July 11, 2023 • 23 mins
In this episode, Compassus' Chief Development Officer David DeGumbia breaks down mergers and acquisitions, or M&A, and the associated challenges and benefits for health systems all the way down to patients. And don't miss David's story on the first patient to have a major impact on his personal and professional journey.
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Episode Transcript
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Ashton Jones (00:04):
Hi everyone, I'm Ashton Jones and this is Home is
where the health is. Thispodcast brings you the latest
news on progress and innovationin the home based healthcare
space in association withcompasses. At the end of the day
every person deserves to becared for with compassion,
whether they're recovering athome, dealing with a serious
(00:25):
illness or nearing the end oflife in the place they call home
no less. That's why every monthwe feature different subject
matter experts, we dive deepinto how their work is improving
home based health care forpatients. In today's episode,
we're discussing mergers andacquisitions or m&a with our
guest, David de Gambia ChiefDevelopment Officer at compasses
(00:48):
will address the current healthsystem landscape around home
based care. Look at some of theinternal factors associated with
m&a execution and dive into theeffect on patients. And don't
miss David's personal storyabout how this work transforms
the lives. There's all that andmore coming up on Home is where
the health is.
(01:14):
Hey, everyone, hope you're doingwell today because we certainly
are here in the home is wherethe help is studio. We're
already on our third episode ofthe podcast and so grateful to
all of you for tuning in. Everymonth, I have our guest David to
Gambia Chief Development Officerat compasses here with me,
David, are you prepared toentertain and inform our
(01:37):
audience?
Unknown (01:38):
Possibly Awesome. Thank you for having me, Ashton.
Ashton Jones (01:42):
Yeah, of course.
Well, it's great to have youhere. And I wanted to start off
today's show by giving ourlisteners a little bit more
information about yourbackground. So from what I know,
you told me that you started asa physical therapist, is that
right?
Unknown (01:56):
That's correct. So I am born and raised in Connecticut,
still live there. Grew up andlive in the same town today, I
raised my children there who areall grown now. But so I'm
basically a homeboy. But Istarted out as a as a treating
(02:16):
physical therapist, and startedin home based care. So working
on integrated teams with withnursing, occupational
therapists, social workers, andthe like taking care of patients
in home. So that's where Istarted my career. I went on to
orthopedics and sports medicine,and then on to operating multi
(02:42):
site businesses across thecountry.
Ashton Jones (02:44):
So your current position is Senior Vice
President, Chief DevelopmentOfficer at compasses, why don't
you tell us a little bit moreabout your role and the value
that your team brings to theorganization.
Unknown (02:57):
So Ashton, my key focus is are really two areas. And
that's acquisitions, and jointventures with health systems. So
when you when you break thatout, and let's just take a look,
(03:17):
we'll start with the acquisitionside. We are out there, my team
and myself, we are out therelooking to acquire businesses
that fit our strategy that havea great culture, businesses that
have really strong employees andleadership and we would like
(03:39):
them to join and become part ofthe compasses team. On the joint
venture side, we're looking forlike minded partners, we're
looking for partners that thatwe share their vision and vice
versa, and that that partner iscommitted to advancing home
(04:00):
based care like we are.
Ashton Jones (04:04):
Well, on that note, let's go ahead and jump
into our first main topic of theday. And today we're talking
about mergers and acquisitions.
So starting off, David, how doesHome Based Care fit into the
larger healthcare ecosystem?
Unknown (04:20):
Wow, that's a that's a great question. Right now. We've
talked about the evolution ofhome based care and where we are
today. When you take a look atat the nuts and bolts, what what
makes home homebase care? Rollor what makes it tick, it's the
(04:44):
people right? It's theclinicians, the nurses and the
therapist and the occupationaltherapist and speech therapist
in the social workers. Workinghard to to make people
independent, to createindependence for People at home.
And so that that's not going tochange. What's going to continue
(05:05):
to advance is our capabilitiesto take care of higher acute
patients at home. And so thatdrives right back to the health,
the larger healthcare ecosystem.
