Latest / Alternative Exit / Alternative Exit #63 | No Silver Bullet, But There Is Magic in EO | Joseph Cureton, Sarvis Health
Transcript
- Andy Farquharson: Hello everybody and welcome back to the alternative exit. Today's guest is Joseph Curitin. Now he's a builder operating at the intersection of technology, worker ownership and cooperative economics. So Joseph's journey runs through some of the most ambitious employee ownership experiments of the past decade. I mean, he previously was sort of one of the founders of Led Obran Cooperative, like the first worker owned cooperative holding company in the US, where they acquired and converted companies into like a 40 million. the adult platform. And now he's the CEO and co-founder of Sarvis Health, where they're something special, ESOP based roll-up of home based care agencies paired with a proprietary operating platform called Sarvis OS. So ⁓ to say, there's lots of exciting things for us ⁓ talk about on this call. So Joseph, welcome to the Alternative Exit. Joseph Cureton: Thank you. to be here. Andy Farquharson: Yeah, absolutely. So I have been so excited about recording this, like since our first conversation a little while ago, further interaction with you and your ideas and thinking that there's so many exciting things for us to dig into. firstly, I want to go back to your years spent at Oberlin. guys were ⁓ of the first ⁓ cooperative holding company. You're spanning lots of different industries across staffing, construction and healthcare. But now at Sarvas, narrowed to home healthcare specifically ⁓ shifted from co-op to ESOPs. mean, so ⁓ what you learn ⁓ at that led to these two very sort of deliberate shifts? Joseph Cureton: Yeah, well thank you so much first of all for allowing me this opportunity to be here and yeah I'm excited to share a little bit of lessons learned and some I think maybe key insights as like an operator. When I first got started with Oberon back in 2016 It was really a sort of labor of love. Like it was a social enterprise trying to figure out how to do staffing, which was our first industry, for people, specifically folks coming out of prison and jail. So very social enterprise. Scrappy, if you will. Fast forward to when I exit in 2025 and yeah, we're growing we have multiple different industries and multiple different segments the business itself is evolved and it's very different and Obviously, there's been a lot of bumps along the way a lot of like lessons and things to avoid but also there's been a whole heck of a lot of like understanding of Different models that could I think in our current reality shift and change folks' outcomes. So the co-op specifically, like why we started there, it actually came the most organically to us. It wasn't ⁓ sort of academic choice. It was mainly a choice of necessity. We didn't have any money to start. ultimately the that we wanted to share the Andy Farquharson: Thank Yeah. Thank Joseph Cureton: business was sort of the root of what we wanted to do. Andy Farquharson: Hmm Joseph Cureton: And building from just a very simple understanding of every person's of livelihood or hour is valued internally the same. kind of evolved or arrived at the cooperative model. Also with a lot of help from our community. So we actually encountered this group called Bread, Baltimore Roundtable for Economic Democracy. And it was a loan or it is a loan fund in Baltimore City, part of a group called Seed Commons now. ⁓ And, ultimately, you know, the Andy Farquharson: Yeah. Joseph Cureton: idea of the co-op formed because it was the most sort of fit-for-purpose thing that we had at the time and it just made sense at the time. Now, I say that the cooperative form also has a lot of drawbacks. ⁓ Specifically in United States there's a, you know, there's a, ⁓ I say a misconception ⁓ of sort of inmates running the asylum, if you will, right? ⁓ Andy Farquharson: Yes. I think that's a global misconception as well. Joseph Cureton: Yeah, ⁓ there we go, unfortunately, right? And that's just simply not true, right? Well actually, we'll say that's true in some cases, and like you know, there's absolutely the reality that sometimes that just is the case. And also, I will push back on it only because just like any business that struggles with early or mid or late stage issues, so do cooperatives. There's actually no real difference in it. I will say the other side of it in the of good part of the inmates running the asylum is that they all actually care about the asylum. And not in a hokey way, in a way that's actually material and that really sort of actually changes things. dynamics and decision making specifically. And so I come to this sort of like next chapter with more maybe of a sober view ⁓ what the benefits drawbacks of shared ownership or employee ownership or however you want to call it. Having been in the sort of in the thick ⁓ ⁓ something that's super hard, that multiple industries, trying to figure out how to both share the wealth and share the upside as well as understanding how to like protect against the downside and risks and all the rest of it. And so yeah, I think I'm like a little bit less rose colored glasses ⁓ this time So anyway, was a long-winded way of saying, like, yes, I've been there and done that in some ways. And I think some of the core lessons are that it is just business as usual, that you actually really do need to understand that this isn't a magic bullet. There is no quick solve. You do have to kind of grind it out. You have to increase revenue, understand costs. You have to ⁓ think about innovation think about sort of understanding where your Andy Farquharson: Yeah. Joseph Cureton: or service fits in the market. There's no silver bullet for that. Management still is management. You still have to actually treat people well with respect and dignity and you have to hire great people, ⁓ board folks that don't fit the culture. There's no magic bullet. And there is some magic. And there is some magic under it. And I think it is really important not to lose sight of that too. I can talk about the sort of like dynamics between the cooperative and the ESOP and like how there's like a little bit of nuance and difference, but ultimately the sort of, you know, the core takeaway here is just, you know, you still have to be a great operator at the end of the day to effect change in the world. period. And then on top of that, we can talk about the magic of the employee ownership side. ⁓ Andy Farquharson: Yeah, look, I think I love how you describe that. Like, it's a fact that there's no magic bullet, but then you sort of highlight that these are all things that just make a great business. It doesn't matter what structure it is. These are just all the things that just need to happen. Joseph Cureton: Yeah. Andy Farquharson: regular daily basis. thing you did talk about there was ⁓ like the little bit of magic where everyone is owner and they feel that. I how are you ⁓ to be bringing that from that cooperative model where it's probably a little bit more explicit, where in the ESOP model where it's a little bit more, it's a little bit, it's a layer away from people. Joseph Cureton: Hmm. Yeah. Well, actually, I think so. just recently was at the National Center for Employee Ownership in the United States Conference there was this, you know, the keynote speaker, Adam Grant, was talking about sort of your challenger network, basically folks in your corner that are kind of disagreeable with you, but they're givers, right? Like they really want to see you win ⁓ and they want to see you sort of thrive. they're kind of just sometimes you're like, yeah, but you're telling me the hard stuff, you know. I think that the actual magic that I have seen, the best magic that I have seen in employee ownership, is that when you figure out how to get those disagreeable givers all around you, and aligned incentive to basically have everybody be disagreeable givers for everybody else, right? The one thing that you really don't want to do that I have made the mistake of in the past is, ⁓ think that you have disagreeable givers and really what you have around you are folks that are like, yeah, this is great. And like, don't know, you're doing great. It's like, no, no, more, right. And so I think the ESO model kind of, yes, it definitely changes the dynamic because it moves it from purely cash flow and distribution of profit to thinking about something I would say more ephemeral or more Andy Farquharson: Yeah. Joseph Cureton: less concrete than that, which is valuation, which could, you know, is subject to market forces and subject to, you know, other things. And at the end of the day, it also is the thing that you are a part of that is there are things in that, that you can control as an, as a frontline employee or as a manager or as a, Andy Farquharson: Yeah. Joseph Cureton: ⁓ participant in that ESA. And our job as operators are to break it down and demystify the same thing in the co-op, right? Like there's no difference. Our job is to create the culture around it. It's the same thing in the co-op, right? There's no real difference there. And our job is also, I think, to keep it in ⁓ view, literally in front of every person, that like this is why we're here. And it's both the immediate purpose of Andy Farquharson: Yeah. Joseph Cureton: serving whatever customer that you're serving or creating whatever product you're creating. But it's also the higher order purpose. It's about the community that we're a part of, or it's about mission that we're doing together. And I think kind of last thing is we get to share the benefit, which is ⁓ last thing here. But it also is an aligning thing. Like everybody's directionally moving in the same way. So the magic I think comes in process is not just in the like, we're all sort of gonna be millionaires at the end of the day. So we might not all be millionaires. One thing I'm very clear about for everybody, whoever has worked with me is like, ⁓ sober about the sort of financial sort of side of things. We practice open book management. We are very clear about what actually is and is not possible. And, ⁓ know, in home health care, it's a specific industry. It's growing incredibly fast. And there is great opportunity for us to acquire companies and to grow into a large entity. And at the end of the day, ⁓ the is you have to take care of the person in front of you. Right. Andy Farquharson: Yeah. Joseph Cureton: And you have to do that well. Andy Farquharson: Love that. Well, while we sort of transition to that sort of home health care conversation, mean, the industry is right at the heart of the Silver Tsunami. mean, not only is there sort of aging owners of these businesses, the clinics that they've got are going to be booming, and we've got a caregiver workforce that deserves a better type of job, like, they need to be engaged. Why is this an industry where you think employee ownership matters the most right Joseph Cureton: Yeah. Yeah. So in Oberon are. I would say largest experiment, the thing that we tried the at was home healthcare. And I think it actually was ⁓ of the places