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“I wouldn’t be in business without the advice and generosity of MSBDC Metro Boston Regional Office counselor Joe Andrews. For six years--from my start-up days to the present--Joe has gone above and beyond the call. He’s been my business alter ego,” observes Middleton, Massachusetts-based small business owner, Cynthia Navarro. A veteran nurse with 23 years of experience in long-term, sub-acute, and acute care, Navarro runs Care for Them, Inc., a fast-growing provider of temporary staffing to the health care industry. Navarro’s health care staff has mushroomed to 300 employees—all of them nurses. This year, Care for Them has shown $5.3 million in revenues. “To get us to this point, Joe has showed me the ropes of small business from soup to nuts,” notes Navarro. “He guided me through my business and marketing plans. He helped me organize my spreadsheets to track and project payables, receivables, cash flow, and investments. He helped me research my customers and the demographics of my target markets.” Those customers include long-term care facilities (nursing homes and assisted living), subacute and rehab facilities, acute care, and physician offices. Navarro confesses to a love-hate relationship with the chronic details of spreadsheets and health insurance paperwork. And there are other necessary evils like background checks on employees and liability issues. “In retrospect, many of Joe’s business exercises and persistent questions were emotional tests,” the MSBDC client remarks. “They had the effect of getting me to ask myself: Am I really ready to be an entrepreneur?” To date, the answer has been a resounding “yes”. With help from two SBA secured loans (a start-up loan in 1995 and a more recent loan that allowed her to refinance), Navarro has continued to grow her business. In October she opened a second site in Danvers to expand into the southeastern New Hampshire market. She has invested in a skilled office staff and first-rate IT system to handle her business’ daunting scheduling challenges and financial and medical paperwork. “We have also invested in an intense quality assurance program, where customers actively rate our services,” continues Navarro,” who in 1999 became a member of the MSBDC’s statewide advisory board. “Our quality program includes painstaking hiring of personnel; prompt, adaptable scheduling; and employment of a staff development coordinator, who orients our nurses to client facilities and procedures.” If one challenge rises above the others for Navarro and Care for Them, it is the constant struggle to secure adequate cash flow. “Early on, Joe pointed out a basic fact of life about this business,” notes Navarro. “Because of health care reimbursement/payment practices, my receivables would consistently be 60-90 days behind. That becomes even more pressing if you’re expanding as rapidly as we are.” Navarro and Andrews discussed and then vetoed the prospect of her taking on a deep-pocketed partner. Instead, Andrews introduced Navarro to non-bank weekly financing—the interest rates are higher but not high enough to offset profitability. “Of course, as Joe pointed out, you can’t grow a business on accounts receivable,” notes the MSBDC client. “That’s where his help and advice on revising my business plan and securing my second SBA guaranteed bank loan has made a huge difference. Thanks to Joe and the MSBDC, Care for Them has both a strategy and the resources to continue its rapid growth.”
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