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elderly care business

newtothis

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Does any one here familiar with elderly care business?

I am talking about the one where you find nurses and other assistants who will come to older people houses and help them, cook them and then their insurance/government will pay me for the services. And I will just pay salary to those nurses ?

It seems like fast lane, but am I missing something ? It seems like I don’t need any start up costs. I only pay nurses when I get paid?

Thank you
 
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PEERless

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New, you seem to keep choosing these high-cost startup ideas! That's OK. Anything's possible. I don't work in the industry, but I know that collecting revenues from insurance is a LONG process -- sometimes only for a FRACTION of the bill!

As I've said before, I think being a retailer of a service is a bad business model. If you don't provide the service directly, what keeps your customers from cutting you out?
 

Russ H

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No offense, guys, but both of you seem to be commenting about a business you know little about.

Please correct me if I'm wrong, and either of you have experience in this sector.

PEERless, the idea of being a referral service from B2B or C2B is VERY fastlane, if you can make the process hands off and scalable.

We all tend to talk about what we know. And sadly, we tend (unconsciously) to reject things we do not know.

These forums are a place where experienced investors and business owners assist up and comers with their business (or investment) ideas.

It's also a place where we can offer fellow forum members our support and encouragement, even if we don't have expertise in the area they are asking about.

But shooting down someone's idea, especially if you do not have specific experience in that area, is just not cricket.

At the worst, it's bad business. And at the very least, it's bad forums etiquette.

Again, my sincere apologies if you have experience in home health care or elder care.

If you do, please offer up the pros and cons you see, based on your experience.

Otherwise, I would suggest, in all humility, that you think twice next time before trying to discourage any poster here about something when you have no direct experience in that particular area.

Your experience with hotels and GDS is, sadly, nothing like a referral service for eldercare. I speak from experience here, as the owner of a lodging property.

The only reason lodging property owners are looking for alternatives to things like Expedia and Travelocity is that the rates these engines charge is completely out of proportion to the service rendered. So much so that the hoteliers are now doing more aggressive marketing to their sites, since it's CHEAPER than working w/a GDS referral system.

BTW, Travelocity and Expedia is VERY, VERY fastlane. Both companies generate over a BILLION in revenues each year (Expedia's last year was $2.67B, 19% higher than the year before), w/HUNDREDS OF MILLIONS OF DOLLARS in profits. It's a model that should be examined, and improved upon.

-Russ H.
 

Russ H

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NewtoThis-

In response to your question, I'd suggest you explore a model where you are hooking up one side with another, not actually taking responsibility for the entire service model.

There is a long (and profitable) history in referral services. And you won't have to take on the liability and worker's comp issues if you just refer.

As I mentioned above, look at engines like Travelocity, Expedia, 1-800-Dentist, and others to see how you could model a referral service that would be hands-off and scalable.

Elder care and home health care are areas of ENORMOUS future growth.

Definitely fastlane thinking.

Keep working at refining your concept, and seeing how to best make it scalable and automated (like a referral website, for example, where either the service provider or the person seeking the service pays you a fee for service).

Good luck! :fastlane:

-Russ H.
 
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Sid23

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take a look at www.eldercare.com and sites like that. what are they doing well? what areas of the market need have they covered?

more importantly, what are they missing? where is the OPPORTUNITY to improve, add, expand upon, etc?

and listen to Russ's advice. as usual, it's top notch!

-Sid23

PS. My brother and I spent about a month on a business plan for at home elderly services. We didn't get far, but there is no doubt elder care is poised for ENORMOUS growth over the next 3-20 years.
 

Russ H

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Sid23-

Excellent points.

And thanks for your kind words. :tiphat:

-Russ H.
 

PEERless

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you seem to be commenting about a business you know little about.

You are right. I only have experience as an insurance provider and as an end-of-life care consumer. My mistake to try to bridge the gap.

I'd suggest you explore a model where you are hooking up one side with another, not actually taking responsibility for the entire service model.

I agree with this concept. Creating an employment network of some kind could work great. I would stay away from having to "pay salary to those nurses." Connect the interested parties, take your fee, and depart.

***Unrelated to Topic***
The only reason lodging property owners are looking for alternatives to things like Expedia and Travelocity is that the rates these engines charge is completely out of proportion to the service rendered. So much so that the hoteliers are now doing more aggressive marketing to their sites, since it's CHEAPER than working w/a GDS referral system.