where I can say that we did ⁓ fairly decent job ⁓ understanding that industry and moving forward in it. I also see when it comes to technology, the ability for us ⁓ as individual company to affect change, not only in just our business, but across the industry. I think employee ownership is when it comes to mission, like, like I said, aligning for us. First, you got to just like take care of the customer or take care of in our case, the patient that's right in front of you. But ultimately you are working as a home health care, aid or clinician, RN, PT, OD, whatever it might be. You know, in a ⁓ rate environment in a, you know, most the time government payer ⁓ rate ⁓ you're setting the terms. Andy Farquharson: Yeah. Yeah. Joseph Cureton: like period right there's less control actually ⁓ the end of the day and all all in my experience anyway of these ⁓ you know the people the actual employees that are there are not in it to make ⁓ millions dollars they're in it because they actually care about human beings and like ⁓ just a starting point i want to be in business with those types of people right you know i could anything with my life and like i could you know Andy Farquharson: Yeah, but like, isn't that tough to differentiate yourself? this world, not so much to differentiate yourself, but in a world where there's ⁓ large amount of pay capital flowing into this, flowing into this space. A home sure who are probably going to potentially pay a lot higher because it's very part of a very different strategy for them. I ⁓ how do you, what is the key sort of points of differentiation that you talk about for the workers and the potential sort of people sellers of these businesses? Joseph Cureton: Yeah, I'll differentiate those two things, right? So for the seller of the business, ultimately they are driven by their own internal motivations. And unlike a, ⁓ like Andy Farquharson: you Joseph Cureton: I am not a monolith or we are not monoliths as human beings, right? And sometimes those motivations can even be contradictory. They want to do the absolute best by their people and they want to make a killing doing it, right? And I'm not going to fault anybody for wanting to be remunerated for their hard work, like ever, right? said, I want to like be clear, right? I think clarity is kindness. ⁓ I want to say here is a fair price and this is what it looks like from day one for us to come and acquire. And what are your goals? Right? Are your goals to walk off into the sunset in six months and transition this business to somebody who just will go and run it? Or are your goals to stick around for three or four years and make this your legacy and put your name on the door and keep it there? Right? So I won't say that there's actually a one size fits all answer to sellers because one human is the same. ⁓ that's an unfortunate reality, but that is part of what I think our differentiator is, is we meet people where they're at and we give them what they actually are after, not what we, you one, ⁓ this and that's it, you know? Andy Farquharson: Yeah. Joseph Cureton: That said, ⁓ incentives are real. ⁓ ESOPs have a fairly ⁓ sort of tax regime in the United States. We can help defer capital gains or if structured correctly, in perpetuity for Generally, when comes to price, we are competitive in the market. We've gone head to head with private equity in the past and won. Andy Farquharson: Yeah. Joseph Cureton: you know, ultimately when it comes to the motivation for the seller that's beyond money, you know, from a stable operator that wants to look at this as a long-term asset to hold and to do right by their community, we are here for the long run. I want this business to be here for hundreds, if not, you know, more of years because this, think, is an asset that is not just specifically home health care, is an asset that is not like a thing to get sold. It's an asset to take care of and root inside of a community and help people in one of the most critical times in their life. That might be different for a toy but for we're up to, it is really important for us to root in a place and for us to be part of that fabric of that community. And they know right? Because literally they've been there and done it for years. And so I think beyond the sort of sale, it is also ⁓ how do we operate? Andy Farquharson: Yeah. Yeah. Joseph Cureton: How do we manage? And the ESA plus what we're building in service that thing that helps both future proof when it comes to understanding our current technology landscape and building against the future of that, as well as doing the just good old practice management of keeping folks healthy and happy. Andy Farquharson: Yeah. When you were sort of talking about, because there's those fundamentals of the business that just need to be running well, regardless, just the operating, right? Which needs to happen. There's obviously that magic that you talked about in the cooperative is something similar. Like there's still that ability to bring that magic to life in the ESOP as well, where there is that shared alignment. What do you see are the key elements that people need to get right to really... Joseph Cureton: Yeah. Andy Farquharson: realize the impact of employee ownership on the business and for the customers or the patients. Joseph Cureton: Yeah, I love this because I think it like ⁓ is a model question and it's actually, think it has nothing to do with the model, right? ⁓ I ⁓ create some ⁓ thing that allows for ⁓ a club, right, an association. Andy Farquharson: Hahaha Joseph Cureton: right? ⁓ ⁓ at