Home Care U - The Ins And Outs of Growing a Home Care Agency Through Acquisitions (John Bennett Pt. 2)

Episode Date: February 11, 2024

Within a few years, John Bennett went from high school football coach to CEO of one of the country's fastest-growing home care companies. What can other owners learn from his journey? Let's ...find out. Enjoying the show? Send me a text and let me know!Learn more about Careswitch at: careswitch.comConnect with the host on LinkedIn: Miriam Allred This episode was produced by parkerkane.co

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Starting point is 00:00:00 Hey, welcome to Home Care U, a podcast made by the team at Care Switch. Nobody went to school to learn how to run a home care agency, so we're bringing the education to you. Join our live audience by going to careswitch.com slash homecareu or listen on your own time wherever you get your podcasts. Home Care U is hosted by myself, Miriam Allred, and Connor Koons of CareSwitch. Enjoy the session. All right, welcome everyone to Home Care U.
Starting point is 00:00:30 Happy Wednesday. Great to be back with you. I hope everyone's having a great week. Again, great to have any new faces joining us for the first time and some existing listeners, subscribers back with us again. I've got John Bennett, the CEO of Sunny Days and Home Care back for session number two. We did an extended introduction of John on our first session, so we're going to get right to the meat of the conversation. But just kind of a quick recap. Last week, he talked about
Starting point is 00:00:55 how he scaled a really impressive agency in the Pennsylvania market. Today, we're going to talk about his M&A activity. He has grown and scaled significantly through recent M&A activity. And we talked a lot about kind of processes, operations, lesson learned, you know, milestones. Last week, today, we're going to focus heavily on the what, the why, and the how, and the lessons learned from some of the acquisitions that his company has made. So with that being said, we're going to jump right in. John, thanks for being here again. Yeah, yeah. It's great to be back on.
Starting point is 00:01:29 Awesome. Well, let's get right after it. I want to start with a quick timeline. If you don't mind just highlighting really quickly kind of the timeline milestones of the business, when you got started, when you started thinking about M&A and kind of how things took shape in the more recent years since the pandemic. So can we start there? Yeah, sure. So Sunny Days, we started in 2011. I came on board in 2015. And we franchised, I guess, for a hot minute, you know, as you would say, and then we decided we didn't have enough control of our entities. So we got into the M&A space. We acquired our company, a smaller agency on the northern side of Pittsburgh.
Starting point is 00:02:10 It was doing about 500 hours per week in 2017. They were split focused between senior care and working with people with intellectual disabilities. We had that company for two years. I grew up from $500 a week to about $1,500 per week. And then we sold it. At the time, we either needed to double down and hire people who were specialized in the IDD space or sell.
Starting point is 00:02:34 And we decided the time to sell and focus on growing Sunny Days. So that was our first acquisition, buy and sale in 17 and 19. Then we did majority ownership of a small agency that was doing about 300 hours per week. Later in 2017, the founder stayed on and we have majority ownership of that company still, but it's grown from 300 hours in 2017 to about 6,000. We just broke 6,000 a couple months ago now. It's also in Western PA. That is a Medicaid-based agency that also specializes in private pay and VA. One of the founders of Veterans. So we have a VA contract and we do a lot of different stuff with Veterans there.
Starting point is 00:03:10 And then we really scaled up, created our holding company in 2021. In late 2021, we acquired a company up in the Upper Peninsula of Michigan that was about 50% Medicaid, 25% VA, 25% private pay. They were doing about 600 hours of care per week. And now we're going to break 2,000 this week. Hopefully, we're really excited about that. And then mid-January of 22, we acquired an agency near Hendersonville, North Carolina, just south of Asheville. Really cool place down there. Predominantly private pay. We have some VA and Medicaid down there now. When we bought it, it was doing about $800 of care per week. Right now, it's doing about $600. So it's actually went down a little bit. And then our largest acquisition, we acquired a company on the east side of Pittsburgh that was doing about 9,500 hours
Starting point is 00:04:00 of care per week. And it still is doing about 9,500 hours of care per week. So we kind of have all in. We have a company that's doing 500, 2,000, 6,000, 9,500, and 15,500. Sunny Day is our main company. So we have about 33,000 hours of care per week or so, but we really have a wide variety of size of agencies out there and location as well. That was a perfect recap. So if I'm not mistaken, is that five acquisition or six totally with the buy and sell one? So five acquisitions, but the one we bought and sold. So we still have four of our acquisitions. And our main company, Sunny Days, we never technically acquired. We just started it. So we have five current
Starting point is 00:04:40 operating companies. Awesome. Awesome. Let's jump back just briefly. I think you probably piqued people's attention with the thought of going franchising, retracting, going the acquisition route. Just kind of in a nutshell, why did you think about franchising and then why didn't it work or why wasn't it a right fit? So we felt like we have a pretty good model. If you listened to the last episode, we kind of talked about our franchise or excuse me, our field manager model, our really good early solid model, but franchisees, you have to get people that really follow all of your policies and practices as well. And like I said, we had a great couple that with our first franchise out in Chicago, really good people just didn't quite work with them following our, you know, all of our policies and procedures the way we wanted it.
Starting point is 00:05:26 And we still speak with them. They were really solid. Just didn't work. We were looking at another place in Wisconsin, and we just decided, you know what? We would rather have full control over it and make sure we can oversee and kind of, I hate to use the word, but enforce, make sure things are getting done the way. I have some friends at Chick-fil-A. They say cascade. That's the word Chick-fil-A is, right? So we want to make sure we can cascade the culture and the policies and everything down throughout the way. I have some friends that say cascade, that's the word. So we want to make sure we can cascade, you know, the culture and the policies and everything down, you know,
Starting point is 00:05:48 throughout the company. So we want to have control, I guess, if you will. Awesome. Yeah, I think that just helps a lot of large owners, operators get to the point where, like you said, have a really sustainable model, know how to scale and question, you know, is franchising a good fit? Is acquisition a good fit? So it's just interesting to hear, you know, you went down that path, you know, pretty quickly saw some of the flaws or some of the challenges that you were up against and intentionally decided, you know, to like step back and go a different direction, which I think is really admirable. And then, you know, look at the growth on the acquisition side. So tell me if you can recall early days when you first started thinking about acquisitions, what was going through your mind? What were you thinking
Starting point is 00:06:32 about? What were you worried about? Where was your head early on in the acquisition days? Yeah. So let me kind of break it into two eras. So the 2017 acquisitions just kind of came to us. We weren't really on the hunt for them. We didn't really have like a holding company set up per se and like a, you know, kind of a shared services division that we have now. We just kind of acquired them and operated them. And so we didn't really think much about, you know, building an empire or anything. We just had an opportunity to get some and it was a good fit that we could kind of, you know, run it as a standalone agency still, but, you know, do some,
Starting point is 00:07:05 there was some duplicity between job positions and we could kind of, you know, combine some things and that worked out well for us. So that was kind of just ones that came to us when we really decided we wanted to really make a big push in 2021, getting into really the M&A space. We really wanted to make sure that we had a holding company. We want to make sure that the corporate veil wasn't going to be pierced. We were very careful about that. We got our attorneys and accountants involved to make sure that we had everything structured properly for legal and liability and tax purposes and everything else.
