The Business of Pharmacy Podcast™
Oct. 3, 2022

Owning a Home Care Franchise | Debbie Marcello, RN, Happier at Home

Owning a Home Care Franchise | Debbie Marcello, RN, Happier at Home

Debbie Marcello, RN, CEO of Happier at Home discusses pharmacists owning a home care franchise.

Please support The Business of Pharmacy Podcast™ by checking out our sponsors at


(Speech to Text)

Mike Koelzer, Host: [00:00:00] Debbie, for those who haven't come across you online, introduce yourself and tell our listeners what we're talking about today.

Debbie Marcello, RN: My name is Debbie Marcello. I am the founder and CEO of Happier at home. And today we're talking about how community pharmacies can benefit from expanding into home and community based services.

Mike Koelzer, Host: I spend. Probably a rather significant time on LinkedIn, above the other social media ones. And you seem to be the face of pharmacy slash nursing slash home care. And I know that's not by accident. 

Let's say that pharmacies don't exist and you still wanted to kind of bond with somebody. What group could that have been? I'm imagining it probably wouldn't have been a dentist, you know, but it could have been a physical therapist. What other group would you have bonded with?

If it wasn't pharmacists?

Debbie Marcello, RN: Initially I was looking for individuals who had experience in businesses. Growth and business development, people who have leadership capabilities, who aren't afraid to get out and talk about their business, they are happier at home. but it happened to be that one of my current franchisees, is a pharmacy owner

He's in Buffalo. And, at that time I saw a difference between how quickly his company was able to start happier at home and grow it. so if it weren't for pharmacies, the other, the other group that I had been working with. Kind of expanded on from some experience.

I was a vice president of our continuum of care, retirement community in New York. There's 11 of them. And, I was in charge of all of the home based services, outpatient, physical therapy, occupational therapy, physicians, house calls. There were many programs that I was in charge of. So one of the things I did for them was to start a happier home business within that organization and it worked great.

Mike Koelzer, Host: When you say you started it, the idea was kind of there and then you came into it and then called it happier at home.

That's when your business started.

Debbie Marcello, RN: Correct. But I did start my business, my corporate location, about 16 years ago, after realizing that there's a real need for home care and to change how home care was being delivered. From my perspective, from the consumer's perspective, when I, when I was actually needing to use the services for my mother, when she was diagnosed with brain cancer with glioblastoma.

So I established the corporate location and being so passionate about business development, I really wanted to continue with, okay, what's the next step for me? And the next step was sharing that business model with companies to be able to expand.

Mike Koelzer, Host: It wasn't like you had this business happier at home and then decided to use that name to expand, that name is synonymous already with the expansion, that name came because you wanted to expand it right away.

Debbie Marcello, RN: Correct. So I, I, and my strategy for expansion was franchising. So being able to share that business model, all of our branding and the name of happier at home with others, individuals or companies that are similar to community pharmacy owners, and allowing them to use all of the operating procedures and processes that I developed.

So yes, happier at home is trademarked and design marked across the country. and I own that. And that's what, as a franchisee. They're able to use that name and branding and everything that goes along with our franchise model.

Mike Koelzer, Host: I'm picturing the sale of going into, because I think franchising is great. I think people have done very well with franchising, both the franchise Z and the franchisee. It's an interesting sell to me. You are going into an independent place, a place that on purpose, nobody there wants to work for a franchise. And I know that the big box stores are not franchises, but they're more franchise than independent, but going in there and selling the franchise idea to someone who's independent, it would be like a vegan going into a meat market and saying they wanted to, use half the shop or something like that.

Again, I think it's great, but is it a weird thing going into someone who is thinking independently and then you bring in [00:05:00] the franchise idea?

Debbie Marcello, RN: Actually, it's not at all because I look for those that are entrepreneurial. These are people who see the value of. The strategy for expansion with home based services and they want to do it. And I'm telling ya, every one of the community pharmacy owners that I speak with are busy people. And so coming from someone, myself, that started the business from ground up, I know that it takes quite a while to ramp up when you don't have the systems in place.