Health Systems are looking athome based care and saying, Wow,
they play such an important partof our acute health care system,
(05:26):
our acute hospital becausethey're helping us with
throughput. They're reducing ourlength of stay. They're reducing
readmissions. So they'rerealizing that home based care
is so important to theirecosystem. And we're committed
our strategy is to continue toadvance that effort to be able
(05:49):
to take care of higher acuitypatients at home.
Ashton Jones (05:54):
Well, taking those insights, how has the landscape
of healthcare mergers andacquisitions evolved over the
past couple of years and whatfactors have really contributed
to those changes?
Unknown (06:06):
I follow the m&a trends pretty closely. And so there's
ups and downs. If you take alook at at at home base care, as
well as other health careplatforms, midway through
2020 21 into 22 things. Thelevel and the amount of
(06:27):
acquisitions were substantial,particularly in the home based
care space, and valuations forthose businesses were sky high.
Things today have calmed down abit for sure. valuations have
come down the level of m&aactivity in the home based care
space has has sort of norm Iwould call them normalized. But
(06:50):
for compasses and I think we'lltalk through later, we're not
just looking to buy to add morebusinesses we are we have a
strategic formulaic approach togrowing this business.
Ashton Jones (07:04):
That's a great segue for this next question,
which is how does compassesapproach evaluating potential
merger or acquisition targets?
And what criteria do youconsider when assessing and, you
know, trying to figure out, arethey compatible and strategic
fit?
Unknown (07:21):
Yeah, so I'll take the big our biggest buckets that we
look at right now. So from anacquisition standpoint, where we
start is when we look atpotential companies to buy
whether it's one agency, or 180agencies, it's the exact same
thing it's does it fit ourstrategy? And then on the joint
(07:45):
venture side, so we have a partof our thesis strategy is we
believe that we can partner withlarge health systems to work
with them in the markets andcreate a pretty special Home
(08:06):
Based Care platform. And sothat's the same thing where when
we evaluate those, we'redeciding, are we aligned with
their goals? Are they alignedwith ours? And is our mission
the same? And so that's how thatstarts.
Ashton Jones (08:20):
So is compasses only focused on larger health
system joint ventures m&a? Whatwould you say to that? Yeah,
Unknown (08:28):
great question, Ashton.
The answer's no. So we, myselfand my team, we're looking at
single agencies, where thefounder of that of that
business, whether it be homehealth, or hospice, or home
infusion is still there, andthey're looking for
opportunities, or they'reconsidering opportunity. So I'll
(08:48):
give you a quick example. Iacquired a business in the
Northeast, and it was a resultof a three year relationship
with the three partners thatwere there. So we started off
with a conversation to say, letme tell you about compasses. And
(09:09):
I want to hear about yourorganization and in what makes
you guys tick and and would itbe a good fit to come over to
compasses to be acquired, or, orat least a portion of your
business be acquired bycompasses. So that's how these
things start. They generallydon't start I want to sell my
business. And we write yourcheck and we buy it. So in a lot
(09:32):
of cases, it takes time to buildrelationships, and it's it's a
fun part of my job. It's what Ilove to do, because I like to to
understand if we're aligned ifwe're going to create value for
those founders and for theiremployees because they built the
business with their team. And soit's important to make sure that
that it's a right fit all arounddoesn't mean that every
(09:56):
acquisition is going to beperfect, but it really helps to
start to build thoserelationships and understand
their culture and understandthat they're aligned with with
our goals moving forward. Andwe're also looking at at medium
sized companies, regionalcompanies, whether it be within
one state or continue contiguousstates. And then we're also
(10:17):
looking at some of the biggertransformational type
transactions that would add alot of territory and patient
capacity to compasses. So toanswer your question, we are
looking at all all ends of thespectrum. While going
Ashton Jones (10:36):
along with that, can you provide an example of a
successful merger or acquisitionthat compasses has been involved
in and then what were some ofthe benefits that came after to
the organization?
Unknown (10:47):
So in 2020, Ashton compasses, joint venture with
ascension at home, that was asentient home based care
business. And it was very, itwas transformational for
compasses because it was ourfirst large joint venture with a
(11:09):
health system such as ascensionand ascension ranks as, I think
the third or fourth largesthealth system in the country.
