What It Looks Like to Sell to a Home Care Roll-Up And Stay On

Adam Berry built As Close as Family over nearly a decade before realizing the business had outgrown what he could sustainably manage on his own. Rather than walking away, he sold the agency to Avenues Home Care and stayed on to focus on the work he enjoys most while gaining the back-office support he was missing. In this episode, Adam and Avenues CEO Doug Markham break down how they found the right acquisition fit, what due diligence actually looked like, and why culture mattered more than valuation. They also share how they divide responsibilities after the sale, which functions are centralized versus kept local, and why giving operators autonomy has been critical to continued growth.

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min

Jul 7, 2026

What It Looks Like to Sell to a Home Care Roll-Up And Stay On

Miriam Allred (00:01)
Hey everyone, welcome back to the Home Care Strategy Lab. I'm your host, Miriam Allred. I am really excited to be back with you this week. I hope everyone's having a great week and thriving. It's summer and there's a lot on the horizon for people, maybe some distractions with kids out of school and things, but hope everyone is doing well and working hard in their businesses.

Today in the lab, I am joined by two gentlemen. We've got Adam Berry, the COO at As Close as Family, and also Doug Markham, the CEO at Avenues Home Care. Gentlemen, welcome to the show.

Doug Markham (00:35)
Thanks for having us.

Adam Berry (00:35)
Thank you for having us.

Miriam Allred (00:37)
Let's go ahead and start with introductions.

Adam, you are the COO at As Close as Family and you've been in the industry for a while. Tell us little bit about getting into home care and then starting your home care company.

Adam Berry (00:49)
So my background's home health physical therapy and during that time I saw the need for another level of home care. There were people doing it you know, not not to a satisfactory way in my opinion. So at that point I said, Hey, there's there's something here, there's a great need. So started that in twenty sixteen and then we've grown and grown ever since and and really grown all over the state of Alabama.

Miriam Allred (01:15)
Amazing. And you started the company you said twenty sixteen. Here we are twenty twenty six. So it's been ten years and we're gonna talk a little bit about your journey and what kind of the stages of your business is, which leads us to Doug, why don't you go ahead and introduce yourself and Avenues Home Care?

Doug Markham (01:31)
Sure. Thank you for having us. really honored that you invited us to participate, so thank you for that. as said earlier, I am Doug Markham. I serve as the CEO of Avenues Home Care. My working career has been primarily spent in insurance and claims and managed care. And a lot of those claims years were spent in the

Automobile and workers' compensation world. And so in the workers' compensation world, we dealt with a lot of claims where quadriplegic and paraplegic, and really long term, long duration claims where an individual would not be improving, but nursing care, skilled nursing was too expensive, and so they would use home care. And that's where my experience came with home care. A lot of times it was hiring a family member, but other times there were

Situations where we were bringing in individuals for respite care or when family members were working. So that was really my introduction into home care. Today avenues

Serves two other brands. Adam is one of those, as Close as Family, which serves Alabama. And then we have another brand name, ClearPath Home Care, which serves Dallas and North Texas. We are in four states, Texas, Tennessee, Alabama, and Georgia, and within those four states we have about 25 locations where we're serving individuals.

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Miriam Allred (02:55)
Amazing. That's perfect. And we're gonna talk about exactly that, Adam. Your journey of essentially selling to Avenues Home Care, but remaining active in day-to-day operations. I said to you both before before this conversation, a lot of operators get to this point, Adam, that you hit, which is where do I go from here? You know, I think of this this kind of like fork in the road for a lot of operators. They may be burnt out, they may be hitting kind of a plateau revenue wise or hours. And

And there's there's options of where to go. And you kind of went down a specific path and got acquainted with Avenues Home Care and essentially sold to them, but I've stayed involved. And so I find this very fascinating and just want to kind of unpack your journey and explain to operators what is possible and then what it looks like to to sell, but then be involved in day-to-day operations. So starting with that, Adam, I'm curious at what point did you start to feel like you were

hitting this kind of wall or this plateau, how many years into the business, how many, you know, kind of hours or revenue? What was kind of this point where you started to feel like was it an itch or, you know, was it stress? Like what what was the feeling and when did that hit?

Adam Berry (04:03)
It was probably nine years into the business, eight and a half, nine years into the business, that I said, Hey, this is we have we experienced just a large amount of growth. And it was it was to the point I was I was like losing sleep at night. And you know, when you start losing sleep at night and you're saying, Hey, a leader is a visionary and that leader has to be looking at not what we're doing tomorrow, we have to be looking at what we're doing six months from now, a year from now, five years from now, one, three, five year plan.
And so, you know, once I saw that, I said, hey, this thing is outgrowing me. And this is something that I need to bring in some other resources. And that's where we got to the point we're at now.

Miriam Allred (04:44)
Were you still very bogged down in day to day operations or were you already kind of starting to step back?

Adam Berry (04:50)
I was starting to step back some, but still I enjoyed the day to day. but you know, some of that was have to, which we'll talk about later of of you know when when we met Avenues and and how that worked. But you know, it was some was have to, some was want to.

Miriam Allred (05:09)
Mm-hmm. What other what did your administrative team look like at that point? I'm just curious because oftentimes, you know, there's the CEO role and it can get lonely at the top and you being the visionary, it's like you carry this this huge burden. I'm curious, did you have other kind of like C suite or director levels? Like what what was the in infrastructure of the administrative team at that point in time?

Adam Berry (05:29)
at that point brought in a vice president of operations and you know she was a a great integrator has been a great integrator and and we worked very very well together we did the the rocket fuel analysis and she scored very high on integrator. I scored very high on visionary and we said, Hey, there's something here. This could this could work and I feel like we were a dangerous duo.

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