 I made the mistakes in the beginning. I learned from them, I learned what works, what doesn't work, how to market, who to market, to, how to hire caregivers. All of these things are enabling entrepreneurs, these independent pharmacies, to be able to use that model, to hit the ground running. 

Happier at home would be a program of your pharmacy. It is not dictating what you do in any way in your pharmacy. Community pharmacy owners have established connections with case managers, discharge planners, physicians' offices, you know, they have all these great connections, especially in their community, they're trusted in their community.

So this just gives them a way to plug in home based services. So you could get going right off the bat.

Mike Koelzer, Host: If you come into a store and you can tell the age of the owner is X. When do you just turn around and walk out? And you say that guy, or gal's not gonna do this. Is it an old guy like me who is 55? Is it someone over 45? 

Debbie Marcello, RN: Hey, I'm 54. Let's be careful there.

Mike Koelzer, Host: girl. You're not 55 yet.

You're just a youngster. I was on the internet last week and for some reason I was on this site and it came up and it said 55 years old is now. What the internet, and that's a conglomeration of everybody on there. They consider 55 years as being an old person. So I'm old and you're young.

All right. When you go into the pharmacy and I know you're gonna say Mike, it has nothing to do with age. It has to do with the fight in them and all that kind of stuff. But come on, when do you turn around, when do you walk in and turn around

Debbie Marcello, RN: I never walk in and turn around number one, but I will say as far as the age, there is, the chronological age and then there's maturity and business knowhow

Mike Koelzer, Host: And probably business age, you know, how long they've been in it and so on.

Debbie Marcello, RN: Right. We have the gamut of franchise owners from 26 to 82. So it really, as long as their focus is staying open to new ideas and, Looking at the landscape of what's happening. you have to do that. You, if you're standing still, then you are failing. You need to continue growing.

Mike Koelzer, Host: It's probably looking at, are they willing to stay open and that's both an emotional, psychological thing, but probably also how much time do they think they have left in the industry? There are 70 plus year olds who are running for president of the United States, which we just saw, or there's, you know, 50 year olds who are trying to cash in.

So I imagine a lot of it has to do with how far out they're looking and so on too.

Debbie Marcello, RN: How far out there looking if they have a succession plan, you know, if, if, if it's a larger chain of pharmacy, pharmacists, or pharmacy Locations, I should say, then there may be more individuals involved. So they may have a board where they actively are looking for new business ideas and opportunities.

So it really depends on how aggressive they are as well. I'd say. 

Mike Koelzer, Host: I imagine there's not any legal problem with that. You know, you'll see it where, uh, a doctor can't, I can't even think of an example, but you've seen some things like that. Is there anything there that prevents that?

Debbie Marcello, RN: No, there aren't any legal implications in that way. As a matter of fact, if you've been paying attention to what's happening in the news in the landscape, you'll see that there are, large, very large box chains that are, and I won't even mention the name, but have purchased, home care. so they know that this is quite an anchor asset to them.

Mike Koelzer, Host: What do you think is the prime marketing for a pharmacy that is happier at home? In other words, is it,[00:10:00] I imagine you don't want to be like, oh, you know, who's got the worst logo is CVS. They've got that CVS, and then they have that forward slash and I never understood the damn thing.

It always looked like it was just kind of hashed together. Let me see if I can find it here. CVS pharmacy image. Yeah, they still have it. I see some do it now with kind of a heart on the left side, but some other ones, they just have CVS.

And like this forward slash pharmacy, it just looks hacked together. And maybe it was because some CVSs, I don't know, maybe they didn't have pharmacies, they just had the front goods or something, but it looks terrible in my opinion. Anyway, 

How close would you advise somebody to have this? In other words, maybe overkill would be to have like our friends at CVS. Did you know Joe's pharmacy is happier at home?

Like in the same logo? I'm guessing maybe that's not recommended, but is there any reason why you're trying to hide that these two are together? Is there any reason that these would not be in the same sentence. Where do you feel the best mix is between the connection of happiness at home to that pharmacy?