the same thing here. Fredrick calls it like evolutionary purpose. Like what is the reason, the raison d'être for being here? Like why do this with your whole life, with your whole day and your whole self instead of doing something else? I think the ESOP versus co-op versus EOT ⁓ Andy Farquharson: Yeah. Thank Joseph Cureton: It's a false dichotomy. It's just a means to an end. There are structural differences. I'm not saying like not washing away the structural differences, but the practice of engaging people, the practice of having somebody come into work and care. That's the, it should be. I believe that it could and should be the same across models. Now, when it comes to how as I, as an ESOP participant versus myself as a member of a worker co-op, Andy Farquharson: Yeah. Joseph Cureton: versus a beneficiary of an employee owned trust, do I actually like tangibly get cash? Okay, maybe those are different. Yes, maybe there are some differences there. And in which case, maybe I'm thinking a little bit differently about the business, but the underlying engagement, the underlying sort of mechanics of when I wake up and I come into work and there's a ritual every quarter around reviewing our financials and we break it down and we look at every line. Andy Farquharson: Yeah. Joseph Cureton: that you have a question about or your fellow aide has a question about. And when you say, well, why are we spending so much on supplies and can't we buy that in bulk? That should be the same. when it's like, hey, we have this recruitment process, but I know that there's this technical school down the street and I'd love to go and talk to them. Can I go and do that? Can I have a business card for that? Great. That to me is where the rubber meets the road. is do you have people piping up and saying, Hey, I really want blank fill in the blank. Right. That to me is really what the difference between an employee owned company, EOT, ESOP, co-op, what have you, and a non. And to me, there is a reality of tying the like incentive to the outcome and like giving people a real clear path or line of sight onto that action that makes something different. Andy Farquharson: guys. Mm-hmm. Joseph Cureton: And lastly, do think from a, I would say moral place for myself, like ⁓ want to put my money where my mouth is at all times. I think Oberon was a massive experiment of me trying to like, ⁓ for right? It me trying to like ⁓ stay with what I believe in ⁓ and true to what I believe in. And don't get me wrong, it was hard, ⁓ you throughout the process. We in Oberon practiced a... Andy Farquharson: Thank Joseph Cureton: I would say fairly radical form of democratic control, where we were talking about inmates running the asylum, where it's like, if another person outside of our organization came in and looked at the organization, they'd be like, whoa. whoa, incredible, right? ⁓ And on their orientation, they be turned off or may be turned on, you know? But ultimately, I think ⁓ it was a of the experiment to stay true to that idea that Andy Farquharson: Okay. Yeah, yeah. Joseph Cureton: both in terms of financial outcome, whether win or lose, and in terms of control, we tightly aligned those two things with being part of the organization. If you're a member, it's supposed to be that you have lots of superpowers, right? In ESOP, it may be a little different. Because of the trustee relationship with the trust, or because of the management and relationship to the organization. ⁓ It's maybe a little less direct in that sort of democratic control. However, I don't think that has to necessarily be the most rate limiting thing. Andy Farquharson: Yeah, 100%. I I loved your observation that this is, it's not dependent of the model. Because even in a lot of those examples that Lulu talks about in the evolutionary teal, a lot of them have a very traditional ownership structure, which is sort of, so you're able to be able to create that sense of evolutionary purpose within sort of whatever form that you've got, but it does just take those great notes. Joseph Cureton: Totally. Andy Farquharson: And so, I mean, you talked about two of those great elements around sort of that having some great rituals around open book management and giving people the opportunity to be able to participate. What are some of the ways, like, I mean, is there anything else that you'd add to that list? And then what are some of the ways in which you bring those to life? Joseph Cureton: Yeah, so things that I would add to that list, ⁓ being at like psychological safety, being able to say no, and being able to have that no listen to is super hard. I don't care what organization type you have. don't care what we're living in a ⁓ where you have to do things that are hard and that are ultimately sometimes really difficult to navigate, right? Decisions that have massive trade-offs on either end. ⁓ But allowing people to say no and really understanding and taking the time to listen to people, for any great organization, and I would say prerequisite for employee ownership, full stop, right? There's worse than saying you're an owner of this organization, but I'm not going to listen to you. Andy Farquharson: I feel that, yeah, ⁓ feel that happens in a lot of employee-owned roles. It happens in a lot of companies, ⁓ Sorry, I just get the focus back there. But yeah, so yeah, a great point to highlight. Joseph Cureton: Yeah. Yeah. And then I would say, so some fundamental sort of process or sort of nuts and bolts things, right? our current experiment and our ⁓ service, what we do is we