Meeting the Patient Where They Are: Interview with Onsite Hearing CEO, Hank Sarazin

July 19, 2022

The new mantra in hearing care is to meet the patient where they are. One segment of hearing care within this service delivery domain is assisted living care.

In this segment, Hank Sarazin, CEO and Founder of Onsite Hearing Care, discusses how his company has grown to be one of the largest, and most successful, providers of hearing health services to independent and assisted living communities in the Northeast.

Full Episode Transcript

Amyn Amlani 0:10
The new mantra in hearing care is to meet the patient where they are. One segment of hearing care within the service delivery domain is Onsite home care to discuss this segment of service delivery. Here is Hank Sarazin CEO and founder of on site hearing here. Welcome to the show. Hank,

Hank Sarazin 0:31
thanks so much for having me Amyn.

Amyn Amlani 0:33
It’s my pleasure. So tell us a little bit about yourself before we start talking about onsite hearing care.

Hank Sarazin 0:41
Sure, I guess personally, I live in Maine, and got two two daughters who are college age. We love it up here. And for those of you who have daughters, you know what that means. So it’s been a great deal of fun. Professionally, I have a degree in accounting back from in the in the 80s. When, when things were not as digital as they are today. And we actually did try Ledger’s on paper, not on computers. It’s kind of funny when I think back at those times, but uh, yeah, I graduated with a degree in accounting, I did that for a better part of about five or six years, sort of discovered, I wasn’t meant to be behind a desk, and followed the traditional accounting career path. And I started selling beer. Actually, it was a bit of a fantastic journey. I was fortunate enough in the late 80s, to join the Boston Beer Company, which is the brewers of Sam Adams. When I went to work for them, they weren’t even sold outside of New England. And I stayed there for 10 years. And it was a pretty exciting time, the owner was a fantastic, fantastically intelligent man. And I was there for the entire national rollout started as just a rep on the streets and ended running basically from Boston to Buffalo. And, and then at that point, the beer business I said, started my family, and it was maybe time for the beer business to be behind me. And, and I went back into finance. And I did that for a few years. And then one of the other former Boston Beer Company employees, I was involved with a company out of Florida called HealthSource associates that was going to do mobile dental care. And she needed a national salesperson, and that was back in 2003. So I said, Well, that sounds like fun. And I jumped on board with her. And we did that for about a year and a half. With great reception, I enjoyed the market a great deal. And unfortunately, that company burned through some money pretty quick and suddenly found that they didn’t have any money, which is a pretty classic story for a lot of startups. And at that point, that company was dissolving. And that triggered me in 2005 to start onsite dental care. Okay, so that’s my snapshot.

Amyn Amlani 3:20
So you started onsite dental care in 2005. And then you’ve also got this other subsidiary called onside hearing care? When did that start?

Hank Sarazin 3:31
That started in 2016- So what are we on seven years for onsite hearing care? Roughly, yes, over the years, you know, calling on the assisted living industry, which, you know, if there’s, if there was a reason for me to choose to justify why I started my own business, it really, it really was the space. You know, after spending about a year and a half, making sales calls, predominantly on assisted living communities. The folks that work in that industry are amazing, you know, I mean, they they’ve signed up to take care of people for a living. And I really, I really enjoyed that also, spending so much time in the consumer products industry, which is a pretty tough business where it’s very competitive. You know, when you’re in the long term care space, everybody’s kind of part of the same family. And I really enjoyed that where, you know, you’re all you’re only in it for the same game, that quality of life of making mom’s day better. So I found the staff to be really fantastic. And then, you know, the more and more you get to sit with some of these fantastic sweet little old ladies, we we have a little bit of a joke here, about 50% of our patient database. Their first names are either Eleanor, Dorothy or Mary. It’s generational. It’s funny, it’s starting to change a little, but it’s quite amazing. How many Eleanor Dorothy or Mary’s we serve but I really I really love the seniors and their stories are just truly, you know, magical, from, you know, being born in the late 30s, you know, bouncing out of the depression going into World War Two, you know, you know, this is pre Happy Days, you know, the Richie Cunningham days hadn’t happened yet when they started. And then on top of that, as a businessman, everybody, you know, always talks about the silver tsunami. And, you know, for the 17 years, I’ve been running this business, we’ve been talking about it, well, it’s now crashing on us, the boomers are in their late 70s, they are now starting to access the long term care market, the various pieces of it, and their expectations are high, they’ve spent a lot of money on their health care, they’ve taken good care of themselves. So I think it will be exciting to see where this industry goes from here now that this massive demographic is going to be hitting the long term care market.

Amyn Amlani 5:58
Yeah, in you know, as we look at some of the disruptions and things that are happening, and I know, we’ll talk a little bit about that later on, you know, again, it’s about meeting these patients where they are, and in some cases, they’ll gonna come to you. And in other cases, you have to go to them. And in other cases, you have to meet them in the middle where, you know, sometimes they’ll come to you, sometimes you may have to use telehealth, or whatever the case may be. And, you know, so you’ve got a unique situation here, where you’re actually taking your providers and going to them. And, you know, so tell us a little bit about how this works, and how you schedule them. And all these things, I’m really fascinated.

