Actively looking to grow as an operator, EF Senior Care is using its consulting roots to more quickly diagnose problems prior to acquiring facilities, while developing its own software platform to better address turnover among administrators.
In its unique business model, EF looks at potential properties through the lens of a consulting firm in order to figure out why, in some cases, a property is distressed and fix the issues once they own it. Or, decide the issues are fundamental and they decide against acquisition.
“In the last month, we’ve got negotiations on two buildings that to the outside look equally distressed. One was a hard no, while with the other one, we’re deeply engaged in [acquiring it],” CEO Mike Nickolaus said. “We don’t need to have 100 buildings. If we could get a half dozen nice buildings in Massachusetts that we can fix and run well, we’d be delighted.”
Expertise in infection control surveys put consulting firm EF Senior Care on the fast track to becoming an operator, leadership says, while its technology background opened up another avenue for software development.
Massachusetts-based EF quickly became the go-to consultant for more than 150 facilities in the state, according to Founding Partner and President Patrick Flaherty; the governor issued numerous surveys as part of its rapid response team protocol at the height of the pandemic.
“It’s very rare, I think, to see consulting companies successfully change their business model,” said Nickolaus. “Patrick and I both come from a technology background in addition to skilled nursing for the rest of [our leadership].”
Consulting has always pointed the group toward owning and operating nursing homes, Flaherty added. It’s a goal the group was able to accomplish last year and effectively acts as EF’s “second lane,” apart from consulting.
Originally founded in 2018, EF currently owns one nursing home in the state with plans to become a regional operator in addition to continuing its roots as a consulting firm. The consulting business grew at an “extremely fast rate” last year, with client engagements nearly doubling in 2021, according to Nickolaus.
Business lines reinforce each other
Consulting, operations and now a technology business line reinforce each other, Nickolaus said, with the administrator app used in the company’s own building and marketed to clients.
There was no need to bring in outside perspectives when the EF team was trying to figure out how to bring occupancy up to 100% since November, and curb agency use to under 2%.
For Nickolaus, it all comes down to sustainability, how EF can create sustainability for the workforce – and in turn operations – through its multiple business lines.
“As somewhat of an outsider, I believe that’s the key. How do you create sustainability? This is reflected in the new CMS ratings; they’re now looking at turnover because they realize how important turnover is to quality,” said Nickolaus.
Instead of buying up a dozen buildings and then figuring out how to backfill them with good staff, EF’s consulting arm is always interested in staff placement prior to ownership. The consulting side does permanent and interim placements, further reinforcing staff so operations can hit the ground running, so to speak.
“At a very basic level, from the ground up, we have people ready to go for these buildings, all ready to operate on day one,” added Flaherty.
As each business arm is primed to grow, especially its tech product and growing as an operator, leadership will continue to look at what their staff is good at and capitalize on those qualities.
“All of our team members are deeply embedded in the Massachusetts skilled nursing, assisted living, independent living environment,” said Nickolaus. One of its founding partners, Matt Muratore, also serves as a state representative. In fact, he’s the only licensed administrator who is in the state house, added Nickolaus.
Technology designed for administrators
The third leg of EF stems from leadership background and its newly formed “second lane” – the team developed a software product to make the administrator’s job easier, and in turn help with turnover and recruitment.
The product is EF’s answer to the staffing crisis.
Called EF Ally, the app acts like a contract book, a document library where an administrator would have all of the paperwork they need while walking the floor with a surveyor, according to Nickolaus. Assigned tasks from the administrator, a record of a department accountable for responding to claims, reporting receivables are all items that can be found on EF Ally.
“We were looking for a tool to really manage our own buildings,” added Flaherty, in explaining where the product idea came about.
The team has just started promoting the product this summer and is starting to get interest from facilities in other states.
Nickolaus and Flaherty said the technology acts as a recruiting and retention tool for administrators, increasing satisfaction on the job with a tool that can help them if they’re new, or want to be better prepared for surveyors.
“It’s a selling point in this industry for attracting a new person. That’s the other angle that we find the owners really appreciate as well. They’re almost more or at least equally excited about this than the administrators themselves,” said Flaherty.
Through a combination of tech and skilled nursing expertise, EF leaders identified the need for such an app and then quickly developed the software to focus on quality and compliance.
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