think about ⁓ current economy, our current sort of world ⁓ as the employee ownership sort of just brass tacks, getting sort of shared and that kind of thing, as well as that control part. Andy Farquharson: Mm-hmm. Joseph Cureton: ⁓ And we actually want to roll that out into home health care organizations in sort of three ways. is culture and people. So thinking about who we hire, how we hire, like, you know, just some of the general, just good business practices on that side. Then a novel thing, then something a little different. We use a piece of technology ⁓ that we've built actually we started Oberon and then moved into service. And that is both ⁓ ⁓ or operating layer of what we're doing. So think everything from intake, eligibility, authorization, ⁓ scheduling of people, ⁓ billing, revenue cycle management. And it's all under a single sort of ⁓ like thing that we built that comes around an agency wraps around their current organizational sort of practices. Andy Farquharson: All right. Joseph Cureton: and standardizes, streamlines, adapts to, with those current processes and it in literally a platform. So ⁓ of key learnings I had in Oberon was like how you do something changes ⁓ the right? if it's done over Slack versus text message, if it's done over email versus text, like the actual tools that you use in your daily life, really having very direct one-to-one relationship with how good or what the quality or efficacy of whatever the intervention or thing that you're trying to do is. So our experiment here is building with that organization and coming around them with novel technology. ⁓ workflows for every piece of that entity, helping do more with less, better, faster, stronger, ⁓ and with them over time. So we come with a solution, but it's not the solution. It is the starting point for them to shape. So that's part one. But then part two of that is then they get to shape it. So there's nothing worse than telling an owner that I'm not going to listen to you. There's nothing better than having a direct way, me as an individual aide, to make a bug report or make suggestion about where this thing might, this product, this ⁓ piece of technology. might get better and then seeing it happen the next day. It is. Andy Farquharson: But isn't that, know, Joseph, I love the idea. It's inspiring. And obviously the evolution that we've had over last six months in terms of that technology shift with AI is making it so much more possible. But speaking to these nurses on the front line. Joseph Cureton: Go. Andy Farquharson: These aren't people who are typically going and building pieces of software or even sort of sometimes they may not even have the right kinds of context to be able to do that. How do you facilitate that part one and part two of that technological shift? Joseph Cureton: Yeah. Part one is I would say the baseline open book management, you know, great sort of, uh, the rituals, right? So like, what does your team huddle look like? What does every day, you know, stand up look like that sort of thing that just engages people and understanding the business of what the thing that they're doing is. I'm in home health care. It's a lot about our census and our reimbursement rate and our payer mix. And, you know, how do we get referrals and then like the things that drive a home health care business. Andy Farquharson: Yeah. Joseph Cureton: Then on this and recruiting, lots of recruiting, right? Then on the second, finding new nurses. Yep, exactly. Exactly. Huge, huge, huge sort of part of our business. The second part is understanding process. Generally in almost every business, there's SOPs, right? There's generally written, hopefully, there's really written. of the things is I say that and then I've done so much diligence on so many businesses and I'm like, no, okay. Yeah. So like ultimately there are... Andy Farquharson: In terms of finding new nurses and carers, yeah. They may be written, they may not be read. Joseph Cureton: Exactly, exactly. So ultimately what we're basically saying is that SOP that was written and never read, right, is a living human process that can be encoded in software. It can, it has the opportunity to be. Now, is it always? No, sometimes it's like technically not feasible at the time. So, i.e. billing in some cases. Some folks just like, it's not possible in some people's situation to do that. Andy Farquharson: Yeah. Joseph Cureton: reimbursement is a very, it's a whole industry. Revenue cycle management is literally a whole industry. That said, we want to, as best we can, come around those processes ⁓ and possible, instead of giving people an SOP to say like, hey, how does this work? How does this ⁓ look? It's okay, you wanna talk about how to schedule a patient. Cool, let me literally do a ride along with you. We have a solution, right? We have a way of doing it. Andy Farquharson: Yeah. Joseph Cureton: Try it, right, but like first, let me just sit with you for a week. Let me just observe you for a week, right? ⁓ this is what you take a piece of paper, you put your route down on a piece of paper, like I literally am watching, right? You put your route down on a piece of paper. In that piece of paper, you're saying, I'm going to this place, this place, this place, then you put it into Google Maps. Okay, cool. Google Maps, you're now creating your day. Okay, right, like. Andy Farquharson: Yeah Joseph Cureton: What would that look like if instead of doing that whole handwritten manual process, right? We just gave you that solution, right? Where pre-filmed, ⁓ routes are