
Founder lived in a nursing home for 3 months to get his start-up off the ground - whocansay
https://www.msn.com/en-us/finance/markets/this-founder-lived-in-a-nursing-home-for-3-months-to-get-his-start-up-off-the-ground/ar-BBJfGMA
======
sk5t
Pretty shrewd "put up or shut up" offer by the nursing home owner. The
healthcare industry is infested with rent-seekers and schemers angling to
secure for themselves a thin slice of CMS or health system spending on the
flimsiest of claims. A founder--with a strong background, even--who will live
in a nursing home's conference room for weeks or months to prove his product's
value is a world apart from 99.9% of the field.

------
ggm
He had direct benefit to the nursing home, and used them for use-case
validation to better work product.

So the general model is, if you have a smart idea for e.g. fender-bender
companies, and want to workshop it... cold call repair shops and be prepared
to proffer something they value in context, to justify the engagement.

His particular use-case had residential qualities. Many ones won't have that.
I guess you could ask to put a hammock in the spray booth, but if you've seen
"blue collar" you wouldn't want to do that (somebody dies in there)

~~~
Spooky23
“Direct benefit to the nursing home”

That’s the problem with this in my mind. I saw the process that kicked into
motion when my father had a stroke. Acute rehab is what patients need, but
hospitals work hard to funnel patients into their in-network nursing
facilities that offer half the therapy at higher margin.

Having doctors video into a patient home doesn’t sound like a recipie for
success. Nursing homes are all about cheap CNAs and LPNs providing minimal
services for minimal dollars. The doctor doesn’t really deliver care, that’s
done by nurses, who don’t really exist in nursing facilities.

Frankly, this sounds like the kind of bullshit that prison medical providers
do. Not patient focused at all.

~~~
FireBeyond
> Nursing homes are all about cheap CNAs and LPNs providing minimal services
> for minimal dollars. The doctor doesn’t really deliver care, that’s done by
> nurses, who don’t really exist in nursing facilities.

Absolutely this. As someone in EMS, a very large majority of nursing homes
will have 1 RN on shift (and we're talking 200+ bed facilities), and a cadre
of LPNs and CNAs.

Their liability insurance means that sometimes, anything more than a band-aid
mandates a call to 911. And oftentimes when we show up, asking for a patient
history, "Not my usual floor", "I just started shift", etc.

Meanwhile, the sign out front advertises "round the clock nursing care" and
they're happily billing the patient, their families many thousands of dollars
a month (sometimes easily into the five digits).

~~~
Spooky23
They play a lot of bullshit games with people. When my dad was transported for
a minor infection, he ended up stuck for at an ER, incurring about $3k in
expense (his insurance doesn’t fully cover ER visits without admissions) and
about $900 for ambulance and $450 for medivan transport.

When a person is admitted with Medicare coverage, reimbursement rates drop
over time. They want to kick out patients with lower lifetime value to get
“fresher” patients, patients with assets to liquidate for long term stays, or
rehab patients with private insurance.

------
justonepost
What's super clever about this is going after nursing homes rather than
generaly avoidable ER admissions. Trying to aim at insurers would have been
probably next to impossible, even though that's where the big market is.

If you're interested in the opportunity, good read here:
[https://www.vox.com/policy-and-
politics/2018/1/29/16906558/a...](https://www.vox.com/policy-and-
politics/2018/1/29/16906558/anthem-emergency-room-coverage-denials-
inappropriate)

------
RobertRoberts
I love stories like this. I learned to bust my butt when I was younger. And
eventually I made a business work. I had plenty of support and help from
people in my life, but no one was going to do it for me.

There may be minor issues with details of the story and missing plot holes,
but the foundation is useful as a lesson in life and in business. Go for it,
put everything you have into something, don't get caught up in appearances or
require unrealistic responses or results, the universe owes you nothing. If
you don't make it, you still get a great story to tell the grandkids and/or
learn a lesson to help you succeed the next time.

------
bsimpson
That was surprisingly worth reading. I didn't have high expectations for
startup content on MSN.com.

~~~
dannyw
Pieces like these are generally significantly written by the company, and less
so by the journalist.

------
nvr219
Why did he live in the nursing home and not with his parents who lived nearby
to the nursing home

~~~
DoreenMichele
Because the nursing home would only agree to work with him at all if he stayed
on site.

Also: This seems to be a YC company. He was flying back weekly for YC events.

