Signs of the next phase in 2024? Veradigm CEO, CFO booted (updated); SmileDirectClub fails, TeleDentists steps up; FruitStreet sues Sharecare for $25M; Walgreens’ former CEO Roz Brewer’s platinum parachute

December 14, 2023 | by | 3 Comments

As your Editor reflects on 2023’s BloodOutOfARock versus 2020-2021’s Alcoholic Bender or the ‘new normal’ touted by the Usual Suspects (with 2022 only a burp on the way), she actually sees some Signs of Hope. 

Having lived through the Digital Health Slough of Despond of 2008-2009 as the marketer for an early telemonitoring company, there are many actions that to the observant are markers that the board is being cleared of the also-rans and never-should-have-beens. They are like dead plants and brush that need to be cleaned out so that new growth can happen. We are cycling through some of them already as we move to a New Reality and winding this up, with some examples. 

  • Early stage companies still in the red, with promising financials, but needing to get to the next stage, suddenly unable to get even modest funding (an early indicator of funding drought)
  • Large companies that can get funding snapping up smaller companies at knock-down rates to fit a ‘vision’. Watch for fill-ins, add-ins, bolt-ons that later are revealed to have taken place ‘just in time’. (And may be sold or spun off later in the cycle.)
  • Large companies veering off into lines of business that look like meadows but are minefields–and hiring expensive senior executives who don’t know one or the other but then have to run both at very high levels. They then depart (or are departed) with expensive packages.
  • VCs and PEs really snapping the purses shut–and shutting. (The latest is OpenView in Boston, not even much of a healthcare player except for a couple in HIT over a decade ago but a recently participant in a Series B for RPM Optimize Health)
  • Public companies moving from party-hearty unicorns to hoarding pens and Post-It notes to locking the doors bankrupt in two to three years. (Cracked SPACs, IPOs, and more)
  • Too many players competing with each other with near-identical services in what turns out to be a limited market–and gaining advantage by cutting patient health, privacy, and regulatory corners. (DTC telemental care and drug prescribing)
  • Layoffs at companies that over-hired in the boom spreading to larger companies that largely did not, cutting their next generation of leaders in response to Mr. Market and creating internal chaos. (Instigating panic at blue-chips like CVS and Walgreens)
  • Stupid (yes) acquisitions being acknowledged and cleaned off the books–none too quietly, but done for survival’s sake. (Somewhere there should be a memorial to Teladoc-Livongo. Sorry, Teladoc.)
  • Increased Federal and state regulation of normal business processes. (FTC’s sudden prominence adding to the usual DOJ antitrust pile-on and senatorial posturing)
  • A general cleansing of the cant and hype infecting a sector. (Look to the conferences and press releases for changes in language.)

In this Editor’s observation, another latter-stage sign is when C-levels don’t survive management failures and are sent packing. Another is seeing a small company sue a larger one over failed partnerships, usually involving IP or program design theft. This past week had examples of these two, plus examples tracking with the above markers.

Veradigm still minus 2022-23 financial statements, boots and replaces its CEO and CFO. The former Allscripts has failed to file financial statements for full year 2022 and to date in 2023 due to a massive flaw in its financial reporting software adopted in 2021 that affected its revenue reporting going back to then. While it is still trading on Nasdaq despite 14 November and earlier 16 August, 18 May, and 20 March notices from the exchange under Nasdaq Listing Rule 5250(c)(1) (Veradigm release), there still is no resolution about when their statements will be filed with the SEC. The company’s latest move was to force the resignations of CEO Richard J. Poulton and CFO Leah S. Jones, replacing them with two interims. From the board, Dr. Shih-Yin (“Yin”) Ho becomes CEO for six months and Lee Westerfield, CFO of Clearsense, becomes CFO. Mr. Poulton, a 10-year veteran, will receive a $1.6 million severance. Ms. Jones will receive a six-month continuation of salary plus additional payments to “provide business-development related services” which is corporate-speak for paying you to transition to her replacement. The board will search for permanent replacements for the CEO and CFO positions.

According to their announcement, the management changes resulted from “the Audit Committee’s previously disclosed, ongoing independent investigation, which is being conducted by legal counsel and relates to the Company’s financial reporting and internal controls over financial reporting and disclosure controls”. Reading it, Job #1 for the new team appears to be reviewing the fiscal 2023 guidance that was released on 18 September and regaining compliance with the Nasdaq Listing Rule. Veradigm also reiterated that they will have a 2020-22 revenue reduction “relating to certain revenue recognition practices.”  