Hank Sarazin 6:39
Sure. I mean, I guess try to break it down into few areas. As far as just the scheduling piece, you know, unlike a traditional practice, where you’re scheduling is your brick and mortar facility, and you’ve got your day and you schedule it, we have two pieces, we have that piece, which is fairly straightforward and similar. But then we have to schedule the deployment of the teams out in some sort of fashion that is both, you know, managing the care that’s needed, as well as respecting the assisted living industries. So we look at those two pieces. I guess, as far as the communities go, we’ve sort of put them on a set rotation where they know we’re coming every six weeks or eight weeks, the size of the community may factor into the frequency. And then within that, too, we sort of tried to cluster within a day because the making the convenience of being able to follow up with people, for both the dental services and the Hearing Care Services matters. And by clustering buildings around a day, that means on Tuesdays, I mean, if you were my audiologist and you were my Tuesday, audiologist would have that cluster, you would know that on Tuesday, this Tuesday, you’re scheduled at a certain community, but your other Tuesday, communities are probably not that far down the street. So it gives you that that sort of system. So I would like to say that all of this was designed in my business plan, but a lot of it was designed by skinning my knees along the way, all those many years ago. And again, the the folks in the assisted living industry were were so positive about having these services. And in realizing that we added a lot of value to their community, they’ve been fantastic at helping us learn how to do this the right way. You know, treating, treating a senior’s a challenge all unto itself, treating a senior in a mobile format just adds even more challenges.

Amyn Amlani 8:40
Yeah, 100%. And I can also see the benefits, as you pointed out, not only to the to the person that’s getting the services, but also to the staff, because now the staff is able to communicate with that individual, and the families. And so it reduces the overall stress, if you will, on that whole segment.

Hank Sarazin 9:00
Absolutely. And the we, the more predictable we can be the better off we’re going to be, you know, like, you know, each day where, you know, we’re sending out equipment, and we’re sending out audiologists or dentists or people we’re sending these people out. And we need to have everybody on the same page when we show up at the community. And there’s a lot of I’s to dot and a lot of T’s to dot to achieve that. You know, you mentioned with the scheduling. When when I look at our sort of daily protocols, we’re pretty specific about what our folks do in general, when you get to the community in the morning, a certain set of activities letting folks know throughout the day you’re seeing patients, no two communities are exactly the same. They might even be owned by the same company. But the executive directors all have different personalities and different backgrounds and then they have their leaders Ship team that manages that building. And, you know, we really need to try to become part of that family. I think that’s mission critical when I’m when I’m interviewing people, as I always say, you know, if you walk in the front door, and the concierge says, oh, there’s there’s the lady who sells hearing aids, hmm, maybe not so good. If you walk in the front door, and you know the name of the house pet, and you know, the concierge’s favorite cup of coffee, and you’ve got a treat in your pocket for the pet. That’s more of what I think makes things work better, because then we’re all in the same package together, just to try to improve the quality of life of their residents. Yeah,

Amyn Amlani 10:43
it’s all about those relationships, whether you’re in your own building, or whether you’re in someone else’s building, it’s about relationships.

Hank Sarazin 10:50
Absolutely. And you’re treating someone’s mom.

Amyn Amlani 10:54
Yeah, 100%. And you would want someone to treat your mother with the same respect.

Hank Sarazin 10:59
It’s, yeah, it’s fantastic. So we, we have that that set of protocols. So as I said, there’s that there’s that real tight operational part of the business that we’ve developed over all these years. As I like to say, it’s really hard to get the puck bias we’ve we’ve done, you know, we’ve learned a lot we, you know, we have OSHA compliance to deal with we have assistive living industry regulations to deal with, we have audiology regulations that, you know, there’s so there’s layers upon layers of of items that you really need to make sure you’ve got in the forefront of all your decision making.

Amyn Amlani 11:35
Wow, that’s, that’s, that’s, that’s good to know. Yeah. So how do you go about servicing an individual?

Hank Sarazin 11:41
Surely, I mean, it starts Everything starts with the new patient call. Um, so, you know, we have some fliers up signup sheets, we do some different activities in the communities, and we’ll get a referral. And I think, for me, that’s, that’s a big part of it is the folks in the office are talking to a son or a daughter, who’s looking to register their mom or dad, about 85% of our patients are females, I mean, unfortunately, for you, and I, the boys still die before the girls in our society. So, you know, it’s 85% of the residents are females, and therefore, the patient base looks a lot similar, but you know, different, it always starts with the family, that phone call, and it’s there’s the routine part of registration forms, and HIPAA and consent forms and dot, dot dot. But then you also need to kind of get a little bit of an understanding from the family, what are their goals? You know, it you know, a daughter who lives down the street from mom in the assisted living industry has a very different set of goals and a daughter that might live five states away. And, you know, we’re dealing with with those folks, first and foremost, and I think for me, you know, as we, as we, as we look at that delivery system, I think one of the most important things that we’ve learned is, you’re not just treating an individual, you know, that that resident is, is the mom of, of someone, and, you know, we’ve, we’ve really learn, there’s one person in people’s lives that you’re not allowed to, I would use a bad word here, but literally, you’re not allowed to mess with people’s moms. They will, they will, they will bring force upon you. Like you have ever brought to bear. So we respect that. And I think with that knowledge, and our experience, every single time we start, we need to realize we’re we’re not just treating an individual, we’re treating a family. And as part of that family, they have moved their mom into an assisted living community so that they they have additional support caring for their loved ones. So you need to include the building, because as you mentioned, you know, not every resident is great at putting their hearing aids on, you know, thank God for rechargeable hearing aids for seniors, you know, changing batteries, for seniors, their dexterity in their hands, it’s impossible for them to do it. So, you know, the rechargeable hearing aid is such a positive impact for them. So making sure the building knows how to manage the hearing aids, and how to, you know, help with mom and service and you know, she’s struggling putting it on or whatever might be the situation. So that’s a very big lesson for us as you’re not you’re not just treating your you’re not just treating an individual, you’re treating the whole family. And that family does include the building.

