Operator-Led Advisory

Strategic advisory for companies ready to scale.

We work with founders doing $2M-$20M in revenue who need a senior operator in their corner — not a slide deck from a consultant who's never run anything.

$500M+
Assets Managed on Wall Street
$300M+
Distressed Assets Advised
8
Health Systems Scaled
30 Day
Outcome Guarantee

Carey Grainger

Three decades of building, scaling, and turning around businesses — from Wall Street trading desks to real estate advisory and healthcare operations serving 1,000+ patients monthly.

1993 — 2004 · Wall Street
Lehman Brothers, Salomon Smith Barney, Citigroup
Grew assets under management from $50M to $500M+ across major institutional desks. Built client portfolios through the dot-com boom, bust, and recovery.
2004 — 2009 · Strategic Advisory
Kairos Advisory
Transitioned from institutional finance to direct strategic advisory, counseling growth-stage companies on capital strategy and operational scaling.
2007 — 2012 · Real Estate
Williams Capital · Kairos · General Advisory
Multi-asset class real estate work spanning hospitality, commercial, raw land, conservation easements, and multi-family. Provided capital management advisory to select real estate development companies on acquisition strategy, capital structure, and asset positioning.
2011 — 2023 · Healthcare Operations
Patronus Medical, Guardian 24/7, RTW
Built Patronus from scratch to 8 health systems and 1,000+ consults per month. Advised on $300M+ in distressed healthcare assets. Hands-on operational leadership, not arms-length consulting.
Current
Construction and Roofing Industry · Operational and Financial Turnaround
Active advisory engagement focused on financial restructuring, operational optimization, and return-to-profitability strategy.

X Holdings was incorporated in 2013 to formalize a practice built over two decades: helping mid-market companies navigate the specific challenges that come between early traction and real scale.

The gap between $2M and $20M in revenue is where most companies either break through or stall out. The problems are rarely about product. They're about capital structure, operational discipline, team design, and knowing which fires to let burn.

Carey's background is unusual for advisory: a decade on Wall Street developing institutional-grade financial discipline, followed by multi-asset class real estate work across hospitality, commercial, and development, and 15+ years actually building and operating companies in healthcare — one of the hardest verticals to scale.

That combination — financial acumen plus operational scars — is what clients get. Not frameworks. Not workshops. An operator who's seen the specific version of the problem you're dealing with.

At a Glance
  • 30+ years across finance, real estate, healthcare, and advisory
  • Grew AUM from $50M to $500M+ at Lehman, Salomon, Citigroup
  • Multi-asset class real estate advisory: hospitality, commercial, multi-family, raw land, conservation easements
  • Built Patronus Medical to 8 health systems, 1,000+ consults/mo
  • Advised on $300M+ in distressed asset restructuring
  • Current financial turnaround advisor in the construction and roofing industry
  • Based in the Southeast US

Advisory that fits how you actually work

Three tiers based on how much direct involvement you need. All include weekly touchpoints, Slack access, and async availability. No 12-month lock-in.

Advisory Lite
$2-4K/mo
Strategic guidance on your terms

For founders who need a seasoned sounding board and strategic perspective without full operational involvement.

  • Bi-weekly 60-min strategy calls
  • Async advisory via Slack & email
  • Monthly strategic memo
  • Quarterly business review
Get Started
Full Strategic Advisory
$15-25K/mo
Your fractional Chief of Staff

For companies at an inflection point — fundraising, turnaround, market expansion — where you need a senior strategic partner embedded in the operation.

  • Unlimited advisory access (same-day)
  • Weekly deep-dive sessions
  • Full strategic planning & oversight
  • Board meeting prep & attendance
  • Fundraising & investor materials
  • Executive hiring & org design
  • Monthly KPI dashboard & analysis
  • Crisis management & rapid response
Discuss Your Needs

30-day outcome guarantee. If you don't see measurable progress in the first 30 days, walk away. No questions, no long-term contracts. We earn the next month.

Advisory that actually moves the needle

Most advisory relationships fail because they're built on frameworks instead of execution. Here's how we're different.

vs Quarterly Reviews

Real-Time Execution

Weekly working sessions with async access between calls. Problems don't wait 90 days, so neither should your advisor. You get an operator in your corner every week, not a quarterly check-in that's already stale.

vs Chair Lottery

You Pick Your Advisor

Peer groups like Vistage assign you a Chair. Maybe they've run a business like yours. Maybe they haven't. With X Holdings, you get Carey — 30 years of directly relevant experience across finance, real estate, healthcare, and mid-market operations.

vs 12-Month Lock-In

30-Day Commitment

Traditional advisory firms lock you into annual contracts. We work month-to-month with a 30-day outcome guarantee. If we're not creating measurable value, you leave. That alignment makes us better.

vs Generic Playbooks

Industry-Specific Context

Deep operational experience in healthcare, real estate, construction, and professional services. Not a one-size-fits-all framework — battle-tested pattern recognition from companies in your specific vertical and revenue range.

Vistage / EOS Big Firm Consultants X Holdings
Engagement Cadence Monthly / Quarterly Project-based Weekly + async
Commitment 12 months 6-12 month SOWs 30-day rolling
Who You Work With Assigned Chair Junior associates The principal directly
Execution Support Peer discussion only Deliverables, not outcomes Hands-on execution
Monthly Investment $1.5-2.5K $20-50K+ $2-25K (your choice)

Ready to work with an operator,
not a consultant?

30-minute intro call. No pitch deck, no pressure. We'll talk about where your business is, where you want it to go, and whether X Holdings is the right fit to help you get there.

"The gap between $3M and $30M isn't a strategy problem. It's an execution problem with a capital structure underneath it."
— Carey Grainger, X Holdings