that our treatments are both state-of-the-art and deeply personal.”


In Cost Savings


Increase in Successful

11 Months

To Profitability

To start 2023 off with a bang, C4 began optimizing all business development efforts including a strong focus on collaborating with the Director of Business Development in the development of an organizational philosophical, value-driven omni-channel marketing and sales strategy, actionable insights and Leadership development within the Business Development department, as well as strategizing on new initiatives to drive inquiries, assessments and admissions.

The optimization of all marketing efforts, top of funnel to bottom of funnel, including strategic collaboration with the new digital marketing company, while advancing sales efforts while focusing on adding value to referents, providers and the community as a whole transformed and fueled aggressive growth for Southern Sky.

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the future

Well, We've Optimized Business Development, Now What?

Q2 2023

  • C4 functioning primarily as a point of contact for an expert perspective to Nathan Shepard and other Leadership Team members
  • Ongoing Business Development strategy development, integration and monitoring.

Ongoing C4 Support:

  • Performance Improvement – data gathering and reporting
  • Digital activity monitoring and review
  • Human Capital – ongoing recruitment and training as needed
  • Clinical consultation on difficult admission cases
  • Strategic planning for growth
  • Business Development Leadership coaching, support and strategic initiative
the results

Holistic Business Optimization Key Impacts

“Their insights have been invaluable on the clinical front, ensuring that our treatments are both state-of-the-art and deeply personal.”


*Increase in Inquiries


*Increase in Assessments


*Increase in Admissions


Customer Acquisition Cost


CAC : LTV Ratio

Benchmark of Quality = 3.0


Lifetime Customer Value

*7 Months Pre-C4 Engagement vs. 7 Months Post-C4 Engagement

the future


For fifteen (15) plus months, Southern Sky Recovery and C4 Consulting have collaborated in a multi-disciplinary, diverse array of service areas that have supported Nathan Shepard and his entire Team in bringing to life the vision they saw for themselves in early 2021.

In a consulting methodology of flexibility, fluidity and value-driven best practices, Nathan allowed the C4 Team to deploy our Consultants to the firing lines to provide acute, ongoing, and long-term support to the Southern Sky Team.

As our collaboration continues, we’ll be excited to present our more updated qualitative and quantitative data to highlight the significant return on investment with C4 Consulting’s services.