~~~
austenallred
Yes, Call9 is S15

------
dr_
Having spent years working in such facilities, I see some potential here,
primarily because they are supplementing telemedicine with the use of local
care specialists, and not just relying on the facility’s nursing staff. The
issue becomes, who pays for it? Regulations require the facility have a
medical director to help them set procedure and policy and to be able to
provide overall care if the pcp is not available. So they are already paying
for the medical director who they expect to be able to perform this task -
even though the commitment of the director varies greatly from facility to
facility. Many facilities also hire nurse practicioners now to help manage
patients acute medical issues that arise within the facility. And finally
there are times the patients really need to go back to the ER - if as a
hospital you are trying to push them out in the shortest amount of time
possible, you shouldn’t be surprised by this. Personally I think , in the era
of value based care, the entire concept of skilled nursing and how it is paid
for and regulated, needs to be completely reworked.

~~~
FireBeyond
> even though the commitment of the director varies greatly from facility to
> facility

Right, in many places the regulations require laughably little oversight.
"Offline review of patient care records at least monthly" (even quarterly)
suffices as "medical direction" in some states.

------
justonepost
"And that's when he saw a note from Peck via his website's contact form,
offering to solve his problem." .. sounds like he could have used amazon turk.
Still, this is all good, if probably sensationalized a bit.

The part where he like, saved a persons life is pretty cool. Shows the value
of having very deep expertise in your startup is important.

Plus this is the future, which is great. My guess is that this write-up
happened because of his investors trying to tell a story. I've been a part of
startups, a huge part of the value add of the VC is their ability to plant
these stories in MSM / Techcrunch / etc because they have cred with
reporters.. Certain aspects will naturally get exaggerated to make the
creation story sounds good.

~~~
provost
> sounds like he could have used amazon turk.

Could you clarify how mechanical turk could have helped?

------
linkmotif
This must be sponsored content?

~~~
justonepost
Yeah, it's astroturfing for sure. But it's very well done astroturfing, which
makes for entertaining reading. Anyone who doesn't realize this doesn't read
very critically.

~~~
jwilk
From the HN guidelines:

 _Please don 't impute astroturfing or shillage. It degrades discussion and is
usually mistaken. If you're worried about it, email us and we'll look at the
data._

~~~
jessaustin
That guideline refers to commenting on comments on HN. Some of them may be
astroturf, but it's of no benefit to discuss that possibility, because usually
that means a fellow HN person will be upset.

The possibility that TFA is astroturf, or perhaps a more apt term may be
"submarine", is entirely appropriate for discussion. If it weren't, we'd be
really handicapped in evaluating anything that gets posted to HN.

~~~
grzm
While the guideline may be explicitly directed at comments, its purpose is to
discourage people from defaulting to positions of bad faith. This is equally
true for articles. With accusations such as this, it's particularly pernicious
because they're hard to defend against: once you tread down the path of
assuming bad faith, any argument against it is likewise assumed to be in bad
faith: you've already dismissed them as untrustworthy. That's why the bar is
so high with respect to comments: you need to have proof. I think it's
perfectly acceptable to hold a similar standard when discussing submissions.

~~~
jessaustin
I appreciate your position, but we simply disagree on this point. If you're
interested, I'd recommend re-reading PG's "Submarine" essay. One can smell the
sickly-sweet odor of PR on this headline, before even clicking through to TFA,
at which point one can barely smell anything else.

After reading TFA, we may conclude that this company is developing a
telemedicine product, and that they had some sort of arrangement with a
nursing home on Long Island. Concluding anything else, positive or negative,
based on obvious self-reportage is not "faith", it's credulousness. It would
even be a mistake to fault this company for using obvious PR; every successful
firm does the same.

~~~
grzm
Thanks for the thoughtful response. I have similar reservations about PG's
piece† it's application on HN suffers from overuse, compounded by invoking it
has the cover of being authored by PG himself. I do think there's room for
disagreement, though, and I'm confident we have the same goal: earnest,
quality discussion here on HN. Cheers!

† I don't disagree the phenomenon exists, is problematic, and something to be
on the lookout for, just that I don't think it's as interesting as its many
references may suggest.

~~~
justonepost
Grzm, there a lot of great telemedicine startups[1]. I think they should live
and die on the merits of their technology, not their founder stories or plant
in MSN.

I think if this article spent some time highlighting those competitors and
briefly discussed their advantages / disadvantages over this one, I would have
been less skeptical.

But, it didn't. And you have to ask yourself why.

1\.
[https://www.google.com/search?q=telemedicine+startups+for+nu...](https://www.google.com/search?q=telemedicine+startups+for+nursing+homes&)

~~~
grzm
I completely agree. I think pointing out those other other startups as well as
pointing out additional information you'd like the article to address (perhaps
adding more information you may have) as you've done here are great additions
to the discussion. Going around in circles discussing possible but
unsubstantiated underhandedness is less so. As is elongating this thread for
that matter, so I'll do my part in refraining from further additions.

------
leetrout
It's a neat story but for those that don't read:

1\. He's a doctor with a Harvard degree.

