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In this "Expert Opinion" interview, David Glickman and Iggy Fanlo, Co-Founders, Lively Inc., discuss monitoring systems, independent living, mobile technology, pricing, and more.....

David Glickman Read the transcript

 

David Glickman has followed his passions throughout his entrepreneurial career. Prior to co-founding Lively, David Glickman was an Entrepreneur in Residence at Maveron LLC, a venture capital firm. Before that, he held senior positions at SYPartners, a transformation consultancy working with CEOs at Fortune 100 companies, and co-founded a popular iPad app to help people get Unstuck in life.  Earlier in his career David was a product marketing manager at Apple, Inc. and held senior positions at Motricity and Kontiki. And perhaps his most rewarding experience is starting a non-profit called CHALK, a nationally recognized early pioneer in integrating technology and the internet to provide transformational employment to at-risk youth. For David, Lively is a natural step forward in using technology to keep the people we value in our lives closer together. 

 

Contact Information:

David Glickman
Co-Founder and COO
david@mylively.com

 

Iggy FanloIggy Fanlo has always been fascinated with health and wellness – he even considered going to medical school (and was even accepted). But, a change of course landed him in the financial sector where be became Managing Director of both JPMorgan and Morgan Stanley. After a 15-year career in that field, he spent 13 successful years in Internet media. He served as CEO of adBrite, transforming the company from a simple fixed price ad network to one of the leading online advertising exchanges. Before then, Iggy held various senior roles at Shopping.com and eBay. He holds a BSE degree in Chemical Engineering from Princeton University. Today, he feels immense gratitude for the chance to satisfy his lifelong obsession by improving persons lives with Lively.

 

Contact Information:

Iggy Fanlo
Co-Founder and CEO
iggy@mylively.com

 

Read the interview transcript:

 

Steve Monroe
Technology is definitely coming in to seniors’ homes and the senior living communities and there are a lot of new products coming out. One of them is something called Lively… the website is Mylively.com. I’m here with David Glickman and Iggy Fanlo. They’re two of the three co-founders of the company. So, tell me a little bit about MyLively.com and what you’re doing and what it does.

David Glickman
Well, I’ll dive in. What we’re really focused on is helping people live as independently as possible for as long as possible. Independence can take on a variety of meanings, whether it’s living in your own home, living in some sort of senior community. And, in doing so what we really felt was there weren’t very, very simple solutions, very elegant solutions and very cost-effective solutions to have people living independently, share a little bit about their daily living.
Many in our industry know the term “activities of daily living.” So, is my loved one or someone in my community taking their medication? Are they getting out of the house? Are they being active? If there’s a fall that occurs, are they able to get help as quickly as possible? Those are the types of things that we’re trying to address in a really elegant solution in which it’s a hub that goes inside the home. And that home can be, again, someone’s independent home within a senior living community. It literally just plugs into the wall, doesn’t require any Internet access. No set-up required. You plug it in, it turns on and it starts communicating with the Internet through a cellular connection. So, nobody has to set anything up.

We have sensors that go on objects in the home. One that goes on the refrigerator, one goes on a pillbox. And what we’re doing is measuring the motion of those objects. And, in addition, we have actually just released our first of several different emergency response systems, or sensors that also communicate with this. Our first one is a next-generation fall detection pendant that has a button, fall detection compliant, so it knows if someone is actually wearing the pendant, which is a very important part of it, as well as some fitness aspects of it.

Steve Monroe
How does this differ from earlier generations of similar kind of home monitoring systems?

Iggy Fanlo
The other remote monitoring systems, when we looked in the marketplace, they were very expensive. They were $500 to $1,000 upfront. And anywhere from $40 to $75 a month. We are radically lower. We’re actually only $39. And…

Steve Monroe
Upfront?

Iggy Fanlo
$39 upfront and $24.95 a month.

Steve Monroe
You’re too cheap.

Iggy Fanlo
Well, we hope so. As a person told us once, we are a Tesla for the cost of a Buick.

So, it’s incredibly cost effective. You can tell by the lines, the beauty—this is the same industrial designer who developed the Nest and the Roku. So we have world-class design and that’s different. We’ve heard folks call it the triple Bs for most senior products—Big, Beige and Boring. And we thought, you know what? Whether you’re 8 or you’re 88, you can still appreciate beautiful things. So, let’s give them something beautiful.

The third thing was simplicity and Dave talked a lot about that, about the setup. We’ve had 90-year-olds set it up in under 5 minutes, by themselves. No help from anyone else.

And then, finally, the social connection piece. I think that’s lost a lot of times in our description of it. And a lot of times there’s almost an isolation epidemic occurring with elders in America, and probably globally. And so we really feel that, let’s find a simple way to kind of close the loop. Because the elder’s going to be sharing data on their activities of daily living and on their emergencies with the first device. Let’s close the loop and let the family share back to the elder. And we’ve done it with LivelyGram here. So there’s photographs and messages. A lot of people have dubbed this Facebook or Instagram for seniors.

David Glickman
And the way that works…

Steve Monroe
Yeah, how does the LivelyGram work?

Iggy Fanlo
What we really did and what we do with everything we design is technology is great, but it’s only as good as what makes sense for each person who’s using it. So, for family members who want to share photos with their loved ones, they’re on a smartphone. They might be using Facebook or Instagram, especially if it’s grandkids or nieces and nephews.

Steve Monroe
My kids.

