Ĭase conferencing brings together health professionals and other surrogate decision-makers to build consensus on goals of care and appropriate steps for current management and advance care planning. Surrogates should be involved in symptom management decisions and care planning, and provide the personal context. Decisions include whether hospital transfers and acute interventions such as intravenous antibiotics will offer net benefit versus detriment to QOL. Communication between staff, health services and families (including surrogate decision-makers) addressing palliative care needs is often poor. Nursing home residents with advanced dementia often receive suboptimal palliation due to limited staff awareness and training. They have better buying power and the infrastructure already exists, so there are no additional costs.Ī back of the envelope calculation suggests my prospective client can expect to recover the outlay of the acquisition within one to two years and achieve a 3 fold return over a 5 year period.Ĭome along to our seminar to learn more about acquisition strategies.Care in advanced dementia requires a palliative approach focused on quality of life (QOL). My client will get access to the client base and would expect to deliver greater margins, both at the gross and net levels. The owner will get some money and will continue with the business under new ownership. My prospective client can give them a safe home and some security. They could advertise with one of the “listings” agencies, but that’s about it. There is certainly not a large market for them, and the value is so low they would find it very difficult to get expert advice on a prospective sale. These tiny businesses that rely upon the owner are not worth very much to anyone other than the owner. I am sure the owners would wish they were more, but these are businesses that are heavily reliant upon the skills and energy of the owner. There are very many tiny businesses that are really lifestyle businesses for the owner. They operate in a very fragmented industry.

They've put in place some management structure, ready to cope with growth and that is a key enabler for them to consider this strategy. My prospective client is stuck at around £3m. I'm not sure of all the factors, but many small businesses plateau at around £1m turnover and others at around £3m. I've been helping a prospective client consider a strategy for growth through acquisitions.

Learning German by Tim Luscombe