I work for a very profitable boutique hotel, with revenues coming mostly from repeat FITs. It is our understanding that Expedia, specifically, is losing ground to its own suppliers for the very reasons you cited. NO DOUBT they are making a ton of money, but I don't see it lasting forever.
 
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randallg99

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Does any one here familiar with elderly care business?

I am talking about the one where you find nurses and other assistants who will come to older people houses and help them, cook them and then their insurance/government will pay me for the services. And I will just pay salary to those nurses ?

It seems like fast lane, but am I missing something ? It seems like I don’t need any start up costs. I only pay nurses when I get paid?

Thank you

I looked into this type of business a year ago and decided against it. Here's my 2 cents:

-you get to save a lot of money using 1099 contracted workers/nurses but the same money saving factor on personnel creates more headaches.... there is no loyalty to your company

-biz that can be operated out of home

-lot's of competition (because it's rather easy to start and fund)

-cash flow is entirely dependent on insurance and/or medicare subsidies... and they pay on their schedule, not yours.

-very rarely you get a private paying customer

Now, the elderly population is going to grow leaps and bounds so there must be a market for them besides pharma...

A study was performed by interns to help one of the charitable boards I sit on rewhich helps seniors and what was found to be #1 concern for seniors was their lack of transportation... many of them have had licenses taken away and their self-dependence becomes nonexistent... some kind of biz providing transportation of elderly is probably lucrative
 

PEERless

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Great Points!

-cash flow is entirely dependent on insurance and/or medicare subsidies... and they pay on their schedule, not yours.

(How come when I point this out, I get berated for not knowing the industry?)
 

BeingChewsie

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Hi :)

I love ideas geared towards helping the elderly. It sounds like you are talking about starting an agency..either sending companions into homes or sending nurses/nurses aides into nursing homes/assisted living facilities. I'm not sure which one you are leaning towards but the nursing end is more expensive to get into. The insurance costs are not so bad you can go through an organzation called NSO...they will insure nursing agencies/home health care agencies. The exact figure escapes me now but I know it wasn't cost prohibitive. Your largest initial costs come from advertising/salaries to get contracts and get nurses/companions. You will wait 60-90 days to get paid from a facility but your nursing/companion staff expects to get paid within a week and in some cases same day(many agencies do same day pay for nurses now) so you need a chunk of change to float your salaries during that time. The average agency registered nurse makes between $40-$50 an hour, companions between $12-$18 an hour, so you need to be able to cover that plus your expenses until you start getting paid.

Sue

Does any one here familiar with elderly care business?

I am talking about the one where you find nurses and other assistants who will come to older people houses and help them, cook them and then their insurance/government will pay me for the services. And I will just pay salary to those nurses ?

It seems like fast lane, but am I missing something ? It seems like I don’t need any start up costs. I only pay nurses when I get paid?

Thank you
 
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Russ H

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Exhibit A:
Randallg99 said:
I looked into this type of business a year ago and decided against it. Here's my 2 cents:

-you get to save a lot of money using 1099 contracted workers/nurses but the same money saving factor on personnel creates more headaches.... there is no loyalty to your company

-biz that can be operated out of home

-lot's of competition (because it's rather easy to start and fund)

-cash flow is entirely dependent on insurance and/or medicare subsidies... and they pay on their schedule, not yours.

-very rarely you get a private paying customer

A study was performed by interns to help one of the charitable boards I sit on rewhich helps seniors and what was found to be #1 concern for seniors was their lack of transportation... many of them have had licenses taken away and their self-dependence becomes nonexistent... some kind of biz providing transportation of elderly is probably lucrative

********

Exhibit B:
PEERless said:
New, you seem to keep choosing these high-cost startup ideas! That's OK. Anything's possible. I don't work in the industry, but I know that collecting revenues from insurance is a LONG process -- sometimes only for a FRACTION of the bill!

Follow-up comment:

PEERless said:
(How come when I point this out, I get berated for not knowing the industry?)

PEERless, I called you out on this for the same reason I called you out on the "I'm going to make $100M" comment.

Specifically:

Your comments do not provide specifics, or indicate that you have actually spent time on due diligence. Or they sound like that of a classic "E"* or "S"*.