Iggy Fanlo
Your kids. My kids. So, there’s an app. And you can go and you can upload a picture right from Instagram or from your camera roll. And then what we do, as Lively…

Steve Monroe
And it comes to you?

Iggy Fanlo
What happens is they send it to us as Lively. And then every two weeks, we compile those photos from the loved ones and print this out. This is where the technology meets, in this case, Cheryl, who’s the elder, all Cheryl needs to know is how to use her U.S. mailbox. That is literally it. This comes in a bright orange envelope. This comes twice per month. And she now feels more connected and has more context for the next time that her grandchild calls and she can say, tell me more about your ski trip. Or tell me more about your swim meet or your soccer match.

Steve Monroe
Do you get the names of all the grandchildren and children so you can prompt them? They might forget to send these things.

Iggy Fanlo
Yeah, you can—it says, “Cheryl, with contributions from Angela, Jean and Tyler.” So those are the family members or friends who contributed. And they all get invited by the family—and actually we have many senior living communities that are already using Lively and they will assist in inviting family members to participate. They get invited and then, you’re right, we send them reminders. We say, Hey, we’re about to publish Grandma’s LivelyGram. Make sure you contribute because your loved ones might be contributing and you want to make sure you get your pictures in.

Steve Monroe
Right, you had to do that because otherwise it would be tough to fill that twice a month.

Iggy Fanlo
Yes. What it does is, this is truly coming from users who have been using the product already, which is it changes the experience of what Lively is about. It’s not just about sharing activities of daily living. It’s now about the connection that I get with my family. So, when I see Lively, first off I see something that’s elegant, not big, beige and boring. But also when I see it, it reminds me, oh, you know what? My next LivelyGram is coming.

And then the last thing I would say is, especially in senior living communities, this is wonderful when we go and visit them when they have Lively deployed. You literally go into the dining area a day after or the day of LivelyGram coming out, and it becomes the social piece that you see …

Iggy Fanlo
Passing around.

David Glickman
Yeah, it’s gotten to the point where the number one customer service request we get on the calls and emails is when is my next LivelyGram?

Steve Monroe
Now, on the monitoring, who in your experience so far, who is the receiver? Who is monitoring it?

Iggy Fanlo
Well, there’s two ways to go with this. You can have the family members or the administrator, the eldest daughter typically, is monitoring it on their smartphone or on the Web. But we’ve also had this great success with Safetynet and essentially home care agencies or even independent living facilities that are extending back upstream. Where they’re saying, we have facilities here in the community and we want to start providing services back to the home. Much like Brookdale at Home. Where they’re saying we can take our services that we have in the facility and bring them to the home.

These folks have taken this great technology and wrapped that last mile of human services around it. So what we like to say is, if you’re a sandwich parent and your mom lives far away and you’re worried sick about this and that, you now have the Lively system, you have the Lively PERS device, the emergency response system. We provide a 24/7 call center. And then Brookdale at Home, Home Instead and a variety of others are providing that last mile so that, if there’s an alert or something, they haven’t taken their meds, they can send someone out, check up on them. Now you have a complete, wrapped solution at an extremely cost-effective price.

Steve Monroe
Great. Now, who are you marketing to more? The retirement communities? The large companies, the Brookdale Senior Livings? Or people in their home?

Iggy Fanlo
Great question and we can share some exciting news on one of those fronts. First off, we are making this available and marketing directly to the elder children. Because part of the design here was a very consumer-friendly experience and, to your point earlier, the price point, families can afford it.

Steve Monroe
It’s cheap and it’s easy.

Iggy Fanlo
Yes, cheap, easy, elegant and, with the LivelyGram piece, has that connection. So, this is available on our website, it’s available on Amazon, it’ll be available in a couple of different retailers this summer, starting this summer. And that’s important.

And, really, from day one we’ve said let’s design this as a consumer product, but we always knew that it had real applicability within the senior living community and in the home care community. So we work directly with Home Instead and other home care organizations. And then, in addition, we, as we both have mentioned earlier, we actually already have this deployed in many senior living communities. And so we work directly with them.

We’re also excited to say that we just launched a partnership with Care Innovations. They saw what we were doing with Lively and some might say, oh, well, these are competitive products. Care Innovations and we really see Lively providing them with even more opportunity to bring services directly to the senior living communities, health care, hospital organizations and others that they cater to. So they will actually be a partner of ours now, bringing Lively into all the different people that they talk to, with the reach that a GE and an Intel have.

Steve Monroe
Now, last question. You’re graduating from the Generator program. What’s the next step? That’s one strategic partnership, what do you do in terms of capital raising, taking it to the next level?

Iggy Fanlo
Well, we’ve raised already $7 million of capital in two rounds and have just world-class investors who’ve been in deals like Zulily and eBay and a bunch of others, so we’re very fortunate there. And have world-class advisors and board members. In fact, Laura Carstensen, who runs the Center of Longevity at Stanford University, founder of it, she’s only sat on one private board in her life and that’s Lively. So we’ve been very, very fortunate.

I will tease a little bit in saying that, in Q4, we’re going to be coming out with a completely blockbuster PERS device. It’s going to…

Steve Monroe
Blockbuster…?

Iggy Fanlo
Blockbuster PERS.  The button, the emergency response device. And I notice on your wrist is this watch. And if you showed it to those folks, the form factor is going to be almost identical to that. So you’re going to be wearing something just like that and it’ll be a watch, it’ll be a pill reminder, it’ll be all these things. It’ll look just as beautiful as that, something you might have bought at a jewelry store. And all you’re going to need to do is touch the sides with that much force and it’ll send the signal to your hub or to your smartphone and that’s an emergency response.

