Nurses & Company CEO: Home Health Dealmaking Doesn’t Have to Take Backseat During COVID-19

For home-based care agencies, a lot has changed over the past two months. Their day-to-day has been uprooted, financial goals have been scratched and expectations for the future have been rewritten.

Likewise, M&A plans have been disrupted — but not for all. For many, the coronavirus has thrown growth plans for a loop. For some, however, the coronavirus has not halted their aspirations.

St. Louis, Missouri-based Nurses & Company Inc. falls into the latter category.


Although the process was undoubtedly unusual, its determination to complete an acquisition of a Missouri agency amid the COVID-19 outbreak was unwavering, CEO Bobby Robertson told Home Health Care News.

“Your typical modeling that you do when you acquire an agency is sort of out the window, right?” Robertson said. “So we’re bringing in all of these new processes, procedures and systems [into the new agency] that would be typical of an acquisition, but on top of that are all the changes in the industry with COVID-19. It can be overwhelming.”

Nurses & Company is a provider of home health care, palliative care, hospice care and private services in Missouri and Illinois, normally treating thousands of patients per week. It recently acquired HomeCare of Mid-Missouri, which also has multiple locations in the state.


Despite the sometimes overwhelming nature, Robertson insists that there are advantages to onboarding new agencies amid a public health crisis.

Firstly, the coronavirus has changed the practices of most businesses. If Nurses & Company was hoping to instill its own unique processes to the acquiree, why not kill two birds with one stone?

“If we drop our processes into this new company — we know it’s going to be a heavy lift,” Robertson said. “But they’re in the middle of needing to change their processes anyway. … So we thought, changing is never easy, but we’d rather go through it once than twice.”

For instance, Nurses & Company wanted to introduce new staff to electronic medical record (EMR) systems and the rapid-OASIS-type admissions that they were largely unfamiliar with. That in itself can be characterized as an overhaul, so implementing best practices for COVID-19 is just another step in the process, Robertson said.

And that’s the thinking that triumphed when COVID-19 shook things up during negotiations. Talks began in early February, but the sides persevered and the deal was finalized on April 1.

There are other potential silver linings in acquiring right now as well, Robertson said.

“If there is [another] advantage, maybe it’s the compression of the valuation, right? Maybe it allows us to come in and do a deal faster because of this, which ultimately costs us less,” Robertson said. “But also, maybe it [forces] a faster decision and less negotiation, which might result in a better — or more favorable — buyers’ market.”

The ability to expedite negotiations is a load off Nurses & Company’s back, especially for a provider that is on the front lines of the COVID-19 crisis in St. Louis. They are currently working with hospitals to free up beds and transfer patients from the hospital to their homes.

The company recently teamed up with Continuity Health Solutions to utilize the “Ally Connected Care” platform to do that in a more efficient way.

As of Thursday, Missouri had over 7,500 confirmed cases of the coronavirus and at least 329 deaths, according to the St. Louis Post-Dispatch. The great majority of those have been confined to the St. Louis area.

Increasing the company’s footprint will allow them to increase the reach of all the new, innovative systems they’re utilizing, and, in turn, enable them to treat more COVID-19 patients.

“I think we’re gonna see some winners and losers out of this ordeal on the provider side,” Robertson said. “And I think you’re gonna find that most of the winners have been agile and innovative.”

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