Amyn Amlani 14:48
Yeah, yeah. Yeah. That makes sense. You know, and you talked about hearing aids in when we’ll stick with this for now. But you talked about hearing aids. So where do you get your hearing aids from Are they from the the big six, so the big five that we typically use? Yeah,

Hank Sarazin 15:06
we, what we’ve done is from the beginning, we ever relationship with, with a buying group, so we have access to everything. And that that ensures us that, you know, if we encounter any hearing aid we have, we have all the big five software, when we can have access to all them, but every now and then we bump into some of the smaller brands, and we want to be able to help, you know, outside of a couple of the brands that are proprietary, and that you don’t have access to their software, we’re ready to handle everything we we’ve been working closely with ReSound primarily for the better part of a couple of years now. Not so you know, I think from a technology standpoint, they’re all making awesome products. And it’s you know, as you well know, every time one of them has a new release out, it’s pretty exciting. They’re really trying to reach new levels of technology to help support, you know, these folks that are having these hearing deficiencies. But it’s nice to have a partner that, you know, that you can work with. And I think that’s been, you know, for us, starting with the other business, the dental business, you know, we’ve looked to align with partners, because a good example is software, dental, dental software, just like hearing care software, it’s made for offices. So we looked at a lot of different software’s, and we use blueprint, and we’ve been super happy with Blueprint, not so much that their software has some, you know, you know, supercharged, you know, mechanism in it, but they’ve been great working with us, as far as, hey, you know what, that report doesn’t work for us, because we’re using that data field for something else. Because we’re mobile, right? Every day, every day, we go to a different location, we need to identify that location, we need to have the patients at that location under that location, not just randomly can’t show up a building a expecting to see a certain patient when they’re not at building a they’re building B. So we’ve had to kind of bend the software a little bit and blueprint has been really great responsive, and they built a couple of nice customs reports for us so that we can track our business and our unique model by you know, being, you know, having multiple people be at different locations every day.

Amyn Amlani 17:29
Ya know, and that’s, that’s good to know, you know, because as people start thinking about mobile audiology, you know, perhaps it’s something that they’re looking at as, as these disruptions start to, to evolve. You know, these are the kinds of things that they have to consider, it’s not the same as having your brick and mortar. And to that end, you know, I’m assuming that your test equipment is also a little bit different as well, I’m not sure if you if you card it in or you leave it there, but it’s not going to be the same as a as a brick and mortar Institute.

Hank Sarazin 18:03
Sure, no, in again, learnings, you know, different things that we tried, we, we work with otometrics, and they’ve got a little device called the Madsen. And what we’ve got is, each of our team members, our audiologist, or hearing instrument specialists, we’ve got a blend of both, they have sort of two primary bags. One is a sort of traditional auditing bag, you’ve probably seen auditors where you know, it’s on wheels, and it’s kind of like an accordion. And then they have a small, like just an overnight hardshell travel bag. They keep all their paperwork, their laptop, their audiometer, all of that instrumentation is in that auditing bag. And then in the other bag, we you know, just use those little plastic fishing tag, you know, the, if you buy a fishing tackle boxes, little plastic containers that are random, and we have one for each of the major brands, and then a miscellaneous one. And then of course, each individual personalizes their setup a little bit, so that you know, they’ve got access to all the bits and pieces that they might need while they’re providing care. And then, you know, it does not take them too too long to set up in the community with this setup that we’ve got here. And, you know, is it is it the perfect scenario, I think that’s where some of the challenge will always come in this idea of going mobile is when you go mobile, you don’t have your office, you don’t have that perfect environment. So you got to, you know, make the best assumptions as to what you want. And I will also share to both in dental care and in hearing care, you know, there’s there’s a line where at a certain point, maybe we’re not the right person here, you know, if your situation is such where you need to go further. We’ve built a good group of sort of complementary services around us, you know, for or the dental care example would be having some oral surgeons that are on our Rolodex to refer out, you know, for the major type of work. And then the same thing. You know, as I mentioned, we were chatting earlier, there’s a fair amount of veterans in these assisted living communities that we go to. Some of them obviously, if you go back to when they were firing weapons in the 40s, and 50s, they were wearing no protective gear. So you know, what’s going on with their eardrum is it’s not the standard old person’s hearing deficiency, where, you know, just the muscles are getting older and tighter and not and not as responsive.

