Acquisitions Anonymous - #1 for business buying, selling and operating - Roll up businesses? The crew has strong feelings about home healthcare - Acquisitions Anonymous 238

Episode Date: October 20, 2023

In this episode of Acquisitions Anonymous, Bill and Heather discuss the complexities of running a senior home healthcare business in the Bay Area, emphasizing the industry's challenges. They high...light the difficulties in scaling due to staffing issues and the operational complexities of managing a large workforce. The conversation delves into the intricacies of billing in the healthcare sector and the potential risks of incorrect billing. They also touch upon the significance of market analysis, emphasizing the importance of choosing the right market for business growth.Thanks to our sponsors!Employer Flexible will help you take action to streamline your company’s HR processes. They are the proud provider of flexible and adaptable PEO services. If you’re a small business trying to grow, and you’re struggling with a lack of internal HR or you’re just dissatisfied with your current HR setup, consider Employer Flexible as your next vendor for HR outsourcing services.Check them out at https://www.employerflexible.com/.------------Double Jump Media is your one-stop shop for creating engaging, high-quality videos.Double Jump is a boutique video production company with over a decade of experience creating professional, memorable videos for clients from around the globe and in various industries. All while helping those clients generate millions in sales through video content.So, whether you’re rebranding a business you recently purchased, launching a new product or service, or want to look awesome, Double Jump is down to clown.Visit www.doublejump.media to check out their portfolio and schedule your free consultation today.Subscribe to weekly our Newsletter and get curated deals in your inboxAdvertise with us by clicking here Do you love Acquanon and want to see our smiling faces? Subscribe to our Youtube channel. Do you enjoy our content? Rate our show! Follow us on Twitter @acquanon Learnings about small business acquisitions and operations. For inquiries or suggestions, email us at contact@acquanon.com

Transcript
Discussion (0)
Starting point is 00:00:00 Hey everyone, welcome back to Acquisitions Anonymous. I am your host, Bill Dallisandro. And this week, I am with Heather Anderson, and we are talking about a home health care business, but we talk a little bit about a home health care business and a lot about the economics of rolling up service businesses versus goods businesses. We also talk about employers in California, and we land on this super interesting business model that helps people get paid by Medicare for already taking care of their own grandparents. So this one went all over the place. I think you will really enjoy this episode of Acquisitions Anonymous. Today's sponsor is Employer Flexible.
Starting point is 00:00:38 And what Employer Flexible does is really function as a fractional HR department for your company or business. I've used them numerous times and putting together my companies. I've used them when I bought companies. I've used them when I started from scratch. And basically, when you're moving quickly or when you don't want to spend the time putting together your own HR department, benefits, all that kind of stuff. you want to get the scale of being part of a larger group, you can reach out to employer flexible.
Starting point is 00:01:03 And what employer flexible does is give you that buying power as if you're part of a bigger group and all that kind of stuff. And for me, I love working with them for numerous reasons. One is I know the owners and a lot of the staff and they've always treated me super good. And then the second thing is I hate HR. Like, I don't enjoy it at all. And this way I can know it gets done right. I get the benefits of having a big fully staffed HR department and the flexibility of having a vendor like Employer Flexible being there as a partner throughout my journey and making sure that everybody I work with is happy, taking care of, and we can focus on what really matters in our business, which is take care of our customers. So you can find
Starting point is 00:01:42 their contact details, locations of their various offices, as well as more details on how they will help your business by going to employerflexible.com. And again, that's employerflexible.com. And thanks to them for sponsoring today's episode. Heather, I am such. It's just us again this week. I feel like this happening more and more. I know. I know. Why is that?
