Home Modifications for Aging in Place Can Be A Lucrative Business With the Right Partnerships

Summary

Nick Middleton, a general contractor and certified Aging in Place specialist, discusses Knoxville Aging in Place and their partnership with Habitat for Humanity.

They offer home modifications such as ramps, walk-in showers, widening doors, and kitchen remodels to help individuals age in place.

Middleton explains the benefits of being part of the VGM Live At Home network, which ensures reliable products and companies.

He also mentions the geographical area they serve, which includes a 40-50 mile radius around Knoxville.

The conversation highlights the success of Knoxville Aging in Place in serving the aging in place market and using Habitat for Humanity as a source for referrals.

Takeaways

Knoxville Aging in Place offers a range of home modifications to help individuals age in place.

The partnership with Habitat for Humanity provides referrals and funding for home modification projects.

Being part of the VGM network ensures reliable products and companies.

Knoxville Aging in Place serves a 40-50 mile radius around Knoxville.

There is a growing need for home modifications as the population ages.

Chapters

00:00 Introduction to Knoxville Aging in Place
02:36 Services Offered by Knoxville Aging in Place
04:52 Partnership with Habitat for Humanity
08:17 Challenges with Lead-Based Paint Removal
10:38 Expanding Partnerships to Other Counties

Transcript

Janet Engel (00:01.261)
Hello everyone and today we have Nick Middleton. He is a general contractor and he runs Knoxville Aging in Place. He is also a certified Aging in Place specialist and really specializes in everything related to helping people stay in their homes for a longer period of time, making their home safer. Nick.

Thank you for being with us. Yes. Can you tell us a little bit about Knoxville aging in place?

Nic Middleton (00:31.908)
Thanks for having me.

Nic Middleton (00:38.948)
Yeah, so Knoxville Agent in Place was thought of or started in around 2018. Our president, Jackie Mayo, recognized that there was an issue for Agent in Place individuals to get home modifications done. And we're part of a...

Janet Engel (00:46.061)
Mm -hmm.

Nic Middleton (01:07.14)
company that has another entity that builds affordable housing. So we found it as a great partnership of the two that we can marriage of affordable housing and being able to help people with disabilities or aging in place situations.

Janet Engel (01:12.941)
Out.

Janet Engel (01:32.205)
And what kind of services does a Knoxville aging in place offer?

Nic Middleton (01:38.5)
So we can do anything from ramps to walk -in showers to widening doors, kitchen remodels. We're right now wrapping up an addition that we added on to a couple's house that has any zero step entry into the additional room.

Nic Middleton (02:10.468)
we, we basically between, us and our sister company, we have the ability of over 40 years of construction knowledge that we can do about anything. But our main focus is around, more just the home modifications for an individual to be able to cope in their house.

Janet Engel (02:35.725)
Yeah, now Nick, I know that you're also part of the VGM network. Can you tell us a little bit about that organization?

Nic Middleton (02:41.604)
Correct.

Nic Middleton (02:45.636)
So the organization, the biggest important thing to us about the organization is they vet their vendors to make sure that they're reliable products and that they're reliable companies that they're partnered with. And so...

Janet Engel (03:07.821)
Mm.

Nic Middleton (03:12.324)
When someone goes through VGM to look for a company or a product, they can kind of rest easy that it's not just something that's been slapped out there. These are people that know what they're doing and products that are more importantly better than just subpar quality. I mean, it's top notch materials and all that.

Janet Engel (03:23.373)
Right.

Esther C Kane, CAPS, C.D.S. (03:41.039)
And what is the geography that you serve?

Nic Middleton (03:45.028)
so we do, we're here in Knoxville, Tennessee, so we do probably 40 to 50 mile radius all around. So it's just outside of the, Nashville, outside of the Chattanooga and outside of the Tri -Cities area.

Janet Engel (04:07.661)
Now, Nick, I invited you on my podcast today because I know that your company has been very successful with serving this aging in place market. And there are a lot of people that are trying to get into this market and serve older adults who want to age in place.

and they're coming from all kinds of different professions like real estate, healthcare. I wanted you to tell us how your company has been successful, particularly in using Habitat for Humanity as a source for referrals.

Nic Middleton (04:51.588)
Yeah, so we partnered up with a.

one of the habitats that's around our area and they have a aging in place home modifications program. With that program, they go out and assess the person's home for electrical, roofing, plumbing, showers, is their main niche that they look for.

to try to do home modifications. And so when they find individuals with those needs, then they reach out to contractors to bid on the work and then those contracts come out. One of the things that we found a niche in our area is a lot of contractors don't want to deal with EPA certifications of lead base.