Debbie Marcello, RN: So we do not try to, make them seem as though, they're not related in any way, 

but you know, as far as the marketing, it is a separate entity. Happier at home would be a separate entity from your pharmacy and, and that's. A purposeful thing. you know, there's a lot of regulations on pharmacies on pharmacies themselves, and we don't want, our, our. Requirements to become blurred with what needs to happen with the pharmacy owners.

So that it's a, it just is the wise way to do it. but we do have marketing materials and we're able to incorporate, let's say, the happier home logo, in connection with the pharmacy marketing materials as well.

one of the other things I offer for our pharmacy owners, I know you mentioned that I am on LinkedIn.

Oftentimes. I go, I make appearances on our local Fox news channel every Monday and. Turn those appearances into videos. and that's all based on just educating the community. So with our happier at home franchisees that are pharmacy owners, we offer to have them use those videos.

If they have a page on their pharmacy website that lets say, for example, it's entitled community resources. 


So you're able to really leverage your position as a community pharmacist to help your business grow.

Mike Koelzer, Host: If one of your franchisees.

 Breaking the rules for some reason, I can't think of a reason. Let's say they're just a, they're just, it wasn't a good connection. If any of them are gonna break a marketing, let's call it a guideline. If any of them are gonna break a marketing guideline, what might that be?

Debbie Marcello, RN: So our guidelines, as the franchisor are put in place to protect the brand name of happier at home. So in doing that, we're protecting all of our franchisees

brand name and reputation. I'll give you a real life example. We want to make sure that our franchisees are looking at their decisions from a very broad scope.


 Let's say you wanna make connections to an independent living community in your area. And all you're doing is getting onto social media on your happier at home social media and. Continually saying how great this one facility is. Well, you're alienating the other 12 that are in your

territory. So we want you to be able to form great relationships with all of the independent living communities, not just one. And, in particular, when you're using the happier at home name and you're saying, well, this place is better than the second place, because the second place doesn't do this. Well, you're kind of creating an enemy right there.

We don't want you to do that. We actually take care of all the social media marketing for 



 I think it is really unique to our company because, when I first started being happier at home, you know, 16 years ago, I knew the importance of content development, but I didn't have enough time.

And I know our pharmacy owners really don't have enough time. so we have a unique program where again, we use those videos from my appearances on TV. [00:15:00] I'm always creating new written content. So our social media marketing manager, she's a new media marketing manager because she keeps up on all of the new trends.

She posts at least twice a week to Facebook, LinkedIn, Twitter, and Instagram. On behalf of all of our franchisees, she will post videos and that content on their websites and then drive those posts. So they are connecting to the website. So they're driving their search engine optimization. and so she'll do all the content development, but in addition, we are always looking for. Things that are unique that are happening in your community. So if one of our pharmacy owners is running a fundraiser or they're going to be at the Alzheimer's association event, we want them to take pictures or even go live on Facebook, on their happier at home account. If they take pictures, they could send them over to us and then we'll post them for them.


Mike Koelzer, Host: Do all of the franchisees have their own happier at home Facebook page. Is it the happier home page for Smiths pharmacy? Well, not Smith pharmacy, but for the happier at home owned by Smith pharmacy.

Debbie Marcello, RN: yes, they each have their own webpage website that's developed by us. And also all of those social media outlets that I told you about. We develop those in happier homes, name for you. 

Mike Koelzer, Host: When you're social media person posts something are they posting to all the individual stores accounts also?

Debbie Marcello, RN: To the individual stores account happier at home accounts? Yes.

Mike Koelzer, Host: You didn't mention TikTok. That's probably around the corner.

Debbie Marcello, RN: We are talking about it. We're we're talking about it, but we're looking also at what's the, what are, what's the demographic that


reaches? So at this point, I think it would be extra, extra work that may not be fruitful.

But if we find ways to use it, then, then, I mean, we're always keeping things on the table and always talking about things, talking about Pinterest, email campaigns is another thing that we do.

I mean, probably most of the pharmacists, pharmacy owners or pharmacists that are listening today have gotten my email campaigns. And, I love those videos that we do. they're quick, little 32nd videos just informing you of just little pieces of information, about becoming a franchisee or the benefits of becoming a franchisee.