Steve Monroe
Interesting.

Iggy Fanlo
So it’s going to completely change the marketplace. We think the young-old, the Boomers, the up-and-coming Boomers, the 65-80 to really probably aren’t thinking about a PERS device, but they might be a little worried if they’re living alone, holy crow, if I can buy a piece like that and you get the whole system now for $49, it’s $10 extra, that’s pretty attractive.

Steve Monroe
Hoo-hoo! That’s really going to break my wallet.  No, that’s something, I don’t know how you’re keeping the cost down. I think it almost makes it sounds like, why is it so inexpensive? And people are going to think they’re not getting some for it, but you obviously can prove that they are. And keeping that costs like that to me becomes almost a no-brainer.

Iggy Fanlo
Well, we can’t afford jackets, so…

David Glickman
Yeah, we can’t afford jackets.

Steve Monroe
Really keeping costs…

Iggy Fanlo
And part of it is, if you look at a lot of the technology in this space, it’s usually been built 5 to even 10 years ago and, when you look at, for instance, the technology we’re using in sensors, it’s pretty commoditized products. So we’ve just been smart and kind of taking our experience from building other companies in Silicon Valley in the past and try to just do things in a very cost-effective way and then create services around that in the form of the monthly subscription that comes with the product.

Steve Monroe
All right, that sounds great, it sounds like you’re on your way.

Iggy Fanlo
We hope so.

Steve Monroe
Can’t wait to see the rollout in Q4.

David Glickman
Yeah, it’s really fun times.

Steve Monroe
Yeah, it’ll be a lot of change. All right, well, thanks for sitting down.

Iggy Fanlo
Thanks for having us.

Steve Monroe
Great hearing about it.

Iggy Fanlo
Thank you.


 

 

 

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July 1, 2014. 60 Seconds with Steve Monroe. CareOne Management is reported to be looking for $2.0 billion for the real estate of its 68 properties....

CareOne On The Market For $2.0 billion

In this month’s issue of The SeniorCare Investor, we talk about the looming market bubble in seniors housing. Just as we went to print, we learned that Jefferies Group was testing the market with a portfolio of about 68 properties, which may include two LTACS, and 29 are in New Jersey, which is a state known for very high values. The portfolio is owned by Dan Straus, under the name CareOne Management. The last time he completed a major sale was in 1997, when he sold The Multicare Companies for $1.4 billion, which by the summer of 2000 had filed for bankruptcy protection. He sold just before that market peak, and if there is anything we have learned over the years, it is that Mr. Straus knows when to buy and when it is time to sell. The rumored price tag is close to $2.0 billion for the real estate, and that means a handful of REITs plus a few private equity firms will be the only bidders. The portfolio includes skilled nursing and assisted living, which could complicate things. But Mr. Straus is not known for leaving anything on the table, so we have to guess he is seeing the same writing on the wall we are. It is a great time to sell.   

 

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June 24, 2014. 60 Seconds with Steve Monroe. After the proposed merger between ALFA and ASHA was aborted, ALFA has decided to re-brand and implement the One Voice initiatives...

ALFA Is Changing Course

By now, everyone should know that Rick Grimes will be retiring from ALFA and that ALFA will be starting a re-branding campaign. In addition, several Board members of ASHA who were pushing for the merger of ALFA and ASHA earlier this year have now joined, and in some cases, rejoined ALFA, and we assume they will remain ASHA members. It appears as if the leadership at ALFA is embarking on all the changes that were supposed to be part of the merger of the two organizations, called the One Voice initiative. Although some of these initiatives were among the reasons why some ASHA members were not in favor of the proposed merger, we hope that the fact that ALFA is moving ahead with all the initiatives will not drive a wedge between the two groups and their respective boards. The senior living industry does not need squabbles among its executives regarding the best way to go about their business. They need to work together, align their interests and minimize any duplication of their efforts since the two groups will remain separate for now. Let’s hope bruised egos will heal quickly, as they should, and that everyone remembers what is important, which is serving your customers.  

 

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In this "Expert Opinion" interview, Josh Jandris, Senior Director of the Institutional Property Advisory Group, Marcus & Millichap, discusses case studies, assets, capital, recent transactions, and more...........

 

Read the interview transcript:

 

Steve Monroe
Anyone who’s been reading The SeniorCare Investor in the last couple of years has noticed there’s been a big increase in sales of county-owned skilled nursing facilities. I’m here today with Joshua Jandris. He’s a Senior Director of the Institutional Property Advisory Group of Marcus & Millichap. Josh, when did you embark on the strategy to target county-owned nursing facilities that really should be prime candidates for sale?

Joshua Jandris
Steve, about back in 2010. One of my former colleagues, Isaac Dole, who had left the firm to go to Aviv REIT and is now heading up Birchwood Capital, a kind of private equity and private REIT, tenant-landlord type company in seniors’ housing kind of found the opportunity. He and my partner, Mark Myers, had seen it start to develop. Isaac had started to prepare a target list, as well as a national database. However, he had left shortly thereafter. It was kind of up for grabs as to who wanted to embark on this journey. 

So, back in 2010, I grabbed the torch and I’ll tell you, it’s been obviously rewarding. It’s been very time-consuming, but it’s been very interesting. So, before Isaac had left here, I think he had effectuated two transactions and since then, Mark and I have handled 28. I think more than half have closed, but we’ve had 28 county engagements of, I think, maybe 32 or 33 total in the whole country, half of those being principle-to-principle or county-to-principle and just a few being handled by other intermediaries, typically local intermediaries.

