Small Business: Merging medical equipment with hospice care

Betty Dillard

Growing up in a family of health care entrepreneurs, Josh Robertson knew at a young age he’d start his own company one day. His dad was a clinical respiratory therapist, who also had served in management positions at several health care corporations during his 30-year career, and his mother was a nurse. Robertson, a Fort Worth resident who grew up in Weatherford, founded National HME Inc. in March 2006, shortly before he graduated from Texas Tech University with a business degree in honors management and marketing. Today, National HME, a niche that provides medical equipment services for the hospice and palliative market, is a family-owned and -operated national company headquartered in Fort Worth. “I had the opportunity to grow up and be involved in multiple family businesses that ranged from home health care, DME [durable medical equipment] services and assisted livings,” Robertson, 29, said. “As I grew older the dream of being in business with my family became stronger and stronger. I’ve turned that dream into a reality as well as my dream of touching the lives of the patients and families we serve.” Breaking new ground, National HME is the first health care company to merge the medical equipment/medical devices market with the hospice industry. Robertson, the firm’s executive vice president and chief development officer, conceived the idea during his final semester at college. He had enrolled in a class called, “Managing a Family Entrepreneurial Business,” and the semester project was to write a business plan. “It was the little fire that was lit. It sparked the dream I had as a boy,” Robertson said. George Robertson, Josh’s father, had transitioned from owning his own business and started working for VITAS HME Solutions, a subdivision of VITAS Innovative Hospice Care, in 2001. Josh volunteered during holidays and vacations at the local VITAS branch and became captivated by the end-of-life care business. “I began to wonder what other hospice companies do for their medical equipment needs,” he said. “I researched and found there was a gap of communication and understanding between the hospice companies and the equipment providers. This was an opportunity to see if there was a business opportunity.” Josh completed his business plan – with the help of his dad – and after graduation, moved home and secured an investor, whose financial backing was added to both his and his father’s personal startup capital and some bank loans. National HME served its first patient in September 2006. After much urging by his son, George Robertson, who had coached Josh from the sidelines, resigned from VITAS and came on board National HME as president and chief executive officer in February 2008. “Josh kept pushing me to start this business and I’m glad he did,” his dad said. “Our goal was to make it a family business based in Dallas-Fort Worth. Our vision is to provide a continuum of quality care and needed care in the hospice health services around the world. The industry was really hungry for a quality medical service business and it just exploded.” The first business of its kind in an emerging market, the company has seen more than a 100 percent growth rate each year except for 2012, which saw 68 percent growth. In 2010, father and son brought in an equity partner, EDG Partners LLC of Atlanta, and the company continues to grow and expand in a now $1 billion industry. The industry is expected to double by 2015, according to George Robertson. “The growth rate for the hospice business is phenomenal. Hospice never stops. In 2010 and 2011 we were at 150 percent growth rate but in 2012 we pulled back the reins on growth to work on bottom line management and improved processes,” Josh said, adding that the growth rate for 2013 will also run about 68 percent. “That’s still a very big growth number for the size of our company,” he said. National HME has grown to 40 locations in 13 states and employs a staff of almost 400 people called “teammates.” About 125 teammates work in the Dallas-Fort Worth area. The company manages 24,000 patients daily nationwide from the 300,000 on hospice service each day. As Josh was completing his Executive MBA degree at Texas Tech in 2011, his father decided to resign as president and CEO and assume the role of executive chairman. “It’s allowed me to step back and look broadly from a strategic standpoint,” George Robertson said. “Our company was the first one to do what we do. We now have competition. Since we’re the first movers in the industry there are high expectations of us. It was time to bring in someone with more experience.” He was replaced in October 2012 by Bill Monast, a health care veteran with experience in managed care, Medicare and home care. The executive team is streamlining operations and restructuring and reorganizing processes to take the company to the next level. Plans are to grow the firm three to four times its current size within the next two to three years, and add up to 50 employees in the D-FW area as the market expands, Monast said. “It’s an exciting time to join the company,” he added. In addition to his duties at National HME, Josh Robertson founded a nonprofit organization, Project 4031, that provides funding and medical equipment and supplies for patients and families in hospice as well as fulfilling dying wishes. “Our mission with both Project 4031 and National HME is to do what we can to make a difference in people’s lives,” Josh said. “Understanding the heart of hospice is our tagline. By that, we mean understanding the urgency, the compassion and empathy to make a person’s end of life journey peaceful and comfortable. We serve people like we would want to be served.”