Starting point is 00:02:02 Did they not like us anymore? Is something going on? Maybe they're running really, maybe they're running real businesses and we're just dabbling. That could be it. Maybe we should work harder. I don't know. Rather than shooting the shit about deals of businesses for sale. For long time listeners, you will know that our joke is that we all get together and we start
Starting point is 00:02:25 chatting before this. And then someone finally goes, quick, quick. Press record. We've started recording the podcast. And Heather and I did that officially again today because Heather brought a deal and was so anxious to talk about it. It's a services business and I have opinions and Heather has opinions as well. So maybe the best thing to do now that we've hit record is to read it and then we will pick up our conversation. Okay. Well, all right. So here's the deal. So it is a profitable senior home health care business in the Bay Area. That's the San Francisco Bay Area. Asking price is $425,000. Cash flow, 173, 934, gross revenue, 724,907. FF&E, 10,000, rent is $950 per month,
Starting point is 00:03:14 and it was established only in 2021. Interesting. It is also in a great location, profitable senior home health care business that specializes in providing exceptional in-home health care. care services to older adults, catering to their unique needs and ensuring the utmost comfort in the familiar surroundings of their own homes. With a focus on quality and compassion, this business offers a wide range of specialized care options for the clients and families, making it easier for them to manage health conditions, injuries, dementia, and other age-related ailments. Their clients relied on a team of highly trained and experienced professionals who are dedicated to delivering personalized care that enhances the overall well-being of the
Starting point is 00:03:56 seniors. The business currently employs 13 active full-time caregivers and three part-time caregivers on an assignment basis with a database of 38 active caregivers available. So it is in Alameda County. There's a very, very tiny office of 526 feet, 17 employees. That's about it on it. They'll give you two weeks of training. So, Bill, what do you think? So when you, you suggest we do this topic, you said that everybody is really hot on these in-home care businesses right now. And I said, oh, boy, everybody loves these services businesses, but I'm not sure service businesses are as cool as people think they are. Can you tell me a little bit more about why you made that comment?
Starting point is 00:04:43 Are you seeing a lot of searchers going after these, a lot of deals in this space right now? Yes, I do see a lot of searchers, a lot of buyers looking at these deals, buying these deals. And a lot of them think about rolling up as well because it's a pretty, fragmented industry. That's the first thing that they see is it's fragmented. And it is, effectively, it's kind of like a staffing business. You know, so you are really just deploying people and making, you know, and you're doing marketing, obviously, to bring in clients.
Starting point is 00:05:13 They're tricky. They can be tricky. It depends on whether it's private pay or Medicare, Medicaid. You know, so it's what we lenders call pay or risk, who is paying you. and what is the risk that the reimbursement rates will change? They've changed in the past. They'll change in the future, I'm sure. And so there's a lot going on there. But yeah, it's a hot space for buyers. I think especially a lot of them think of it maybe as a first-time acquisition.
Starting point is 00:05:42 I'm not so sure it's a great one if you don't have health care experience. There's a few reasons I think that. It has to do with the billing and how complicated that can be within anything. in health care. Let's table the billing thing and get back into that because that's really important. But at a higher level, right, service businesses when it comes to search, right? I know they're very hot. Like the classic one, which has got really hot and now people are realizing it's very hard
Starting point is 00:06:13 is HVAC and other home services, right? That was really hot amongst searchers for a while. And then they figured out that, geez, this business is really hard primarily because you need good technicians, like finding the right text. is super difficult. And you're kind of beholden. And now, I think the bar for elderly care is maybe a little lower than, like, you know, certified age fact tech, because it's, it's not that it's an easier job or anything,
Starting point is 00:06:38 but, you know, there's less rigorous qualifications, it's less technical, perhaps. But you are still kind of at the whim of, can I recruit enough people? It's a staffing agency. And the other thing is people that go, okay, I'm going to roll these up, right? I'm going to roll up home health care businesses. there is not necessarily anything about a service business that gets intrinsically easier with scale. In fact, things get harder. You've got more people, more thick, and there's just more complexity in the system.
