Max Lafer – Home Health Care Services of New York

It was an interesting start for Home Health Care Services of New York.

Husband and wife founders Jeff and Agnes Shemia conceived the idea for their Brooklyn-based business while talking on a park bench in 2004 and started building their healthcare dynasty from there. They’d leave all the legal details on how to make it happen to attorney Max Lafer.

Max Lafer | Chief Legal Officer & Head of Acquisitions | HCS

The move marked a turning point in Lafer’s career he offered his strategy to help the home healthcare service provider enter an era of acquisition. As the outside counsel for HCS for the past several years, Lafer officially joined the company in October as its chief legal officer and head of acquisitions.

With three completed deals to date, Lafer predicts more acquisitions will come as HCS diversifies its business from company headquarters in Brooklyn. With plans to expand nationwide, Lafer says the owners have a billion-dollar vision to develop the company’s home healthcare portfolio.

“What’s most exciting to me is having the opportunity to shift away from a traditional legal function to becoming a strategic partner,” he says.  “Here, I am helping to improve areas using the toolbox I developed in private practice.”

Building a business

Lafer started working as outside counsel on the latest acquisition for HCS/Girling while at Hodgson Russ more than two years ago. The $50 million deal will be completed on December 31.

However, acquiring Extended Home Care—a pediatric special needs-certified home healthcare agency—has been particularly arduous. Lafer’s been sifting through a process filled with negotiations, New York state’s stringent regulatory environment, funding issues and more. A purchase agreement was finally signed in September 2019.

“The negotiations involved a cast of characters and I’ve painfully been in the middle of it,” jokes Lafer. “It’s been a long—but worthwhile—slog.”

The effort will pay off, as HCS/Girling will soon be able to provide services for 3- to 18-year-olds classified with cognitive or developmental disabilities. Extended Home Care will be woven into the HCS/Girling’s two other acquisitions: A&J Home Care of Westchester, New York, in 2014; and A Better Life, a direct care company in Missouri in 2020. All told, the organization now has 6,000 employees.

The diversification of services fits in with the overriding mission of the organization to provide patients with options for around-the-clock healthcare services. Its offerings include adult and geriatric care, case management services, home health aide and personal care, housekeeping, skilled nursing to assist with wound and catheter care, companionship, meal preparation and physical therapy.

“Covid-19 brought the issue of home health care front and center,” Lafer says. “Why go into a hospital when you can stay home?”

Next step: integration

The latest acquisition is setting a strategic direction for the future, he notes, as HCS/Girling delves into researching the best places to support its geographic expansion, as well as identifying the types of related businesses to add to the mix.

What Lafer knows is that the pandemic has only ignited business opportunities. Offering care at home is better for most than going into a hospital.

“We want to provide a spectrum of in-house offerings rather than having people turn to an outside company or be hospitalized,” he says.

To accomplish the mission at HCS/Girling, Lafer is streamlining processes between the newly acquired businesses to create consistency across the organization. Specifically, he’s addressing contracts, regulations and identifying potential liability that’s inherent in the home healthcare business.

“There are many elements including establishment of HR policies, setting up insurances, compliance, and making sure all the intake processes with nurses and aides are being reported the same way to deliver a uniform quality of care,” he adds.

In addition, HCS/Girling is looking at how to incorporate technology into the business, including remote monitoring devices in patients’ homes.

“Given the nature of these times, it’s growing increasingly important,” Lafer says. “Now we can check all vital signs and a doctor can track the patient’s care in real time.”

Future focus

Recognizing the potential of the business opportunities, the owners not only hired Lafer, but a CFO as well, and look to fill other management functions.

“For basically a mom and pop organization to grow to $325 million in revenue in 16 years without a lot of professional management is astounding,” he remarks.

Fortunate to have good mentors along the way, Lafer says he was taught the importance of understanding each client business and establishing relationships.

“I don’t think anything in law school prepares you for these situations, let alone interacting with clients,” he adds, explaining that with most legal work lawyers don’t get to see the impact of what’s happening in a business daily.

The excitement for Lafer is seeing all the practical applications of his work—down to ordering tables or chairs with handles. He’s also on the frontlines of the operation and gaining an understanding of how the business impacts the people he works with and, of course, the patients HCS/Girling can help.

“While my tenure here has been short, it’s been an interesting ride,” Lafer says. “I’m happy to have the opportunity.”