Additional board changes include the chairman, Greg Garrison, as executive chairman and the appointment of Carol Zierhoffer (bio), retired CIO of Bechtel Corporation, as lead independent director. Perhaps Ms. Zierhoffer can help with the conundrum of a software company engaged in vital health and financial information transmitted via practice EHRs and practice management having its own massive accounting software problem derailing them for two years. CFO Dive has more details on the audit and a shareholder suit filed in November.

Update: A Nasdaq panel spared Veradigm’s exchange listing, for now. Mark 27 February 2024 as the date Veradigm is required to provide their 2022-2023 financial reporting to Nasdaq as required under Listing Rule 5250(c)(1). This was reported in Veradigm’s 8-K filing to the SEC on 13 December. Note that Nasdaq’s release states “The Company plans to file its Form 10-K and the Form 10-Qs as soon as possible; however, no assurance can be given as to the definitive date on which such periodic reports will be filed.” (Editor’s emphasis) Stay tuned. Healthcare Dive, 

No rescue for direct-to-consumer clear dental aligner provider SmileDirectClub. SmileDirect, which along with Byte (acquired 2021 by dental industry giant Dentsply Sirona), NewSmile, SnapCorrect, and several others market DTC aligners and teledentistry, failed to find a buyer or new financing after its Chapter 11 filing in September. The plan centered around the once-billionaire founders buying the company back, but they could not get their main lender HPS Investment Partners and other creditors owed $900 million, nor new investors, on board.

Heavily advertised SmileDirect IPO’d in 2019 with a valuation of $8.9 billion, but never turned a profit from its combination of DIY and teledentistry. Other drains were a patent fight with CandidCare and multiple patient complaints including jaw damage, migraines from misalignment, and tooth loss. Candid, like Invisalign, now works only through dentists who do the impressions, filings for tooth separation if needed, progressive aligner delivery, and tracking progress over what is typically one year for children, teens, and adults (over 60% of business). 

In the FAQs on the lone page on its website, SmileDirect no longer will honor customer contracts for aligners and dental checkups or lifetime guarantees, but continues to demand payment from patients on SmilePay contracts. (Good. Luck. With. That!) The Hill, Fortune, HIStalk 11 Dec. For the teledentistry service The TeleDentists, it is a marketing opportunity to join with Byte in prescribing and providing dentist services for their clear aligners (email promotion). The TeleDentists is also partnering with WebMD Care for consumers seeking care after researching a dental condition. (Release) 

(Editor’s note: Having gone through Invisalign as an adult to correct a growing problem with alignment, your Editor cannot conceive of a DIY approach to a complex process that also required a significant amount of daily self-discipline.)

Fruit Street Health sues former partner Sharecare for $25 million. The interestingly named Fruit Street provided its diabetes management program to digital health conglomerate Sharecare as part of Sharecare’s unified virtual health management platform for individuals and enterprises. Starting in 2018, Fruit Street had a business agreement with Sharecare to offer its CDC-recognized diabetes prevention program (DPP) on Sharecare’s platform. Sharecare now has its own diabetes prevention program, “Eat Right Now”, which Fruit Street claims violates the terms of its agreement. The lawsuit was filed in Fulton County, Georgia. Sharecare claims not only that the lawsuit is without merit, but also that Fruit Street owes them $3 million in payments.

Fruit Street was founded in 2014 as a public benefit corporation [explained here TTA 24 Feb] headquartered in NYC by Laurence Girard. It is modestly funded at $35 million. Atlanta-based Sharecare was founded 2018 by serial entrepreneur and WebMD founder/CEO Jeff Arnold with Mehmet Oz, MD, surgeon, TV celebrity, and former Senate candidate. Sharecare went public on Nasdaq in the palmy days of early 2021 via a SPAC with Falcon Capital Acquisition Corp. It broke out of the gate with a $3.9 billion valuation, but like most SPACs it cracked downward within months and shares now trade at an anemic $0.99. In January, current CEO Arnold will be transitioning to executive chairman. Long-time Centene exec and retired president Brent Layton will move from a board director position to the CEO chair (release). MedCityNews, Axios, 

