DELRAY BEACH, Fla. — A mile off the main drag, in a neighborhood outlined by a single-lane unpaved road and featuring rows of waist-high hedges, a 5,000-square-foot mission-style house is innocuous enough. In the backyard, four men gather in a circle of lawn chairs on the patio. They have just returned from yoga. It's the middle of summer, and the midday sun beats on their shoulders and glistens off the pool at the center of a manicured lawn. “Sometimes I look around,” says one of the men, “and wonder how I got here. Not necessarily at a place that's as beautiful as this, but a place where I feel secure.”
This is an addiction treatment center, and these are four of the patients in the 10-bed home. They range from ages 24 to 47, hailing from New Jersey and Western Massachusetts. They all have stories: heroin, alcohol, strained family relationships. Some have been to rehab before—some more than once. “I've been at places with 30-40 beds, places that you can just slip under the cracks if you want to,” one of the men says. “And so that's what I did. It's not like that here.”
A few feet away, Anthony Fasano looks on and smiles. He is about to enter his 12th season as an NFL tight end, and he is the owner of this facility.
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An active NFL player kick-starting a second career isn't exactly novel. But when Fasano, who has played for the Cowboys, Chiefs, Titans and is about to begin his second stint with the Dolphins, opened Next Chapter Addiction, it raised eyebrows for being unconventional, and risky.
And indeed, it has been a complicated venture for Fasano. His playing career is dwindling (the 33-year-old just signed a one-year deal with Miami). He invested in the facility in part because it could be lucrative. It's also personal. Fasano's brother-in-law struggled with addiction and recovery.
“I feel like I went into this for all the right reasons and because I wanted to do things the right way,” Fasano says. “At times I feel like I'm way over my head. But I hope in the end it's worth it.”
Southern Florida, specifically Delray Beach—nestled among the retirement communities between Fort Lauderdale and West Palm Beach—has attracted dozens of addiction treatment facilities over the past decade. There's a nationwide opioid epidemic, and there's a race to capitalize on it. According to a 2016 fact sheet by the American Society of Addiction Medicine, the overdose rate in 2008 was nearly four times the 1999 rate and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.
The treatment industry can be flush, but it's also brimming with fraud and seedy practices. The Palm Beach Post has reported extensively on facilities using suspect methods to lure patients, profiting off their addictions and insurance policies. This month alone, the Palm Beach County Sober Home Task Force has made at least six arrests. The charges range from patient brokering (the owner and manager of one sober home were accused of taking 11 payments last summer, totaling $2,993, in exchange for referrals) to running up charges on urine tests to make profit.
When Fasano's brother-in-law was in treatment in South Florida, he often came over to Fasano's house for dinner. Now recovered, the brother-in-law moved back to Florida permanently in part to distance himself from his previous life in New Jersey. He began working at the center that helped him with recovery. Often he and Fasano discussed the industry. Fasano, who majored in business marketing at Notre Dame and completed the NFL's Business Management and Entrepreneurial Program at Northwestern in 2012, has done some angel investing over the past eight years. He'd ask questions about the business model and growth opportunities.
“It really piqued my interest, and I thought initially I could invest in their next real estate piece or expansion,” Fasano says. But that facility hit a rough patch.
Meanwhile Abe Antine, a clinical social worker, envisioned creating a facility with a holistic approach to treatment. “I was really unhappy with the facility where I was working,” Antine says, “and thought, If I could just meet the right people who could help facilitate my ideas…”
Antine and Fasano first crossed paths in 2015, through an acquaintance of Fasano's brother-in-law. Immediately, they clicked. “It's really serendipity,” Fasano says. “A lot of things came together at a weird juncture really quickly.”
In May 2015, Antine and Fasano became partners. They put together a business plan. They created a code of ethics. They determined that the facility would center around treatment. Though 12-step recovery has been the traditional philosophy for addicts and alcoholics since the 1920s, Antine wanted to have a facility that centered on therapy, looking at issues of childhood, family, emotional abuse and neglect. They would offer separate therapists for family members to help them deal with their own issues. “We wanted intimacy,” Antine says. “Tender love and care put into each patient, to repair negative experiences through positive.”
And so they built a dream facility, a place Fasano says he “would feel comfortable sending family members.” The price tag wasn't an issue. In the offseason Fasano immersed himself. Next Chapter opened in December 2015, purchasing a five-bedroom home once occupied by a family. They hired 14 full-time staff members, including Fasano's brother-in-law. Soon, Fasano and Antine realized that building an addiction treatment center—and doing things the right way—takes a lot more than a good idea.
“I'm not going to lie and say it has been easy,” says Fasano. “Going in, I was totally ignorant. I knew nothing about how treatment centers work, let alone the politics. I just wanted to help. I had no idea what I was getting myself into.”
The bills piled up—Fasano has poured seven figures-worth of his own money into the venture and has yet to see a return. Yet, he has pushed on. A second home officially opened last December, two houses away on the same street.
In describing the early struggles, Fasano says it's “typical growing pains of early startup stuff.” Though Antine wrote the program, there's always a tweak; every patient is different. From the business side, Fasano was overwhelmed by the sheer bulk of decisions to be made. For example, Next Chapter is currently on its third billing company.
Some of the decisions Antine believes make their facilities more attractive than competitors aren't necessarily cost-effective. They don't want a therapist to have more than five clients at a time. They have separate therapists for patients and parents of patients, spouses and loved ones, something most facilities don't offer largely because insurance companies with whom they deal with don't consider it to be a medical necessity for the patient. The second home allows for Next Chapter to offer age-specific groupings (one home is for 18-29 year-olds while the other is for 30+).
“The house is great, the program is great, the product is great,” Antine says. “When we opened, I was very confident this would be an immediate success, but I don't think I fully understood some of the other treatment centers out there, and the corners they were cutting.”
Though Fasano's stature as an active NFL player might seem like it would be a draw, he says his largest hurdle has actually been exposure. “The industry is so saturated,” Antine says. “The big fish have so much to spend on advertising, it's difficult to compete.” Fasano, 17 months in, is still going with what he calls an “old school, grassroots approach,” leaning on relationships and word of mouth.
And by virtue of being new, Fasano and Antine don't have as many connections with doctors and agencies that send referrals. Last summer, of the five patients occupying the 10-bed home, all of the patients have come through word of mouth. Fasano has attended conferences over the past year to learn about the industry and initiate outreach, and says he will have more time to do that after he retires.
“We're only 17 months in,” Fasano says. “It's going to work out in the long run, I know it will. It's just another thing I'm going to have to work at.”