Starting point is 00:07:36 But we really wanted to make sure that, once again, our whole focus at Sunny Days was we handle all the back office stuff so everybody can focus on the people in the field. And we've taken that same approach to our acquisitions is we'll handle all the back office stuff so everybody can focus on the people in the field. And we've taken that same approach to our acquisitions is we'll handle all the back office stuff, whether it's in our corporate, we call it our home office now, or if it's in the back office of each of these companies. But we want the people still focused out in the field on caregivers and clients and making sure care is being delivered. So we've kind of structured it to model. There's some nuances and differences between the different regions and areas and the different payer sources. But we've really tried to structure it in a similar manner to Sunny Days.
Starting point is 00:08:13 We've also tried to set it up. I guess one of the takeaways from franchising is how well franchises are structured from an org chart standpoint and the support and when you need to add additional support and everything. So even though we stopped franchising, we took some of the stuff that we learned from it, we've implemented that into the way that we have the M&A set up and structured. So that's kind of what we were thinking going into it is we really want to make sure we are structured properly for that start. Can you share a little bit more about the holding company, the thinking there? Obviously, when you go the M&A route, financing, capital partners, there's a lot of options. There's a lot of different paths. You maybe didn't know everything
Starting point is 00:08:49 up front. Can you share why the holding company route? And then just briefly, like the benefits of the holding company and some of the core purposes. Holding company, you want from a legal standpoint, just so you can have each company separated individually on its own, and all the money kind of flows up to that holding company. You know, if you have company A here, you don't want company A loaning money to company B over here. You want everything flowing up to your holding company. And then, you know, the holding company can loan money if necessary, like if you're short on payroll, or there's some kind of expense that comes up or whatever,
Starting point is 00:09:21 really from a legal standpoint. And we can talk about how that benefited us with one of our acquisitions where we've had some legal issues we've had to deal with. And the other thing we set up kind of underneath the holding company is a shared services company. The way I kind of break an agency down is into three parts. You have your operations, you have your finance, and you have compliance. Some people may put compliance under operations, but we break it out into really three separate areas. And we try to take all of that and have that all parked in our shared services division of people that are dealing with finance, dealing with compliance, and then overseeing operations. In each entity, we have a director of operations and all of our field staff that are out there working with the caregivers. But as far as who's overseeing and supporting operations, that's all on the back end in our shared services model. So we have holdings kind of from a legal and where all the money flows up to shared services is really like our, you know, our combined operating entity. And then we have each one of our actual, you know, agencies out there that's providing care. Awesome. Yeah, that's super useful. As far as the financing goes, you brought in a lending partner, correct? At one point,
Starting point is 00:10:25 you know, you did get kind of some outside money. When did that come into play? Yeah, we knew that if we actually did our first two acquisitions out of pocket with money that we had kind of saved up, and we did two smaller ones intentionally, we're going to kind of get our feet wet and learn before we got to a larger one. But we knew we needed to get a partner, you know, from a financial standpoint with a larger one. But we knew we needed to get a partner from a financial standpoint with a larger one. So we started to work on that in summer of 2021 with the idea that we would have funding secured by January of 2022.
Starting point is 00:10:55 Actually took until March. Some various issues. We had a lending partner that bank backed out last second because they had a similar, we in the home care were collateral light, right? We're a service-based industry. We don't have a lot of collateral that the bank can kind of have if something happens to you. And they had a similar loan in their portfolio that kind of went down the tubes, nothing to do with us, but they backed out because of that. So we had to find another
Starting point is 00:11:19 lending partner a couple months into it and start the process over again. So we were able to find, secure a partner and get everything squared away with them. We found somebody that they were able to... They had some experience and did some research in the home care space. They ran some different reports and they contacted a lot of different people. They wanted to make sure it was a good space for them to invest in as well. So we got them and we've been working with them to make sure that we have everything space for them to invest in as well. So we got them and, you know, been working with them to, you know, to make sure that, you know, we have everything covered to go acquire, you know, acquire a larger acquisition. Was that finding a lending partner, would you say
Starting point is 00:11:52 that was harder, as hard, easier than you thought, you know, just like strategically and broadly, was that difficult to do or you think it is doable? It was difficult to do at the time because we didn't have our finances structured in a way that was, I guess, kosher for what a lending partner would be looking at to loan you a large loan. Our P&L is really, we have to get audited financial statements now and everything. And before the lending partner, we were pretty organized, but it was more geared towards how we ran the business and not necessarily how it presented from a financial standpoint. So we've really changed how we do all of our financial reporting, our profit and loss, and our statement of cash flow, our balance sheet, all of those things.