Steve Monroe
But how did you know which ones to target? Did you look up their financial statements on the county records to see who was losing the most money?

Josh Jandris
Certainly. As a broker, this is probably about half of what I focus on, so just like any other smarter strategic broker, you’re going to look for opportunities. What’s great about seniors’ housing and being an intermediary in this space is as long as there’s volatility, there’s always opportunity. If you’re just looking at non-county or government assets to broker, you would look at states that have a bed tax coming in or Medicare cuts across the board or Medicaid cuts across the board, similar to this space. 

So, what we did is we looked at things at a very high level, not only on the Federal level, but state level and then, all the way down to county government. So, if states were implementing hard property taxes, or if states were shifting more of the budgetary responsibilities from Fed to state to county, then we saw that as being an opportunity for us to help counties.

I’ll give you a really good case study. A few years ago, New York. Anybody that operates in New York or has sold things in New York, they’ve been going through this—they’ve had, I think, four or five or six different iterations of their Medicaid reimbursement programs since, I think 2010. In addition to that, when Federal dollars started to be taken away, I believe it was FMAT and it was  TARP, the Federal dollars to the states and then, kind of trickle down—I apologize.  I don’t have it in front of me, but what we saw was obviously a larger share of costs being shifted to county governments and at the same time, the state assembly had put in a hard property tax cap.

So, with the counties not being able to raise property taxes and their expenses growing, they had no choice but to monetize assets. All along while this was happening, that was just one ancillary or adjunct to a much larger issue. That larger issue was revenues staying stagnant and expenses going up because of whether it be collective bargaining agreements that were negotiated during the roaring years of ’04, ’05 and ’06. I can’t really say it’s one thing, but it’s been a number of things.

Steve Monroe
It seems like almost all of the county facilities you’ve sold are in the Northeast and half are in New York. Are there just not many county-owned facilities in Indiana and Kentucky and…?

Josh Jandris
That’s a great question. There’s actually quite a number of county-owned facilities in Indiana, but it’s because of the IGT program in Indiana. So, in Indiana, you have counties and county hospitals that partner with other operators and that system is flush with cash. States like Kentucky, I guess outside of the Northeast—

Steve Monroe
I was just picking those randomly.

Josh Jandris
I understand. So, outside of the Northeast, there really isn’t a critical mass. Obviously you have some sprinkling of homes in several states, but where you have the critical mass and you have a pretty proactive legislative bodies, you have that more in Pennsylvania, New Jersey, Maryland, New York.  I mean, we’ve handled transactions in Illinois, Wisconsin, and Arizona. We privatized the last county-owned home in Arizona a few years ago. But either there wasn’t that traditional or historical plan of that. I mean, a lot of these county homes started as alms houses back in the late 1800s or even the middle 1800s, so where you look at concentrations of population and history, that’s where the correlation is.

Steve Monroe
When you’re talking to these counties, what’s the most important factor in selling? Is it getting rid of that $2 million-a-year annual cash flow loss or is it raising the $5, $10, $20 million of new capital from the sale that can be deployed for other uses in the county? Is one a bigger factor than the other?

Josh Jandris
It’s a number of factors. Not only do you have the capital event when you sell an asset, but you’re shifting liability. You’re adding property to the tax roles and obviously, you’re erasing, or getting rid of, a tax-subsidized asset that’s been there for—I don’t know if it’s always been a tax-subsidized asset, but at least for the last three-to-five, even 10 years, they’ve been having to allocate money in order to keep it going. Many other states soon, they just don’t think that it’s a long-term, it’s not viable to continue to hold the asset. 

Obviously there is a huge benefit to being able to have that capital event and then, again, allocate that money to things that are really more of their core principles. There’s definitely a little bit of disagreement on the part of some county governments where, “Is it our core competency? Is it not?” I think ultimately the ones that end up selling are either in a position where they say, “Listen. This is not in our charter. This is not what we’re supposed to be doing,” or, they say, “Listen. We’re losing so much money and our sales tax revenues are down. Our property tax revenues are frozen. We have to do something.” As you know, those are the two large revenue streams for a county, so if they have the opportunity and the necessity to monetize something besides an office building, which usually goes first, they’ll sell that off with the long-term lease.

Steve Monroe
How difficult is it when you’re selling these things? Some of these properties are losing $2 million even before debt service and then, you have to try to convince a buyer to pay $10 or $15 million for the property. How difficult is it basically to restate the income statement or are these buyers so sophisticated they just do it themselves and they don’t have to worry about your numbers?

Josh Jandris
A lot of it is proprietary, but what I can tell you is we’ve handled assets that were losing anywhere from $500,000—right now, we’re handling a property in Orange County, New York, with everything it’s losing about $30 million. On the books it’s losing about $18 million. We’re handling a transaction in Rockland County, New York, up in Muncie or Pomona. That facility was losing $16 million. It’s really a function of educating the buyers on how a county operates and then, having the wherewithal and the understanding of what they can do with what’s already there. So, when we underwrite an asset, we always underwrite current, but then, we use a proprietary formula to drive our proformas, thus driving valuation.

Steve Monroe
I know it can be difficult with the buyer. Have you ever done a post-sale audit a year later to see whether in fact, the costs did go down and they were able to change the census? That’d be a great story.

Josh Jandris
We’re actually doing quite a bit of that. One of our most recent transactions was Beaver County.  It was just featured in The SeniorCare Investor, as well as some other national publications.  That facility was losing about $16,000 a day.