Mike Koelzer, Host: Isn't it interesting though, how fast social goes? The average age of someone making a decision to get, let's say their parents into this are gonna be what, 40, 45 years old, something like that

Debbie Marcello, RN: Well, it can range from about that age up to 70, 

Mike Koelzer, Host: up to 70, 

you mean for their parents 

Debbie Marcello, RN: For their parents. Yes. Yeah. But I, I think a little bit older than that is the average, maybe about 50, 55,

something like that. Yep. The adult children. So you don't see a 

lot of them on TikTok, 

Mike Koelzer, Host: And Right now that's the Facebook crowd. But isn't it amazing how fast that changes, Facebook users are gonna start liking TikTok and then all the TikTok users are gonna say, you know, my mom's on it and stuff, and then they're gonna be, they're gonna go off it. 

I can't figure it out, but the tough one is Pinterest.

I think Pinterest. Is built for moms who are not tech crazy, but then all the tech crazy people don't know how to use it. I can't figure out Pinterest for the life of me.

Debbie Marcello, RN: I love Pinterest. I 

really do. 

Mike Koelzer, Host: My wife loves it. And she's the first one to say she

gets upset with me whenever she has to ask me to help her with the computer stuff, because she always says that I make her look stupid. Like she feels stupid because she has to ask me a question and I think it's gotta be her. I've searched inside of my soul and I don't know how I try to make her look stupid when I. Help her, but the only one that she never asks about is Pinterest. And I can't figure the damn thing out

Debbie Marcello, RN: Yeah, I, I think it would be a good source, for the business development for, but I, I agree it's, it seems to be more of a female based, form of social. and I love it [00:20:00] for decorating and hairstyles and things like that, color schemes. but You're right. Looking at the progression of how things change.

I mean, I used the yellow pages when I started 16 years ago. I, I mean, does anyone know what that is? so, but it, everything needs to stay on the table because it all evolves very quickly. and I do, I think that a, a focused way to use Pinterest, I would look at that as more of a possibility right now than TikTok for our business.

Mike Koelzer, Host: It's got me thinking, because now that you mention it, my wife she'll never show me her Pinterest board and say like, look at the Snickers that I found and I pinned. You know, like dollar 50 stuff, it's always like a new kitchen or a new couch. Like you mentioned, it's always the expensive stuff.

And I'm starting to think here now that, you know, they used to have those websites, like private eyes, or I forget what they were called, where you don't let your kids go on certain sites, you know what I mean? And they, and then they notify you and stuff like that. Kids are too smart. I've never found a good way to do that, but I'm thinking if I could get that for Pinterest, I don't think my wife would figure it out.

I She would just say I can't get on Pinterest anymore. And I would just kind of shrug my shoulders.

Debbie Marcello, RN: Yeah, but that would be a mean thing to do. Mike. I don't know why you would do that. 

Mike Koelzer, Host: mentioned couches. You said it. If it was talking about snicker bars or, you know, maybe a favorite coffee or something like that, but it's like the couches in the kitchens and the screen porch ideas.

It's that kind of stuff. It's all expensive.

Debbie Marcello, RN: it is it's, you know, if you think about it, it's like keeping a file of all the ideas electronically 


your office redo, you know, 


Mike Koelzer, Host: Now you're talking now you're talking, Debbie. I think I know the reason, but why did my mind, well, I know because I know the numbers. Why did my mind automatically go to saying it's, you know, 50 to 70 year old ladies? Doing this for their parents. Why do the men not make these care decisions?

 I imagine it's just an extension for, you know, women care for babies better than men do. And it just goes through life. They care more for the new child starting school than the dads do. And I suppose it just goes to, you know, their parents too, but why do you always see so many ladies making these decisions and not meant?

Is it just the extension of life?

Debbie Marcello, RN: I, I think it is a cultural thing that, oftentimes our country has dealt with certainly different countries, feel that they need to have the woman taken care of that nurturing part.


And although we are getting away from that more, and I have to say, we do have so many men that are involved in their parents' care.