Janet Engel (05:52.333)
I'm learning.

Nic Middleton (05:53.444)
And a lot of our houses and our surrounding communities are 1978 or older. so with that, we, we ended up going and doing a lot of work for you at, for habitat. and so, I mean, it's been a great partnership with that County and we've actually reached out to four other counties and started working with,

Janet Engel (06:19.437)
Nic Middleton (06:22.628)
We just started a relationship with a second County of Habitat. I think one of the best things about the partnership is everyone knows Habitat for Humanity, where they don't always know Knoxville Agent in place. And so that's one of those great ways to get your foot in the door with a company that is widely globally recognized like Habitat.

Janet Engel (06:27.725)
No.

Janet Engel (06:36.141)
Mm -hmm.

Janet Engel (06:40.589)
Right.

Janet Engel (06:53.389)
Right. Now, you know, it surprises me going back to what you were saying that most general contractors don't want to deal with the EPA standards for how you remove lead paint from an environment, which surprises me because about 90 % of the housing stock in the US was built before the 1980, before 1980. And so,

And also something to know is that even though that rule, the RRP rule states that any house built before 1978 has to be inspected and you have to have the proper way to remove lead from that environment. But actually paint companies were able to continue to sell lead paint until 1985.

So really that lead paint was still on the shelf. So really that rule should be 1985 and before homes should be treated as if they do have lead in the environment. I would think that general contractors would be losing out on business left and right if they weren't EPA certified.

Nic Middleton (08:16.804)
Yeah, and there are a lot of great contractors that follow the practices like they're supposed to be. Unfortunately, there's some that feel like they lose out on the job because they've got a bid and to bid with practice and lead certification raises the cost of the job, which sometimes they feel like knocks them out.

Janet Engel (08:23.565)
huh.

Janet Engel (08:42.509)
Hmm. I understand right because they have to quote the customer a higher amount of money

Nic Middleton (08:48.516)
And so I feel like unfortunately sometimes the contractor instead of revisiting their price scope of how they price a job, they just end up not practicing what they need to. So.

Janet Engel (09:02.381)
Okay. And because of Knoxville Aging's in place partnership with Habitat for Humanity, then that kind of removes that kind of competition from the land.

Nic Middleton (09:04.42)
Nic Middleton (09:16.004)
Yeah, a lot of times they don't want to deal with that. And a lot of times working with Habitat, they're trying to do a wide scope of work for the client. And so sometimes that's not always the most lucrative, you know, shower stall or kitchen remodel or anything like that. They've got to try to...

spread the money out between different projects. And so a lot of contractors don't want to deal with that also because they know they're having to come in and be at a certain price scale instead of being able to price a luxury job.

Janet Engel (10:04.045)
Mm hmm. I see. Tell me about those programs. You said that your company has been reaching out to other Habitat for Humanities in different counties and you told me that they either have a home modification program or an aging in place program and they have volunteers that will do this work. But usually what happens is that.

They don't have the skill set and so that's when they hire a company like Knoxville Aging in Place. Is that the case?

Nic Middleton (10:37.636)
Yeah, correct. One of the problems I think they run into is a lot of times people volunteer their time, which is great. Unfortunately, when someone's volunteering their time, you're kind of on their schedule. And so if the job takes multi -days and they can only volunteer one day, then they're leaving that client also hanging out there with their project.

Janet Engel (10:47.949)
Mm -hmm.

Janet Engel (10:58.349)
Hmm.

Nic Middleton (11:07.704)
And so, and then sometimes those volunteers are not very, you know, they don't have the skill set those licensed contractors have. And so sometimes it's just above their skill set. Now the different counties, and this is talking to Habitat from what I understand is Habitat has global standards for all of their locations, but not.

Janet Engel (11:15.725)
Right.

Nic Middleton (11:36.804)
everything as a global standard. So like one habitat might have a home modification program where the next county over doesn't have that program.

Janet Engel (11:46.381)
Okay.

Nic Middleton (11:48.292)
So there are certain programs that are not the standard in the habitat.

Janet Engel (11:58.125)
Do you know if now with so many people aging every year, we have 10 ,000 baby boomers turning 65 every single year and that's till the year 2030. Every day, I'm sorry. Yeah, every day.

Nic Middleton (12:12.836)
Thank you.

Esther C Kane, CAPS, C.D.S. (12:13.707)
every day.