Steve Monroe
Oh, I remember that one.

Josh Jandris
I believe $5-$6 million a year. Immediately following the sale, the buyer, which is a group called Comprehensive Healthcare. It’s a consortium out of New York and New Jersey. They are looking at an $8 million profit first year. That’s the byproduct of not only ramping up Medicare census between—during the escrow period when they took over management. They took the Medicare census in the span of three to four months from eight Medicare As, up to 42 Medicare As. They’re amazing operators. They’ve done an excellent job with that. In addition to that, what’s really important to always utilize is local counsel; somebody that is very adept with working, not working against, but working with the unions. In Pennsylvania, we work with a group called Capozzi Adler. I would say that they are the best union negotiators in that region. They’ve handled the union side of, I think, four of the last five Pennsylvania acquisitions that we’ve handled and they’ve produced great results for our clients.

Steve Monroe
Now, with the economy improving there is less pressure on Medicaid reimbursement, are you seeing any slowdown in counties wanting to sell or are they still having the financial problems and this is going to be going on for several more years?

Josh Jandris
They’re still having the financial problems. One of the big issues with the less pressure from Medicaid is the plan is already in place for managing Medicaid. The way that counties are structured versus for-profits or not-for-profits, in states where you have bed taxes or additional quality assurance fees, things like that, counties are under a totally different plan. So, in Pennsylvania, for instance, I believe they froze all counties’ Medicaid rates, I think from ’06 on, so while the for-profit providers were getting the case mix index adjustments, capital, everything like that, the counties don’t have that and they never will. So, that’s where you have pressure, for instance, in Pennsylvania itself. 

In states like New York, the economics in some situations are so dire that even if the economy comes roaring back, which I think we all know has been very incremental—it’s been encouraging, but incremental—they still have the pressing need. In a state like New Jersey, counties have a unique reimbursement where they get not only your typical nursing home Medicaid reimbursement, but they have an additional add-on to that reimbursement that goes towards community, public aid community care. It’s looking like that’s going to be wiped out once they go to managed Medicaid. So, again, volatility is volatility. 

Steve Monroe
I think you’ll be busy for the next several years and a lot of good business prospects. Joshua Jandris, thanks for the update on the county nursing home situation and I look forward to writing about a lot more of your sales.

Josh Jandris
Thank you so much, Steve. I really appreciate your time.

Steve Monroe
Take care.

 

 


 

 

 

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June 17, 2014. 60 Seconds with Steve Monroe. Kindred is taking its offer to buy Gentiva Health Services directly to Gentiva shareholders with a slightly higher bid of $14.50 per share.

Kindred Healthcare Increases Gentiva Health Bid

Well, well, well, it looks like Kindred Healthcare really does want to create a huge presence in the home health and hospice market. After making its $1.6 billion unsolicited offer last month for Gentiva Health Services, which was promptly and repeatedly rejected by the Board, Kindred has decided to take it directly to the shareholders. While we are not surprised, we were a little surprised that the all-cash tender offer was increased by only 50 cents a share to $14.50. Investors must think Kindred will go higher, as shares traded up to $14.69 after the announcement. Gentiva advised its shareholders not to respond until the Board has fully evaluated the offer. That seems absurd, as they should know whether it’s a good deal or not by now, and with a 70% premium now, it is an even better deal for shareholders. In the meantime, Kindred has announced a 9 million share stock offering, presumably to finance the deal, so their confidence level must be running high. As it should.

 

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June 10, 2014. 60 Seconds with Steve Monroe. The once clubby health care REIT sector has become decidedly less friendly

Health Care REIT Competition Turns Negative

What is happening to our clubby little world of seniors housing investing? Just two months into the job, Health Care REIT’s new CEO has not only been quoted as saying he was hanging around a potential deal just to drive up the price so someone else could pay a high price for mediocre to poor assets. But in addition, he said because seniors housing is not sexy, the best and the brightest are not looking to work in seniors housing. Who, exactly, is he talking about? You….me….or the employees at the other REITs? Come on Tom, I know you went on to ask, what’s sexier than the demographic trends and the growth characteristics in our industry? But if you are having fun “hanging around the hoop” to drive up the bidding, keep in mind that what goes around comes around. And when you talk about other people’s assets as being mediocre to poor in quality, let’s just hope you keep a close eye on some of the chickens in your coop, and that high quality does not become mediocre, because as you will learn, it’s all about the operations. Welcome to the club Tom.

 

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In this "Expert Opinion" interview, Jay Connolly, CEO, Lift Hero, discusses senior transportation, mobile technology, benefits of ride sharing, Lift Hero, and more.....

Jay Connolly Read the transcript

 

Jay is a San Francisco-based technologist and entrepreneur who is also a registered EMT. Most recently, he was one of the first employees at Science Exchange, an online marketplace for scientific experiments. Jay’s expertise includes server-side web development (including automated IVR phone systems, API design, and scalable infrastructure); agile project management; and the Lean Startup methodology.

Previously, Jay was a medical student at Columbia University and a published clinical research coordinator at UCSF. Jay holds a B.A. from Harvard University, where he captained the varsity Water Polo team.
 

 

Contact Information:

Jay Connolly
CEO
Lift Hero, Inc.
J@lifthero.com
office: (866) 486-2917

 

Read the interview transcript:

 

Steve Monroe

Everyone knows about Uber Services for taxis when you’re caught in the rainstorm or have other problems and you can’t hail a taxi on the street. Well, now there is something out there similar to that for the elderly. I’m here with Jay Connolly, he’s the founder of Lift Hero.