 And you know what, maybe in different ways, oftentimes we see the men dealing with. The financial part and maybe the sister of that gentleman will be dealing with the doctor's appointments and the home care and that kind of thing. So being able to split up responsibilities for a family is a really important thing.

So one person doesn't get burned out, but it just, I think it is kind of a natural extension

of what we normally do.

Mike Koelzer, Host: Picture, happier at home, not working out for a potential franchisee. What would be the attitude or what would that person be like? That would fail. Your program, and I'm not talking about you failing, I'm saying that you've got this package going to them and they're failing.

What kind of attitude would fail this?

Debbie Marcello, RN: First of all, we do go through an entire discovery process to make sure that we feel that they're a good fit and, you know, to make sure that they understand their responsibilities. So way back when I started franchising, a gentleman came to me and wanted an individual who did not own a pharmacy, came to me and wanted to purchase a franchise.

And he was a military man. smart, I thought I was gonna be a real hard worker. And, that was not the case. So I figured, well, he's gonna get his marching orders. He's gonna do exactly what he needs to do. He's gonna work hard, follow the processes, And be successful. So what happened was, he didn't want to work.

he thought that, in his words, he thought it was like, McDonald's you put out a sign and everyone comes, that's a completely, obviously different business model. So I would say the person that is not going to work is, someone [00:25:00] who is not, interested in connecting with the community, not interested in really putting the work behind, developing something like this or not, wanting to go out and, connect with those doctor's offices and 

case managers, that type of 


Mike Koelzer, Host: Talking about the managers, it's hard enough to deal with employees that are with me all day and we're chatting and maybe there's some motivation because of that. You know, you grow a little, uh, um, comradery and I, it walks out the door when they quit or you fire 'em, but basically there's at least a work relationship there.

It sounds terrible to do that with somebody in the home. I know you have to have an answer for that or else we just have to hang up here and go our separate


Debbie Marcello, RN: All right, we'll talk to you later now.

Mike Koelzer, Host: Tell me about

Debbie Marcello, RN: Bye bye. so. From your question, it sounds like you're talking about that person. Who's gonna be your business support manager, managing caregivers

that go into 


Mike Koelzer, Host: and managing caregivers.

Debbie Marcello, RN: Yep. So that is probably the biggest question we get from our candidates that we talk to.

So what we provide for our candidates is number one. They could through our discovery process, talk to our other pharmacy owners that are also franchisees. So any questions they wanna ask them about how is this working for you 

and are you having problems hiring that kind of thing?

you can get an actual answer from one of our franchisees. You could also. Ask them about me, ask about our support and how, if they would've made that decision again. But part of our training, both initial training and boot camps that we do are focused on looking at the type of person that we know is successful in being a caregiver, and how to recruit that person.

And, then our training for that individual, the caregiver that you're hiring. and then what your culture should be like. Maintain those caregivers. We want our caregivers to understand that we're in this with them and we appreciate what they do. 

Mike Koelzer, Host: It helps, but it's still a pain in the ass, right. 

Debbie Marcello, RN: Sometimes. 

Mike Koelzer, Host: I'm guessing maybe it's hard to attract home care Is it?

Debbie Marcello, RN: It is in the way the, the, the profile or the type of worker or caregiver you want to attract. And we share that with our franchisees, 

how to 



Mike Koelzer, Host: A high school dropout might not be the same candidate as having a. Parent whose kids just went back to school and they're kind of empty nesters during the day, at least while their 

Debbie Marcello, RN: Right, right. 

Mike Koelzer, Host: now in grade school.

Is that on the right track?

Debbie Marcello, RN: Exactly. Yes. And, you know, even professionals that have retired, who are looking to give back and enjoy doing that. So they're enriching someone's life and their own, feeling that they're giving back to the community as well. 

You know, sometimes it is a pain, but it's, I'll tell you that I have a file sitting right next to me that I've kept for the last 16 years of all of the notes and the comments and thank you for helping us.

And we would not have been able to do this without being happier at home. Those things over, they definitely outweigh the bad parts of it, you know, and I think with any business, realistically, you could have problems with an employee.