And so it gave us an opportunityto take the best of ascension
and the best of compasses andbring that together as a joint
(11:30):
venture, which ultimatelybenefited the employees, we were
able to create a strongernetwork retaining patients. And
treating treating higher acuitypatients at home, we continue to
advance our products withascension is just a great
(11:51):
collaboration to work with suchan esteemed healthcare partner.
And so it's every day wecontinue to learn we continue to
collaborate with the ultimategoal of advancing care home
based care within thecommunities.
Ashton Jones (12:09):
And in this rapidly changing health care,
industry and environment. Howdoes compasses adapt its
strategies to stay ahead ofemerging trends and challenges?
Unknown (12:21):
Good question.
compasses, I would say, from mystandpoint, I believe that, that
we're part of those trends. Partof our mission is to make a
positive dent in the universe ofhome based care. And you spoke
with Jordan and Jeff, when youtake a look at our product side,
when you take a look at ourclever core services. Those are
(12:43):
roll up our sleeves and do itunbelievably well. But when you
take a look at the advancedproducts, such as snip at home
and taking care of higher acuitypatients, and advanced care
management, and then leaninghard into value based care and
creating narrow networks withwith health systems, so that we
(13:04):
could take care of more patientswithin a community and allow
them to recover at home.
Ashton Jones (13:14):
We're gonna take a quick break from our main
discussion to share a story withyou. And the reason we want to
spend some time on a singlestory is because when you're
looking at the big picture, it'sso easy to forget about all the
people who are impacted by thiswork. And at the end of the day,
it's really about touching alife. Before we get started, I
did ask David to come preparedwith a story to share with all
(13:37):
of you something that has reallyimpacted him both professionally
and personally. So David, do youwant to get us started on what
your story is about?
Unknown (13:46):
Yeah, so I'm gonna go all the way back to when I first
started as a physical therapist,taking care of patients at home.
So one of my first cases, firstassignments was taking care of a
stroke patient and let's herlet's call her for the sake of
this conversation. Her name wasTess. And so Tess had pretty
(14:08):
significant stroke, right sidedif I remember correctly, and I
had the ability or had theopportunity to work with the RN,
team, social workers,occupational therapists, speech
therapist, and so our our goalwas to create an environment in
(14:31):
her home where she was saved,and was able to return to her
activity, activities of dailyliving. At the time, I was an
aspiring wine collector, amateurwine aficionado and she was a
longtime collector. And so weactually adjusted our physical
(14:51):
therapy schedule so that she wasmy last patient of the day. And
after our session, she wouldshare bottles from her cellar
and part of the therapy waswalking down in the doing the
stairs and walking down into ourcellar and choosing bottles of
wine for us to sample after wewere done with treatment to move
this story along, on on her lastday we all got together when we
(15:16):
were discharging her. And so itwas sort of a send off for her
because she had made such Ramatmiraculous gains that everybody
wanted to get together. And soshe shared with us a bottle of
French burgundy. And it was,it's called Domaine de La Romana
content, which is a very rareburgundy. And so when we were
getting near the end of that,that night, she started getting
(15:38):
very emotional. And so we wereall just comforting her and
saying, listen, we're gonna keepin touch with you. And don't
worry about we're here if youneed anything, and she says no.
She said, That's not why I'memotional. This is the last
bottle of Domaine de la Romani.
She has just just a wonderfulsense of humor, and we all
cracked up, she was just tryingto lighten us up. But I bring up
(16:00):
that story because I love wine.
And she was one of my early winementors, but it really goes to
the heart of home based care,she, we were able to help her
get back to her normal ADLs. Andshe had a pretty severe stroke.
(16:21):
And so that's why I have justsuch respect for our clinicians,
when when I'm able to get out inthe field and visit them because
I know what they do. Every day,I've had the opportunity to walk
in their shoes, and I just,that's what this business is
really about. I just have theutmost respect for our
clinicians. And it's excitingfor me to spend time with our
(16:44):
clinicians. And because they'renot, they don't, they don't just
love what they do. You can justtell they're meant to do that
job they are meant to servepatients in their home.
Ashton Jones (17:00):
Well, let's go ahead and jump back into our
main discussion about m&a. Andwe're going to pivot a little
bit this time and look at someof the external and patient
facing effects. So David, how doyou ensure that the integration
of acquired or merged entitiesreally aligned with compasses,
mission, vision and values?