Starting point is 00:07:07 So, I mean, Heather, do you see that? Have you ever done any deals where you see people roll up services and it gets harder or not easier? Yeah, absolutely. And I think the labor shortage, however, which way you want to look at it has been a huge problem for those. businesses the last couple of years in particular. Like you said, you've got to be able to maintain a certain size staff just to keep the business going. You want to grow. You've got to be able to recruit. You've got to have a whole recruitment sort of arm of your business. That's a whole job in and of itself is how you're going to find these people. And then once you find them,
Starting point is 00:07:41 how you're going to retain them. And of course, there's online reviews with this kind of business, right? The family may say, so-and-so was terrible with my mother. And, Don't use this company, right? So you have a lot of reputation risk in terms of the people that you do hire, let alone finding them and keeping them and everything else involved. So, yes, I think I've seen a number of folks struggle to grow, especially with the labor shortage. And I do, I think the labor shortage, my personal view on it, is it's a little more demographic
Starting point is 00:08:15 than anything else. And that is a long-term issue. I think that is not something that resolves with an economic cycle. It's just not going to resolve. So anything that you can't really throw technology at to make people more efficient, then kind of falls in this bucket of, well, then what are they going to do? And I don't think you can throw technology at home care and home health. You know, you need a certain...
Starting point is 00:08:43 At the same time, it'll be around when the cockroaches are ruling the earth. You need people to help people. Yeah. But the reason people like, the reason why... The reason rolling these up and scaling services businesses is so attractive, and the reason private equity is love these types of businesses forever is because of two really unique things about services businesses, which is that there is no CAP-X effectively, right? You don't have to buy more machines or more trucks or whatever for most services businesses.
Starting point is 00:09:11 You just scale by hiring people. So there's no CAP-X, and there's also no inventory. So there's really no working capital either. I mean, there might be some receivables. But for the most part, it's not like an inventory-based business, a manufacturing business, you know, any other kind of goods-based business where you have capex to scale often and working capital needs to scale, where it's way less capital-efficient. Services businesses can be really capital-efficient if you're scaling them up.
Starting point is 00:09:39 But the flip side is what we just talked about is because you can't just call and buy more inventory, you've got to actually recruit more human beings and train them and everything it's much more operationally complex sometimes to scale than a goods-based business is to scale. I think this is where the term human resources came into play. It's human capital. That is your cap. That's your CAPEX. You've got to find people, and that is costly.
Starting point is 00:10:05 I will say, I want to say one thing about what I just said about throwing technology at it. I have one client I'm working with that did successfully use technology to become much more efficient in this space. and it was really an interesting story. It was his business, his mother was the founder, and he became sort of the operator eventually. And being younger and more technologically adept, created some really great software solutions for the logistics side of it, for the management side of it.
Starting point is 00:10:34 And for what I've seen, and I'm not the expert, did a great job. So there are some ways I think you can be more efficient than your competitors in this space using technology. But at the end of the day, you still need a certain number of caregivers to patients and clients no matter what you do. And there's also a distinction between home health and home care, skilled and unskilled labor, the kind of people that you need, right?
Starting point is 00:11:01 You may need a certain type of nurses for the home health, and you may only need, you know, non-licensed just caregivers who come in and clean and do a little bit of cooking and helping with medications. Maybe I don't even know if they're allowed to do that, actually. but whatever it is they're allowed to do. You know, you've got skilled and you've got unskilled. And so they're kind of in two different camps. You usually see one or the other.
Starting point is 00:11:24 And the more you're going into the skilled, the more you're really in health care. You know, home care, maybe not so much, but you're kind of adjacent to it. Home health, you really are in health care. You need nurses. Gosh, have you heard about the nurse shortage? There is one.
Starting point is 00:11:40 It's a big one. Yep. Yeah. And so, yeah, you're competing with the hospital. and everybody else for those nurses. That's not easy. So that would be something to understand about this business. Are they hiring skilled or unskilled labor?
Starting point is 00:11:53 Right. And of course, there are pros and cons, right? If it's skilled labor, you probably bill them out significantly higher, right? But at the same time, you have a worker shortage. On the flip side, if it's unskilled labor, you probably can, it's easier to find people, but they're also probably a less stable workforce, you know, probably more churn, and you can't bill them out as high. So there's pros and cons to both, but you really want to understand what you're getting into in buying a business like that.