Former Walgreens CEO Roz Brewer eyewatering compensation revealed. A final example of our third bullet above is the excellent financial arrangement Ms. Brewer had with Walgreens Boots Alliance. Her package of compensation and stock options awarded by the board was $71 million for about 30 months, which included a $4.5 million signing bonus to lure her from Starbucks, over half a million in moving expenses, and $60 million in three years of compensation. According to the information in The Messenger, a good portion was in stock which fell in value 57% during her time at Walgreens, continuing a trend before her arrival. It was also consistent with an executive termination without cause, which also tied her to non-disparagement and non-disclosure agreements. Was her departure by mutual agreement with the board? That is fairly typical language, but reports in the article attributed the real cause in this statement from a source indicating loss of confidence by the most important man at WBA, Stefano Pessina: “Stefano thought she was a lightweight and unable to do the hard, transformational things he needed her to do.” (Was buying the majority of VillageMD, starting the joint store/practice location plan, buying CareCentrix and specialty pharmacy Shields Health Solutions during her tenure, not quite enough? Perhaps too much spent in a hot market and not enough return, especially by VillageMD on Summit Health and CityMD?) 

Her departure and replacement by a healthcare veteran with directly related management and organizational expertise, Tim Wentworth, is yet another example of this particular cycle coming to completion. And now that we’re in the midst of clearing the field, what happens next?

The TeleDentists now in 14 states with Anthem

June 30, 2020 | by

Updating our May article about The TeleDentists expanding their coverage via Anthem Blue Cross and Blue Shield (BCBS), our initial information was that Anthem was offering teledentistry in only nine states. The current total since May is actually 14 states and covers by state and plan:

  • CA – Anthem Blue Cross
  • CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI – Anthem Blue Cross and Blue Shield
  • NY – Empire BlueCross BlueShield

Part of this Editor’s puzzlement is that each health plan issues releases for its plan by state, and when our original article was written, only nine states had issued releases. This is in addition to their agreement with Cigna in employer-sponsored plans announced in April [TTA 15 April]. Hat tip to FischTank PR’s Kate Caruso-Sharpe for the update on behalf of Anthem.

10 years in 2 months: prognosticating the longer-term effect of COVID-19 on telehealth, practices, and hospitals

May 2, 2020 | by

crystal-ballThis Editor recounted last night in the article below on The TeleDentists’ fresh agreements with Cigna and Anthem the observation of a former associate who has been in the thick of the remote patient monitoring wars for some years that telehealth/telemedicine has progressed 10 years in 2 months. Seema Verma, the head of the Centers for Medicare and Medicaid Services (CMS), stated to the Wall Street Journal (paywalled),  “I think the genie’s out of the bottle on this one. I think it’s fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.” Even in a short period of time, CMS-reported telehealth visits as of 28 March trebled from 100,000 to 300,000. When the April numbers are in, it would not be surprising to see it grow well into seven figures.

The genie may be out of the bottle, but what will the genie do? Genies are, after all, unpredictable, and fly around.  Out of the smoke, some educated guesses:

  • Insecure, non-HIPAA compliant audio/video platforms will be the first which should be struck from CMS approval. Zoom has become a hackfest, with all sorts of alerts from mobile providers like Verizon on how to secure your phone. (An organization of which this Editor is a member had a panel this week completely disrupted by a hacker in five minutes.) Skype’s problems are well known. The winners here will be telehealth platforms that integrate well with EHRs, population health platforms (or may be part of population health platforms), and have robust security.
  • Primary care practices and specialists, who’ve been surviving on non-F2F visits, will be adjusting their practices to patient demand, and integrating telehealth with physical visits in a way that their patients will prefer. This means a search for integration of EMRs/EHRs with secure platforms and reconfiguring areas such as care coordination. If planned correctly, this could create better management of patients with multiple chronic conditions.
  • Actual physical visits will rebound, creating financial pressure on Medicare, hospitals, and private payers. How many people’s health has declined in two-three months is key. Small practices, who may see this first, will see another level of pressure, because they will be held to their Medicare quality metrics in value-based models even if adjusted. Hospitals will also rebound–if they are able. The dark side: private payers may run the numbers and scale back on benefits for the 2021 year especially if COVID is projected to make a return.
  • Behavioral health may benefit, yet drive individual practices and a wave of retirements, or a consolidation into clinic or group settings. There’s a reason why Optum is buying out AbleTo; we may see a wave of competitor acquisitions in this area with the emphasis will be on cognitive health and short courses. Why retirements? Many psychiatric practices are still independent, concentrated geographically, and the average psychiatrist is over 50. Psychiatric EHRs are both costly and not particularly suited to practices. If faced with technological challenges, a lot of MDs and senior clinical psychologists may very well exit–threatening clinics which need MDs to legally operate.
  • Rural health’s failure accelerated. USA Today’s analysis pinpointed at least 100 rural hospitals to close within the year. They already operated on thin margins, but with COVID expenses for additional equipment, the closing down of more profitable elective procedures and dependence on Medicaid, the over 1,100 unprofitable hospitals, over half of which are the only hospital in their county, have received a body blow. HHS allocated $10 billion to rural hospitals and clinics of the $100 billion aid package, but it may be too little and too late. Becker’s Hospital Review continues to track the bankruptcies and closures. Here there are no easy solutions from the digital health area.
  • A culture of cleanliness should accelerate. If the genie pulls this out of the bottle, one major benefit will be that hospital-acquired infections will decline. Effective sanitization methods that reduce human application and scrubbing will be the ones to look at: disinfecting foggers and UV full room or area systems–or combinations of same. Cleanliness and lack of virii and bacteria may become a new metric. Look and bet on companies that can provide this, from rooms to computers/mobile tablets and phones.

Readers can help with these prognostications and especially how they will play out not only in the US, but also in the UK, Europe, and worldwide.

Anthem Blue Cross Blue Shield adds virtual dental care with The TeleDentists in 9 states

May 2, 2020 | by

Could it be that a certain sage from New Jersey is on the money in predicting to this Editor that telemedicine has advanced about 10 years in the past two months? Anthem Blue Cross and Blue Shield (BCBS) is adding the virtual dental care provided by The TeleDentists to its plans in nine states: Maine, New Hampshire, Connecticut, Ohio, Kentucky, Indiana, Wisconsin, Colorado, and California. Through 30 June, the plans will cover virtual exams at 100 percent with no deductibles, copays, paperwork or claims to file. The virtual visit dentistry service offered by The TeleDentists is designed for urgent situations and to avoid an initial visit to the ER which can be several hundred dollars.

A member will locate a remote dentist through Anthem’s provider finder, then link to The TeleDentists’ site where the member is screened for history. A connection to a dentist then takes place quickly, in as little as 10 minutes, 24/7/365. The format is a video consult plus chat (TeleDentists uses the HIPAA-compliant VSee platform) to evaluate the plan member, then to guide on next steps. If necessary, the dentist will prescribe medications, such as antibiotics and non-narcotic pain relievers.

In the US, Anthem is #3 after UnitedHealthCare and Kaiser. It is the largest for profit insurer in the Blue Cross Blue Shield Association. In California alone, it has 800,000 members.  This adds to The TeleDentists partnership with Cigna announced earlier this month [TTA 15 April]. Releases (9) on Business Wire. Hat tip to CEO Howard Reis.

Cigna launches dental telehealth with Dental Virtual Care–including The TeleDentists

April 15, 2020 | by | 2 Comments

In the US, most insurance payers have been responding to the COVID-19 pandemic by waiving cost-sharing, such as deductibles and co-pays, for coronavirus treatment–and also waiving co-pays for medical telemedicine/telehealth visits for any reason. A medical area that hasn’t been considered previously, but is becoming more important as restrictions continue, is dental treatment. Nearly all dental practices have been shut or open for emergency treatment only since mid-March.

Cigna is possibly the first payer to innovate a Dental Virtual Care program for emergency care using its own dental network and that of The TeleDentists [TTA 19 June 19]–and at no cost through 31 May. (For instance, The TeleDentists’ average consult cost is $69.) Cigna’s 16 million members of their employer-sponsored insurance plans are eligible for the program. 

Teledentristry is designed for urgent situations, such as pain, infection, and swelling, and to avoid an initial visit to the ER. The visit is done through a video consult plus chat (TeleDentists uses the VSee platform) to evaluate the plan member, then to guide on next steps. If necessary, the dentist will prescribe medications, such as antibiotics and non-narcotic pain relievers.