already there and you can just execute on your day. okay. It's like that level of just very specific for a single workflow and then do it again and again and again and again and just like delight people with the ability, with the speed. Andy Farquharson: Yeah. Joseph Cureton: you can actually deliver on things. And it's an accumulated win, right? So it's not just one win. You have to win over time and prove over time that this thing works in order to get engagement. So we believe that AI, artificial intelligence, language models, whatever, right? We are ⁓ like, I say not even like a 10th of the way of usefulness. Andy Farquharson: Yeah. Joseph Cureton: Meaning there's utility stored in these models. The capabilities are way outstripping our use of it. And so our job is to diffuse that into the business or to allow for adoption of that capability. right now we're like, just scratching the surface in most of the sort of business use cases that we have for this, but deploying it through a specific substrate, like deploying it through a piece of technology that we as an individual work around thing own. Andy Farquharson: Mm-hmm. Yeah. Joseph Cureton: I think that's the magic. Andy Farquharson: Yeah. Yeah, I think that that sounds huge, especially like you think about home care. It's not the most technologically advanced industry. You'd think that this is one that is it's not the one that where people are saying AI is coming for your jobs. No, like these are the safe jobs, but these are the ones that like there's obviously a lot of opportunity to make these easier with AI. But so this is the question I've got for you. This type of investment from you guys, in terms of this this role of platform, Joseph Cureton: No. Right, right. Andy Farquharson: that this is a big investment in technology and also people, because I'm sure that this means you've got to put the technologist in with these nurses who are the experts in their job. I what does that look like in terms of sort of how you invest, how you drive that collaboration between those two people? Joseph Cureton: Yeah, so our team is currently small but mighty. So we have a lead engineer who has actually joined us from Tesla, myself. have a software engineering background. And basically a people or process person that ⁓ kind of is the glue between the two of them. Andy Farquharson: Yeah. Yeah. Joseph Cureton: So what we're looking at is when we come into an agency, that agency generally our target is 10 to $15 million in size, right? So from an enterprise value perspective. And we're, you know, maybe a hundred, 150 people, right? So, you know, I can still be friends with all of them, you know, at the end of the day. really ⁓ job, our initial starting point job, the investment to make ⁓ how fast can we start in the back office before we move into the front office? So when I say back office, it's all of the people who would be sitting in the agency's literal office, not seeing patients, not seeing folks the field, and win trust and win points there first, right? So. Andy Farquharson: again. Okay, are we starting there just because it's more contained environment where the problem. Joseph Cureton: Yes, is a more contained environment and also it is generally the most, like we use a lot of robotic process automation meets large language model meets a UI, right? And so it's a lot of ⁓ easier early wins from a margin lifting workflow perspective where we know that we can affect change really quickly. So billing is generally the first place that we look because in this industry like 16 % of claims are denied because of human error and like there's generally like, you know 20 or 30 percent of just every dollar that comes in is subject to some clawback or denial or something because of a human, you know in the loop not saying, I mean, these are heroic, you know, sort of like feats, ⁓ payer and our healthcare system bureaucracy is insane. So just like, let's start there. ⁓ it is definitely strangling the ability to care, for care to actually happen. But so that's where we went right first. Once we kind of start there, let's a month, right? So once we sort of start and win there, and we do we're currently doing with two design partners. design partners for us is a way of basically trialing and testing the software in a kind of safe to fail environment ⁓ taking some game share with them. So ⁓ not, don't own the agency. We want to make sure that we're sort of proving the technology out first. But we're really seeing lots of benefit ⁓ in in those test cases. Andy Farquharson: Okay, so this is like pre-acquisition. You're just working with them. Yeah, okay. Joseph Cureton: Pre-acquisition. Yeah, so we believe that this pro, so we're thinking about like a spectrum, right? We don't own the company until we own the company fully. in the case where we don't own the company, we still believe that this industry needs to evolve. ⁓ I think part of that is evolving towards employee ownership. I believe that for myself, but it might not be right for everybody at every time. So we started with design partners, thinking about software and then software plus. Andy Farquharson: Yeah. Joseph Cureton: operations, then moving to the employee ownership side. And once employee ownership, we're building a network of these employee owned or non-employee owned companies in the United States. Right. yeah, we're currently working with design partners that are interested in taking basically what they have as a very low tech, you know, EMR plus maybe some spreadsheets, maybe some tools and it into