In his post, Randallg99 mentions, first off, that he investigated this as a business idea (a "B"* perspective)

Meaning, he did considerable due diligence, as is evidenced by his bullet point summary.

Then, he shares some direct experience from one of the boards he sits on (an "I"* perspective). He brings up a study that points to transportation being a primary concern for seniors, and that addressing this area might be lucrative.

Do you see the difference in your comments, and his?

*********

I realize that it may seem like I'm picking on you.

That is really not the case here.

It's just that, when you give your 2¢, you're not really telling us what type of life experience or due diligence you've done to justify your comments.

So the casual reader is left thinking you don't really have that much experience, and therefore, are justing making "off the cuff" comments.

MJ called these kinds of people "No Net Worth Know-It Alls" (NNWKIAs).

**************

Back to the cocktail party analogy I used with you in an earlier thread:

Let's say I'm at a cocktail party, and I meet someone. We're chatting about elder care, and they mention that they're looking into how to provide service to this sector, and how best to structure their service.

Looking at it from a business-building perspective (something that can be automated and scaled), I'm likely to make comments in that direction. And I'm also likely to recommend the internet as a vehicle, and suggest that the person build the company so it can either go public or be sold down the line.

And I'm also going to say that I don't have any direct experience running an elder care facility, or working with this part of the industry. Nor have I ever taken a company public. Nor am I any kind of net guru.

But I have developed businesses for the past three decades, and my orientation/bias is towards building Businesses that can be sold to Investors(to put it succinctly, I look at ideas from a B and I perspective).

I'll also point out that I happen to know a couple of very successful people who have developed website referral businesses, connecting B to B or C to B. And that some of their efforts generated hundreds of thousands of dollars in revenue, and (eventually) gave them a tidy sum when they sold the business.

****

Now, at this point, another person at the cocktail party who has been listening in, offers their opinion:

"I think being a retailer of a service is a bad business model. If you don't provide the service directly, what keeps your customers from cutting you out?.

This also seems to be a high-cost start up idea! That's OK, I suppose. Anything's possible. I don't work in the industry, but I know that collecting revenues from insurance is a LONG process -- sometimes only for a FRACTION of the bill!"

******

And that is all that they say.

Let's say you are the person developing the idea, or someone just listening in.

Which person's comments have more credibility to you? Who are you more likely to trust, or want to discuss things with further?


*********

I realize that you've said, in other threads, that you do significant due diligence on these things before you make comments. And that you choose not to share this with us for your own reasons.

That is certainly your choice.

Please also consider that, if you do offer business or investment advice based on your experience as a S* or an E*, you are likely to get called out on these forums, as S and E points of view are not scalable, or of interest to investors. They are worthwhile points of view, and can certainly generate capital.

But they are NOT fastlane.

For instance, as an Employee of a hotel that grosses less than $5M a year, you may not like Travelocity. Your hotel, since it's a boutique, is probably not the model that Travelocity caters to (they get most of their billions from chain hotels).

Saying Travelocity is a bad model does not acknowledge the fact that they have been making in excess of $1B a year for more than a decade. This is significant.

Or let's say you were a Self-employed insurance agent or an E complaining about how being in insurance is a waste of time, and hard to get collect.

Tell that to Warren Buffet, whose insurance companies generate hundreds of millions in revenues for him each year.

To recap:

On the fastlane, we look at things from a Business or Investment perspective.


How to make things hands-off, and scalable.

I wish I did a better job of communicating this to you. I fear that I'm sounding too condescending, or critical. I am truly sorry if my words are coming out this way. It is not my intent.

I'm just trying to point out that when you offer up comments without explaining your B and I experience, that they are likely to be given short shrift on these forums.

I'm hoping this makes sense. And that you will reconsider and share your actual experiences with us in future posts.

Respectfully,

-Russ H.

*E, S, B, I = S= Self-employed, E= Employee, B = Business owner, I = Investor
 

newtothis

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thank you everyone for their advices.

I want to clarify it a little maybe some one can help me to break it all down.

I am thinking more about sending companions into homes or sending nurses to their homes.
So it does seems like a middle man service, or no? I can probably crate a site on top of that as well.

But what I am trying to find out?

