We caught up with one of our newest board members, Shari Costantini, to discuss her hopes and dreams for StarterStudio and tech startups in Central Florida. Don’t let that phrase fool you, Shari is much more than a “hope-and-dreams” kind of person. From 2003 to the fall of 2021, when she retired, she grew her medical staffing business, Avant Healthcare Professionals, from $650,000 in annual revenues to $175 million. Not bad for someone who started out as a registered nurse? Along the way she earned an MBA, found an angel investor, attracted private equity investors, and pivoted more times than a ballroom dancer. In this interview, she shares more of her entrepreneurial journey and hopes for local startups.
StarterStudio: We don't want you to have to go through your entire biography, but maybe you could talk a little bit about your professional life, particularly as it relates to your staffing firm.
Shari Costantini: Well, my professional career is kind of an interesting story. I remember graduating from nursing school, and people asking me, “What are you going to do in five years Shari? Because I know you have a plan.” My plan at that point in time was really to get my masters and go into the business side of healthcare. So, I went to nursing school really as a kind of a technical degree that I thought would help me in the business world. As things evolved, I ended up leaving the hospital setting, recognizing it really wasn't for me. I learned first-hand about the cultural issues in hospitals for nurses that continue to be a huge issue in terms of retention.
StarterStudio: How did your entrepreneurial journey begin?
Shari Costantini: The groundwork started when I went to the company that I was employed with at the time and said, “I've got this great idea for how we can make the transition easier with clinical programs.” I did not get a positive response to that. So, I ended up leaving. My entrepreneurial journey began as a result of that moment. I decided to start my own company in 2003. I found an angel investor who had a passion for what I was doing. He was from Mozambique and came to the US and went to nursing school, eventually growing a very large per diem nursing and respiratory staffing business. That's how I got the funding, the original angel funding, to start the business.
As I look back, while I’m doing some of the mentoring I do now, there were so many things that I just didn't know. So, I told myself, I'm going to roll up my sleeves, I'm going to start a company. Now, we just have all these accelerators and great resources for people that want to be entrepreneurs. But I didn't have those.
StarterStudio: Can you tell us about the growth of the company?
Shari Costantini: My entrepreneurial journey started in 2003. A couple of years in, we grew to $7.4 million, and we were running out of money. I hit that pivotal point that every entrepreneur hits, where you say, “Do I want to grow this business organically with the resources I have? Or do I want to go out aside and raise professional money?” For many people, that answer is no. For me, the answer was yes, because I had already started a business with an angel investor. I was building shareholder value in my mind.
To do that with professional money was not really scary to me. I knew that I had to have an exit at some point in time. That really comes front and center when you do raise professional money.
StarterStudio: You had some pretty tough regulatory hurdles to get over as you grew the company, right?
Shari Costantini: Yes, and they forced us to make some substantial pivots in the business. My original idea was to place internationally educated nurses in the U.S. and international hospitals. But visa delays for skilled nursing staff forced one of our first pivots. We switched to the placement of physical and occupational therapists, growing that to a $22 million business.
In 2012, we pivoted again because of regulatory issues for skilled nursing facility reimbursement for therapists. In late 2014 to early 2015, those visas came back for nurses. That really proved the original thesis of what I thought the business could do in terms of growing and scaling. In 2015, we began building back that client base of hospitals and placing nurses in hospitals.
StarterStudio: Most graduates with a nursing degree don't know anything about finding an angel investor or the idea that they might even need one to get started. So where did that sort of information get into your outlook and vision?
Shari Costantini: I earned my MBA in 1993. The last portion of the program was building a business plan. I went to the general manager of the hospice where I worked in Chicago, and I said, “Hey, if you give us the financial model (because that was the hardest part for us), we'll build a business plan for Milwaukee and give you the plan. They ended up opening one of their hospices in Milwaukee, based on the plan that we developed.
StarterStudio: You don't need to memorize the entire mission of StarterStudio, but if we boil it down to two themes, strengthening the tech startup ecosystem and elevating the region in the eyes of investors, what about those themes resonates with you as an incoming board member?
Shari Costantini: Well, I've been working in the entrepreneurial ecosystem in Orlando since about 2010 when I joined the Chamber. It's been called different things over the years, but the Chamber was called Orlando Inc. at the time.
We were really focused on building support for entrepreneurs at that time. I became chair of the Capital Task Force where we researched bringing more capital to the area. We looked at all the things that were happening in a fragmented way. We never got to where we wanted to go with the ecosystem. When you're dealing with a lot of different entities that have different visions, it's difficult to do that. Now, I'm also part of The Entrepreneurs Alliance of Orlando. It has a similar mission, to leverage the magic of the region for investment grade businesses. I think that that's really what we're trying to do at StarterStudio as well; really leverage the region to help these new entrepreneurs scale their businesses. The first step is to come up with the idea, and really be able to vet that with people that know a little bit more about, scaling a business and then help point them in the right direction to build that business, scale it and attract the investment needed.
StarterStudio: Do you have any personal goals in serving on the board?
Shari Costantini: All my work with entrepreneurs is really focused on giving back to entrepreneurs, sharing my experience, connections, and helping to make their journey a little bit easier than mine was.
StarterStudio: Do you have any passions on the side that we don't know abou that could help a startup? Obviously if it was something in staffing, you'd be the go-to person, but is there anything else you have a side interest in: energy, electric vehicles, fashion? You build super computers at home on the weekend or anything like that?
Shari Costantini: What has become really interesting to me is how applicable the principles of building any business are to every business. I did some interim work for a company that really was targeting mining, petroleum, dredging, anything that, you know, had big pipes and they wanted to measure what was in the pipes. I found that I could quickly learn things about a new industry, and then apply the principles of scaling a business to them.
StarterStudio: Think about your superpowers- what is one of your superpowers? How will you apply it towards StarterStudio’s success?
Shari Costantini: I think one of my superpowers is creative thinking. And it goes back to the regulatory side of the business. You know, after building a business that was so impacted by government regulations for 18 years, I had to figure out how to get around that.
So, I led the trade association, I helped found it. Then I led the trade association for about seven years as the chair of Regulatory Affairs. We had regular regulatory issues with licensure boards, with immigration regulations with foreign governments. When you look at the complexity of those problems, oftentimes it's about relationships. Who do you need to get to know in the government? How do you find a way around it? I'm working with a company now that is looking at EPA approval process versus FDA. I'm helping them to think through what's the timetable? What's the cost? What's the alternatives? What kind of obstacles can we hit? And how do we minimize the impact of those obstacles? That is really something that I have learned over the years that I can apply to other businesses
StarterStudio: If you were to look ahead five years and you were reading your favorite business journal or business blog, whether it was the Wall Street Journal or the Orlando Business Journal and they were doing a story, what would you like that story to be about as it relates to StarterStudio?
Shari Constantini: I would like it to be about the way that they've impacted startups in the community. And when I say that, I mean there are two ways that you impact startups, right? First help them figure out a path to become an investment grade business, which means you're going to be scalable, create value for shareholders. There's a lot of people that go in with a great idea that may not pan out the way they anticipated.
I think at StarterStudio, really, you can help them think through that idea which is the second way to impact the community. Maybe that idea pivots, maybe it morphs into something else that can be investment grade, or maybe it's just not something that you're going to want to invest your life and your time. When you're an entrepreneur, it is your life. You feel like it's your life. And for some people, that might be a hugely successful path to starting that company. And for others, it may be this isn't right, I'm going to go do something else. That's not a bad thing. That's really helping those businesses and those people.