Nic Middleton (12:17.988)
I'm out.

Janet Engel (12:19.405)
and will continue, our society will continue to age, you know, up until 2060 because then we have Generation X, which is the one I belong to, you know, and then you have millennials. Are there, do you know, since you have such a close relationship with Habitat for Humanity,

in your area if there are plans for future programs, future funding to serve this community.

Nic Middleton (12:52.612)
I, the plan I think is to continue to grow it bigger and bigger. and I know the one that we're working for right now, the surrounding counties have taken, recognition of it and realize this, this group has found a program that's working great for them. And I think a lot of them are starting to think about maybe trying to.

mimic or get their programs kind of up and running that same way.

Janet Engel (13:30.573)
Well, that's great. So it sounds like you've really found a niche for your business. And then at the same time, you have the opportunity to help so many people who really need these home modifications and may not have the money to pay for it. So you told me that when you have a client that their home,

It's very extensive what they need. Let's say they need a curbless shower, which you know is a very skilled job Then they would bring a contractor like you to come in and bid for the job and then and Habitat for Humanity actually pays for this work to be done, correct?

Nic Middleton (14:23.396)
Correct. Yeah, so they work on different funders to fund those programs. It could be a government assistance, from what I understand, or it could be even a private donor that has set up a trust to pay those kind of programs.

Janet Engel (14:46.157)
Okay, well that's that's wonderful. Is there a limit to how much let's say that someone For example the bathroom remodel which is very common Where they need a whole bathroom remodel and they also need their outside steps to be Modified either where you need a ramp or just turn them into Walker steps?

is will they pay for all of that work to be done?

Nic Middleton (15:21.956)
so from completely what I understand of their program that they'll come in, do like the assessment and then there's so much money that is funded towards the project. If they've surpassed that or there's more projects to be done, then that homeowner can actually reapply for further funding after the initial funding has covered.

whatever projects have been through.

Janet Engel (15:57.453)
Sorry, my dog is, let me close the door.

Esther C Kane, CAPS, C.D.S. (16:02.575)
Nick, what is the time lag? Because it's basically funding and donations and what is the time lag from the time that you go in and assess the project and then you get the funding for to do the project and then doing the project.

Nic Middleton (16:19.556)
So by the time we're called by Habitat to come out there and do the bid, they've already been approved for a set amount. Now they don't discuss to us what that set amount is, obviously, because that would maybe dictate how we price the job. But by the time we're being called to come out there and do the bid, the project has been approved. It's just now finding.

Janet Engel (16:34.413)
Right.

Nic Middleton (16:48.932)
the right contractor to...

Esther C Kane, CAPS, C.D.S. (16:51.983)
Okay.

Janet Engel (16:52.301)
Now, Nick, let me ask you, initially when someone goes out to do this evaluation, for example, if the person has a progressive condition or they've experienced a traumatic event like a car accident or a stroke, is that evaluation done by a healthcare professional?

Nic Middleton (17:15.844)
no. So that assessment is kind of somewhat done by their project manager.

Janet Engel (17:22.893)
well, that's a shame. Is the project manager CAP certified or, or has some kind of aging in place certification?

Nic Middleton (17:25.22)
Yeah. All right.

Esther C Kane, CAPS, C.D.S. (17:25.231)
Yeah, it is.

Nic Middleton (17:33.924)
that I honestly don't 100 % know if he does or not, or, or in some counties it's a female side. I don't know if she does either. So, they'll sometimes rely on any of us that have that kind of knowledge to ask questions, give what our opinion would be, how to progress. I can tell you a lot of people that are in that type of program or.

in the lower income bracket or in the rural bracket. So sometimes a lot of these structures are not in the greatest shape. So a lot of people are just glad to actually have someone that cares enough about them to come out there and help them.

provide some kind of home modification that allows them to have some daily access around to their house that they didn't have before.

Janet Engel (18:35.213)
Yeah, well, I really think that.

Habitat for Humanity needs to start including occupational therapists that are certified aging in place specialists to really get a good handle on what that person needs. Because if they're going to spend money on this person's modification, you want that modification to work for them now and years from now. And so that's why it's imperative that you get the right professional in there. And of course, we need people like you as well.

Nic Middleton (18:58.468)
Right. I agree.

Janet Engel (19:08.767)
But, you know, that's not your level of expertise, someone that's had a stroke, figuring out how is that person going to transfer in and out of the shower when they have a paralysis on the right side of the body.