Jay, tell me about what you’re doing? I know you’ve rolled it out in the last four weeks, your service. Give me a little description about the product and service, and what you hope to accomplish.

Jay Connolly
We’re very happy to have launched and to be piloting with a Brookdale community right now, and the service is basic. We’re a platform that’s connecting seniors and their family members with qualified, trusted drivers.

That’s the basics of it.

Steve Monroe
So it’s not a taxi service that is kind of hooked in.  It’s just individuals?

Jay Connolly
Right. And this has only recently become feasible both from a regulatory perspective and the technology perspective now that everyone has a GPS device in their pockets, and you’re getting used to, as you said, ordering transportation on your Smartphone.

Steve Monroe
I was wondering how a non-taxi driver would know how to get places, but everyone has GPS, so everyone can get anywhere they want to get to. How does it work? If I’m a 90-year-old guy at home, and I don’t have a cell phone, can I still use your service?

Jay Connolly
Absolutely. That’s one of the key components of our platform is that we have that analog phone interface so that someone can just call in. Maybe the caregivers set up an account for them, and they don’t even have to worry about payment at all or they can do everything over the phone, and we connect them with the appropriate driver who’s driving the right car and able to handle their needs.

Steve Monroe
Can you pre-order a day, a week, every Wednesday at 2:00, that kind of thing?

Jay Connolly
Absolutely. And that’s one of the really exciting things for us is we’re finding that people are scheduling those recurring rides, so it’s every week indefinitely, I need to get to this doctor’s appointment or go on this shopping trip. That’s another feature, it’s not just door-to-door, it’s door-through-door.

Steve Monroe
Let’s talk about the door-through-door concept.

Jay Connolly
It’s actually going and helping the person from their apartment and then the companionship aspect. We try to make sure it’s a good match on a personal level as well between the passenger and the senior. They’re available to help with the shopping, to carry bags, to sit with the person at a medical appointment.

Steve Monroe
I was going to ask you about that because I can imagine that someone living alone or even someone if they’re at a retirement community, they may like Bob, and they may want Bob every time. So it becomes not just a driving service, it’s a social experience. Are you kind of consciously trying to build that into it?

Jay Connolly
Absolutely. I think you talk to anyone in this space, and it becomes clear that social isolation is the number one issue that seniors are facing, and a lack of transportation is a huge component of why that’s true. We think our drivers can provide some of that. As we get to know the person, Bob’s not available, but someone with a similar profile can step in and already make the person feel comfortable.

Steve Monroe
You’ve rolled out a month ago, where are you currently operating?

Jay Connolly
We’re just in the Bay area for the moment. We’re totally bootstrapped, we haven’t raised any money and already we have some revenue coming in.

Steve Monroe
When you do a more statewide California rollout, which I assume is next, and then you go regional and national, what are the restrictions you’re going to face with … like in New York City, the Taxi & Limousine Commission would probably try to shut you down.

Jay Connolly
Totally.  First of all, I mean local governments are way more supportive of our service. It’s accessible and doing something that they are frankly failing at. Secondly, we’re fortunate enough to be following on the coattails of some other pioneers in the ride sharing space who have blazed those trails for us, and we share one of the lawyers with one of those companies.

Definitely, it’s new ground in a lot of states with the regulations.

Steve Monroe
I would think that might be the only thing that would kind of inhibit growth anywhere that there’s a strong taxi lobby.

Jay Connolly
Yes

Steve Monroe
But, I think having the same person come and ordering ahead of time on a consistent basis, on a social part, might help it take off.

Are you looking for capital now?

Jay Connolly
Yes, we’re looking—we’ve been iterating on our service, and we really think we’re ready to scale. We’ve been testing a few different distribution channels, and we have some more tests to run to see, which is the most effective, how far the money will get us. But, yeah, we are looking to help millions of Americans with this.

Steve Monroe
Great. Well, good luck and keep us posted on how the rollout goes.

Jay Connolly
Absolutely.

Thanks for having me.

Steve Monroe
All right then. Good luck with the capital.
 

 


 

 

 

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June 3, 2014. 60 Seconds with Steve Monroe. Ventas buys ARC Healthcare Trust, and CareTrust REIT is spun out of The Ensign Group

REIT Deals Take Center Stage

Is this an historic week in our market? First, we have the surprising announcement that Ventas agreed to buy American Realty Capital Healthcare Trust for $2.6 billion, just when we thought ARC Healthcare was going to announce its deal to acquire Griffin-American Healthcare REIT II for $3.7 billion. The musical chairs just don’t ever stop. It is possible that ARC II or III could be the ultimate buyer of Griffin-American, but it is just as possible that Ventas or Health Care REIT or NorthStar Realty Finance could step into the void if there even is a void. Ventas shareholders appeared underwhelmed by the ARC deal, despite the 10 cents per share accretion next year. Our estimated 6% cap rate on Ventas’ smaller $900 million deal for 29 retirement communities in Canada didn’t seem to convince shareholders either. While ARC is being snapped up, The Ensign Group completed its spin-off this week of CareTrust REIT. It has been trading between $21 and $22 per share, giving it a market cap of about $425 million. It may just be a matter of time before someone makes a land grab for this one as well.

 

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In this "Expert Opinion" interview, Dan Trigub, Co-Founder, OpenPlacement, discusses care transitions, home health, accountable care organizations, the internet, and more.....