2\. The nursing home he stayed in was close to his parents... "When he needed
a shower, Peck — who was 35 at the time — would drive to his parents' home,
which happened to be nearby."

I'm not knocking the significance of things- it's a cool read and a reminder
how painful it is to work in and around healthcare with all the bureaucracy
and how sad it is he contacted 2000 institutions and only three got back to
him.

Worth the read- just a tiny bit sensationalized IMO.

Edit: added quote

~~~
tomcam
1\. The Harvard part of the degree is completely irrelevant

2\. His parents’ home happen to be nearby, but note that was a semi-lucky
coincidence. He was living in Silicon Valley when he cold-called all of those
institutions. One of the few that actually answered was near his parents’
house.

Here is the relevant passage: “So he cold-emailed and called more than 2,000
facilities across the country.“

This guy will succeed because he was willing to cold call 2,000 places despite
having a Harvard degree. He was willing to live in a conference room despite
having a Harvard degree. He will succeed at whatever he does and it wouldn’t
matter if he went to Cal State Fullerton.

In my opinion this story is intrinsically sensational because he is such a
stud. A guy willing to go this far is a guy YC is lucky to have.

~~~
cup
>1\. The Harvard part of the degree is completely irrelevant

Except It's a pretty good indicator of his socioeconomic background and the
numerous opportunities that were made available to him in his life that others
didn't have. Apart from that yeah..

Oh and also the copious networking opportunities it gave him and access to
circles that others don't have. yeah.....

~~~
manigandham
Anyone can apply to Harvard, and they all have to be good enough to create the
opportunity to be accepted in the first place.

~~~
cm2012
Except realistically, 80% of harvard grads come from high income households.

~~~
manigandham
So at least 20% don't? Given the high standard of qualifications which are
obviously easier to meet when you have more resources, that's pretty good.
We're talking about the #1 school here, which is also free for any low-income
families.

~~~
cm2012
Yeah, 20% come from families under 65k family income.

------
waytogo
> When he needed a shower, Peck — who was 35 at the time — would drive to his
> parents' home, which happened to be nearby.

Why didn't he then just live with his parents for the 3 months? He still could
have go there to get that 'invaluable knowledge'. Nice outcome but the story
feels a bit like click-bait...

~~~
lima
It's in the article, the nursing home owner wanted him to be on-site.

~~~
waytogo
Being on-site != lived in

~~~
lima
The whole point of the service being 24/7 availability, I can see why he'd
stay there overnight

------
eecc
I’m fed up of these “dog learns to speak” miracle stories when it comes to
startups.

No wonder it’s a dysfunctional society if it selects for the most lunatics
when it comes to change-makers.

Another rich weirdo on Twitter is complaining about people not “compelled
enough” to quit their day job to work on their startup (in USA, which means no
more health insurance for you and your family, if you have one.)

What kind of crazy, self harming culture is this? It’s not even Darwinian when
it suggests to take huge disastrous gambles to chase rare unicorns!

I tell you, it’s this shit that’s holding back humanity. How many are just
locked back into uncomfortable routines because of this barrier?

Is it perhaps the signature of a conservative society, when change requires
grotesque sacrifice stories and is controlled by a small elite of gatekeepers?

~~~
cheriot
The guy is a doctor enrolled in YC. I doubt he'll end up on the street if his
startup fails. A large part of other founders are engineers that can walk into
a six figure job on relatively little notice.

For all the talk of risking everything, most founders risk time and foregone
salary, but not their future. If microsoft had failed, Bill Gates would have
re-enrolled at Harvard and graduated a little late.

Your average Joe or Jane that dreams of owning a coffee shop and has to put up
their own capital is another story.

~~~
Xylakant
You’re inadvertently making the parents posters point. The reason why most
founders stem from a demographic that allows them to either find a solid
paying job or fall back on (parents, spouses, ...) financial support is that
he current way of doing startups selects harshly for exactly this. No one else
can afford that risk and gamble. If you’re single, your startup fails and you
have to move in to your parents place for a while, that’s tough luck. If you
have a family, a few kids and maybe parents that rely on your financial
support, a single dry month without income may spell disaster.

The current way of doing things self-selects for types willing to put in crazy
hours and with access to money.

~~~
samolang
> The current way of doing things

Is there a realistic alternative? Sure, universal basic income eventually, but
that's not practical at the moment.

~~~
eni
_Is there a realistic alternative?_

I read a lot on entrepreneurship during 19th century and early 20th century
US. My limited understanding: in those days entrepreneurs came from much wider
range of demographics. In other words, entry barriers were much less during
those days.

~~~
samolang
I mean many people start bodegas, restaurants, etc. I imagine that's more akin
to 19th century entrepreneurship and still is by far the most prevalent form
of entrepreneurship today (only like 1.3% of businesses are created in the Bay
area and 1.1% of the population lives there).