Starting point is 00:12:35 But because of our lending partners. So it's tricky because of that. I mean, if you have your finances set up in a way that whether you have a CPA or maybe if you're large enough to have a CFO, you may not deal with that issue. We're good now, but at the time, it wasn't very easy because of that. There's a lot of people out there who want to lend you money, but they need to feel comfortable about your business and about your financial reporting. And I think they felt comfortable about our business, but our financial reporting was accurate. It just wasn't formatted in a way that was the easiest to
Starting point is 00:13:04 understand. And we had to get that all fixed and straightened out. So going at it again, you know, at some point we're going to need another lending partner or to re-up with our current lending partner whenever our term ends. And it's going to be a lot easier now because our finances are in order, you know, the way that they are presented. Okay. Yeah. You kind of answered my next question, which was going to be when you were getting your house in order, for lack of a better terms, what was it specifically that was out of order? And it sounds like it was a matter of formatting. Maybe you had all of the financial, the balance sheet, but it was even messier than ours. So we knew we could control kind of what's under the umbrella of our house because we currently own it, our agency, but going out there and trying to acquire a company, we had a grasp around what the company was bringing in, what they were billing for, what their gross margins were after they paid
Starting point is 00:14:02 the caregivers, what's their gross margin, and then what their net was, you know, we were able to figure that out, kind of all their expenses between gross and net, that was where it was kind of tricky. And, you know, there was random expenses. And we don't know, you know, when we say marketing, what falls under the category of marketing for us may be different than somebody else. Or when you say, you know, subscriptions, you know, some some may have, you know, like we use WellSky. WellSky is not under our subscriptions. We have it for our own category. Some of the acquisitions we've looked at, they have, you know, their platform that's, it's underneath subscription. So just figuring out all those nuances, you know, for companies that you're looking at,
Starting point is 00:14:36 it's just a little bit tricky. You just have to ask a lot of questions and find out what, what does this number mean? You know, there's a lot of numbers, but what are those numbers mean? And be a humble beginner to ask all of those questions. Cause sometimes it's intimidating to go to an outside entity and it's their bread and butter, but it's not yours. And just be kind of a humble beginner and ask all those questions to make sure everything's in order. A question that I've been wanting to ask you is about, you know, who these agencies were that you acquired context. There's been a lot of M&A activity the last five years, obviously because of the pandemic, a lot of people were burnt out,
Starting point is 00:15:12 you know, ready to exit, looking to exit. I personally have come across a lot of owners that, you know, their agency was thriving, you know, pandemic hit, they dipped, struggled, kind of fell by the wayside. I see a lot of agencies trying to like regrow and build back up to be able to sell. When you were, you know, looking for these acquisitions, more seeking them out, is that typically the case of what you saw of who was looking to sell? Or is there different, you know, similarities or kind of a different trend that you saw on the agencies that were looking to sell? No, that's kind of what we dealt with. Typically, when we're looking at it, people are trying to sell because of the pandemic. And it's just not the same
Starting point is 00:15:52 dealing with caregiver shortages and margin compression and that type of thing. Or it's people that are older and want to get out of the business. Or it's people that maybe they're not older, but with the increased regulations that you're dealing with from a state, whether it's Medicaid or private pay, there's still increased regulations that you're dealing with the threat of unionization, kind of all these, what if, you know, monsters in a closet, they could come out that people get worried about, then they're selling because of that, you know, so those are those are kind of what we looked at, we do the three acquisitions, since we've set up our holding company, we looked at about
Starting point is 00:16:25 40 companies. I think it was like 38 or 39 and ended up with three that we went after. There was a lot that looked great, but then digging into finances, there was a company we were really excited. Actually, two different companies we were really excited about. And both of them had got PPP money, which you got to be careful with how that's done because there's a lot of people that were doing that, you know, fraudulently, but they put the PPP money in their income for the year, right? So it overinflated what they were bringing in. And as we dug in and did our due
Starting point is 00:16:54 diligence and broke that out, we identified that and it was like, wait a second, this company's they're not making any money, and they're asking for this. And it's just, you know, it's not worth, you know, it's not worth it. So that's that's one of the things. But, yeah, it's. We were really looking kind of to go to your question, we were looking for companies that were run well, that actually cared about people and that had a good culture where the people were focused on delivering the care and that financially they were run responsibly and that there was opportunities for growth. So those are the three things. And we've kind of from a growth standpoint, I mean, I'm usually pretty transparent. The three companies we got, one has exceeded our expectations. One has been exactly what we
Starting point is 00:17:41 expected and one has been below our expectations. So we've kind of got all three with our three acquisitions that we've had recently. Yeah. Let's dig into that vetting process. Now, yeah, now I'm really intrigued. You talk about vetting 40 agencies and three came out of that. There's a whole process there. You were just kind of broadly mentioning what you were looking for. Let's dig in a little bit deeper. You know,
Starting point is 00:18:05 how, how do you find those agencies? What's like the number one thing you're going to look at first is that finances, you know, where does culture and personnel play, like kind of just dig in a little bit deeper on like that vetting process and how you approached it. So there's a lot of different platforms out there. If you just Google home care agencies for sale that have agencies, you know, people are trying to sell. Also, if you ask, you know, if you're involved with like your local state chapter, ask if there's people that are selling, you can ask even like your vendor, if you're like our workers comp agent, he's does workers come specializes in home care. So he kind of knows everybody in the area that's in home care. And our first acquisition
Starting point is 00:18:42 way back in 17, he's the one who told us, hey, this lady wants to retire. And I told her about you guys, I think you'd be a good match. And he was right. We were. So put your feelers out there. I guess if you're interested in doing acquisitions, let people know in the industry. I mean, we work with some different agencies that do home health and hospice. And every now and then we'll send them referrals or they'll send us referrals. Let them know, hey, if you know an agency that wants to get out, let them know about us and we'd be interested in talking to them. So just getting the feelers out there. And as far as what we're looking at, right? So I asked my team this question in our leadership retreat, because we're going to be doing some more,
Starting point is 00:19:17 hopefully another acquisition before the end of this calendar year. If you could look at a company and pick three categories, three things, you can only look at three things. You can look whatever you want, have access to whatever you want, but there's only three that you can pick to look at a company and pick three categories, three things, you can only look at three things. You can look whatever you want, have access to whatever you want, but there's only three that you can pick to look at. What would you look at? So that's a good question. If you're listening to this podcast, you're probably thinking about that. So for us, the three things we would look at are how many hours of care are you completing per week or month, however you track it. We do weekly, some of you do monthly, but look at that in the trend. What's it been over the last two years? Has it went up? Has it went down?
Starting point is 00:19:45 Has it been the same? So what's your hours of care completed? Not scheduled, but actually completing. The second thing we look at is gross profit margin. We had a really great looking agency that I looked at on Christmas Eve a couple of years ago. I had a great call with this lady. And our gross profit margin, everything sounded great. Culturally, everything sounded like it was a perfect fit.
Starting point is 00:20:01 And then I got to her gross profit margin. And she had formerly done a different service line where she was billing about $5 an hour more, had closed that down, but her caregivers were still making money as if they were getting paid $5 an hour more and they weren't. So her gross profit margin was so low that they were basically breaking even. So that was a deal breaker for us because she's like, well, you could hire all new caregivers. And what are we getting at that point then? We're not really acquiring anything. So gross profit margin is a big deal. And you need to figure out what you're comfortable with. We look for gross profit margin kind of in the range of 40%, give or take a couple
Starting point is 00:20:34 percentages depending on... And gross profit margin for me is if you're billing 20 bucks an hour, and you're paying a caregiver, let's say 15 bucks an hour, then your gross profit margin will be $5 an hour, five out of 20 is 25%. So that would be too low for us. So if it's 12 bucks an hour that you're paying a caregiver, then that's 60% that you're paying to the caregiver, your gross profit margin will be 40%. So for us, we're billing around 20, paying around 12. So our gross profit margin is right about 40%. So we're looking somewhere in that range. And then below the line, we can make it run efficiently. That's a big thing we do is efficiency. So the third thing, so we have hours completed, gross profit margin is shift coverage. So a lot of these companies, they have all these hours, gross profit margin is great, but they're not covering the shifts, particularly when there's call-offs.
Starting point is 00:21:20 So we like to look at shift coverage. We pride ourselves on shift coverage. That's a metric we track. That's one of our main KPIs at every agency we have. We want our shift coverage to be as high as possible. We try to hit 100%. Don't usually get there, but all of our agencies, but one, because of some geographical issues are 98% and above. One of them is around 95, but it's really spread out up into upper peninsula of Michigan. So when there's a call-off, you don't have caregivers that are within driving distance in some locations. But that tells you if your shift coverage is really high, what that tells us is they actually care about making sure that people get care, especially whenever there's call offs and they're replacing the call offs. Or if you have open hours, right, that you don't have staffed yet, and you have a bunch of those, that's not good.