Great question.
Unknown (17:24):
You can buy businesses all day long, you can joint
venture all day long. But if youdon't integrate properly, you're
going to start off in a hole,and ultimately, employees and
patients will suffer. So from anintegration standup standpoint,
(17:45):
the nuts and bolts of ofConsummating a transaction, you
can run into problems there. Butthat usually works itself out.
If you make mistakes during theintegration progress process.
It's not as easy to fix becauseyou are dealing with with
(18:05):
employees and patients withinthe community that that have to
trust you. So integration isjust so important. And you know,
from a high level, how compassesdoes it. We're authentic. It's
authentic leadership, we maymake mistakes, but we're we're
(18:27):
open and honest, we build trustwith with our new colleagues and
work hard to align our goals andour mission.
Ashton Jones (18:39):
And how do mergers and acquisitions really impact
patient care and access toservices? And then how does
compasses prioritize patientwell being in that process?
Unknown (18:50):
So when you take a look at how mergers affect the
community, the patient base, wewould say that when we are
acquiring or joint venturing,we're doing it for a strategic
reason. And that strategicreason is that we can serve
(19:12):
those patient communities at ahigher level. Let's not forget,
healthcare is local, no matterhow big your company is, how
many states you operate inhealth care's logo. And so the
first thing that has to happenwhen when you're acquiring
businesses and you're advancingthese mergers and acquisitions,
(19:35):
your light has to be on. So whenyou think about home based care,
you can have the greatestclinicians in the world you can
have the greatest strategy inthe world, your light needs to
be on meaning when a physicianor discharge planner, makes a
referral. You need to be able tosee that patient within a
reasonable amount of time. Youcan't see him while it's the
(19:56):
weekend. You know, I'll see himon Tuesday. And when you take a
look Look at what's happeningwith with the nursing shortages,
therapists shortages and othershortages that's posing a
problem right now. And so it hasto be top of mind and has to be
top priority.
Ashton Jones (20:14):
Well, you say that it takes a lot, you know,
building on that what kind ofchallenges and obstacles usually
come about during the m&aprocess? And then how do you
navigate that.
Unknown (20:27):
So that the when you when you look at the steps of
the m&a process, there's lots ofdiligence that needs to be done,
and you hit upon the mostimportant point, which is
integration. It is buildingtrust within our new colleagues
and employees that we'reacquiring, as well as preparing
(20:51):
to continue to serve theircommunities, their patient
communities and, and elevatethat. So mergers and
acquisitions for me is reallyexciting, because it's about
something new. It's aboutadvancing homebase care. But it
can be scary and challenging forthe people that you're
(21:11):
acquiring, as well as for ourpeople. Because we're taking on
such a such a bigger entity. Iwork hard, and my team work
works hard to make sure thatwe're sensitive to that, and
that we are applying resourcesearly and when needed so that we
don't run into lots of HR issuesand cultural issues and
(21:34):
integration issues. Well, David,
Ashton Jones (21:37):
now that we're nearing the end of our
discussion, what message do youwant to leave our audience with
Unknown (21:42):
key message for me is that this is home base cares
time. This is our time to takewhat's transpired over the last
how many decades of home basedcare which has been great work.
But this is our time to advanceservices within the home. When
(22:04):
you take a look at the servicesthat are provided today and will
be provided it's going to looklike home everything, if you
will. But this is our time toshine and be able to take care
of patients at home with withhigher acuity. Now, it's going
to take a village maybe morelike a city to be able to do
(22:28):
that. But we're we're excited isthat we're excited to work with
integrated home health systemsto bring our services together
with theirs in advance theservices and products of of home
based care so our future isbright home base cares future is
bright, which ultimately meanspatients are going to win.