Starting point is 00:12:18 Right. And any kind of elderly care business, and there are many others besides just this, they kind of want to have the whole cycle of care available. You know, so you start someone at home health or home care, excuse me, that maybe doesn't need a nurse just yet, but eventually they might. Or you're going to lose that client if you don't have home health, right? And if from there they go to, they need to go to a nursing, a skilled facility, you know, this. So you have to kind of look at what part of the cycle of someone needing this kind of care are you playing in? And are you going to have churn of your clients that way? If you're just in home care, you probably have a lot more churn because you're kind of getting them at the beginning and where they don't need as much help. And later they might.
Starting point is 00:13:01 Yeah. So my grandmother is elderly and she needed in home care recently. And it was really hard to the comment of shortages. It was hard to find qualified in-home help. And when you need it, like, you need it because my mom was over there every day, six or eight hours a day, you know, taking care of her. And so it's either consuming a family member's life or they need to be an inpatient care if you can't find out patient care. And interesting that you mentioned that. There are some states that allow these agencies to employ the family member.
Starting point is 00:13:34 So it's really interesting. So I've seen these deals before where so a family member is, you know, not having a job. job or whatever it is to take care of the family member, that can become the employee, so they get paid through these agencies. Who pays them? The insurance? Medicare or Medicaid or private insurance. But it's only allowed in certain states, and I don't, of course, remember which ones they are.
Starting point is 00:14:01 But I thought that was interesting. So people that would have done it for free, right? Most likely. But at the same time, they are giving up the opportunity for another job while taking care of a family member, and maybe they can't really afford to do that, there are ways that these agencies can employ and pay the family member, which I think would probably get pretty tricky, because how do you keep track of someone who's a family member living with grandma taking care of grandma? I don't know. I mean, you got to have them clock in and out. I bet there are, you know, pre-de-if, if you're billing
Starting point is 00:14:33 insurance, I'm sure there are billing cuts. Like a day of care is whatever. And you bill it out. But that's incredible, right? If you would be helping with your mom, your, your elderly mom anyway, you know, why and you why not get paid and make an insurance claim? It's like one of those things that almost feels like insurance fraud, but at the same time, like it seems like the person is doing the job, you know? Right, right. So interesting. Yeah, there's a lot that you learn about this space.
Starting point is 00:14:59 And of course, you know, it's the aging population, which I guess is also the reason we have the shortage of people to take care of this aging population. You know, that's, again, the sort of the demographic dichotomy, am I saying the right word? you know, that we are sort of within. We've got a very large aging population and perhaps not enough young people with the right skill set to care for them. And so, yeah, the cost is going, you know, quite high. But people like this industry because of the tailwinds of that, right? But I've never heard anybody really say, when does that tailwind end? You know, when does that population sort of stop? you know, they die at some point, right?
Starting point is 00:15:43 And when just, I don't know if that's got another 20 years to go, I would imagine probably. Yeah, I think you're kind of that baby boom generation, right? You know, they're still 65. Yeah, right. So they've got, so it's another 20 years. Yeah, right. Do you need video content for your business that doesn't suck? Double Jump Media is your one-stop shop for high quality, highly engaging video content.
