You own your region — not the company.
Operators own their sub-regional entity (their market). Not PSR. Not the parent. Your equity is local — tied to what you build in your specific geography on national infrastructure.
Structure & Equity
Ownership
PSR is an MSO with a regional equity model — not a franchise. Here's exactly how the structure works, what operators own, and how revenue flows.
An MSO with equity — not a franchise.
PSR is a management services organization (MSO) with a regional equity model.We use “franchise” as a plain-English metaphor in marketing — but structurally, we deliberately stay off the franchise-law side of the line. There is no disclosure document, no state franchise registration to manage.
Two design choices keep it that way: the management fee is a fee for services (not a franchise royalty), and the keystone's equity is a genuine ownership stake in their regional entity (not a franchise sold for a required buy-in). The structure has been confirmed by franchise counsel.
This matters because it means operators get real ownership — not a license, not a royalty arrangement, not a contract that mimics equity. A stake in the entity that runs their market.
Revenue cycle & billing.
PSR owns the revenue-cycle relationship end to end. We invoice the facilities, collect, and distribute to our 1099 contractors — every Friday, by direct deposit.
For billing execution, we partner with the nation's largest surgical billing company. That relationship gives PSR — and every operator in the network — infrastructure that would take years to build independently.
How Ownership Works
Local equity. National scale.
Chris is always the controlling owner.
Each regional entity is majority-owned by the parent. Christopher L. Sweebe retains controlling ownership across the organization. The model is closely held — by design.
No outside capital.
PSR is not venture-backed. There are no outside investors, no board demanding growth at any cost, no exit timeline baked in. Operator value comes from the regions themselves — not from selling the company.
You own and grow your market.
The ownership pitch is local: you build a team in your geography, you earn equity in that entity, and you profit-share on every assistant under you. National infrastructure makes it possible. Your effort makes it valuable.
Ready to understand what ownership looks like in your market?
Every region is different. We'll walk you through exactly what a keystone's equity and profit-share looks like for your geography.
PARTNER · OWN · PROFIT · GROW