Starting point is 00:22:02 You want to staff this. Obviously, there's circumstances and everything else, but in general, we want to have really high shift coverage. So if we can look at those three things, hours completed, gross profit margin, and shift coverage, we have a pretty good feel of what that company, how they're performing financially, how they're growing or not growing, and what their culture is. Is their culture a culture of making sure that people get their care? So that was a kind of long-winded answer, but those are the three we look at. So, so, so, so good. This is amazing. What I'm curious is, I think the first two are relatively common for any business to be tracking shift coverage. Maybe they are, or maybe they aren't. Were these acquisitions that, or these agencies that you were
Starting point is 00:22:38 vetting, were many of them tracking shift coverage and did they have like a firm KPI or was that all over the board? So we had to get access kind of to look into their systems to see what that was. One of the agencies, because it was local for kind of competitive purposes, didn't want to do that. So we had to get from them what their shift coverage was. And the way I asked them to do it, when they first sent it over, it wasn't correct, right? Because when we think shift coverage, what are we scheduling, right? So say we schedule 1,000 hours.
Starting point is 00:23:10 Let's say we schedule 1,100. Let's say there's 100 canceled by client. They go to the hospital or they're sick or whatever. So now we're 1,100. We're down to 1,000 hours. Well, if we have 30 that we don't replace for caregiver call-offs and we have 70 that are open hours that we never staff, then we've got 900 out of 1, thousand, right? Cause we subtract the client cancer that we're able to staff. So that'd be 90% shift coverage. So explaining, we had to really simplify it to these agencies and
Starting point is 00:23:34 how to get that explained to them. And so most of them, that's not something they were able to get it for us, but they weren't tracking it. So that's something that we had to teach them how to do. Yeah. And what about when you helped them with that calculation, like when you got that information, any estimation of like what their coverage rates were? You mentioned, you know, Sunny Days is doing 98% most of the time, you know, 98 plus. Were these other agencies in that ballpark or not really? Yeah. So one of them was like 99%, which was great. A lot of Medicaid, some family cases, more of a small footprint, really close-knit community. So that was, I think, why? Because they could cover call-offs
Starting point is 00:24:16 very easily. There was a call-off and there was somebody two blocks away, right? So it was a little easier to cover call-offs. The agency up in Michigan at the time, they were like 80, which was a little bit of a concern for us, right? So when you get a metric that you don't like, you need to ask the question, why? Why is it 80%? Well, their policy, whenever there was a call-off by the caregiver, they would just tell the client, we don't have anybody for you today. If you have an issue with not being okay, please see your emergency backup. So there wasn't an attempt to staff them. We found out after doing some more due diligence and vetting and talking to employees, the lady there running their operations, who's retired since then, that was her policy.
Starting point is 00:24:59 And nobody was allowed to try to find another caregiver because she was worried about getting a caregiver that didn't match and getting them upset and losing the client. So we knew why. We knew once we changed that policy that we'd be able to get that once we changed that policy that we'd be able to get that up. At least we anticipated that we'd be able to get that up. Then our company down in North Carolina, their shift coverage was really high. They had a platform, I'm blanking on the name of it right now, but it actually tracked.
Starting point is 00:25:16 You have WellSky or CareSwitch or whatever, Lyacare, AccessCare. This company actually tracked. I think it may be called CareSmart 360, may have been what it was, but it actually tracked. And if you filled in a call off you got like 20 points once you got so many points you could get swag or bonuses and stuff like that um so their culture they had a culture of caregivers stepping up to cover shifts but it varied but the one that we didn't like we had to find out why and there were some agencies that we looked at and then we canceled
Starting point is 00:25:44 them out like during a due diligence process because that we looked at and then we canceled them out like during our due diligence process, because when we asked why it was, well, we can never get caregivers to cover shifts. We try and we just can't. We don't like that. And there were some other issues that wouldn't be the only deal breaker, but there was no even thought in their mind that they could possibly get people to go do that. It wasn't just somebody saying, no, it was, well, that's not really what we do here. So that was tricky though. And that's, you're right. That's not, when I talk to different people, some of the different association events we go to and everything, not everybody's tracking care coverage, shift coverage. So if you're not, check it out. It's worth tracking. It tells you a
Starting point is 00:26:18 lot. Yeah. That's kind of where my head is at. I've heard you track it. I know other agencies do. I don't feel like it's one of like maybe the core KPIs that we talk about in an industry, but I think that's really useful. And you're identifying really useful in this context of looking at the performance of another agency with the acquisition in mind. But what I'm thinking about with these three weekly hours, gross profit margin and shift coverage, they are leading indicators and tie back to a lot of other processes, people, culture, like some of the less quantifiable things. Those things are a good indicator of all of the backend, which was going to be my next question based off the acquisitions, you know, and you looking at those three things, how, or do you rank like culture, people, processes, some of those things that you don't really know until you make the acquisition,
Starting point is 00:27:15 you know, how, how do you factor those in? Or do you just trust, you know, kind of the metrics and hope that you can mold everything else accordingly? I'm going to put some caveats in my response to this, right? So I think it depends on your location. If you're doing an acquisition that is closer to your office, right? Like one of the first ones we got, it was 35 minutes away. It was their office location. So the people there in management weren't as important to me because I felt like we could easily go cover it. You know, my leadership team could go cover it ourselves if there were issues. But our acquisition of Michigan, it's a 12 hour drive from here to there.
Starting point is 00:27:54 The people were hugely important. I mean, they're important anywhere, but more important the further away the acquisition is. Right. So that's very important. Obviously, metrics, too. But the culture and the culture is usually important. And the shift coverage really tells you a lot about that, you know, what they're trying to do. Also, the other thing that tells you like their growth, if you look at their growth, if it's been going up, you know, it's a culture that they're trying to grow and expand. If it's been declining or stagnant, you know, that they're kind of okay with status quo or they have issues, like they're not trying to grow or something's wrong. They're not bringing on business or they're not retaining business well, retaining employees, whatever it is.