Ashton Jones (22:58):
Well, that brings us to the end of this episode of
Home is where the health is.
today. We talked about m&a andthe associated challenges and
benefits for health systems allthe way down to patients. David,
I want to thank you for beingour guest and sharing such
insightful information onmergers and acquisitions. And
for our listeners, we helplearning more about this topic
in relation to compasses wasbeneficial to you. If you liked
(23:20):
today's episode and you'relistening on a streaming
service. Go ahead and give us alike and a follow. And be sure
to tune in next month foranother in depth discussion on
innovation in the home basedcare space with one of our
experts. Until then this isAshton Jones with Home is where
the health is. Thanks forlistening
Hi everyone, I'm Ashton Jones and this is Home is
where the health is. Thispodcast brings you the latest
news on progress and innovationin the home based healthcare
space in association withcompasses. At the end of the day
every person deserves to becared for with compassion,
whether they're recovering athome, dealing with a serious
(00:25):
illness or nearing the end oflife in the place they call home
no less. That's why every monthwe feature different subject
matter experts, we dive deepinto how their work is improving
home based health care forpatients. In today's episode,
we're discussing mergers andacquisitions or m&a with our
guest, David de Gambia ChiefDevelopment Officer at compasses
(00:48):
will address the current healthsystem landscape around home
based care. Look at some of theinternal factors associated with
m&a execution and dive into theeffect on patients. And don't
miss David's personal storyabout how this work transforms
the lives. There's all that andmore coming up on Home is where
the health is.
(01:14):
Hey, everyone, hope you're doingwell today because we certainly
are here in the home is wherethe help is studio. We're
already on our third episode ofthe podcast and so grateful to
all of you for tuning in. Everymonth, I have our guest David to
Gambia Chief Development Officerat compasses here with me,
David, are you prepared toentertain and inform our
(01:37):
audience?
Unknown (01:38):
Possibly Awesome. Thank you for having me, Ashton.
Ashton Jones (01:42):
Yeah, of course.
Well, it's great to have youhere. And I wanted to start off
today's show by giving ourlisteners a little bit more
information about yourbackground. So from what I know,
you told me that you started asa physical therapist, is that
right?
Unknown (01:56):
That's correct. So I am born and raised in Connecticut,
still live there. Grew up andlive in the same town today, I
raised my children there who areall grown now. But so I'm
basically a homeboy. But Istarted out as a as a treating
(02:16):
physical therapist, and startedin home based care. So working
on integrated teams with withnursing, occupational
therapists, social workers, andthe like taking care of patients
in home. So that's where Istarted my career. I went on to
orthopedics and sports medicine,and then on to operating multi
(02:42):
site businesses across thecountry.
Ashton Jones (02:44):
So your current position is Senior Vice
President, Chief DevelopmentOfficer at compasses, why don't
you tell us a little bit moreabout your role and the value
that your team brings to theorganization.
Unknown (02:57):
So Ashton, my key focus is are really two areas. And
that's acquisitions, and jointventures with health systems. So
when you when you break thatout, and let's just take a look,
(03:17):
we'll start with the acquisitionside. We are out there, my team
and myself, we are out therelooking to acquire businesses
that fit our strategy that havea great culture, businesses that
have really strong employees andleadership and we would like
(03:39):
them to join and become part ofthe compasses team. On the joint
venture side, we're looking forlike minded partners, we're
looking for partners that thatwe share their vision and vice
versa, and that that partner iscommitted to advancing home
(04:00):
based care like we are.
Ashton Jones (04:04):
Well, on that note, let's go ahead and jump
into our first main topic of theday. And today we're talking
about mergers and acquisitions.
So starting off, David, how doesHome Based Care fit into the
larger healthcare ecosystem?
Unknown (04:20):
Wow, that's a that's a great question. Right now. We've
talked about the evolution ofhome based care and where we are
today. When you take a look atat the nuts and bolts, what what
makes home homebase care? Rollor what makes it tick, it's the
(04:44):
people right? It's theclinicians, the nurses and the
therapist and the occupationaltherapist and speech therapist
in the social workers. Workinghard to to make people
independent, to createindependence for People at home.
And so that that's not going tochange. What's going to continue
(05:05):
to advance is our capabilitiesto take care of higher acute
patients at home. And so thatdrives right back to the health,
the larger healthcare ecosystem.
Health Systems are looking athome based care and saying, Wow,
they play such an important partof our acute health care system,
(05:26):
our acute hospital becausethey're helping us with
throughput. They're reducing ourlength of stay. They're reducing
readmissions. So they'rerealizing that home based care
is so important to theirecosystem. And we're committed
our strategy is to continue toadvance that effort to be able
(05:49):
to take care of higher acuitypatients at home.