Amyn Amlani 20:38
Yeah, in for these individuals, you know, sometimes they need a, an augmentative device, like an assistive listening device. And I’m assuming that you also provide those instances where they’re needed.

Hank Sarazin 20:50
Yeah, we, the folks at Oaktree, you know, they, you know, we set each one of our folks up with an account at Oaktree Products, and they go in and order anything, but I’ll share a unique story we, we had an assisted living community in in, in Rhode Island, and there was a woman who was reading the newspaper just before lunch. And she reads with a magnifying glass. And at lunchtime, she put the newspaper on the ground, and she put the magnifying glass on the windowsill next to her chair, and she went to lunch. The sun hit the magnifying glass, the magnifying glass hit the newspaper, and the newspaper started smoking. Yeah, well, it wasn’t a disastrous fire, but it triggered a real fire alarm. So the fire department in the regulations in Rhode Island at that time, they don’t need to clear the building, but they’ve got to access every room and confirm that people are safe. They’re knocking on doors in full fire gear, right, and opening up doors. And there are sweet little old ladies and gentlemen sitting in their chairs, they never heard the fire alarm. The building assessed that about 25 of the residents didn’t hear the fire alarm. So that particular building, we actually went into a program with them. And we we picked it up a notch. And we went there once a week. And we did hearing tests on every single person in the building, which is a bit extreme, but the executive director kind of wanted to get a sense of what was going on. That was an extreme version. But again, a reality of the situation where you know, the high pitch sound of an alarm so so all those devices that can connect alarm clocks, they can connect fire alarms, to your devices, pocket talkers. You know, we’ve worked with some of the CaptionCall folks, you know, the different folks that have those phones, we have all those to offer. You know, it depends on the individual, I think, you know, sometimes, you know, these, these awesome sweet little ladies I keep referencing, they still have plenty of vanity. And they love going to get their hair done once a week, you know, they’re that generation, they get their perm, they want to look good, they care about what they look like. And, you know, they might not want their friends to know that they have one of those caption called phones, because that would mean they can’t hear well. And we have to deal with that little subtle nuance all the time.

Amyn Amlani 23:30
Oh, yeah. I can only imagine and you know, that generation, I just love the Top Hats and canes and the you know, the Sunday outfits and you don’t see those you don’t see that as much these days.

Hank Sarazin 23:42
No, they’re there. They’re still a relatively formal group.

Amyn Amlani 23:46
Yes, they are.

Hank Sarazin 23:48
Relatively, you know, and that’s, you know, some of the learnings too, we, everybody, most folks know it, but when we’re talking to people, they’re all Mr. And Mrs. You know, from the beginning until they give you permission to call you something differently. And a lot of them don’t if they appear that you’re younger than them, they expect you to call them Mr. And Mrs. Which is a generational thing.

Amyn Amlani 24:12
Well, and you know, we’ve talked about this quite a bit on the show with other hosts as well. You know, we’re seeing different generations for the first time, it’s not just the silent group or the baby boomers, now you’ve got the millennials and the Gen X’s. And if you don’t know how to behave with these different groups, it’s very, very different. And in your particular case, you know, if you get a millennial and they act, the way that they act with their peers, it’s not going to go well with this older generation because they had the expectations are so different.

Hank Sarazin 24:46
Even something as simple as a tattoo. Tattoos are so commonplace for our younger generations. But if you ask your average person living in an assisted living community, their idea of someone who has a tattoo is They were a bad person. Because that’s what it was way back then. And it’s kind of hard sometimes as the founder and the owner when I have a younger employee, and I’m trying to explain to them this without making them upset, but trying to get them to realize, you know, she, she’s not a bad person. She’s not saying you’re mean, it’s just what she knows.

Amyn Amlani 25:24
Yeah, yeah. Yeah. No, that’s, that’s very interesting. And I think that’s something that, you know, as, as we have to deal with these generations we’ll, we’ll have to be more mindful of, but getting back to what you were saying earlier, you have these devices, you have these assistive listening components that you are also sharing. But then you also have to have the educational piece not only for the patient, not only for the family, but also for the staff. So how does that work? And how do you how do you deploy that,

Hank Sarazin 25:57
you know, we, we always offer out sort of three opportunities, doing doing in services at the building with the frontline folks to care managers, when we do those quite a bit. You know, it’s it’s a simple sort of presentation, it doesn’t take very long, but we want the care managers first and foremost, to not be afraid of the hearing aids. They, you know, they know, they’re not the cheapest thing that’s in in the residence hotel, you know, in the residence room. And, you know, they’re kind of a little bit worried, what if I lose it? What if I break it, and we want them to get over that sort of fear so that they’re ready and willing to help mom with her hearing aids no matter what it is, and they know how to get a hold of us and get some basic understanding for them of, you know, something as simple as talking a little slower. Talking a little deeper, you know, unfortunately, a lot of caregivers are females, and I’d say it’s probably an 80/20 rule. Most females have a slightly higher pitched voice. And I will share with you that COVID Really, really made it difficult because of the masks. I don’t you know, I think even we forget how much we watch people’s lips, when we’re communicating. It’s just a built in habit that we all do. But as as senior start to lose their ability to fully hear all those words, they start focusing in on some of those other senses to try to help them out. Which is decided your lips moving? Yeah, yeah. That was a hard thing for the industry. Really difficult thing for the industry was the mask.