Starting point is 00:28:29 So those tell you a lot about culture, those metrics. I think we talked about this on the last episode being too culture heavy or too data heavy, and it's good to have a mix. I think they're really closely intertwined when you're looking to see whether a company is one that you want to acquire or not. And the data speaks volumes initially, because when you look at particularly finance, a lot of the, like the four that we looked at, there was like 20 that as soon as we got the financials were like, this is a no-go, unfortunately, you know, whether it was a location we liked or whatever, it was just, people were asking, you know, for way too much for something. And it's just, you can't do it financially. You can't make it work no matter how great the people are. So that really is kind of a step one, whether they're
Starting point is 00:29:08 financials, if financials aren't good, you can't really, it's not worth you spending money on to, you know, or time to go through the rest of it. So we're people first, but in order to be people first, the company has to be profitable. Let's talk about people and about retention specifically. I'm curious, with all of the acquisitions, how has employee retention been in the office and on the caregiver side? It's a big deal for the people that are being acquired. There's a lot of change, a lot of new processes, a lot of new phases. How has retention been both at the office and the caregiver level? Yeah. So I'll start with the caregiver level.
Starting point is 00:29:46 It's been great. We came in and as we're a larger entity, there's a couple of things, you know, offering, you know, we pay for part of health insurance. We offer the ability for caregivers to earn time off. We call it accrued time off. You know, our policy is every quarter, if you have no call-offs, at least 90% EVV, you got to work at least 20 hours a week, you're on a day off. So we have abilities for caregivers to do that. And none of these other agencies had that. So caregivers, they were kind of moving up, if you will. So that
Starting point is 00:30:13 helped. And we really wanted it to be, we think about client retention too, was really important to us. We sent out some letters. We tried to make it as smooth as possible so there was no interruption of care. We got swag for the caregivers, which was big, and sent that out. Some scrub tops or t-shirts, depending on what the preference was. Really just tried to make that good with the caregivers. Caregivers, not much turnover. Clients, not much turnover either. Other than our one acquisition, I was over-promised. This gives them the office too I was under I guess understated how much the owners were doing they're like oh we're not doing this much and that much and after the sale we found out that they were doing way more than they said and
Starting point is 00:30:53 they were leaving and moving to another state and that's the company that has actually went down a little bit and we had clients on the schedule that shouldn't have been on the schedule that were either abusive to our caregivers or just didn't belong. They needed more care and we shouldn't have been in there providing non-medical care. They needed medical care. So we've had to remove some of those clients and haven't really been able to get our groove back. We did just change the name.
Starting point is 00:31:17 That's something I'll probably talk about when we do that and stuff. But we did just change the name. I think it's going to help us down there with kind of getting some positive momentum going. But office staff down there, because I didn't have a strong leader initially, we've had to make some changes at the one location. The other one, we had to make some small changes. I'd say our retention in the office, we probably have kept 90% of the people that were there. We went in and we'll be with any acquisition. We have no intentions of getting rid of somebody when we come in, even if there's duplicity and, and, you know, job descriptions, uh, we'll repurpose that person into something else. And with the intentions of growing, right. Cause that's our goal. We can repurpose them and
Starting point is 00:31:53 grow and, um, you know, keep them on board. We don't ever want to come in and get rid of people just because to do that, you know, to save the bottom, you know, save, save the bottom line. So, yeah, that's, that's amazing. Uh, We hadn't talked about this beforehand, but to, to be looking at, you know, really high caregiver retention, client retention, 90% office staff retention, I would say that's really successful and amazing because it does create a lot of change for them. Obviously you control all of that change and you position it and you communicate it, but inevitably, you know, there there's change that comes you position it and you communicate it. But inevitably, you know, there's change that comes along with it and you want to reinforce and highlight all the benefits. Like you said, health insurance to the caregivers, time off, things that they'd
Starting point is 00:32:34 never experienced. You know, it's a win-win for them as well. You did mention what I wanted to hit on was renaming these businesses. Has that happened with all of them? And if so, when did that change occur? Yeah. And just one other thing. So we have had caregiver turnover since our acquisitions, but it hasn't been related to the acquisition. It's your standard type of turnover you would have anywhere else. So I don't want anybody to think we don't have any caregiver turnover. That'd be amazing. But yeah, as far as names, so we renamed our location in Michigan after a year. So we have Sunny Days, we have Sunny Days, So we have Sunny Days Inumcare. We have Sunny Days Inumcare Great Lakes. We want to continue to expand into the Great Lakes region.
Starting point is 00:33:09 Now we're in Michigan, but we've expanded into Wisconsin as well now. And then North Carolina, we waited for two years and renamed that Sunny Days Inumcare Carolinas. I would say in hindsight, a year is a good time. Keep everything calm, not rock the boat too much. But if you're going to make the name change two years, that was not the wisest decision I made. And then the local entities that we have, we've kept them all kind of having their own specific names because the way that their referral sources and kind of who they target is all different. And I kind of look at it as, you know, we have one agency that's got a giant boat that's fishing for
Starting point is 00:33:42 tuna, another that's fishing for salmon, and another that's fishing for sea bass, right? And if I combine them all into one big entity, maybe we are bigger with the tuna, you know, we're catching more tuna, but I feel like we're not going to be catching the, you know, the sea bass and the salmon then, if you can track with my fishing boat analogy, right? So we've kept the three different names in kind of the Western PA area. You know, maybe that's something we do in the future. But for the time being, just the referral sources. And there is, you know, some personal connections to the original name, you know, from some
Starting point is 00:34:14 of the founders, the founder's family who's still involved. So that is something that I always try to consider the personal and emotional connection with something and weigh that out versus, you know, the business benefit and, you know, is it worth it or not? So for anything kind of outside of the area, we'll probably rename it. But, you know, locally, it kind of depends on what the referral if we acquire a company, you know, in Western PA, that's getting the same type of referral sources, it's just in a different geographical area, we'll probably change the name a year in is kind of what we expect to do. Yeah. Thanks for sharing that. To be honest, it's kind of a mixed bag and it's all very situational. You know, I think if I'm
Starting point is 00:34:50 not mistaken, like ideally is to roll everyone up under one brand, but like you're saying, it's not that cut and dry. It's not that simple. There's a lot, a lot that goes into it, particularly with the referral sources. You know, if you were to rebrand, lose all your referrals, you know, that could tank a location overnight. And so there's just a lot of strategic thinking that goes into everyone. And it's not as cut and dry as someone may think of, I'm going to acquire these businesses, change their names within a year. And it's that easy. It's really just not. So that was cool to hear you kind of just, you're thinking behind all of that and the factors. I want to talk about the payer sources. So we talked heavily last week, sunny days is
Starting point is 00:35:30 heavily Medicaid, like primarily Medicaid. But you do do some private pay, you do do some VA. You mentioned that not all of these acquisitions were Medicaid heavy businesses, if I'm not mistaken. It sounds like there is a pretty diverse group of payer sources amongst now kind of your full portfolio of companies. Was payer sources high on your kind of key factor list because you know Medicaid so well, and it's your bread and butter? Were you apt to look for other Medicaid businesses, or were you interested in diversifying through acquisition? Was it high when we got into it? No. Is it high now? Yes. So learning experience. So we know Medicaid well. We know the VA pretty well too. Private pay, I don't claim to be an expert on
Starting point is 00:36:15 private pay. We do private pay. We've had private pay. Sunny Days was initially private pay. We still do it. It's a small portion of our business and the cases we have, we feel like we do pretty well. But the company we have, we feel like we do pretty well. But the company we acquired in North Carolina was 100% private pay. We've since got Medicaid set up. And we do some aid and attendance with the VA. We're in the process of getting a contract set up with the VA, which we should have here in about two months.