So I mean that's crucial if we're really going to help this population especially low -income people which tend to be minorities and also people who are poor tend to have worse health and have more comorbidities than you know people middle -class upper -class So it's very important to provide the right

professionals, bring in the right people and you know, bring in everyone because we, it takes all of us to create a good home modification for someone, especially someone that has a progressive condition or a traumatic event. That's my pink snake. I'm sorry. I'm very passionate about that because I, we see it over and over.

Nic Middleton (20:13.764)
What?

Janet Engel (20:21.293)
that occupational therapists get left out of the equation when we really provide so much insight and so much value.

Nic Middleton (20:32.164)
And I think to be on, this is just strictly my opinion. I think that's why a lot of the programs that they have, for instance, are called home modifications and not a hundred percent labeled aging in place or.

and I think that's what a lot of contractors struggle with also is, yeah, when you, when you start labeling agent in place and all that, you're starting to put, I know what I'm, I'm doing, or I, or I'm going to deal with modifications that allow people with strokes and all that to function in their house. And so then that puts you kind of under this umbrella of.

Janet Engel (20:55.277)
Okay.

Nic Middleton (21:18.724)
I'm going to do this skill type labor instead of, Hey, I'm a contractor. I can just come in there and just build anything.

And so I think a lot of people or a lot of contractors or companies get scared of that and they step back from that.

Janet Engel (21:35.885)
But you see, you shouldn't because if they provided the right professionals, everyone stays in their lane and everyone speaks from their expertise and their background. And that's how we can serve people the best.

Esther C Kane, CAPS, C.D.S. (21:51.119)
And it's a way of scaling your business. I mean, building it to other, you know, getting funding or income from other sources besides this one narrow lane. I mean, it just, it makes sense for everybody.

Janet Engel (21:54.477)
video.

Nic Middleton (22:05.956)
So like Knoxville in place, for instance, we give one of our jobs is we can come out and do a home assessment. We're only given the contractor's kind of perspective of what we think needs to be kind of done. Sometimes we'll work with OTs and all that with, or they'll be the ones that have called us to ask us to do the home assessment. And I know recently I just did an assessment where the contractor was like,

Listen, I don't know anything about building and the agent in place scope of work. So my recommendation would be you guys call these guys, ask them to come out and do an assessment. And then I'll come back and somewhat follow their assessment and we can talk through that and we'll start working. So it was one of those that we did the assessment. We're not going to get the project because they've already got a contractor that they've hired, but.

Janet Engel (22:49.069)
Mm -hmm.

Right. Yeah.

Nic Middleton (23:04.324)
The contractor at least was big enough to say, hey, this is not my lane. And like you said, stay in his lane. And so he wanted some pointers or some knowledge of what products were out there that he could start installing for this person.

Janet Engel (23:25.229)
Right, and that really is the best thing that we can do as professionals and to serve others. I know personally, no one wants me to identify which wall is load bearing and which one isn't. No one wants this OT to do that. And I wouldn't do that to anyone.

Nic Middleton (23:33.7)
Thank you.

Janet Engel (23:50.669)
But just the same, I don't want someone speaking as if they went to school for almost seven years like I did. So that's great, Nick. I think your company is doing some great things and I really commend Knoxville Aging in Place for creating a niche and not only creating a niche, but now you're also expanding this niche and you're...

you're in the black and you're building business and continuing to grow and you're also part of VGM, which is like you said, this network that has, you can rely on their name and you can count on the fact that VGM members are going to do good work. And,

Nic Middleton (24:46.852)
Right.

Janet Engel (24:49.037)
are going to do right by people and that they have this organization, VGM Live at Home, that only deals with this type of work. People that need home modifications so that they can live in their homes and be safe and prevent falls.

Well, thank you, Nick, for being with us. Esther, is there anything you want to add?

Esther C Kane, CAPS, C.D.S. (25:19.535)
No, just want to say thank you and I love the work that you're doing. It's, I think it's so important, especially nowadays with the gray tsunami, as they call it.

Nic Middleton (25:21.828)
Yeah, thanks.

Janet Engel (25:33.293)
And you know, before we finish, I wanted to mention that the way we met Nick was he is a member of the directory that Esther and I created, aginginplacedirectory .com. And Nick participates in the mastermind sessions because he wants to get the most out of it and learn how to market their business and use AI and just so many different things.

and he's been a great contributor to our group. So we're really glad to have you.

Nic Middleton (26:08.484)
Thank you. I appreciate it.

Janet Engel (26:11.149)
Bye Nick. Bye Esther.

Nic Middleton (26:12.516)
Bye.