Ashton Jones (05:54):
Well, taking those insights, how has the landscape
of healthcare mergers andacquisitions evolved over the
past couple of years and whatfactors have really contributed
to those changes?
Unknown (06:06):
I follow the m&a trends pretty closely. And so there's
ups and downs. If you take alook at at at home base care, as
well as other health careplatforms, midway through
2020 21 into 22 things. Thelevel and the amount of
(06:27):
acquisitions were substantial,particularly in the home based
care space, and valuations forthose businesses were sky high.
Things today have calmed down abit for sure. valuations have
come down the level of m&aactivity in the home based care
space has has sort of norm Iwould call them normalized. But
(06:50):
for compasses and I think we'lltalk through later, we're not
just looking to buy to add morebusinesses we are we have a
strategic formulaic approach togrowing this business.
Ashton Jones (07:04):
That's a great segue for this next question,
which is how does compassesapproach evaluating potential
merger or acquisition targets?
And what criteria do youconsider when assessing and, you
know, trying to figure out, arethey compatible and strategic
fit?
Unknown (07:21):
Yeah, so I'll take the big our biggest buckets that we
look at right now. So from anacquisition standpoint, where we
start is when we look atpotential companies to buy
whether it's one agency, or 180agencies, it's the exact same
thing it's does it fit ourstrategy? And then on the joint
(07:45):
venture side, so we have a partof our thesis strategy is we
believe that we can partner withlarge health systems to work
with them in the markets andcreate a pretty special Home
(08:06):
Based Care platform. And sothat's the same thing where when
we evaluate those, we'redeciding, are we aligned with
their goals? Are they alignedwith ours? And is our mission
the same? And so that's how thatstarts.
Ashton Jones (08:20):
So is compasses only focused on larger health
system joint ventures m&a? Whatwould you say to that? Yeah,
Unknown (08:28):
great question, Ashton.
The answer's no. So we, myselfand my team, we're looking at
single agencies, where thefounder of that of that
business, whether it be homehealth, or hospice, or home
infusion is still there, andthey're looking for
opportunities, or they'reconsidering opportunity. So I'll
(08:48):
give you a quick example. Iacquired a business in the
Northeast, and it was a resultof a three year relationship
with the three partners thatwere there. So we started off
with a conversation to say, letme tell you about compasses. And
(09:09):
I want to hear about yourorganization and in what makes
you guys tick and and would itbe a good fit to come over to
compasses to be acquired, or, orat least a portion of your
business be acquired bycompasses. So that's how these
things start. They generallydon't start I want to sell my
business. And we write yourcheck and we buy it. So in a lot
(09:32):
of cases, it takes time to buildrelationships, and it's it's a
fun part of my job. It's what Ilove to do, because I like to to
understand if we're aligned ifwe're going to create value for
those founders and for theiremployees because they built the
business with their team. And soit's important to make sure that
that it's a right fit all arounddoesn't mean that every
(09:56):
acquisition is going to beperfect, but it really helps to
start to build thoserelationships and understand
their culture and understandthat they're aligned with with
our goals moving forward. Andwe're also looking at at medium
sized companies, regionalcompanies, whether it be within
one state or continue contiguousstates. And then we're also
(10:17):
looking at some of the biggertransformational type
transactions that would add alot of territory and patient
capacity to compasses. So toanswer your question, we are
looking at all all ends of thespectrum. While going
Ashton Jones (10:36):
along with that, can you provide an example of a
successful merger or acquisitionthat compasses has been involved
in and then what were some ofthe benefits that came after to
the organization?
Unknown (10:47):
So in 2020, Ashton compasses, joint venture with
ascension at home, that was asentient home based care
business. And it was very, itwas transformational for
compasses because it was ourfirst large joint venture with a
(11:09):
health system such as ascensionand ascension ranks as, I think
the third or fourth largesthealth system in the country.
And so it gave us an opportunityto take the best of ascension
and the best of compasses andbring that together as a joint
(11:30):
venture, which ultimatelybenefited the employees, we were
able to create a strongernetwork retaining patients. And
treating treating higher acuitypatients at home, we continue to
advance our products withascension is just a great
(11:51):
collaboration to work with suchan esteemed healthcare partner.