Amyn Amlani 27:39
Yeah, yeah, it’s a fine line between you got to live and you got to hear and, you know, how do you manage that. And eventually, they came up with those, those transparent masks, and I assume that they helped at least a little bit, when they were available to you. Yeah, we

Hank Sarazin 27:55
use those, we actually bought 10 masks for every community, we service and sent them to the communities and said, you know, if for nothing else, we were hoping that it would at least increase the awareness of the challenges that the residents were having now, because, again, it not only did it cover their lips, but it muffled the sound, right? It there was multiple levels that are masked does and and you know, the seniors were really, you know, and they were even that much more isolated. I mean, social interaction is the recipe for a senior, you know, at the end of the day, that is, that is the secret sauce of assisted living engagement. You know, you’re not, you don’t put your mom in an assisted living community. So she sits in her room and watches the prices right all day. You want her to go out and interact with the other residents and interact with the staff and, and go to bingo and go to chair yoga, or the painting class or believe me, I complement these assisted living industries, they are always trying to come up with some idea that will get the residents together and engage them and activate all their senses. Because that’s, that’s what they have. Now. You know, there’s no, there’s no big cruise coming. There’s no you know, European vacation coming. You know, what, what do they have to look forward to, you know, being able to wake up in the morning and you know, listen to the music and look outside and see the birds and be able to enjoy your breakfast and taste your food and have enough dexterity to manage things. You know, those five senses, in my opinion, are the absolute foundation of of what helps make a senior want to get up again and live the next day. I’ve actually I’ve added in a sixth one that I’ve learned I call it the sense of independence, which is really one of the one of the real hard things for a lot of seniors you know, first you sell the house to move them into the assisted living community. Then you take the car away And then you take the checkbook away, and mom’s really starting to lose her independence. And that’s, that’s very, that’s a very demeaning part of someone’s life. And I see that, you know, their sense of independence might just mean something as simple as they can just take care of themselves, by themselves without any help. And that’s, that’s those are important things for for our seniors. Definitely, without a doubt in that I love the services that we provide for that reason. Helping them eat and taste their food and helping them be able to listen to the music and communicate with their friends and go to chair yoga and follow the commands. You know, it brings big smiles to people’s faces, it’s pretty special when we get to have that opportunity and see a scene and make a difference and see that smile.

Yeah, but it’s all about quality of life. And it sounds like you guys have mastered it in a very eloquent way. So you know, my hat’s off to you.

We try- mastered might be kind of a big word. You know, one of the things we’ve learned is that every family is a little bit different. And we need to, you know, sign up i It’s an experience to sit in our office with a couple of the folks who do those new patient calls. You know, you’re asking, Okay, so when was the when was the last time your mom had her hearing tested? And you get I don’t know anything about my mom, I don’t know any of her meds that, you know, this is the the adult child issue in our society is a big deal. And we have a lot of, you know, people our age, I should have asked, I mean, how old your mom and dad if you don’t mind me asking?

Amyn Amlani 31:42
Yeah, my, my dad is close to 80. My mom passed away in ’18, she would have been 81. This year.

Hank Sarazin 31:50
I’m sorry to hear that. But so you have an acute sense of what I’m talking about is, is the even you know, my my wife, I her mom is 81 We’ll call her Nana. And I listened to my mom and dad passed away. But I listened to my wife on the phone with Nana, trying to navigate doctor’s appointments. And what did they say and and try you know, especially if there’s distance there, this issue of the adult child and having people in our 50s, early 60s, having older parents that they have some level of responsibility for it’s about to explode the data, I mean, I’m sure you’ve seen it the data of the number of people that are turning 78 and 79 and 80 right now, and then that 20 year span.

It’s a lot.

Amyn Amlani 32:43
Yeah know, 100 percent and you know, we don’t have, you know, we don’t have the supply, we don’t have the number of audiologist and hearing instrument specialists to service all of these individuals. And so now, you know, we’re moving to a disruptive model of over the counter. And so have you all had a discussion? Or what are your thoughts on over the counter as it relates to your model?

