Fulcrum Equity Partners Invests $11M in HomeFirst Home Healthcare

A young but rapidly growing in-home care business headquartered in Nashville, Tennessee, has secured millions of dollars to further fuel its expansion.

The Atlanta-based Fulcrum Equity Partners announced Thursday the investment of $11 million into HomeFirst Home Healthcare, a home-based care platform company formed in September 2020 by a team of home health veterans.

The investment included support from existing investors, including Harpeth Ventures.

“Given our vast experience with larger-type organizations, the plan always was to expand the business by using our first acquisition as a platform,” HomeFirst CEO Jim Happ told Home Health Care News. “And to expand the business through not only growing in the markets that we’re in, but through strategic acquisition.”

HomeFirst Home Healthcare teamed up with Harpeth to launch its business a little over a year ago, with a concentration in Middle Tennessee. Specifically, the pair had purchased two home health operating licenses to serve a total of 24 counties.

Happ has held various home health leadership roles throughout the years, including serving as COO at SunCrest Home Health.

“I have over 30 years in the home health industry, working in different executive roles,” he said. “I’ve served as a chief financial officer, being a CPA. I’ve served as the chief executive officer for a large national company as well.”

With roughly three decades of experience, Happ’s thesis for HomeFirst was to establish an immediate presence in a Certificate of Need (CON) state and expand in that home market, then move into neighboring CON states.

The $11 million investment from Fulcrum – a growth equity firm that manages over $600 million in assets with a focus on health care services and IT companies, among others – allows HomeFirst to do just that.

The infusion of capital enabled the home health provider to acquire Mountain Home Health, which has multiple locations in North Carolina and Georgia, and BridgeWay Home Health, which has two locations in the Atlanta area. The financial terms of those transactions were not disclosed.

Overall, Happ and his team acquired five provider numbers through the moves.

Mountain Home Health and BridgeWay Home Health shared the same owner.

“For probably eight months, we had been looking at ways to get Fulcrum involved in investing in our business,” the CEO told HHCN. “When the opportunity came along for us to acquire these [assets], it was the perfect time.”

In addition to the investment news, HomeFirst has added two new members to its board: Wally Dant, who was CEO of SunCrest, along with Tom Greer, a partner at Fulcrum.

“I have worked together with Wally for many years, and he’s been extremely successful in the home health and health care industry, in general,” Happ said. “He adds tremendous value in many ways. And I’m really excited about having Tom Greer join our board.”

Moving forward, HomeFirst plans to continue exploring M&A opportunities in its current CON states, along with neighboring ones. It’s also looking at ways to add to its portfolio of services by potentially adding hospice in the near future.

The provider has already added private-duty services to complement its core home health offerings.

“We started out by essentially buying a very small revenue base, and we’ve basically rebuilt the platform,” Happ said. “We feel very, very good about what we’ve accomplished in the last 12 months, to really put together a very strong foundation, with a strong leadership team and an excellent employee base.”

While HomeFirst isn’t the largest home health player around, it’s bullish on its ability to gain market share and add scale in a highly competitive landscape.

It sees its concentrated focus and local presence as a strategic advantage, Happ explained.

“I think what’s really unique about us today is we’re not part of a large corporate chain,” he said. “I think that gives us a lot of local flexibility in many ways – in working with our referral sources, working with our employees and working with our patients.”

“Corporations do tend to have decisions made at a central place, someplace far away from where the business is taking place,” he added.

Additional reporting by Joyce Famakinwa.

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