Is where do I find those insurance companies that I contact and find out if they have elderly people who need assistance ? or there is a different approach to that . do insurance companies just have elderly customer who needs help and they just need companies who will fill those spots ?

i have a friend who runs a transportation company, the way it works there is a company that has disabled or drug attics who needs to be transported to medical facilities, so he has a fleet of drivers who drives those people there and then that company pays him. So there is a company that gives him work.
Is there a company like that that gives work to home care providers ?
 

randallg99

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>>>Is there a company like that that gives work to home care providers ?<<<

assuming you have a telephone and the internet... go make some calls in the area and get on it.
 
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Russ H

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Thanks, Jim.

Today was a good example: Woke up, handled my Tripadvisor forum duties (we're local experts for the Napa Valley), then dealt with some political issues coming up w/the City Council and local B&Bs.

Helped dress our little one and took her to day care.

Drove into SF (1.5 hours ea way) for IVF (in vitro fertilization). Keeping my fingers crossed. We'll know beginning of April. :)

Was on the phone the whole way, back and forth, administrating and keeping on top of job sites. Also B&B questions/problem solving (a few of those).

Came back, programmed up a photo frame for presentation to all the Napa Valley B&B owners (a promotional idea I'm spearheading). Spoke w/the director of the Napa Valley CVB earlier today (he called from Washington D.C.). Hammered out an agreement in principle that is VERY cool for us. Will have him sign this week, when he gets back in town.

Assembled and wrote a consensus presentation for tonight's Napa City Council meeting, and sent it to the membership for approval (I'm president of the Napa Bed & Breakfast Inns).

Drove on over to the City Council meeting, spent 3 hours on this issue we prepared for.

Got home and gave my wife hormone shots for the IVF.

Got caught up on the forums.

11pm. Time to go to bed. KT will wake up between 12:30 and 2 am, and I have the night shift. ;) (this is how I can still do my part w/KT, and get so much done during the day-- I just work nights! :)

-Russ H.

PS Oops, almost forgot: I try to do something fun every day. Saw a movie (Horton hears a Hoo), and had a late lunch at a new favorite spot. :)

Sleep? What's that? . . .:sleep:
 

Russ H

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Update- KT got to bed late (I usually do this, so when mom does it, sometimes it takes a lot longer-- KT just wants to keep playing w/mom!

But that meant that I got to sleep from 11:30 to 4:00 (when she woke up).

Life is GOOD! :banana::banana::banana:

-Russ H.
 
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newtothis

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does any one here, how to engage and work with insurance companies, so that I can provide those who in need with lets say nurse or someone who will cook or clean for them and just collect money from insurance companies. I will just keep nurses/house care helps as sub contractors and pay them hourly.

Any one in similar business or has any experience?
 

hakrjak

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does any one here, how to engage and work with insurance companies, so that I can provide those who in need with lets say nurse or someone who will cook or clean for them and just collect money from insurance companies. I will just keep nurses/house care helps as sub contractors and pay them hourly.

Any one in similar business or has any experience?

My G/F is a social worker for one of these homes right now, so she's the one who sets up home care/aid, etc when they return home after rehab or what have you. The insurance companies are extremely stingey with this kind of stuff, and they'll only pay for a set period of time, and only if you have a very specialized need. In other words, they aren't just lining up to hand out free money to anyone who wants to take care of an old person ;)

It's not going to get any better if socialized medicine happens either -- We're going to see the level of care just get worse and worse, and the care providers making less and less.

- Hakrjak
 
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hakrjak

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Does any one here familiar with elderly care business?
It seems like fast lane, but am I missing something ? It seems like I don’t need any start up costs. I only pay nurses when I get paid?

Thank you

Your state will have licensing requirements. Your startup costs will usually include the $4k or whatever it is to get licensed as a healthcare administrator.

Then to get business you're going to have to market every social worker in your city, which is going to be a pretty big cost -- to wine them & dine them, and get them to send business to your company instead of the competition.

In order to be considered legit, you'll probably have costs associated with setting up an office as well.

- Hakrjak
 

Jbellefeuille

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Two points:

1. If someone can invent a way for people not to sleep, and still feel rejuventated then they will surpass ingvar, Bill and Warren, but until then WE will try to operate on as little as possible

2. two words: Adult Daycares
 

GoldenEggs

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Adult daycare, do you mean something more than just a senior center?

There is relatively new senior center in our area. My father in law hasn't tried yet, but I like their concept. They have tiered rates, depending on the level of care needed during the day at the center. But, once a week, they have an afterschool program for kids and the kids interact with the seniors.