Hank Sarazin 33:07
You know, I think, obviously, as we know that the hearing industry’s got a lot of disruptions going on right now. One of them being you know, some different players wanting to get into space in the passing of that bill. I don’t, I don’t see how my typical patient is, has the dexterity, the visual skill set, and the hearing skill set to do this on their own, it’s too many different senses at the same time to try to activate they they’re getting, we’re seeing more and more folks, you know, there’s a lot more iPads in assisted living community than they were five years ago, of course, cell phones, more comfort level with the seniors and these devices. But you know, also on top of that is you have, you know, all the arthritic situations going on, you know, and the ability for them to even use the device, you know, even as big as they are now. So, I think that it’s going to be a very difficult challenge. I mean, I think this will be in so many ways. I think technology is not the friend of the senior. I would love to have those great big huge hearing aids. Because they can, you know, the average senior that I deal with, they can’t feel that button on the back. We actually working with ReSound, they have a small little mini remote, that’s super simple. It only has a program button and a plus and a minus button. I like simplicity for the seniors to get them to maximize, you know, whatever that might be. So I don’t I don’t think over the counter hearing aids are going to necessarily find their way to us. That doesn’t mean sons and daughters who have the time can’t sit down and maybe navigate this with their moms or dads. But I’m not I They don’t see them, at least not right away, maybe 10 years from now when you know, the next group of seniors are a little bit more technologically savvy. But I think that’s I had a couple notes. You know, I think that’s probably, you know, what I see right now is when when we send one of our teams in, and they sit with one of the residents, the residents light up, it’s a social visit for them with someone who, who was someone who cares about that, you know, that’s, you know, if there’s a hiring trait that I reach out to the world to have them helped me find, it’s how do I hire people that care, you can’t train that. I mean, and that’s, that is the absolute secret sauce recipe of our company is those folks that are going out into buildings, they have to genuinely care. And right now I’ve got an awesome team of five folks and hearing care about nine folks on the dental side, they’ve all been with me for quite some time now. And my office staff has been with me, I got a lot of people that they were built to do this, and that’s what I look for. And so it’s going to be interesting to see how technology seeps its way into senior care.

Amyn Amlani 36:18
Well, and I think we’re going to learn as this this segment evolves, we don’t really know it yet. And, you know, we, it’s, as you said, you know, we’re gonna skin our knees before we really figure it out. And, you know, the story will tell itself in a few years, and you and I can look back and say, you know, what, it worked over here, and it necessarily didn’t work over here. And and, you know, we’ll all learn and that’s part of the evolution of being in this business,

Hank Sarazin 36:45
and laws and regulations. Right. I mean, you know, represent, you know, healthcare is, is a big conversation in our country. What does that mean? You know, right now, we know that there isn’t any support in Medicare for there’s none for dental and there’s none for hearing. And I, you know, I find that kind of amazing, those are two of your critical senses. And we don’t have any support for those senses. In our in our in our federal health care program.

Amyn Amlani 37:14
Yeah, yeah. Ya know, 100 percent and, you know, hopefully things like MAASA will help with some of the treatment issues and so forth and so on. And, you know, again, it’s, it’s an interesting space that we’re in and, you know, we the future is very, very bright, you know, knock on wood, that all of these things come to fruition. And actually, you know, for the benefit of the patient at the end of the day.

Hank Sarazin 37:39
Absolutely. You know, I think, I think sometimes that can be a challenge. What, what is in the eyes of the patient in the family? What is that? Yeah, right. What is that? I think, sometimes, you know, maybe from a clinical standpoint, it’s up here somewhere. But that’s not reality, and how can I make mom’s day better? How can I make her more successful, taking care of herself and enjoying her day, so that she’s excited to get up tomorrow morning, enjoy another day. And that, that I think, sometimes is another part of this recipe, when you’re taking care of seniors is, make sure you’ve got the whole family involved? And what are the goals of what we’re trying to achieve?

Amyn Amlani 38:24
Well, you know, and I think that’s a critical point, I think these are the things that we miss, sometimes as audiologists, we think, you know, we’re gonna put a hearing aid on you and the world is going to be a better place. But at the end of the day, is that what their end objective was, and we need to hone in a little bit, because it may be something beyond that, and we need to understand what those things are. The what are the things that I I’ve had lots of knee surgeries and things from playing ball back in the day and, you know, then having some mishaps as as an adult. And the one thing that I’ve always appreciated when I went to the, to the surgeon, and then on to the physical therapist, there was always a plan and the plan was based on what do you want to be able to do at the end? Do you want to be able to run? Well, then this is what we need to do Are you just looking for flexibility? then this is what we need to be able to do. And at the end of the day, you also have to say, these are the limitations of what you can do, given what you’ve done to your body or what your body has done to itself. And because of those things, you know, this is the realistic traits of what you’re going to be able to do. And if you want to do something more than it could be this or this is where you’re at. And I don’t think we do enough of that in our profession.

Hank Sarazin 39:40
And and make sure you’re looking at the whole patient. Right and we’re here for a specific discipline, right I’m I’m here for a vision appointment, whatever it might be. But I mean, these folks are on a lot of medications. They have a various amount of ailments. Most Most of these ladies were smokers. That’s a big part of the 50s. I can’t tell you how many times we pull up to an assisted living community. And there’ll be four or five ladies sitting out in front sitting in the chairs, smoking a cigarette with their oxygen on.

Amyn Amlani 40:16

Hank Sarazin 40:20
You know what it again, I remember my dad, Unfortunately, he passed of cancer. And towards the end, I remember my mom struggling with you think it’s okay if I let him smoke a cigar? And it’s like, Mom, absolutely let him smoke a cigar. He’s, we’re not we’re not curing dad. We’re not, you know, I mean, if making today better by him smoking one of his pipes or smoking a cigar is going to make him happy. By all means. I think those are differences that, you know, always hard to kind of see. But you always try. I think our organization tries to make sure through the registration pause process and the collection of information where we’re sending folks in with that with the blinders off to the best of our ability.