Starting point is 00:36:37 We know that really well. In the future, if we go to find any companies, I'm looking more Medicaid VA. But I'd still be interested in a private pay if it was a larger established business that had been around a long time. So they already had the referral sources. They already kind of had the business model up and running. You know, they're doing, you know, maybe 3,000, 2,000 hours a week plus, maybe up to, you know, three plus in that range.
Starting point is 00:37:00 I'd be interested in that. But a smaller private pay agency like the one we acquired, it's tricky. You know, I like the people down there and I don't regret regret acquiring that company, but it is different. You know, it kind of it's just a different, you know, Medicaid and private pay from especially from a referral source standpoint. It's a little bit different. And so in the future, private pay. But with the stipulation that has to be large enough that it's already performing and running well. So we're really looking for more Medicaid and VA, smaller Medicaid and VA we're fine with because we know we can grow that space.
Starting point is 00:37:32 Putting you on the spot, looking back at those 40 or so agencies that you vetted originally, do you recall what percentage of those were heavily Medicaid focused? Was it a big portion of those? Was it a small portion? I'm just curious. I would say somewhere around probably 60 to 70% were Medicaid focused. A lot of the private pay agencies that we looked at were smaller that were for sale. It seems like from a private pay standpoint, 500 to 900 hours, maybe a week was kind of the range where we saw a lot of private pay agencies at. And it just seemed like agencies that people couldn't get any bigger than that. We're experiencing that ourselves right now with, you know, with North Carolina, you know, until we get Medicaid kind of rolling down there. Yeah, 60 to 70% were Medicaid,
Starting point is 00:38:19 but the ones that were private pay were smaller. We didn't really, I think it was one larger private pay one that we looked at that just didn't seem like it, they were asking too much. And I guess, you know, I'll say that as well. So from like a multiple standpoint, so you're looking at your EBITDA, which is kind of in our space, kind of like your net profit. And, you know, you're looking for something, we're looking for stuff that's typically four to five times EBITDA is kind of what we're looking for. If it's really big, maybe six, but kind of four to five, maybe even three, if it's smaller, it's kind of, and we have people. If it's really big, maybe six, but kind of four to five, maybe even three if it's smaller. And we have people that if their company's EBITDA was $200,000, we're looking to pay $800,000 to $1 million for it.
Starting point is 00:38:53 And they're asking for $2 million. And we talked to them, maybe they're willing to get down to $1.8 million, but still they're asking for like a $9 or $10x. It's not realistic. If anybody pays for that, they're overpaying for it unless there's some special growth connection that they can have with it, you know, fairly quickly. So, but yeah, that's kind of the breakdown of what we were looking at. Awesome. Yeah. Again, super helpful. And I, and I don't want even myself included to like generalize that, you know, what you're seeing and what you're sharing is like kind of the rule of thumb in the industry. But I was just curious, you know, are there more private pay businesses on the market? Are there more Medicaid? You know, like you said, the size, you know,
Starting point is 00:39:26 maybe smaller private pay, mid to large Medicaid, like there's so many factors here, but I'm just curious, you know, what you saw and if that can kind of relay back to the industry of, you know, what's available and what's happening. Let's shift gears a little bit and talk about lessons learned, about challenges, about, you, about maybe the horror stories that most people wouldn't wanna share because I'm sure you've come across things that you weren't expecting. I'm sure you've learned some really tough lessons.
Starting point is 00:39:54 So I'll let you kind of steer, but where do you wanna start? So I would say lessons learned. There's a lot here. So one is if you don't feel like you could leave your business for a month, and it would still be running without you successfully, you're probably not ready to do an acquisition. So I would say that's one lesson. So these are kind of tips, I guess, too, for
Starting point is 00:40:13 two would be, are all of your processes and procedures standardized in your company? Ours were not a lot of it was in my brain brain or other people's brains, which is great when you have one agency. But how do you get this process? This is a very specific one. Someone loses Medicaid eligibility. What is our process? Right. My compliance person is really good at answering that question. But how do I make sure that somebody in Michigan does that the same way that we do? Well, I have to have a typed up process for them. So lesson learned is making sure that you have processes squared away that you can adapt.
Starting point is 00:40:47 There's obviously nuances in each state or region, but that's a big one for us. And we're still kind of catching up with getting some of these processes typed up and changed for each entity. The third thing is, if you have stuff that you know works really well, you either need to implement that at the agencies that you acquire, or if they're killing it, do what they're doing and stick to what they're doing. Don't try to hybridize it and do what you have and what they have. And it kind of gets into this watered down version. And we ran into that kind of at two of our three acquisitions. And that was tricky.
Starting point is 00:41:26 We don't want to come in and say, this is what we do. We don't care what you've done before, right? That's not good either. But if you know you have systems and processes in place that work really well, you got to figure out how to sell it to the people there that, you know, from the company that you just acquired, but stick to what you know works. Obviously get the input. There's going to be nuances. You know, my kind My philosophy on it is 80% of those stuff that you have, you should continue to do everywhere you acquire a company. 20% is up for negotiation and wiggle room, but there should be an 80% that's like, this is how we do things. And that's probably one of the biggest ones I would say. So those are all things that I would say, lessons learned are
Starting point is 00:42:00 some of the biggest ones. I guess the other thing is this. So our company that we acquired in North Carolina, we did not get to talk to anybody other than the owners before because they were worried about them finding out about the sale. If we would have talked to them, we would have found out how much the non-ownership was doing down there from a management standpoint. And we would have approached the acquisition a lot differently and probably paid a little bit less for it, knowing that, and maybe had some more contingencies or kept more money in an escrow. But we would definitely approach it differently. So in the future, we have to talk to the key players, even if it's a local competitor across town, if they're not willing to let us talk to their, you know, their key personnel and management, we're not moving forward. That's a deal breaker for us.