The program will continue later than 31 May subject to state regulations and benefit plans as part of Cigna Dental Health Connect. Cigna release. Hat tip to CEO Howard Reis.

Virus-(almost) free news: Cera’s $70m raise, Rx.Health’s RxStitch, remote teledentistry to rescue, Alcuris responds, Caravan buys Wellpepper, and Teladoc’s heavy reading

March 21, 2020 | by

Keeping calm and carrying on (but taking precautions, staying inside, and keyboarding with hands that resemble gator hide), yes, there IS some news that isn’t entirely about COVID-19:

This Editor had put aside the $70 million funding by the UK’s Cera at end of February. What is interesting is that Cera Care is a hybrid–specializing in both supplying home-based care, including dementia care, and providing tech-enabled services for older adults. The funding announcement was timed with the intro of SmartCare, a sensor-based analytics platform that uses machine learning and data analytics on recorded behaviors to personalize care and detect health risks with a reported 93 percent accuracy. It then can advise carers and family members about a plan of action. This sounds all so familiar as Living Independently’s QuietCare also did much the same–in 2006, but without the smartphone app and in the Ur-era of machine learning (what we called algorithms back then).

The major raise supports a few major opportunities: 50 public sector contracts with local authorities and NHS, the rollout of SmartCare, its operations in England and Wales, and some home healthcare acquisitions. Leading the round was KairosHQ, a US-based startup builder, along with investors Yabeo, Guinness Asset Management, and a New York family office. Could a US acquisition be up next?  Mobihealthnews, TechEU

Located on NYC’s Great Blank Way (a/k/a Broadway), Rx.Health has developed what they call digital navigation programs in a SaaS platform that connect various programs and feed information into EHRs. The interestingly named RxStitch engine uses text messages (Next Gen Reminder and Activation Program) or patient portals to support episodes of care (EOC), surgeries, transitions of care (TOC), increasing access to care, telehealth, and closure of care gaps. Their most recent partnership is with Valley Health in northern NJ. Of course they’ve pitched this for COVID-19 as the COVereD initiative that supports education, triage, telehealth, and home-based surveillance as part of the workflow. Rx.Health’s execs include quite a few active for years in the NY digital health scene, including Ashish Atreja, MD.

Teledentistry to the rescue! Last summer, we focused on what this Editor thought was the first real effort to use telemedicine in dentistry, The TeleDentists can support dentists who are largely closing shop for health reasons to communicate with their own patients for follow up visits, screen new patients, e-prescribe, and refer those who are feeling sick to other telehealth providers. For the next six weeks, patients pay only $49 a visit. More information in their release. Hat tip to Howard Reis.

What actions are smaller telehealth companies taking now? Reader and commenter Adrian Scaife writes from Alcuris about how their assistive technology responds to the need to keep in touch with older people living alone at home. Last week their preparations started with giving their customers the option to switch to audio/video conferencing with their market teams. This week, they reviewed how their assistive technology and ADL monitoring can keep older people safe in their homes where they may have to be alone, especially after discharge, yet families and caregivers can keep tabs on them based on activity data. A smart way for a small company to respond to the biggest healthcare challenge of the last 30 years. Release. 

Even Caravan Health, a management services company for groups of physicians or health systems organizing as accountable care organizations (ACOs) in value-based care programs, is getting into digital health with their purchase of Wellpepper. The eight-year-old company based in Seattle works with health plans to provide members with outpatient digital treatment plans, messaging services, and an alert system to boost communication between care teams and patients. Purchase price was not disclosed, but Wellpepper had raised only $1.2 million in debt financing back in 2016 so one assumes they largely bootstrapped. Mobihealthnews

And if you’re stuck at home and are trying to avoid chores, you can read all 140 pages of Teladoc’s Investor Day presentation, courtesy of Seeking Alpha. 

Oral health: more than a public health challenge, an opportunity for telehealth?

July 31, 2019 | by

Untreated caries in permanent teeth was the most prevalent health condition in 2010, affecting 35% of the global population, or 2·4 billion people worldwide. In 2010, severe periodontitis was the sixth-most prevalent health condition, affecting 10·8% of people, or 743 million, worldwide.

Worldwide in 2015, dental diseases accounted for US$356·80 billion in direct costs and US$187·61 billion in indirect costs.

