DIVERSIFYING INTO PRIVATE PAY HOME CARE A CASE STUDY PRESENTED TO LEADING AGE PEAK LEADERSHIP SUMMIT WASHINGTON D.C. MARCH 19, 2014 MARK ZWERGER, PRESIDENT AND CEO THE OSBORN NETWORK, RYE, NY

THE OSBORN - BACKGROUND 105-year-old charitable organization on 54-acre campus in Rye, NY First 60 years a life care community for women Became a licensed nursing home under Title XVIII : $120 million expansion and renovation project to create a 21 st century CCRC Today we are CARF–CCAC accredited, Fitch A- stable rated, 382 unit fee-for-service CCRC and home care company: 188 Entry Fee IL apartments, 17 Rental IL apartments 80 Assisted Living beds, 13 Memory Care beds 84-bed Skilled Nursing Facility 132 caseload home care agency.

WHY HOME CARE? March 1995 Osborn Management recommended establishing a home care agency with five missions: “1. Meet the care needs of The Osborn's assisted living population 2. Provide intermittent home care to independent living residents in their apartments or garden homes 3. Provide private duty care to residents of The Osborn Health Care Center 4. Provide home care services in the community targeted at prospective residents in our primary market, especially people on our waiting list 5. Provide follow-up home care to residents discharged to the community from The Osborn Health Care Center.”

EARLY YEARS Opened Sterling Home Care in January 1996 as a Licensed Home Care Services Agency (LHCSA) in New York serving Westchester and surrounding NY counties grew nicely to $5 million in annual sales 2002–2007 business levels off at about $5 million in annual revenues.

RECENT YEARS Re-Launched the business under a new name “Osborn Home Care” in 2007 Doubled the business in six years - from $5 to $10 million in revenues We have learned how to effectively manage a much larger agency Looking to take the next step in growing the business.

Revenues Expenses Contribution to Bottom Line Performance CCRCCCRC

OSBORN HOME CARE CENSUS OF 132 CASES AS OF 2/6/2014 BY LOCATION 61% on-campus clients vs. 39% off-campus. We provide about 60% of the total private duty care on the campus. Nearly one in five residents of our CCRC purchases some level of home care from us.

KEYS TO SUCCESS IN HOME CARE 1.Hire home care professionals experienced in running a community home care agency – it’s not a CCRC! 2.Differentiate the product – create a value proposition for the client. 3.Spend money educating the public and building your brand. 4.Hire great staff, screen them thoroughly, weed them out quickly, train and retrain and retrain. Compensate them fairly and give them hours; treat them well. 5.Provide consistent, thorough, ongoing nurse supervision and support for your aides. 6.Build-in quality controls and audits from the beginning. 7.Get regular feedback from your clients. If your customers are happy the business will grow.