Starting point is 00:42:42 A red flag. Yeah, if you're talking about red flag, that's a red flag. Yeah. Let's talk about kind of the hybridization. I like that word. I think that's really interesting. And then we'll talk about maybe some other red flags. The 80-20 is really interesting. 80% needs to model kind of like the corporate structure, the headquarters needs to be similar, but that 20% of negotiation, I'm assuming at this point, you have that pretty well defined, like, what are some specific examples of things that some of these agencies are doing well, that you've thought, like, we don't need to override that I don't want to override
Starting point is 00:43:19 that because it is going well, can you share any like specific examples that training is it rewards? Is it like, what are those? Yeah. So and when I say that, it's not like we're cramming stuff, you know, down people's doors. The 80% for me is finance has to be the same everywhere. Compliance has to be the same everywhere. I mean, there's maybe there's different things like with TB tests that varies from state to state. But in general, compliance has to be the same everywhere. How you do reporting has to be the same. Anything back office has to be the same everywhere. Right. So that's where like, that's non-negotiable, basically. And that's nice when we kind of have it all combined in a balance. But front facing is where there's some flexibility, right? So we have a policy that if you don't cover caregiver,
Starting point is 00:43:57 we're going back to the caregiver call offs. If you don't cover caregiver call offs, like that's a major issue. And that's getting addressed by, as a field manager, your direct supervisor is addressing that with you. With the region in Michigan, because it's so spread out, they don't cover caregiver call-offs up there. And we had to be okay with that because it just doesn't... The clients are okay with that. The clients up there are lower our clients. It's not as dire if somebody doesn't show up. And that's just not culturally how they are up there. We want to cover the shifts and we do everything we can. But if they don't, the client doesn't want to, we do that, oh, we're going to lose the client. We really push back.
Starting point is 00:44:34 And we actually lost some clients because we were so pushy about sending in another caregiver that they weren't as familiar with. So culturally, they didn't want another caregiver. In Pennsylvania, North Carolina, they were fine with another caregiver. So we just had to adapt to, and we learned the hard way because I'm like, no, this is how we do it. I pushed it and it backfired a little bit on us. And we lost a couple of clients because of that. So we had to kind of reset and say, all right, well, maybe we need to change our view on that policy up there. Still try to get great shift coverage, but we're not going to force it kind of like we do in other locations. This is super interesting because one of the questions I wanted to ask was,
Starting point is 00:45:08 how do you maintain continuity of culture through acquisitions? It sounds like from what I'm hearing, it's more malleable than you may think. The local market, the people at that office, there is already a culture established there. Things may be going really well and you don't want to rock the boat too much. And so maybe culture, there needs to be, yeah, continuity of processes, finances, reporting, et cetera. But like I'm hearing is, you know, the culture is a little bit more fluid and less black and white through acquisitions because these are people, these are clients, these are families, you know, this is a little bit more fluid and less black and white through acquisitions because these are people, these are clients, these are families, you know, this is a local feel and you've got to, you know, go with what's working. Yeah. And we like, I guess, you know, you say that like the
Starting point is 00:45:55 product, how we do an intake is the same everywhere, right? How we do a client interview, excuse me, a caregiver interview is the same everywhere, but how we respond to, you know, the interactions with clients and caregivers, when situations arise, we have kind of our, this is the bumpers on the bowling alley lane, right. That we got to deal with, but inside that's where there's the flexibility because it is people, right. And it's, it's different. Yeah. Let's, let's talk, you know, briefly about red flags. Obviously that's, you know, to me seem like a pretty obvious one. You know, the owners don't want you to talk to other administrators. That's, that's a red flag. Any other red flags that you either saw or didn't see until later that you wish you would have recognized? Yeah. So finance, you know, obviously that's kind of,
Starting point is 00:46:39 I don't even want to come there. That's just a, you know, out of the gate. The other thing is, so R1 acquisition and share, and I'll share this. So we acquired, three weeks after we acquired it, they got raided by the FBI and IRS for Medicaid fraud. I went over there. There was like 25 armed agents in vests. I felt like I was on a movie. That was 18 days after the acquisition. And this is a home care business.
Starting point is 00:46:59 So everyone's aware this is a home care business that this happened at. Yeah. So anybody that's got something crazy that's happened to them, sure there's crazy things that happen, but that's really high up there for about as crazy as it gets. One of the things that we believe happened is we believe there was caregivers that were essentially filling out timesheets before EVV in 2018. And they were working at Dunkin' Donuts or Starbucks or somewhere else. And then having, you know, signing off on these timesheets and taking advantage of either maybe there was family
Starting point is 00:47:28 run cases or clients that had dementia. They're taking advantage of clients that were vulnerable and writing in times that they worked double dipping, essentially working another job. We think that's what happened. We haven't been able to prove that. And this is way before this was like five years before the acquisition. But I'm dealing with that now. So one of the things that we look at is if a company, and this is a, I guess, with a beige flag that gets your attention, but maybe isn't a red flag, right? So this is a, if companies have used timesheets recently, that should get your attention. And you should really go through the vetting process of how they're ensuring that fraud's not being committed.
Starting point is 00:48:03 We've learned that and are still dealing with that situation. So timesheets really scare me. And I guess also, are there client visits occurring? How are you making sure that the caregivers are in the home with the client performing the tasks that they're performing? You know, there's things to be looked at. They said, oh, the state requires us to go once a year. Or I don't know, we never go.
Starting point is 00:48:23 No one ever goes. It's just the caregiver and client there day after day, year after year. No one's been in that home in three years. That's not good. So I would say that, I guess just the checks and balances that are in place to make sure there's no fraud or that clients aren't being taken advantage of. If there's nothing like that, you got to start asking questions and really dig into it. That's what I was going to ask. And I don't know, maybe this is a dumb question, but like how they could send you anything. They could give you any papers. They can make up a spreadsheet. Like, I don't think many people would do that, but this is a big deal, you know, to purchase another business. Like there's a lot of money,
Starting point is 00:48:56 time, resources. So they could send you anything. How, how do you like fact check? I think you mentioned like getting into their software,, getting access to their tech stack, doing the due diligence there. Would one step further be contacting people, contacting clients, families, employees to really do an extra layer of fact checking? Yeah. We hadn't done that. It's not a bad suggestion. I mean, people may be nervous that that would cause kind of a stir with the clients and caregivers that they could freak out, that there may be an acquisition. It's not a bad idea. But getting, I guess, asking people, recording everything that they're saying. And then before you get into it, we check their system of all of these companies. I was in their scheduling system and in their QuickBooks before the
Starting point is 00:49:37 acquisition to verify everything that they said was true and accurate. And if it didn't match with what they told us, that's not, you know, then is there some, there's some integrity or some trust issues you have to deal with. So you are trusting. I mean, you have to be comfortable with the person because you are trusting them with certain things. And like I said, we've, we were burnt a little bit in North Carolina, you know, but I think if we asked the management team some very specific questions, I think we would have not been burnt and we would have had a better grasp on what was going on there. Yeah. I by no means mean to be like a pessimist. It's just to me, it's like, you want to go to the ends of the earth to really make sure you feel good about
Starting point is 00:50:13 things. At the end of the day, there is some trust and accountability and like, you know, like a leap of faith just to like, you know, go all in on it. But I guess, yeah, my wheels are turning on like, you know, you can prove and identify so much, you know, with the existing records, but you know, at one, at what point do you maybe go one step further and just have those conversations? Like you said, there may be concerns of like rocking the boat or even an entertaining and acquisition, but you know, if you're really serious about it, it could be coming either way. And you just have to figure out how to approach those conversations with these people.