Dan Trigub Read the transcript

 

Dan is a co-founder of OpenPlacement and helps drive the company's strategy, growth and day-to-day operations. Dan is a serial entrepreneur helping found and start several prior companies and brings 10 years of early stage startup, finance and consulting experience.  Most recently Dan helped found Blue Bite, a leading provider of targeted location-based mobile content delivery solutions and pioneer in the Near Field Communication (NFC) space. 

Prior to building startups, Dan was an Associate at GCA Savvian Advisors, a leading M&A and Capital Advisory Investment Bank in San Francisco and worked extensively with emerging technology, Digital Health and healthcare facility companies.  Most notably, Dan spent over two years working closely with the management team of one of the largest Long-Term Acute Care Hospitals (LTACH) in Southern California which ultimately sold to Kindred Healthcare.  An alumni of Vassar College, Dan earned a B.S. degree in Economics.

 

Contact Information:

Dan Trigub
Co-Founder
Open Placement
Dan@OpenPlacement.com
(O) 855-277-6736 ext. 705
(F) 800-858-3078

 

Read the interview transcript:

 

Steve Monroe

The need for caregivers or appropriate senior housing settings for the elderly is going to explode literally in the next 20, 30 years. And OpenPlacement wants to provide families and care coordinators with all the tools that they need to take care of that. I’m sitting here with Dan Trigub, he’s the co-founder of OpenPlacement.

So, Dan, tell me what OpenPlacement does and how you’re going to solve some of these problems.

Dan Trigub

Absolutely. So, simply put, we try to make care transitions easy. So, right now, if my grandmother had a hip surgery at a local hospital, she has a pre-op visit where they start talking about discharge planning and places she needs to go to. When it’s time to find either skilled nursing care or home health after that procedure, which 99% of the time the patient’s going to need after an ortho procedure like a hip, the best resource the hospital has that they provide to the family, provide to the patient, is literally a list. A piece of paper with some options and they say, “Here you go—good luck.”

Now, from the patient, the family perspective, they look at this piece of paper, who’s good, who’s bad? Who has a bed available? Who’s in my price range? Who even is in the geography I need to be discharged to? And it’s absolutely antiquated, paper-pen, phone call-driven.

So we said, in today’s day and age, I can make all the analogies—Hotels.com, Open Table for restaurant reservation, Travelocity—why can’t there be a tool for the patient, the family or a caregiver that they can say, listen, I need skilled nursing care in this geography, this is my budget, this is my insurance. Show me who’s out there that can meet those needs. Now, from the provider perspective, whether skilled nursing or home health or whatever it might be, they cross their fingers that they’re on that list, that list that the hospital hands to the patient and the family, because they know, they so much rely on that.

Steve Monroe
Not on the list, they don’t get the business.

Dan Trigub
Exactly right. So, how do we give them visibility? At the end of the day, the hospital has to give choice to the family. They can never be seen as saying this is the best place for Mom. But we say is we want to give choice. We want to give the best choice, based on their specific needs. How do we make that process more efficient? How do we connect them to that provider by email, a phone call, a text message? How can we begin that process even pre-op, pre-procedure, so last-minute the case manager at the hospital isn’t scrambling and making phone calls trying to find a good fit for the patient.

Steve Monroe
So you’re doing that either before or during.

Dan Trigub

Absolutely.

Steve Monroe
How do you get all those providers, the case manager at the hospital—who determines what providers get on their list?

Dan Trigub

So, just like a hospital, we at OpenPlacement have to give choice. We’re not steering anybody. There’s no, we’re not endorsing, promoting, there’s no premium listings on our site. As a starting point, we have a database of every single licensed provider across the country. You can go on OpenPlacement today and search and find care providers in any state in America.

However, when you become a subscriber to our network, you as the provider own your profile.

Steve Monroe
And the subscriber would be the skilled nursing or home health?

Dan Trigub
Exactly. Those care providers—and we’re talking a lot about skilled nursing and home health because, where we’ve had the most success at hospitals is ortho and that’s where they’re going. However, we work with many skilled nursing facilities, for example. They have a patient, they’re there for 100 days of Medicare coverage and now they have to move that patient to assisted living, independent living, hospice, home health, non-medical home care. Same idea, they can still use our platform, they can find all these providers. If the provider is subscribed, they get the opportunity—it’s kind of like their Facebook profile page. They can upload videos, pictures, pricing information, availability information. And have this direct access to this highly-coveted referral source.

The biggest difference between us and A Place for Mom or Caring.com or a traditional placement agency is we don’t deal with random leads. These aren’t random people searching the Internet who may or may not even need skilled nursing care for another two years or whatever it might be. The providers get bombarded with 100 emails a day from A Place for Mom and other placement agencies, but they have to qualify these people. They have to sift through—are they move-in ready or are they not?

For us, they’re getting direct access to the patients at their local hospitals in their area that have search and filtered and need their care today.

Steve Monroe

So if I’m a skilled nursing provider and I’m not subscribing to your service for ABC Hospital, then I’m not going to be on that discharge planner’s list.

Dan Trigub
You will, but you’ll fall to the bottom of the search results. So, by being a subscriber and claiming your profile, you will rise to the top in the search results. If you’re a licensed provider in this country, 99.9% chance you’re already in our database and people will get very basic information. You know, from Google Street View what your building looks like, a Medicare rating if you’re a skilled nursing facility will be on our site, contact information, a phone number and that’s it.

Steve Monroe

Gotcha.