Starting point is 00:16:08 They have over a decade of experience producing, great memorable videos for their clients across North America and beyond. And those clients have taken those videos and turned that into millions more in sales for their business to help them grow and achieve their goals. And a distinguishing characteristic that sets them apart is they have a small team that does everything in-house. So what you see on their portfolio page and what you see on their website, that's what you're going to get. They do everything soup to nuts, consulting, scripting, strategy, production, post-production, helping you put it all together to produce something that is just as top-notch as your brand. So whether you're rebranding an existing product,
Starting point is 00:16:46 you've just bought a business, or you're trying to grow the one that you have, the double-jump team is one that is down to clown. By the way, they've wrote that down-to-clown. I know what it means, but it sounds awesome. So to get in touch with them, visit doublejump.com media, fill out their form, tell them that we sent you, have an introductory call at no cost to you, and figure out what's best for your business. They're great folks and can help you on your journey in producing amazing video content to help meet your business needs and goals. And thanks to them for sponsoring today's episode. So Heather, you said an important consideration in this industry is the billing. Can you expand on that? Right. So you are billing insurance. That is extremely complicated. And if you don't do it right,
Starting point is 00:17:28 you don't get paid. You can also get thrown out of a network. If you're not following all their rules, not just with the billing, but the services, everything, you have to stay within regulations and rules that are set up for you. And it's like anything, I'm an SBA lender. I wouldn't expect anybody who doesn't do what I do to understand what some of these rules are, where to even find them, and why we interpret them the way we do. Sometimes I have just as an aside, sometimes a client will say, well, I want to read the SOP and I just, I shake my head like, no, no, you really don't. You know, it really don't because it's not going to, what you think it's going to mean is not what we think it's going to mean. So it's just, that's the kind of thing that comes only from experience
Starting point is 00:18:14 to understand what certain rule languages mean, you know, how they're applied, you know, even down to like what the latest audit cycle is catching people up on, right? You have to kind of be on top of that. So if you are coming into a business trying to, that's billing that way into that kind of system and you don't have that background at all, any kind of health care, I wouldn't recommend it. I think it would be pretty scary because you have to, your learning curve would be very steep
Starting point is 00:18:43 and the danger of failure is high because the consequences are pretty extreme. So that being said, though, there is an entire industry that is medical billing, right? Like you can outsource and you probably damn well should outsource your billing
Starting point is 00:19:00 if you're in the home healthcare industry, right, for exactly the reason you just described. Exactly. So you have a cost to that, right? You have, that's a vendor that you need. But just like any vendor, it's a critical vendor. So who is your vendor going to be? How good are they?
Starting point is 00:19:15 Don't go price shopping probably, or at least not to any great extreme because you're going to probably get what you pay for. But yes, you can get help with those things. But nonetheless, you still have to understand the world within that rule set that you have to operate within pretty well. Not to say that people can't step in without the experience and still be successful. I just think it would be. kind of scary for them.
Starting point is 00:19:38 Well, I mean, I presume you buy a business they're already billing, right? Right. So they got some solution here. I have heard of people making huge differences, buying a business, and their entire investment thesis is they're billing wrong and do nothing else, but they know how to bill for, they bill Medicare for it better, and they double the revenue overnight. Now, of course, you've got to make sure you're doing this ethically. Right? It's usually that the seller is doing it wrong and as a result is getting paid less and you can come in and bill it the right way and it happens to be at a higher reimbursement.
Starting point is 00:20:17 Right. Now, I'll throw another monkey wrench into it. If you are thinking of roll-ups in health care, and that's, again, this is what it attracts people. Look how tiny this one is. If you bought this one, I hope it's an add-on or you're planning, you have a great pipeline to do roll-ups because this one's probably just too small. But let's just say you're going to do that. Integration of the billing can be an absolute nightmare because they don't, they're not all going to be using the same vendor. They may not be doing the same type of billing. You know, like you said, maybe one is billing the same service one way, another is billing it another way.
Starting point is 00:20:53 I've actually seen this happen where a business rolled up a number of medical practices and they couldn't get the efficiency or even close to it, what they expected, because they could not integrate the billing systems. They were too disparate. So there you go. It's kind of all comes down to the people and the billing in this business. And the people side maybe you can solve for without experience, but you're up against, you know, the market.
Starting point is 00:21:20 And the billing side, I don't know. I think you need some experience to do really well there. You know, I think a lot of times we cover businesses on this podcast, and we sort of joke like how many people are between you and driving a truck, right? Like how many people got to call out before the owner is driving the truck? And in this business, that's one of my first questions. How many people between me and changing an adult diaper? That is something that I really want to know.
Starting point is 00:21:49 That is very different than a driving a truck, isn't it? Yeah. Yeah. Right? I mean, there's one people like, I don't want to drive a truck, but that is not what I do. So I really want to know, is there a manager in place? You know, it does say in the description of this business, have a stable of 38 providers that they can call on. But at the same time, what that is sort of
Starting point is 00:22:11 telling you is that none of them are full-time, and you probably got to call 10 of them to find someone who has hours, and then they probably flake out, and you've got to put a new person in place. So you might go, oh, this is great. They've got this huge stable of contractors. There is a reason they have a huge stable of contractors, right? It's because they're all flaky. So you really would need to understand in diligence, first of all, there's probably like six of them that are your bread and butter
Starting point is 00:22:37 that are effectively full time and you can always want the hours and there's probably 30 of them that are basically useless. Yeah. You know? Right. That's exactly the problem.