Is oral health the next big SDH (Social Determinant of Health)? A focus in this month’s Lancet is the neglect of global oral health. Most of our Readers know that oral self-care can be a challenge with older adults due to physical limitations, finances, and access, but oral  and periodontal disease affects nutrition, is a source of pain, tooth loss, consequent low self-regard, low quality of life, and can lead to other diseases such as sepsis and undiagnosed cancers.

The Lancet’s two articles, Oral diseases: a global public health challenge and Ending the neglect of global oral health: time for radical action (open access, registration required on these links) point out the current allopathic model does not fit the wider societal need,  and come down hard on the social and economic origins (very hard on Western dental practice, the sugar industry, and food providers). However, the articles are light on solutions other than universal health care and community based dental practice. Even in less-developed countries like India and Brazil, practitioners don’t migrate to poor, rural areas. It is true, however, that much of dentistry, at least in the US, has an increasing focus on cosmetic restoration.

Here is a wide-open area for telehealth development. Some areas to explore:

  • Creating wider access to dentistry that treats immediate problems
  • Greater access to proactive dental care, whether dental checkups and to encourage better self-care
  • Connecting rural fixed or mobile clinics staffed by technicians or locally trained staff with dentists for remote screening and scheduling care. 

Hat tip to Leah at The TeleDentists for these articles. The articles are also attached as PDFs here and here.

Comings & goings: The TeleDentists go DTC, gains Reis as CEO; University of Warwick spinoff Augmented Insights debuts (UK); a new CEO leads GrandCare Systems

June 19, 2019 | by

The TeleDentists leap in with a new CEO. A year-old startup, The TeleDentists, has announced it will be going direct-to-consumer with teledentistry consults. This will permit anyone with a dental problem or emergency to consult with a dentist 24/7, schedule a local appointment in 24-48 hours. and even, if required, prescribe a non-narcotic prescription to a local pharmacy. Cost for the DTC service is not yet disclosed. Currently, the Kansas City-based company has provided their dental network services through several telehealth and telemedicine service providers such as Call A Doctor Plus as well as several brick-and-mortar clinic locations.

If dentistry sounds logical for telemedicine, consider that about 2 million people annually in the US use ERs for dental emergencies; 39 percent didn’t visit a dentist last year. Yet teledentistry is just getting started and is unusually underdeveloped, if you except the retail tooth aligners. Several US groups are piloting it to community health and underserved groups, with Philips reportedly considering a trial in Europe (mHealth Intelligence). This Editor notes that on their advisory board is a co-founder of Teladoc.  Release

The TeleDentists’ co-founder, Maria Kunstadter, DDS, last week announced the arrival of a new company CEO, Howard Reis. Mr. Reis started with health tech back in the 1990s with Nynex Science and Technology piloting telemedicine clinical trials at four Boston hospitals, which qualifies him among the most Grizzled Pioneers. He also was business development VP for Teleradiology Specialists and founding partner of The Castleton Group, a LTC telehealth company, and has worked in professional services for Accenture, Telmarc and SAIC/Bellcore. Most recently, he started teleradiology/telehealth firm HealthePractices. Over the past few years, Mr. Reis has also been prominent in the NY metro digital health scene. Congratulations and much success!  

In the UK, the University of Warwick has unveiled a spinoff, Augmented Insights Ltd. AI will be concentrating on machine learning and AI services that analyze long term health and care data, automating the extraction in real time of personalized, predictive and preventative insights from ongoing patient data. It will be headed by Dr. James Amor, whom this Editor met last summer in NYC. Long term plans center on marketing their analytics services to tech providers. Interested parties or potential users may contact Dr. Amor in Leamington Spa at James@augmentedinsights.co.uk |Congratulations to Dr. Amor and his team! 

And in more Grizzled Pioneer news, there’s a new CEO at GrandCare Systems who’s been engaged with the company since nearly their start in 1993 and in its present form in 2005. Laura Mitchell takes the helm as CEO after various positions there including Chief Marketing Officer and several years leading her own healthcare and marketing consulting firm. Nick Mitchell rejoins as chief technology officer and lead software developer. Founders Charlie Hillman remain as an advisor and Gaytha Traynor as COO. Their offices have also moved to the Kreilkamp Building, 215 N Main Street, Suite 130, in downtown West Bend Wisconsin. GrandCare remains a ‘family affair’ as this profile notes. Congratulations–again!