a, you know, single platform that they're running their entire agency on. That is all AI automated workflows that you can, we can roll out with that operate sort of side and build best practices around. So yeah. So, and then as a next step, we start with like a group of clinicians. So when in the back office, start with a small test case. And generally these are the like, the tractors. So in every agency have folks that if any sort of home health care agency operator is listening, they're going to be like, yep. Andy Farquharson: Yep, I know. Joseph Cureton: You have folks that are just the noisiest, that are like the most opinionated, that just like every time that there's a group call, just like the most annoyed at the agency. Generally, those are the folks that care the most. Generally, those are the folks that really want to do the best job they possibly can. they just, they just want to be heard, right? So ⁓ first thing is we generally look for those. And those are our first five to 10 like design partner in the design partner, right? So we generally call them like a, you know, innovation team or something, you know, give them a good title, right? ⁓ And those are the folks that we build with because they're the ones that are gonna tell us all the things that are wrong with every process and everybody and why they don't like blank because blank happens. that's great, right? It makes the product stronger. It makes the process better. Andy Farquharson: Yeah. Joseph Cureton: ultimately once we win with them ⁓ then shout from the rooftops that like these guys are real All right, like ⁓ actually listen to you and then they do stuff when you say that it needs to be blank Then they just show up the next day with the model, but it just does it right? So that's sort of like it's not very secret. It's just like, you know practical rollout strategy for any change in any business, right? Go with the willing Andy Farquharson: Yeah. Okay. Joseph Cureton: but listen to the detractors, listen to the people that are trying to like kibosh it and involve them in the solution. we pay them for that. Even the design partner side things, we'll bring that group together and we'll pay them for that time because that's expertise that they're baking into the product. And then from there, it's about adoption. So... Andy Farquharson: again. Yeah. Joseph Cureton: A key integration metric for us is how fast or how slow we're able to actually acquire, LOI to close, but then how fast are we able to get every human, every person in that organization just fully using and running ⁓ the operating system on Sarvis that we're building. And, know, what key AI workflows are they using? Are they doing routing with us or are they still doing something? by themselves? Are they doing scheduling with us, you know, or are they doing something by themselves? So that's sort of the other side. Andy Farquharson: Thank Okay, how much the rituals, the huddles, the start of the standups, the communication ⁓ going to be running through this OS as well? that everything? Okay. Joseph Cureton: Everything. Yeah. so yeah. So the beauty, so we built, one of the first things that we built was communication because duh, right? ⁓ in O'Brown, we were spending something crazy, like half a million dollars or something on Slack. You know, like it was just, you know, it's insane. and so we were like, okay, how do we do this? You know, HIPAA compliant communication platform, both real time and sort of async, in a way that makes sense for home health care. And also how do we bake in what we're doing from the great game of business side into it? So what does it look like to have just a dashboard ⁓ you ⁓ current key metrics that we're running and how does it look to have like, you know, obviously ⁓ Sanitized just in front of everybody right at all ⁓ you know how do you check in on your share price? And how do you then play with the model underneath it? Andy Farquharson: Yeah. Joseph Cureton: to say like, what if we do a census of a thousand to two thousand? What if we do a census of to blank? And like, what happens in that scenario? ⁓ yeah, mean, happy like maybe follow up with a little demo video for the link or whatever. But ⁓ yeah, mean, that's the whole point here is like, it's not just about the operations of home healthcare business. It's about the operations of your employee owned business inside. Andy Farquharson: Okay. Yeah. Look, I'm sure a lot of people will be reaching out to you for that demo. I know that I definitely am one of those. like if we look at five years, what does a thriving service look like? And what do you think the broader landscape of sort of tech enabled employee owned companies looks like? Joseph Cureton: Sure. Yeah, I think that what we're doing should be novel. So this is ⁓ a little paper that I worked up and shared with you. ⁓ But I that this pairing, the idea that AI enabled human-centered workflows that are built into a single platform, a single plane, not five different apps all stitched together. One place that every person logs into, you can call it your intranet, you can call it whatever you want. But ultimately that enables all of the core business processes to me should be standard in employee ownership because of the reinforcing loop ⁓ that ownership begets care or interest or participation, engagement. That engagement needs a place to go, right? Andy Farquharson: you Joseph Cureton: If it just sits, it'll fester. And if at the worst case, it festers, ultimately then people are like, but like I need to do blank. it's