Dan Trigub
If you claim your profile, you get videos, pictures—video is doing very well for our users. We actually even provide video tours for providers in conjunction with their subscription. So they have an opportunity to get videos done by us. Those always do better, people want to see it, feel it, take a look at what the place actually looks like.

The only thing is, you’re now directly connected to your profile. So you have an email address that your intake coordinator or your marketing person has access to and, when inquiry is actually made, you get an email message and notification saying “Patient Mary from XYZ Hospital is interested in moving in. And, by the way, they have Aetna insurance.” So we also want to pre-qualify a little bit, too. We have basic insurance information, but we’ll send you a message saying, “please verify that you will accept Aetna” or whatever it is.

Steve Monroe
What’s going to happen with this—because I understand it and it seems like it would work very well—with Accountable Care Organizations. Because, so now I’m a hospital and I’m part of an Accountable Care Organization and really out of the 12 skilled nursing facilities, there’s really only two in my ACO.

Dan Trigub

So, you can have those featured. If you are an ACO, you can say these are preferred providers that I want my patients to go to. And we can do that with basically a logo. When they do the search, those will rise to the top and always be there. End of the day, too, they want to give choice and even show outside that network, as well. Because maybe the patient’s going to a different geography. The family lives in a different state and they have to find another provider. In those situations, the discharge player or case manager is literally picking up the phone book or doing a Google search trying to find a provider. Well, why not use our platform where they can get Medicare ratings, other quality metrics, video, pictures? And most importantly, directly connect with the intake coordinator.

Steve Monroe
You have rolled this out in just California right now?

Dan Trigub
So, as I mentioned earlier, our database is national. So, somebody in Alabama could come to our site and search and get basic information on assisted living, skilled nursing, whatever. Where our subscriber—our subscribership right now is California. So, this idea has been in concept for about two years or so right now. We’ve been live and deployed in the market here in California for about 8 months. We are very focused on California right now, northern California is where we have most of our subscribers.

The goal is really now to accelerate our growth. We think we’ve proven out a model and it’s really about, okay, let’s get to other key territories.

Steve Monroe

Okay, and what’s going to follow next? The big states, Texas, Florida, New York?

Dan Trigub
First California is by far the best and largest opportunity, it’s 10% of the entire long-term care market. After California is Texas, Florida and New York. Those four states are a third of our market opportunity, how we view it. So, Texas, Florida and New York are definitely are next key battlegrounds.

Steve Monroe
And when do you think you’ll go into those?

Dan Trigub
Hopefully in the next six to eight months. It’s really a function of how quickly we can raise our round of capital right now. And really find the right partners. We’ve also been very good at partnering with national providers, so the Atrias, the Brookdales, ones that have presence in all the key markets already. By us proving it out here in California makes it easy to get into these other territories.

There’s certainly a lot of mom-and-pop operators. You know, here in California, what’s called a board-and-care facility, five-, six-bed facility, there’s as many of these as there are 25-bed and more. These are mom-and-pop organizations. I’m a patient at a local hospital. The discharge planner, case manager can’t possibly know every mom-and-pop board-and-care. But there might be a great fit for me. And our approach is like Open Table for a restaurant. I can tell you every Chinese food restaurant in San Francisco. Today, I can’t tell you every single board-and-care place where I’m going to send my mother and now I can.

Steve Monroe
Okay, good. Well, good luck on the rollout. When do you think you’ll do your financing round?

Dan Trigub

We’re in the middle of it right now, so we’re talking to a few very interested parties and hopefully in the next month or two we can get this behind us.

Steve Monroe
Okay, good. Are you looking for a certain amount or can you…?

Dan Trigub

We’re not a CapEx-intensive business. We think a million and a half right now is our goal.

Steve Monroe
Oh, that’s it?

Dan Trigub
It’s a small round, we’re certainly open to a larger round. But we truly believe that, with a limited amount of capital, we can get very, very far. And to a point where then, okay, then we do your traditional big series A or series B. But right now we’re actively looking for the right partner. Somebody who understands this industry, who has relationships with other providers and can really add fuel to the fire.

Steve Monroe
Good, good. Well, good luck. I’m sure you’ll get the million and a half and you may even have more people who want to fund it, you never know.

Dan Trigub
That’d be great.

Steve Monroe
All right. Well, great talking to you and look forward to seeing how the whole thing rolls out.

Dan Trigub
I appreciate it, thank you.

 


 

 

 

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May 27, 2014. 60 Seconds with Steve Monroe. Two hostile takeover attempts in deals worth more than $1 billion, but only one has a chance to close.

Hostile Takeovers In Vogue

These days, we don’t often see hostile takeover attempts, unlike the 1980s when CEOs would get the 5 pm Friday call that another company had purchased a block of shares, telling the stunned CEO, “we want to buy you.” It also did not happen much in the health care space. But this month we have seen Pfizer make several unsolicited offers for AstraZeneca, all rejected and now withdrawn, in what would have been a deal valued well over $100 billion. And Kindred Healthcare jumped in a few weeks ago with its own unsolicited bid for home health and hospice provider Gentiva Health Services, in a deal valued at more than $1.6 billion including assumed debt. This was also rejected, but with the substantial premium and prospects for Gentiva’s shareholders not quite the same as for AstraZeneca, we think Gentiva’s board will eventually cave. The deal certainly gives Kindred some home health and hospice bulk, but at what price, especially if they have to increase the offer to get the deal done? But will this be the last big one before Paul Diaz retires? We will see. 

 

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