Amyn Amlani 41:12
Yeah. And you brought up an important point, and that’s looking at the person holistically. You know, and so we’ve been talking about hearing, but what about balance and presbycusis? And you also have cerumen issues, I’m sure. So how do you handle those other intricate pieces of the of the service delivery?

Hank Sarazin 41:30
Yeah, the interesting part when the vestibular in the National Council on Aging, was doing some presentations just before COVID hit, and I kind of need to re circle with them. The single largest expense to Medicare is the finances related to falls by the number almost my jaw dropped i 52. A was crazy. And And ironically, late a couple of years ago, my mother in law, Nana, as I referenced was was playing bridge. And when they get up to take their break from bridge, another woman tripped on the carpet, and they both fell and they both broke their hip and Nana then it hasn’t been the same since, because they can’t do the rehab. Right. That’s the challenge of you know, for you and I might have been might hurt a little bit, we could probably muscle our way through some some rehab. But I think that’s, that’s a very important thing. So many of the communities have put together a program called it’s called Evidence Based falls prevention. And basically what what everybody’s trying to do is what are the things that make foot folks fall. So example is, you know, you’ve got a new resident in the community, they’re not familiar with the community, so no furniture, right around corners, right? So they don’t bump into a piece of furniture that, you know, could cause them to flat surfaces. And then obviously, as you know, hearing appointments and checking on that part of things, because it’s an enormous thing. So we’re trying to make sure that as part of their evidence based falls prevention program, that a professional, whether it’s us or somebody else is at least checking in to take a look to see if there’s something there that, as you said, with with proper assistance or proper care could be avoided. not cured, right. I think that’s, that might be one of the challenges of this business is we don’t cure people. That’s right. Right. We don’t you know, even you know, we don’t cure now- yes, we do things to make them better and more successful. So I think that’s an important thing. And then, you know, the presbycusis , it’s kind of funny, you know, we sort of joke we have, we have an awful lot of the same audiograms, right, you know, 15 to 20% Drop in an attenuation with a significant high frequency slow, we see that a great deal. And let me clarify, I don’t have any letters after my name. So I when I when I talk like an audiologist, but a typical of what a, you know, a senior’s audiogram looks like we see those, those are, like you said, that’s where hearing aids play a great role. They’re good at that. They are fantastic at leveling that out and bringing that up and making it work in a few different environments, and they’re getting better. So I think that’s a good one for us. Yeah, we do run into some stuff where it’s, it’s just simply out of scope. And they either need, you know, to go to another level of care or unfortunately, they’re in a situation that they need to figure out how to live with. And that’s when we talk about augmenting them with those other devices that might make them more successful. Sarin Sherman, this is a this if there’s an issue that exists in senior care, it’s this one. I can’t tell you how many times we see a resident in an assisted living community with earwax build up. And we’re pretty pretty. Crossing the x on digging in there – too many, too much blood thinners are going on in the assisted living industries. And even the most innocence of working to try to remove some cerumen could you know could cause a problem. I will share it from technology if there is a piece of technology that I’m really excited about. It’s the first the folks from Safkan and their Otoset, Yes. I actually have we have I have one similar to you a PhD an audiologist, who right now is working directly with those folks. You know, there’s it’s brand new, it’s I love the idea, it makes complete sense. We’re trying to put it on the head of a short shrunk little old woman who’s got osteoporosis. Not perfect, so to speak. But I still think if we can work with them and figure out how do we use that tool. It’s so difficult for a family to navigate that if we say to a family, your mom’s got impacted earwax, we can’t do a hearing test on her to get the building to coordinate the debrox maybe send them out to get

it’s like nine different things have to happen. So what happens when we go back the next time, nothing has happened. And we’re right where we were. So, you know, we we’ve reached out to the you know, the VA the you know, the nurse that you know, the VA community of nurses trying to trying to find a way for us to solve this problem. And then I will share one of the reps from resound was at a trade show in Texas, and he sent me an email, he’s like, holy crap, Hank, there’s this new device out there. And we’ve got a couple of them and we’re trying to work with them right now. They’re, there’s their direction is good. I think that they know some of the shortcomings of their first prototype. And I’m excited to see where we go with that, because that can be a game changer for seniors and for my company without a doubt.

Amyn Amlani 47:08
Yeah, 100% we, you know, Jackie, Jackie Phillips is a Texan, because I’m in Dallas here, so I don’t Well, and I was at that ReSound event when they unleashed to this, this new product, and it’s a it’s a really cool product. And I think, as you pointed out as they as they continue to evolve that product, that you know, they may have a number of different units to fit different models, one of them being the one that you’re in and but it’s exciting, again, this whole evolution and the opportunities that are starting to, to surface so that we’re not having these hang ups that we’ve had for so so long. Right? And they’re

Hank Sarazin 47:49
just it’s logistics, right? That’s what’s frustrating about it. So, no, you know, I could see, we could we could have three of those. And we could spend a day in an assisted living community, just taking care of earwax on folks. I mean, forget anything else. It’s such a major issue, particularly for the hearing aid wearers who are making even a worse problem.

Amyn Amlani 48:12
Yeah, yeah. Well, Hank, this has been fabulous so far. So I’m going to ask you one last question here. What’s what’s next for you? We’re looking at expansion. What’s what’s what’s next? You’ve done so much already?