I LOVE that. Old life and young life mixing together... When I was younger, my parents' friends owned a retirement home and I grew up there with the residents and the block my parents chose to live on was full of retirement homes so I am pretty used to being around seniors. I would love to provide something like that and it is a looooooong term goal/plan for me.
 
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Bobo

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There are a few challenges here to consider. Wife and I engaged home healthcare aides for both of her parents when they were ill and I knew a gent who ran one of these businesses. I talked to him about how hit/miss the help was and that was his major problem

Consider that they charge around $16/hr or just under $200 per day.

How much are they paying the workers? It is certainly less than $10/hr.

One of the things... OK, THE thing that killed my last venture was leaving my business in the hands of $10/hr employees to go fix problems created by those home health 'workers'.

As a general rule, I think you will find that while there are good, decent, hardworking people out there who will take $10/hr they are incredibly hard to find because anyone that responsible is worth more than you can charge for a home health aid.

Not trying to be a killjoy, just think hard about 'workforce challenges'

Some workforce challenges we encountered:
Employees who got arrested while taking my packages to fedex (had to bail them out and get car from impound to mail shipments)
Employees who disappeared and could not be found for 6 months because they joined the army and it slipped their minds
Employees who were meth addicts (yes, we are naive, that is not the world we live in and just thought it odd that someone would work like mad for 12 hrs one day and sleep on the keyboard the next)

This will sound harsh but people earning that rate, more often than not, will have a lot of issues that prevent them from earning more. If you set expectations clearly and draw a clear line between you and them it may work. This will sound reallllly harsh if you've never had employees but if you listen to their problems they will become YOUR problems.

LOL, not that I am bitter or anything.

Let me offer you this suggestion: Call a service and tell them about your sick aunt edna and ask to meet 5-6 of the workers. Talk to them for a while to get an idea of what you are going to be working with. One caveat - the service is a business so if you use them for your research then be decent and pay them for the time.
 

Jbellefeuille

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An adult day care is a poor term for the type of establishment I would suggest creating. It is a place that allows seniors to interact with each other while, getting out of their homes, and seeing the city, things that they used to be able to do on their own they are now able to do in a group. In addition to this, here in MN the government can be charged for basic services and insurance companies and other groups can be charged for Transportation.

I personally would attempt to make the service more of a value added company for a more luxurious clientele. We have a Masonic Home here in the twin cities that actually has independent town homes for clients and guests in a massive complex. very interesting organization.
 

M&T

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Russ,
Bravo! That is exactly what we were talking about in the thread I posted with the poll on Business owners and employee's. I know we got to this very subject through that thread.It's a point I agree with you totally on and feel is very important esp. to new people on this forum.
M&T...
 
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Bilgefisher

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The assisted living sector does have a lot to be desired. Speaking from family experience, its either very costly or very poor quality.

-I would suggest talking to people with family members in assisted living conditions. Find their likes dislikes, fears etc. If you can truly provide an improved service from whats out there, minimizing the cost to the average Joe, the money will follow on its own. In my opinion there is a definite need in this industry.
 

newtothis

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Thank you for everyone’s posts. but I think im not being clear enough. I am referring to business idea where people actually stay home b/c they either old, sick or both and cant or want to be at the hospital, so they stay home but they need someone to cook, clean, and take care of them. so that’s a service I want to provide for people who’s insurance will pay my company for providing a service. no physical location.
 

hakrjak

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There is no insurance available to pay for what you are outlining here. You can't just "want" to stay home, because you don't "want" to go to the old folks home. When they deem that you are no longer able to care for yourself, they will take away your rights and stick you in a home -- end of story.

The only people who can get what you are refering to are the wealthy folks who have enough money to pay for these types of services out of pocket.

Usually these are the guys though who choose to pay $2000 a month to move into an independent living facility or something similar, and get waited on like a king day in and day out. 5 star dining, activities, etc...

Cheers,

- Hakrjak
 
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Russ H

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hakrjak said:
these are the guys though who choose to pay $2000 a month to move into an independent living facility or something similar, and get waited on like a king day in and day out. 5 star dining, activities, etc...

Wow-- for only $2K/mo?

5 star dining, a place to stay, lots of fun activities, and get waited on like royalty?

Hey, where do we sign up? ;)

-Russ H.
 

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