Mike Koelzer, Host: I mean, it can be music to your ears because it's a whole to fill, you know, with good 


Debbie Marcello, RN: oftentimes you hear people complain, but you don't hear the, the actual praises, so it's

easier for people. 

Mike Koelzer, Host: You never do. 

If I come to you, not as a franchisee, but I say to you, Debbie, I want to care for people in their home. Am I gonna be wiping them behind?

 It depends on what state you live in. Give me that list quickly because I gotta make sure what state is a minute. All right. So this brings us up then. What are we doing in the home? And now with your answer to that, certain states can do certain things.

Debbie Marcello, RN: Right. so we stay in the non-medical space. So that means that we are staying away from the skilled nursing, occupational therapy, physical therapy, wound care, IV things. so it can be divided into. Companion care like New York state I'm in New York state, highly regulated. They make it so difficult to do business.

if I look at companion care, which is [00:30:00] what our companies in New York state are for all of our franchisees and my cor my corporate location, , those are things like light housekeeping meal planning and preparation, medication reminders, providing transportation, dementia care, things where you're really not putting your hands on the patient queuing, things like that.

but in New York state, if I were to get licensed to do that, your profit margins are diminished extremely to a point where you might have a 3% profit margin. It is not a business model that I would want.

Mike Koelzer, Host: Is that because the insurances start coming in or because you're limited in how much you can charge even to a cash paying customer.

Debbie Marcello, RN: So that is only in New York state. I have to say, because with their regulations, they're requiring, let's say you hire a full-time RN and have her, him, or her on staff and that someone who you can't bill for. So that comes outta your that's an overhead 

expense, all of their licensed requirements for let's say HIPAA, the office requirements, everything they require you to do as a licensed agency, are all chipping away at your profit margin.

Now that is not the case in every state. I ha it's New York state

Mike Koelzer, Host: You might price yourself out of the market, but they're not saying what you can charge the customer, but there's only so much charge that's gonna cover all those costs. It's just an impossible situation.

Debbie Marcello, RN: Right. And so the beauty of this business model is the private pay cash source of revenue. and if we did get into licensing in New York state, then we would be having to deal with health insurances and that type of thing, which is one of the things that I want to avoid. our franchisees in different states, you know, we're in Texas, Alabama, Michigan, and you know, looking at their licensure requirements, let's use Alabama for, for example, they don't have a licensure.

I talked. Companion care, but, personal assistant services is the next kind of step up. So, in Alabama, they don't have to have a license to do the personal assistant services. So you're able to help, as you say, with their hygiene, transfer, lift people, that type of thing. and then you go to Texas, Texas has a license that doesn't have as many regulations and regulations and requirements as New York state.

So you could still keep your profit margins if you price yourself where you should be, which is one of the things that we even help with before our franchisees open.

Mike Koelzer, Host: When I was in late grade school, once a week, I would go over and I'd call it babysit my grandma. She was 90 years old and my aunt who lived with her had something every Tuesday night. So I'd go over and sit with my grandma. And I shouldn't tell you this cause I'm gonna low ball my price, but.

Alls I got from that was a, a can of Pringles and a Coke, but 

Debbie Marcello, RN: But your good grandson. 

Mike Koelzer, Host: well, the key to it was watching happy days and then Laverne and Shirley,

Debbie Marcello, RN: I totally associate with that.

Mike Koelzer, Host: Tuesday nights. And 

Debbie Marcello, RN: Then Yeah. 

Mike Koelzer, Host: my mom wasn't allowed to watch three's company. Remember three's company.

Debbie Marcello, RN: Yes, I do. 

Mike Koelzer, Host: I, 

wasn't allowed to watch it cuz you know, it dealt with some, it was funny, but it dealt with higher things, but she never.

Debbie Marcello, RN: and they wore tight 


Mike Koelzer, Host: I don't think she really clamped down on it, because then all of a sudden Mike's gonna say, you know what, I might have better things to do on Tuesday night.