Hank Sarazin 48:25
You know, I, I guess first, you know, I’m so lucky. I mean, you know, my dad owned a construction company. I got to go to college, I graduated from college, and I’ve worked in different fields, and I’ve gotten to be an entrepreneur. And I’ve been able to do something really special, I’ve been able to make people’s lives better, and in some cases, much better. My director of regional operations, Fran maxtow, she’s been with us for 16 years, we’re only 17 years old. And we always kind of joke. When we’re not having a good day, we joke that it’s time to go to a community and spend some time with our patients. Because they just, it’s awesome. It’s awesome. So and I’m really lucky that we, you know, whether it be you know, maybe giving delivering a brand new set of dentures to somebody, or, or having a son or daughter actually communicate with their mom or dad over a phone with mom’s new hearing aids on and the smiles that we make. So So I was built to be here, and I don’t plan on going anywhere. So that’s the first thing the the assisted living industry is a national business. And therefore there’s no reason for me not to dream and I do have experience from the consumer products industry of growing a company. But at the end of the day, I mean, I’m only as good as my next hire. Yeah, in and I don’t, I don’t see. I don’t See me growing this business without an army of awesome caring people Yes, I will use technology when it when it makes sense and it’s available and we can we can gain further successes and making people’s lives better. But I think if there’s a skill that I want to hone, it’s it’s my skill to continue to figure out how to find people that care and in this environment, as you know, staffing is, it’s more difficult than it’s ever been. And particularly in health care, our customer, the assisted living communities, they are fighting the fight right now, as you can imagine, with their staffing challenges. But you know, I’m in New England based company right now i service over 200 communities for dental care, and we’re about at about 125 for hearing care. If I could bring on board three or four more good caring hearing instrument specialists, or audiologists, those buildings are waiting for me, um, you know, they’ve been doing, they trust us, they’ve been working with us for a long time, and they trust the way we do things, that we’ll treat their residents well will treat their staff well, and will treat their sons and daughters well. So I mean, I think that’s the first piece. The second piece is the dental business has different regulations. So you know, there’s, there’s big, they call them DSOs dental service organizations that manage lots of practices, and we function like that in dental care. And I’ve really sort of tried to treat hearing health the same way. I think it was Ronald Reagan, once it had a quote something along the lines of, I try to surround myself with the brightest smartest people I can and then get out of their way and let them do their job. That’s my goal is is to give someone an audiologist, a hearing instrument specialist, a dentist, if I decide, I get asked if I’m going to do vision or podiatry from my customers all the time, give them the structure, give them all the systems, give them the office support structure, put the patients in their chair, give them the rules about you know, what are lessons that we have learned from doing this. But give them the ability to do what they do. And that is patient care. And we do it pretty well now, and if I can keep doing that, and keep doing that better. And then I can learn how to interview and find caring people. My train is heading west.

Amyn Amlani 52:33
Well, Hank, it’s been fabulous. And I, I hope to see you move west in expand, I love what you guys are doing. And again, it’s all about that patient care. And, you know, hopefully, down the road here, we’ll be able to get you back on and you can then tell us that you’ve hired some new folks and you’re seeing more people and as you said the train is headed towards the Rocky Mountains and maybe further than that,

Hank Sarazin 52:58
yeah, no, I love the space for a lot of different reasons. I was definitely for some reason I ended up here because I love what we do. It’s it’s had its days, and I’m sure it will have its days again, but I love what we do we make people smile. And that’s that’s pretty awesome.

Amyn Amlani 53:17
Yeah. Well, Hank I appreciate it. And you know, again, thank you for all that you do for the seniors. It’s it’s been wonderful chatting with you.

Hank Sarazin 53:24
Yeah, it’s been great getting to know you and chatting with you as well.

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About the Panel

Hank Sarazin is Founder and CEO of Onsite Dental and Onsite Hearing Care. Hank grew up in RI, and now resides in Falmouth ME with his wife and two girls.  He graduated from Bryant University in 1986 with a degree in Accounting.  After spending 5 years in the accounting field he joined the Boston Beer Company. During his 10 years he was part of their national roll-out, IPO, and in his last role, ran Boston to Buffalo as a Regional Manager.  After spending several years in Finance he joined a former colleague as the National Sales Manager for a mobile dental company out of Florida.  That company was unsuccessful, and when they closed down their operations, that triggered Hank to start Onsite Dental Care in 2005.  He has successfully guided and grown Onsite Dental over the past 17 years to be a leading provider of dental services to Assisted Living Communities, now serving over 200 assisted living communities in New England.  In 2016 Hank launched Onsite Hearing Care to accompany Onsite Dental.  Currently Onsite Hearing Care is providing services to over 100 assisted living communities in New England and continuing to grow.


Amyn M. Amlani, PhD, is President of Otolithic, LLC, a consulting firm that provides competitive market analysis and support strategy, economic and financial assessments, segment targeting strategies and tactics, professional development, and consumer insights. Dr. Amlani has been in hearing care for 25+ years, with extensive professional experience in the independent and medical audiology practice channels, as an academic and scholar, and in industry. Dr. Amlani also serves as section editor of Hearing Economics for Hearing Health Technology Matters (HHTM).


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