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Imagine a herring teaching a whale to swim in its school and you’ll have an idea of what Nurse Next Door (NND) just accomplished. The Vancouver-based in-home care franchisor announced February 8 that St. Joseph Health—the operator of 16 hospitals in southern California—has acquired 26 franchises, increasing Nurse Next Door’s stateside footprint by a third in one splash.

After trying and largely failing to set up its own “private duty” practice providing meals, baths, housekeeping and basic medical services to seniors and the disabled in their own homes, St. Joseph approached Nurse Next Door in 2014 intending to acquire all or part of the business. The Canadian company politely declined. “We’re a private company. We’re not for sale,” explained president Cathy Thorpe.

But instead of showing the US$6 billion-a-year non-profit the door, NND kept the conversation going, eventually steering St. Joseph towards a partnership on its terms. “They knew that Nurse Next Door had figured out private duty and they hadn’t. It became about the knowledge transfer and the ability to work together,” Thorpe says. “They acknowledged that they are not experts in this area, and they really just want to leverage the system that we’ve developed and grown since 2007.”

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Introducing franchises run by St. Joseph managers could have proved a problem—virtually all of NND’s other franchisees are owner-operators with a vested interest in the success of the business. Fortunately Nurse Next Door had some experience on that front. Since 2001, the company has run its own corporate location with managers in Vancouver. “We’ve taken the model we have from a corporate perspective and scaled it out” for St. Joseph Health, Thorpe says.

Still, NND had to satisfy itself that its values and St. Joseph’s aligned. “We spent a lot of time getting to know each other,” Thorpe says.

Ten of the new territories are already up and running, and the two organizations plan to open another 10 within three months, bringing the total number of Nurse Next Door locations across North America to 137. The remainder are expected to roll out over the coming year.

Is there a risk of a whale-sized franchisee rocking Nurse Next Door’s boat? Thorpe insists that St. Joseph is on board with all the rules and obligations of the company’s standard franchise agreement. “With franchising you have to be very consistent and treat everyone the same way,” she says.

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