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Business Observer Wednesday, Nov. 25, 2009 9 years ago

Young at Heart

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Nicci Kobritz began reforming her own health care business long before the industry became a political powder keg. The result is a $4 million company that has grown revenues almost 60% during the recession.
by: Mark Gordon Managing Editor

Nicci Kobritz has immersed herself on opposite ends of the executive spectrum: She has run a multimillion-dollar company and she has been in charge of a large state bureaucracy — the latter of which she says was enough stress to last a lifetime.

But Kobritz says she learned her most valuable lessons about life and business when she was in her 20s, long before she ran any company or state government department. That's when she worked as a house-call pediatric nurse in rural Maine.

Kobritz drove around the state in a Jeep Wagoner, treating children of low-income families suffering from everything from ear infections to rashes to child abuse. She was so successful that the American Academy of Pediatrics selected her program as a national model to use in other states.

And it was that experience that led Kobritz to learn this valuable entrepreneurial nugget: Never settle. She learned that mantra by having to work with hundreds of children and families in poverty, many of whom just accepted their fate without putting up a fight, she recalls.

Indeed, Kobritz' stubbornness is the base of how she built a successful niche business in the highly competitive field of home health care services on the Gulf Coast. Her company, Sarasota-based Youthful Aging, glams up the traditional home health care business model, which is built around sending a caregiver into a home to help a senior with the basics of daily living.

“I wasn't happy with the traditional model because seniors have far greater needs than just sending someone into the home with a care plan,” Kobritz says. “It was obvious to me that seniors needed more.”

Kobritz aims to give seniors more through Youthful Aging, which she founded in 2005 after spending the previous decade running a traditional home health care company.

That company, a unit of national franchise firm Staff Builders, peaked in 2005 at 250 yearly clients and $3.5 million in annual revenues. It utilized a high-volume business model.

Youthful Aging, however, operates on a lower-volume, more specialized attention business model. For clients, that means paying as much as 20% more than most other local home health care firms charge. Youthful Aging only accepts private pay or private insurance.

But even in a recession, clients have responded to Youthful Aging's individualized and measured approach: Kobritz projects Youthful Aging, with a client base 50% smaller than the peak of her Staff Builders years, will end 2009 at more than $4 million in annual revenues. That's a 23% increase over Youthful Aging's $3.25 million in 2008 revenues, as well as 14% better than Staff Builders' best year.

Moreover, Youthful Aging's revenues are up nearly 60% since 2007, when it finished the year at $2.5 million.

Decision control
Youthful Aging, which has about 100 employees, is also the work of four years of never settle-style scientific and anecdotal research on seniors conducted by Kobritz. Her work included speaking with doctors nationwide who treat elderly patients.

The result of Kobritz' research led her to come up with this formula when working with elderly clients: memory and mobility. Those two facets can put seniors on a path to a higher quality of life, Kobritz says, whether that means the ability to drive a car or simply the capacity to be able to go from a bedroom to a lanai.

“There is no instructional guide for agencies to follow on how to improve the ability of the frail elderly to function better,” Kobritz says. But the Youthful Aging philosophy, adds Kobritz, “enables us to look at seniors very differently. Now the client can remain in control at all times.”

Kobritz never expected to end up in Florida, running a boutique health care business catering to the needs of the elderly. Instead, her first love in health care was actually working with children.

That's how she found herself driving around her native state of Maine in the 1970s and 1980s, treating children. She later developed a program for the state on how to treat abused and neglected children.

Her work impressed some high-level officials in the office of Maine Gov. John McKernan. So much so that Kobritz was appointed to a cabinet-level position running various parts of the state's children and families services department. She worked for McKernan, a Republican, for four years.

The job was satisfying but stressful. Says Kobritz: “It was some of the best years of my life and it was some of the worst years of my life.”

Kobritz moved to Sarasota in 1992 to both decompress and to help care for her elderly parents. Kobritz says she quickly discovered that she was “fascinated by the delivery system of home health care.”

So in 1993 Kobritz founded Home Health Centers of Excellence, her first go-around at home health care. She bought a Staff Builders franchise unit a year later and she ran that company for about10 years, until she began researching ways to give seniors a better daily quality of life.

The quest to bring meaningful improvement to a senior's daily life is the holy grail of home health care services. That quest is becoming ever more competitive on the Gulf Coast, as the industry has seen an influx of new firms pop up the last few years, many of which are local outlets of national franchise operations. Sarasota Memorial Hospital even has its own home health care unit.

Sue Wise, founder and owner of Sarasota-based Take Care, one of the industry's leading local firms, says there is room in the industry for different business models and competition only makes her company stronger.

Still, Wise worries that some of the newer firms to the region are taking such a low-cost, high-volume approach that the quality of care will suffer. That in turn will bring down the entire industry.

“If home health care is done right, it's not an overnight success,” says Wise. “This is not a Monday to Friday, nine-to-five business.”

'High functioning'
That philosophy holds true at Youthful Aging. The firm's program begins by working with the patient's doctors. Youthful Aging caseworkers contact the client's physicians to reinforce treatment plans and monitor medication and potential side effects.

The next three steps of the process go to the core of what Kobritz says she discovered during her research on home health care for the elderly. One step involves physical fitness, another step works on brain fitness and a third step monitors the client's socialization efforts.

Youthful Aging has even formed a Brain Academy to help clients work on cognitive aspects of daily living, such as sensory input, attention and concentration. “It's important to keep whatever mental activity [seniors] have left at a high functioning level,” says Barbara Brancatelli, the facilitator for Youthful Aging's Brain Academy.

The Brain Academy has been so successful with Youthful Aging clients that Kobritz has brought it to a few nursing homes and retirement communities in the Sarasota area. Kobritz says she is working on other partnerships and programs that could be launched by early next year.

Kobritz says the other component that has driven Youthful Aging's success, past the research into how to provide a better life for seniors, is what she calls “the art of practicing home care.” That art, for example, is the delicacy in how Youthful Aging caseworkers motivate clients and manage setbacks.

That combination of art and science, says Kobritz, is the why she thinks her business model, despite its higher consumer costs, will outlast the competition.

“When you run a volume driven business, it's difficult to do something innovative or creative,” says Kobritz. “Our system is designed to manage the more challenging and difficult clients.”

Health 'reform' worries executive
Nicci Kobritz has big plans in 2010 for Youthful Aging, her boutique-style home health care services company. Those plans include hiring more people, launching new programs for the elderly community in Sarasota and possibly expanding to new locations.

Her biggest obstacle? The pending federal health care overhaul currently weaving its way through Washington D.C.

“That's what's going to hurt the most,” says Kobritz, a former Maine state government official who worked in cabinet level positions overseeing health care services. “That's what going to prevent me from hiring more people and my ability to continue to innovate.”

Kobritz, who worked for a Republican governor in Maine but considers herself a political Independent, says the bill has more to do with a government takeover of the health care industry than real reform. Her biggest worry is that the cost of the bill, in terms of the business taxes she will be forced to pay, will make the recession look like easy living in comparison.

“If 60% of every dollar I make goes to the government,” says Kobritz, “it will impact how I can operate my business.”

REVIEW SUMMARY
Businesses. Youthful Aging, Sarasota
Industry. Health care
Key. The firm is seeking ways to grow during a period of uncertainty in the health care industry.

AT A GLANCE
Youthful Aging Year Revenues % growth
2007 $2.50 million
2008 $3.25 million 30%
2009 $4.0 million*
*projected

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