Starting point is 00:22:48 There it is right there. And it's the logistics of just scheduling all that. What kind of systems? What kind of software are you using? You know, how good is your relationship with all of those folks? How flaky are they?
Starting point is 00:22:59 You won't know until you're in the chair on that one. So absolutely not an easy business to run as an owner. And you're right. You might have to go out and take care of something, somebody, you know, at some point because you can't get anybody else to do it. And we're talking about people here. They need help when they need help. Can't wait.
Starting point is 00:23:21 Yeah. This is what we're talking about before we start recording, which is like this sounds like a very hard business. to me, you know, I talk about buyer business fit all the time in the podcast, to me, this sounds very hard. I don't like people. I like widgets, machines, like, I like the quantities. I like things that scale, right? But like, the more you scale this, the more people you have, the higher, the more people you have, the higher chances to your point, one of them screws up and something goes really bad, or you get sued by somebody you terminated, or two of them have a fight with each other, or two of them
Starting point is 00:23:55 have a romance with each other or like you just the more people more people more problems right it's kind of my mantra and you know and not just this business but all services business it's a people business um but some some entrepreneurs love people and they're great with it and they and they make tons of money because if you can solve the people problem services businesses are great one other thing i learned about these businesses um i was talking to an expert i have a number of different Q of E providers, and I try to match them up, you know, that I know, I should say, that I try to match them up with my clients based on, you know, the type of deal. And so there is one that specializes in health care. I always bring him in on anything health care related. And he pointed
Starting point is 00:24:39 out to me that when you're looking at these businesses, there are A and B and C markets. And in his mind, the A markets are the places where there's already been a lot of consolidation of this home health and home care. So they're owned by conglomerates or they're owned by hospital systems or they're owned by non-profits in the community. If you buy a small home health in one of those markets, he said it's fine, but you're never going to compete. And you're never really going to have that opportunity to grow because they've already gobbled up the big accounts, if you will. So your best opportunity for small home health, in his opinion, was in the B or C markets where there hasn't been as much consolidation. So I think like if you're thinking about this space,
Starting point is 00:25:25 you really want to go do some analysis on the density and what pockets you, you know, look attractive to you. The Bay Area, I'm going to guess, right, would be one of those A markets. Maybe it's not. I have no idea. I'm totally guessing. But I think that's one of the things to consider. And it's, I think it's something that I think searchers often forget. You might have a thesis and you might have an industry and that's all great, check, check, check. But if you buy it in the wrong market, where there's not room to grow, you know, it's all for not. You're going to stay small. Yeah, because a lot of searcher businesses are, at the end of the day, local businesses, like this one is, right? It's not like you're buying an e-commerce business and the geography
Starting point is 00:26:08 doesn't matter. The geography really matters to your competitive set, to the demand in your market, to your pricing power, all these things. The cost of your wages and the people you have to hire, I mean, you can't hire people in Idaho to provide care in California. You know, it just doesn't work. you're hiring Californians. Oh, and by the way, guess what? Now you're hiring Californians. Good luck with that. The compliance. I mean, unbelievable. I'm a Californian. I think it's great here, but no, it's... Have you? Heather, you have a new business and you were about to start hiring people. Are they going to be in California? I know. I've already gone through this. I'm not sure. I'm not sure about that yet. I would like them to be local, at least initially, but you know, you're right. There's a lot of
Starting point is 00:26:51 considerations there that I got to think about. Tell me when you start trying to jump through those hoops. I will. We'll have a special episode about Heather in California hiring. Okay, so let me tell you a story about employing someone in California. So we have a stellar candidate for a role. We interviewed her, she's awesome, we want to hire. Then we find out she lives in California.