And so it's every day wecontinue to learn we continue to
collaborate with the ultimategoal of advancing care home
based care within thecommunities.
Ashton Jones (12:09):
And in this rapidly changing health care,
industry and environment. Howdoes compasses adapt its
strategies to stay ahead ofemerging trends and challenges?
Unknown (12:21):
Good question.
compasses, I would say, from mystandpoint, I believe that, that
we're part of those trends. Partof our mission is to make a
positive dent in the universe ofhome based care. And you spoke
with Jordan and Jeff, when youtake a look at our product side,
when you take a look at ourclever core services. Those are
(12:43):
roll up our sleeves and do itunbelievably well. But when you
take a look at the advancedproducts, such as snip at home
and taking care of higher acuitypatients, and advanced care
management, and then leaninghard into value based care and
creating narrow networks withwith health systems, so that we
(13:04):
could take care of more patientswithin a community and allow
them to recover at home.
Ashton Jones (13:14):
We're gonna take a quick break from our main
discussion to share a story withyou. And the reason we want to
spend some time on a singlestory is because when you're
looking at the big picture, it'sso easy to forget about all the
people who are impacted by thiswork. And at the end of the day,
it's really about touching alife. Before we get started, I
did ask David to come preparedwith a story to share with all
(13:37):
of you something that has reallyimpacted him both professionally
and personally. So David, do youwant to get us started on what
your story is about?
Unknown (13:46):
Yeah, so I'm gonna go all the way back to when I first
started as a physical therapist,taking care of patients at home.
So one of my first cases, firstassignments was taking care of a
stroke patient and let's herlet's call her for the sake of
this conversation. Her name wasTess. And so Tess had pretty
(14:08):
significant stroke, right sidedif I remember correctly, and I
had the ability or had theopportunity to work with the RN,
team, social workers,occupational therapists, speech
therapist, and so our our goalwas to create an environment in
(14:31):
her home where she was saved,and was able to return to her
activity, activities of dailyliving. At the time, I was an
aspiring wine collector, amateurwine aficionado and she was a
longtime collector. And so weactually adjusted our physical
(14:51):
therapy schedule so that she wasmy last patient of the day. And
after our session, she wouldshare bottles from her cellar
and part of the therapy waswalking down in the doing the
stairs and walking down into ourcellar and choosing bottles of
wine for us to sample after wewere done with treatment to move
this story along, on on her lastday we all got together when we
(15:16):
were discharging her. And so itwas sort of a send off for her
because she had made such Ramatmiraculous gains that everybody
wanted to get together. And soshe shared with us a bottle of
French burgundy. And it was,it's called Domaine de La Romana
content, which is a very rareburgundy. And so when we were
getting near the end of that,that night, she started getting
(15:38):
very emotional. And so we wereall just comforting her and
saying, listen, we're gonna keepin touch with you. And don't
worry about we're here if youneed anything, and she says no.
She said, That's not why I'memotional. This is the last
bottle of Domaine de la Romani.
She has just just a wonderfulsense of humor, and we all
cracked up, she was just tryingto lighten us up. But I bring up
(16:00):
that story because I love wine.
And she was one of my early winementors, but it really goes to
the heart of home based care,she, we were able to help her
get back to her normal ADLs. Andshe had a pretty severe stroke.
(16:21):
And so that's why I have justsuch respect for our clinicians,
when when I'm able to get out inthe field and visit them because
I know what they do. Every day,I've had the opportunity to walk
in their shoes, and I just,that's what this business is
really about. I just have theutmost respect for our
clinicians. And it's excitingfor me to spend time with our
(16:44):
clinicians. And because they'renot, they don't, they don't just
love what they do. You can justtell they're meant to do that
job they are meant to servepatients in their home.
Ashton Jones (17:00):
Well, let's go ahead and jump back into our
main discussion about m&a. Andwe're going to pivot a little
bit this time and look at someof the external and patient
facing effects. So David, how doyou ensure that the integration
of acquired or merged entitiesreally aligned with compasses,
mission, vision and values?
Great question.