 I shouldn't tell you that because now I told you that, you know, I'm worth a can of Pringles and a Coke.

Debbie Marcello, RN: well, that was previously, so I won't judge you,

Mike Koelzer, Host: My rates Have gone up.

Debbie Marcello, RN: Yeah. well, you're a pharmacist now you should be charging a lot per hour,

but it's your grandmother though. You know, that's 

Mike Koelzer, Host: Well, God rest her soul. 

Debbie Marcello, RN: With family members, they really want to be there and they want to help out, but they're the sandwich generation, you know, they're trying to take care of their own children and at the same time, take care of their parents.

So they're getting crunched with all of their responsibilities, plus the responsibilities of caring for their parents.

Mike Koelzer, Host: I'm against assisted suicide because pretty soon people, maybe they feel like a burden.

Like, ah, maybe I should, you know, tell my family they can get rid of me because uh, everybody else is doing it. And the fact that I wanna live [00:35:00] longer, you know, I'm kind of a burden, like how do I deserve to live longer with that said,

It's easier with my parents having a. Rather quick illness and death, and it's so hard for some people they've got 10, 20 years of some of this stuff. It's hard for a family. And again, it's usually the sandwich of the women in the family who are taking on this burden. It's really tough for families.

Debbie Marcello, RN: It really is. And, you know, I actually, I think it was last week or the week before, when I had my appearance on TV that I talked about some of the top fears of people as they age. And that was one of the fears that they're going to be by themselves. And they're not sure how they're gonna be able to take care of themselves.

And I've seen so many couples that maybe had been married for, you know, 60 years and, one might have dementia, but the other spouse has physical problems, but together they were able to stay, independent, but then one of the spouses dies 

and all of a sudden the family then does have to jump in and it is difficult.

So just doing your research and understanding what resources are out there for you is really key to help.

Mike Koelzer, Host: Sometimes families can move too quickly. , the father dies, the mom's there. And instead of realizing that maybe she's going through a three week stint where she twisted her ankle or whatever, sometimes they want to jump in so quickly and move her out and things like that. Where a lot of times it's just a little blip of that.

Debbie Marcello, RN: Right. Right. And having, having a professional come out and really do an evaluation. I know any of our franchisees, they do free evaluations. So really understanding what the circumstances are. And, you know, sometimes you're right. You just make a suggestion or, I mean, one of the common problems with older women is boy, they, they could have, they could be having a urinary tract infection and they look like they're having a stroke or, you know, they look like they're on death's bed.

It gets some antibiotics in 'em and they're fine, you know, they're out walking around and cutting the grass the next


Mike Koelzer, Host: Debbie, you wake up tomorrow and somebody says you're no longer allowed to do anything. Medical. you've got your skills. You've got your business skills. You've got the franchise ideas. You don't have to go down that road, but you do have those skills, but it can't be anything medical.

What do you do?

Debbie Marcello, RN: Well, if it was another life, I love marketing. I think I would be involved in marketing. I am very creative. I enjoy, Just making something, creating something and sitting back and saying, that's awesome. I did that. so I think marketing, I always, when I was younger, I went back and forth with becoming a doctor.

And if I became a doctor, even though that's medical and you asked about non-medical, I would probably go toward things that are not so life and death, so would be more of, maybe a medical spa, something fun, something I would just enjoy. That's fun. That's not high pressure, life and death type

of medicine.


Mike Koelzer, Host: I met my desk right now and I'm looking at my drawer and I've got about 20 gift cards thatI'm exaggerating, but people have given me for like, massages. Like I guess they're not even medical massages. They're just like massages at one of these spa places.

Debbie Marcello, RN: Yeah.

Mike Koelzer, Host: They made a ton of money off me. Cause I'm not gonna use those. 

Debbie Marcello, RN: You should. They're great. 

Mike Koelzer, Host: You know, how much I would've to tip somebody to be rubbing me all over. That's not even fair to them.

Debbie Marcello, RN: Hey, no, that's their job

Mike Koelzer, Host: I've got one of those, um, handle things now, you know, that pounds, you know, those S hook things that were out like 10 years ago,

Debbie Marcello, RN: with the 

Mike Koelzer, Host: hooks, not the roller, but it's got the thing that you can pull over your shoulder and like cramming into your back.

