$18 million tech startup eyes create efficiencies specifically for assisted living

Community Insights data from August Health. (Image courtesy of August Health)

A chance encounter on a playground led to the launch of a startup focused on streamlining the work of assisted living employees and operators through technology. August Health’s case study provides a look at how technology is transforming the senior housing industry.

Justin Schram, MD, and Erez Cohen come from very different backgrounds. But in between casual conversations about their young sons on the playground, they discovered a shared desire to build a modern control and data platform specifically for assisted living.

“Operators struggle with managing a deluge of paperwork, heightened compliance requirements and collecting paper checks,” Cohen said. “Meanwhile, related industry players – pharmacy, referral, payers/healthcare providers – have no interfaces to exchange information. Faxing is still the state of the art.”

The two founded August Health in 2020 to try to bridge this gap by building a platform to “unblock essential workers”, guide them to best practices and build an underlying platform to “connect the industry”.

The startup, which began using its platform to manage care in more than 60 residential buildings for seniors within six months of its initial launch, recently raised a $15 million Series A led by venture capital firms Matrix Partners and General Catalyst, as well as industry veterans Columbia Pacific founder Dan Baty and Formation Capital founder Arnie Whitman. The company has raised $17.6 million to date — including $2.6 million in seed funding — and has assembled a team of ex-operators from Apple, Google, Adobe and digital health companies.

Broken system

Schram, the former medical director of California-based home health care provider Landmark Health, said that with each home care visit to his patients — many living in senior living communities — his frustration grew at his inability to provide quality care because most records were on paper or “held hostage.” within inaccessible, outdated systems.

“It’s been hard to get medication lists, code status, what’s going on with a resident,” Schram said, adding that paperwork consumed the time and energy of frontline workers trying to prevent residents from going to the emergency department.

“I saw the burning, the churning,” said Schram. “So much of what frustrated them could be addressed through automation, technology – a modern, elegant platform. Seniors’ old systems worked just like 1950, or used older server-based software built for skilled nursing and turned into an afterthought. focused on assisted living.

Today, a new generation of operators who are digital natives are entering the field, along with families demanding technology they already use in all other aspects of their lives. Seeing an opportunity with the demographic change led by the baby boomers on the horizon, Schram left his clinical job to research his idea.

“The old system cracked and the fault lines became apparent, and people realized that the old systems weren’t working,” he said.

Birth of a Partnership

While pushing his son on a swing, Schram met Cohen, founder and CEO of Mapsense, a data mapping company acquired by Apple. Cohen, an IT expert in Silicon Valley, had recently left his position as Apple’s technical director and was considering his next project.

The two started talking and Schram shared his idea, which he couldn’t quite carry out.

“Justin opened my eyes,” said Cohen.

Cohen looked at the long-term care industry and found that 74% of senior communities did everything on paper: medications, allergies, diagnoses, care plans, schedules. Of the 26% of communities using technology, he said, it was legacy technology typically designed for an adjacent industry.

“There wasn’t really a tool out there,” Cohen said.

Together, the two seniors began visiting communities in the Bay Area where Schram had patients, and spoke to staff, administrators and families. Senior residential communities, Cohen said, face issues related to resident care, staffing, transportation and habitation, and families have no understanding of what goes on in a community.

“We learned a lot,” Cohen said. “It kept coming back to everything — every problem — there was no system to do that.”

For example, in one community, Cohen said, residents and employees spent hours signing papers. After a resident moved in, that information stayed on paper forever and didn’t translate into concern.

“Municipalities are doing a good job of capturing data about a resident,” but they’re not doing anything with it, Cohen said. “Coming from a data science and analytics background, that was shocking. Alarm bells went off in my head.”

Cohen said that was his “aha moment” and when he knew there was a business opportunity.

Business launch

August Health Home Screen
August Health move screen. (Image courtesy of August Health)

August Health signed its first client, San Francisco-based CiminoCare, a family-run owner and operator of senior housing in California that focuses on mid-market assisted living and memory care communities. The company worked closely with the organization and its employees to design a platform while simultaneously raising funds, hiring a designer, and building a business.

“We built something around their day-to-day workflows to meet their needs,” said Cohen.

Mark Cimino, CEO of CiminoCare, called August Health “grassrootsy,” and said Cohen and Schram showed him that CiminoCare could achieve a “very good” return on investment by changing its software platform.

“We were immediately impressed even before they started working on the product,” said Cimino McKnight’s Senior Living† “They immersed themselves and understood the industry. They can talk to almost anyone.”

He mentioned “the spirit of where they come from, and the basic attitude they have to make even the one-time or medium-sized operator feel that they are special and that the software is going to help them individually.”

Looking to the future

Schram says he is looking at what the residential care community of 2040 will look like and what technologies are coming. Some of that technology is available today with virtual reality headsets to deal with loneliness, sensors to detect falls and toilet seats to detect infections. But if each emerging technology needs its own login and portal, it makes it more difficult to use.

“You need one central platform to know who’s in which room, what medications they’re taking, and who their emergency contact is,” Schram said. “In essence, we are the system of registration. We are the platform to integrate these and be the interface the community uses to enable technologies for senior care.”

Cohen said the discontent in the wider technology market sparked the interest of engineers and designers to join their company.

“We are building a company that will make a demonstrable change in people’s lives,” said Cohen. “People are starting to see their parents reach an age where they need this support.”

Schram said that when working with staff on customer premises, they take success measures that demonstrate that their platform is doing its intended job: making older workers’ jobs easier.

Legal, clinical care, billing, compliance and regulatory expertise, a family portal, and best practices are all built into the tool. “We’re not just trying to build some new assisted living software,” Cohen said. “We’re building something that’s a different, bigger vision. It’s service embedded.”

Josh Allen, RN, director of Allen Flores Consulting Group, a consulting firm for senior nurse nurse specialists, has become a cheerleader for August Health. McKnight’s Senior Living that he was impressed by the simplicity of the platform.

“It’s very intuitive, easy to use and has a short learning curve for a new nurse — one of the industry’s biggest problems,” he said. “It sounds like a simple matter, but having an EHR platform that a nurse can learn and get used to in a few hours can have a major impact on retention, turnover and job satisfaction.”

Allen acts as a sounding board for Schram and Cohen, providing weekly feedback on how the product can be improved every step of the way.

The name Augustus

While they have many stories in retrospect about how they got to the name August Health, including that the domain name was available, Schram said he sees August as the season in a person’s life when the person begins to think about later life.

“The word August means venerable, respected,” Schram said. “That word resonates to me about how we feel about community residents and what the elderly are.”

The partners said they are working to build a national brand and business to make an impact on the lives of seniors.

“We still have a long way to go,” says Cohen. “We are still very focused on solving the problem for the senior residential operator who runs a building and the staff in that community.

“There is a one-mile road map to build a business. There is chance after chance after chance.”

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