Unknown (17:24):
You can buy businesses all day long, you can joint
venture all day long. But if youdon't integrate properly, you're
going to start off in a hole,and ultimately, employees and
patients will suffer. So from anintegration standup standpoint,
(17:45):
the nuts and bolts of ofConsummating a transaction, you
can run into problems there. Butthat usually works itself out.
If you make mistakes during theintegration progress process.
It's not as easy to fix becauseyou are dealing with with
(18:05):
employees and patients withinthe community that that have to
trust you. So integration isjust so important. And you know,
from a high level, how compassesdoes it. We're authentic. It's
authentic leadership, we maymake mistakes, but we're we're
(18:27):
open and honest, we build trustwith with our new colleagues and
work hard to align our goals andour mission.
Ashton Jones (18:39):
And how do mergers and acquisitions really impact
patient care and access toservices? And then how does
compasses prioritize patientwell being in that process?
Unknown (18:50):
So when you take a look at how mergers affect the
community, the patient base, wewould say that when we are
acquiring or joint venturing,we're doing it for a strategic
reason. And that strategicreason is that we can serve
(19:12):
those patient communities at ahigher level. Let's not forget,
healthcare is local, no matterhow big your company is, how
many states you operate inhealth care's logo. And so the
first thing that has to happenwhen when you're acquiring
businesses and you're advancingthese mergers and acquisitions,
(19:35):
your light has to be on. So whenyou think about home based care,
you can have the greatestclinicians in the world you can
have the greatest strategy inthe world, your light needs to
be on meaning when a physicianor discharge planner, makes a
referral. You need to be able tosee that patient within a
reasonable amount of time. Youcan't see him while it's the
(19:56):
weekend. You know, I'll see himon Tuesday. And when you take a
look Look at what's happeningwith with the nursing shortages,
therapists shortages and othershortages that's posing a
problem right now. And so it hasto be top of mind and has to be
top priority.
Ashton Jones (20:14):
Well, you say that it takes a lot, you know,
building on that what kind ofchallenges and obstacles usually
come about during the m&aprocess? And then how do you
navigate that.
Unknown (20:27):
So that the when you when you look at the steps of
the m&a process, there's lots ofdiligence that needs to be done,
and you hit upon the mostimportant point, which is
integration. It is buildingtrust within our new colleagues
and employees that we'reacquiring, as well as preparing
(20:51):
to continue to serve theircommunities, their patient
communities and, and elevatethat. So mergers and
acquisitions for me is reallyexciting, because it's about
something new. It's aboutadvancing homebase care. But it
can be scary and challenging forthe people that you're
(21:11):
acquiring, as well as for ourpeople. Because we're taking on
such a such a bigger entity. Iwork hard, and my team work
works hard to make sure thatwe're sensitive to that, and
that we are applying resourcesearly and when needed so that we
don't run into lots of HR issuesand cultural issues and
(21:34):
integration issues. Well, David,
Ashton Jones (21:37):
now that we're nearing the end of our
discussion, what message do youwant to leave our audience with
Unknown (21:42):
key message for me is that this is home base cares
time. This is our time to takewhat's transpired over the last
how many decades of home basedcare which has been great work.
But this is our time to advanceservices within the home. When
(22:04):
you take a look at the servicesthat are provided today and will
be provided it's going to looklike home everything, if you
will. But this is our time toshine and be able to take care
of patients at home with withhigher acuity. Now, it's going
to take a village maybe morelike a city to be able to do
(22:28):
that. But we're we're excited isthat we're excited to work with
integrated home health systemsto bring our services together
with theirs in advance theservices and products of of home
based care so our future isbright home base cares future is
bright, which ultimately meanspatients are going to win.
Ashton Jones (22:58):
Well, that brings us to the end of this episode of
Home is where the health is.
today. We talked about m&a andthe associated challenges and
benefits for health systems allthe way down to patients. David,
I want to thank you for beingour guest and sharing such
insightful information onmergers and acquisitions. And
for our listeners, we helplearning more about this topic
in relation to compasses wasbeneficial to you. If you liked
(23:20):
today's episode and you'relistening on a streaming
service. Go ahead and give us alike and a follow. And be sure
to tune in next month foranother in depth discussion on
innovation in the home basedcare space with one of our
experts. Until then this isAshton Jones with Home is where
the health is. Thanks forlistening
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