Starting point is 00:50:47 And I'll add, so let's say something bad does happen. What team do you have in place that can go down and make sure that it doesn't turn into a giant dumpster fire, right? So if you're going to do acquisitions, is it you? If you're the person who's going to go down and save the day if something really bad happens, can your team at your current agency handle everything without you there? Can you go down there and set up shop? If it's not you, who is it on your team that's going to go do it? Do you have somebody that can go down there and be the hero and run that agency while you get it under control? If it can't be you
Starting point is 00:51:18 and you don't have anybody, you either need to get that person before you do acquisitions or maybe you're not ready. I want to discourage anybody from doing anything because if you're listening to this, I would say that you probably want to be better as a home care agency. If you want to be better as a home care agency, you actually care about people. And if you actually care about people, and there's a lot of agencies out there where people don't, you should be buying those agencies. So those people that they're taking care of and that they're employing have somebody like you that's overseeing the agency.
Starting point is 00:51:46 So I don't want to discourage anybody from doing it. Just I want to say make sure that you have everything set up and squared away, especially personnel, whether it's you or your top players that can go handle it. And that's a little bit of a safety mechanism for me is I know if we go buy something and something doesn't work, I have a good team in place, depending on the situation that can either run all the other locations and I can go there. Or more likely, I have a couple of players that can go there now and handle it and make sure that everything gets, you know, gets taken care of. So that's that's really important. And that goes back to being, you know, trusting the team that you have in place. Yeah, that was really well said. I think the essence of what you just said represents you as a CEO, represents Sunny Days really well. You've explained to me that you want to help the most people possible and you're really good at what you do. And now you're really good at scaling. you can impact, we're talking thousands and thousands of people.
Starting point is 00:52:45 And if it's done right, you know, you're really having a lasting impact and creating this, this culture of care, you know, and like the greater Pittsburgh, but then even, you know, regionally. And so I just think it's, it's so neat, you know, to find people like you that are so passionate, but are also sharp and pushing and working hard day in and day out to help as many people as possible. I think it's admirable. And I really just think it's incredible. Yeah. And it's something that I think there's, you know, there's a roll up happening in our space right now with M&A. And there's a lot of firms getting into home care that maybe don't care as much about the people and they just care about, you know, the bottom
Starting point is 00:53:23 line. And it's agencies like, like ourselves and like everybody that's listening to this and live and is going to be listening to it, that really want to do good things that, I don't want to say unite, but kind of like, we need to step up and acquire these companies or grow the companies that we have to make sure that the people that need quality care are going to get it because there's agencies out there that, you know, everybody knows there's competitors out there. have that aren't delivering quality care.
Starting point is 00:53:48 And you feel bad for those clients. I mean, I personally feel bad for those clients when I had somebody yesterday, an auditor that audited us, and her son is getting care. And she was talking about some issues she's seen at other agencies. The agency that her son is getting care from, you know, they're a solid agency. But there's other ones she talked about that people go weeks and months without care and no attempts to staff them. And, you know, those people, there's a reason that they're, you know, qualified for care. There's a reason they've called you if it's property and they've asked for care is because they need help.
Starting point is 00:54:17 And they don't want to go to a facility. They want to stay at home. So agencies like us really need to step up and make sure we're getting care for those people. I couldn't say it better myself. You know, we talk about bad actors and there are some. But like you're saying, you know, whether it's roll ups, consolidation, it's really just letting the best rise to the top, you know, and have, you know, their pull and their influence on the market and to help as many clients at that level, you know, of care that really should be standardized across the board. So I couldn't
Starting point is 00:54:49 agree more. Just in closing, anything that I didn't cover or any kind of last tips or advice that you want to make sure we get in in the last couple of minutes? Yeah, I would say that when you go to do acquisitions, everybody thinks about acquisitions. Maybe it's just as lessons I've learned. The acquisition, all the due diligence and everything else, maybe that takes three to six months. That's not the hardest part. The hardest part is the integration. Once you've acquired the company, getting it integrated to run to the same standard that your company is running. Obviously, due diligence and the acquisition part is very, very important. But make sure you have a plan in place, a checklist of everything that you want to get set up
Starting point is 00:55:27 from an integration standpoint, down to whenever I hire a caregiver, is there a letter that I want them to get from me as the new executive or owner? I mean, you want everything squared away. If there's satisfaction calls to clients on a monthly basis, what statement am I telling them? I mean, you really want to get that all figured out. And how are you going to train that? How are you going
Starting point is 00:55:49 to implement that? The integration, like I said, the acquisition placement, maybe three to six months, the integration is taking more like three to 12 months. That's just a longer process to get all that set up because you can't force feed it too fast for it to be done correctly. So that's a really big thing I would say that I would note that integration is actually harder, in my opinion, than the acquisition. And then I guess lastly, if you acquire a company that's doing 1,000 hours a week or you acquire a company that's doing 5,000 hours a week, it's pretty similar in the amount of work that is involved. So when you're looking at companies, we have found that the due diligence, acquisition, and integration process for the one company we acquired
Starting point is 00:56:30 that was smaller, that was at the time around 800, and the company we acquired was doing 9,500 hours, very similar in the amount of work. There's obviously more players and more people that need notified, but the amount of work is similar. So if you have the means to buy a larger agency, maybe it's doing a
Starting point is 00:56:45 couple thousand hours a week versus under a thousand, and you're not sure what to do, it's the same amount of work to buy a smaller agency. There's reasons to buy smaller or larger agencies, but from a work standpoint and the acquisition integration, the workload we have found at least has been about the same. Wow. Some really good points here at the end. John, I just want to thank you for your leadership at your agency, at your org, but also at the end. John, I just want to thank you for your leadership, you know, at your agency, at your org, but also across the industry. You're one of the maybe hidden gems in the space, but no, I needed to dig you up and make sure you could share these insights with the industry because it really is fantastic. So thank you so much for all that you're doing and for joining us and for sharing so much transparent information the last two weeks.
Starting point is 00:57:24 You're so willing to just share and vocalize and highlight lessons learned. And I know a lot of people are gonna get a lot from this. So thank you so much. Hey, thanks a lot for having me on. And it's been great. And yeah, for everybody that listens to this, go out there and crush it in 2024
Starting point is 00:57:37 and take care of as many people as you can. Awesome. Well, we'll end here. Thanks everyone for joining us. Thank you again, John. And we'll look forward to seeing everyone back next week. That's a wrap. This podcast was made by the team at CareSwitch, the first AI powered management software for home care agencies. If you want to automate away the
Starting point is 00:57:56 menial of your day to day with AI so that you and your team can focus on giving great care, check us out at careswitch.com.

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