You know, it's like a massager, but I threw that one out. Cause I've got the electric one now. I'm surprised how often I use it.

But It doesn't have feelings. It's not like when I come home, it's not thinking like I gotta touch that guy.

Debbie Marcello, RN: I think you're being too sensitive. I think you just need to go get your massage. Yes. Yes. I think you're thinking about it too much. Yep. I'm not kidding. Next time I will talk to you. I wanna make sure that you would have already had a massage with one of those gift cards. 

Mike Koelzer, Host: Your company you're on the right track because there's so many things that are not. Medical per se, not, [00:40:00] down the medical lane, but all kinds of stuff that people are going to need, I mean, what really has medicine done for us?

 The death rates haven't really improved and heart disease is still the number one killer of old farts like me. And it's like, there's more out there. Healthcare wise, that's not down the traditional medicine route. And I think your company is on the right track, branching off just a bit and helping families through, especially these trying times.

Debbie Marcello, RN: Yeah. I agree. When, when we look at our patients and when we do our assessments, we're looking at them holistically. So I really feel like that's the key. And, we're training our franchisees to really look at the patient from every aspect, understand what their spiritual needs are, understand what their routines are like in their home, because maybe they have a problem with even.

Getting services, to take care of their yard. And when that person comes, they're taking advantage of them financially. So our, our company can be that buffer, and even by virtue of our care advocacy portion of that company, it really gives our patients an individual, care plan to understand what their routine's like, what they're missing in their life to help them 

remain independently 

and in their home.

Mike Koelzer, Host: can see pharmacists going that extra step because that's where like the care starts almost at home when the people are making the day to decisions of, living it out. And I can see where pharmacists not only would have this as a business, but also as an outreach of sorts just not let someone jump off a cliff once they've left the pharmacy.

Debbie Marcello, RN: Yeah, really helping to change how home care or care is delivered and, looking at, okay, that's great. You provide the medications, but are they actually compliant with them while with your happier at home business, you're able to address that. So you're really closing the loop and making sure that those things are, are happening.

Mike Koelzer, Host: I think that if people looked at health more interconnected, there'd be a lot more progress of people realizing that it all has to come together.

Debbie Marcello, RN: yeah. Yeah. I'm making sure people don't follow between the


Mike Koelzer, Host: Debbie, thanks for being on. It's a pleasure to finally meet you after seeing you online all this time. Keep doing what you're doing both the service you're providing and also opening.

Hope for pharmacists who have been a bit downtrodden and let them know that there's some ideas out there and there's some ways out there for them to keep moving.

Debbie Marcello, RN: Yes, you're welcome. And I appreciate you inviting me on. I really enjoyed our conversation. I think what you're doing, with pharmacy owners, bringing different ideas to them, the podcast has been great.

Mike Koelzer, Host: pleasure having you we'll talk again soon, Debbie.

Debbie Marcello, RN: Okay, take care. Bye bye. If I come to you, not as a franchisee, but I say to you, Debbie, I want to care for people in their home. Am I gonna be wiping them behind?

Mike Koelzer, Host: It depends on what state you live in. Give me that list quickly because I gotta make sure what state is a minute. All right. So this brings us up then. What are we doing in the home? And now with your answer to that, certain states can do certain things.

Debbie Marcello, RN: Right. so we stay in the non-medical space. So that means that we are staying away from the skilled nursing, occupational therapy, physical therapy, wound care, IV things. so it can be divided into. Companion care like New York state I'm in New York state, highly regulated. They make it so difficult to do business.

if I look at companion care, which is what our companies in New York state are for all of our franchisees and my cor my corporate location, , those are things like light housekeeping meal planning and preparation, medication reminders, providing transportation, dementia care, things where you're really not putting your hands on the patient queuing, things like that.

but in New York state, if I were to get licensed to do that, your profit margins are diminished extremely to a point where you might have a 3% profit margin. It is not a business model that I would want.