like, well, here's a way. Here's a way to affect change today, tomorrow. And loop really helps drive engagement when it comes to understanding the business too. Because as soon as you're moving in one direction, you're going to be like, ⁓ open up your eyes. So I think that should just be standard. Second thing, in five years, I think that we're yeah, I think the employee ownership landscape has adopted the idea of AI enabled sort of, you know, single platform, and like baked in all of the sweet, delicious benefits that are inside of employee ownership already into that. And that are out competing because of that. Right. but in home health specifically, the benefit of, or I would say that like, Unfortunate reality on the good news and sad news is like, you know, we're all aimed at that end, right? So home health care is primarily helping folks in a time of their life and a season of their life where they need a little extra support or where they need somebody to come in and help and it's generally in the end of your life, right? ⁓ One in five Americans are turning 65 every sort of day, like every 15 seconds or something, right? Andy Farquharson: Thank Joseph Cureton: ⁓ and ultimately we think that we are going to, know, we're going to be on the ⁓ end of that, of that trend. and know, we're really wanting from an execution standpoint, to look at a couple of geographies. So we're in, you know, ⁓ the Great Lakes primarily, and trying to figure out how to, how to bring together, let's say four or five different states in that time period. and really build a. a community and a platform that can help those in Michigan and Illinois that are able to actually root in a community in a way that makes sense for the owned businesses that we're operating. And then I ⁓ really love idea of both spreading the word about employee ownership and building a platform that helps folks just imagine what it might be like for them. And so that's part of our sort of design partner or our ⁓ Andy Farquharson: Yeah. Joseph Cureton: kind of like non-owned business strategy or a network, if you will, we call it sort of our alliance. It's really like helping folks adopt software early, build in value, maybe prepare a seller for ⁓ ready to exit and then building and charting sort of like the path where employee ownership becomes the, the duh sort of option for you. But you're still ⁓ reaping the of the technology alone. Andy Farquharson: Yeah. Okay, love the sound ⁓ that vision. It's super inspiring. Now we're coming to the end of the podcast. before I ask people, ⁓ before go, I always ask people three fast round questions and you just offer a quick response. Does that sound okay? Okay. So who is the leader that you most admire in employee ownership? Joseph Cureton: Sure, let's do it. Hmm, leader I most admire. Jose Maria Rosmendi Arriata. Andy Farquharson: Okay. Joseph Cureton: So that's from the Mondragon cooperatives, ⁓ priest in Spain ⁓ sort of the 1900s. Anyway, ⁓ one of the founding sort of ⁓ movers the Erismendi or the Mondragon group of cooperatives. Andy Farquharson: Yeah. And stop. Very cool. the first person to mention Mondragon here in that question, which is great. And so what is your favourite resource on employee ownership? Joseph Cureton: favorite resource on employee ownership? Yeah. Well, I mean, I'll give you the nerdy answer, which is sort of, you know, the IRS code. my second would be, yeah, I like the companies we keep. don't know if you know that book. Yeah, it's not really a like resource in the same way as like a technical manual might be a resource, but it is something that I've definitely shared with a lot of different folks. Andy Farquharson: Yeah. Love that book. John Abrams heading here. Joseph Cureton: And then maybe the second, maybe the first or second, we'll see which one, is Collective Courage by Jessica Gordon-Nemhard. And it is a study of Black cooperative economics in the United States sort of throughout the sort of formation of super inspiring, lots different ⁓ case studies in ⁓ So yeah, between two. Andy Farquharson: Okay, definitely I need to download Collective Courage. And then lastly, what would you say to a business owner who's sitting on the fence about a transition to an employee owned model? Joseph Cureton: I'd say that is on the fence. So they're already aware of, but they're, but they're. Andy Farquharson: Yeah, they're tossing up whether to go with EO or the family succession or the trade sale or the PE. Joseph Cureton: Sure, sure, sure, sure. I would say... Yeah, in a quiet moment when you have nothing but time, sit with a question of would you like to be remembered, right? And if in five years or 10 years or whatever you look back and there's a decision point ⁓ that you're what option would you regret not taking? Andy Farquharson: Absolutely love that one, Joseph. Thank you. I think it's a great thing to end the podcast on. people want to follow your journey, get that demo, where people learn more and reach out? Joseph Cureton: Yeah, for sure. So always happy by email, joseph, J O S E P H at Sarvis health.com. Um, and also on LinkedIn, uh, I think it's a backslash. Joseph builds is I think my, my handle or whatever. So yeah, those two places are fine. Andy Farquharson: Very cool. Joseph, thank you so much for your time. Thank you for leadership and look shining a light on a new journey ⁓ how employer and companies can thrive and better environments for everyone. ⁓ thank very much for joining us in the alternative exit. Joseph Cureton: Cool, thank you so much, Andy. All right. right.