Starting point is 00:27:13 And we're going to have to not hire her because we can't support the overhead and miscellaneous costs that are required by the state. state. I'll give you an example what that means. If we hire a California employee, our health care plan has to add all of these coverages that she probably doesn't want, and certainly all of our other employees don't want to need, but are required we have to have a California compliant health care plan. We have to offer her a California compliant health care plan because she lives in California, and we can't have different health care plans for her or everybody else, which means we have to change our whole health care plan. And the incremental cost of that health care plan is more than her salary. Wow. So,
Starting point is 00:27:51 I can't hire her. Like, I actually can't. And that's just one example of why hiring Californians creates all this extra overhead. So you need to, like, be a company that deals with Californians or that doesn't. And people that live in states think that laws don't have consequences. They're like, oh, yeah, we want more of this free stuff. Like, we'll stick it to the companies. Well, you know what the companies say? I guess we're not hiring Californians then. Welcome to remote work. Rant over. Wow. Oh, man. Well, I actually even heard of a bank at one point that wouldn't hire anybody in California. It must be the same reasons, like just no employees in California so they don't have to go down that path. But you're right. It's either all or nothing. Either you have enough people here that's worth it to hire or you just don't go there at all, which is unfortunate. It's too bad. But yeah, this one, you're all in California. So you're doing whatever California requires anyway. So I Yes, and you're building that cost into your client, so I don't know that it matters as much here.
Starting point is 00:28:53 But it would if you're trying to go multi-state and kind of really get big in this industry. But I think this is a small one. You'd start here, and you'd probably try to grow in the neighboring communities around wherever it's based. But super, super challenging. It reminds me there was a deal I saw one. So we're talking about the reviews and how important it is, you know, that you have good people. They're not doing crazy things when they're out there in the home of your, client. I had a deal. It was in California that was, they provided services to people who were
Starting point is 00:29:25 mentally challenged, adults who were mentally challenged and they were paid by a state program in California. And there were some pretty funny Yelp reviews where the, the patients had said, so-and-so's coming to my house and smoking pot and just smokes pot and looks at their phone all day. Oh, boy. Yeah. I mean, that's the kind of thing that, that you might, you know, be dealing with in reality is people that might do things like that and give you reviews like that. So I do think there's so many reasons this is a challenge, challenging business, and it would only be worth it if you can scale, in my opinion. Yeah. That's the only way.
Starting point is 00:30:06 So, Heather, you mentioned earlier that in some states you can get paid to take care of your own grandma, essentially. I did some Googling because what I thought is obviously the best business here is to be the staffing agency that hires people who are already placed and are not going to be smoking pot in grandma's bathroom because it's their own grandma, right? This is the best possible employee. They're already in place. You don't have to recruit them. In fact, they come to you because they want to get paid and you just take a Vig and I go, this is the best business ever, right? It's just basically helping people get government money and then take a Vig out the top. And I googled and it exists. I was right. It's called joingivers.com.
Starting point is 00:30:47 And it is basically this, and there's a couple of them I've found, careforth.com. There's a few others. And they're basically, they look like really good D to C websites. And there's this really optimized flow where you say what state you're in, what you're doing, and they just essentially help you apply to start getting paid by Medicare
Starting point is 00:31:04 and Medicaid for the work you're already doing. And they take like a fee. Brilliant. I love it. Yep. Well, I didn't even know about those. I have seen actual home care agencies like this that, at least part or all of their staff is that way.
Starting point is 00:31:20 You know, it's just just family members that are already giving the care. So, yeah, that's pretty amazing to know. That's really cool. It's really cool if you're listening, joingivers.com. And they've got like a thing on the homepage where it walks you through each state, like what you'll get paid, what the hourly wage that Medicare pays in the state and like a full guide on how to apply. And I'm still trying to figure out how to get paid, but I'm sure they do.
Starting point is 00:31:43 Very cool. Yeah, that is very cool. Yeah, that's the business to be in. I want to be in that one. Good business. All right. Let's wrap this one up. That was very interesting.
Starting point is 00:31:53 I hope you guys enjoyed it. And Heather, I will see you next week.

There aren't comments yet for this episode. Click on any sentence in the transcript to leave a comment.