How to Start and Scale Your Own Home Care Agency

More than 55 million older adults live in the US, and the demand for care services is slated to continue at a high rate. Since most older adults want to age in place, this is the perfect place for you to be.

CareTime user and owner of America A Care, Dr. Malik, founded his home care agency after caring for his parents in Bangladesh. He wanted to bring that care to his community in the US, holding a standard for 110% client satisfaction. With over 43 million Americans caring for someone they love, almost everyone has a personal connection to this space. 

What’s more, 72% of Gen Z plan on taking care of their parents, according to new research from Caring.com. This is all to say that, home care is in demand, and will continue to be for years to come.

Rosalynn Carter once said, “There are only four kinds of people in the world — those that have been caregivers, those that are caregivers, those who will be caregivers, and those who will need caregivers.” Use this mantra as a North Star when opening your home care agency. 

Starting a home care business is a worthwhile and profitable endeavor when you do it right. We’ll spill the tea and share what you need to know to be successful. 

Legal and Licensing Requirements

Before going out and buying a domain name, make sure that you take a step back to review the legal and licensure requirements for your state. They vary widely in depth and will shape the types of services you offer, and to what extent. 

For example, in California, home care providers can only hire caregivers who are found on the state’s Home Care Aide registry. 

You may also benefit from sitting down with a business attorney familiar with the space to lay out what you need to get done ahead of opening to stay compliant from the get-go. We are partnered with Polsinelli, and you can find more information about them on our partners page.

A few of the basics they should cover:

• Employment laws and regulations 
• Requirements to open and operate an agency (Ex: the regulatory body that oversees personal care)
• State and federal laws that effect your agency 
• Common DOL and other business risks 
• Types of insurance that you should carry

Finding and training staff

The first order of business in home care is securing your supply. 

The demand, from a client perspective, is there, but it’s important to have an adequate supply and flow of caregivers coming to you for work. And once you do have them, keeping them around is the next part of the journey.

According to the 2023 HCP Benchmarking Study, the median caregiver turnover was at 77.1%, an increase over the last 2 years. 

There are two ways to think about this data:

• The industry outlook is not good.
• The industry is ripe for disruption, by using best practices to hire the most qualified caregivers and retain them long-term with training and support.
  
  

“At CareTime, we’re greatly encouraged by home care business owners who treat their caregivers with dignity and respect. It shows in their data and continued growth,” Julio Barea, Head of Sales at CareTime. 

Here are a few best practices to keep your recruitment and retention in check: 

Happy caregivers are the secret ingredient to unlocking growth. Dr. Malik shared that his clients come from word-of-mouth referrals, and those can come from “a happy caregiver, a satisfied client, or a neighborhood referral source.” When you position caregivers and clients on the same level, it makes business decisions much easier. 

Capitalize on what makes you different on Indeed. Indeed has consistently ranked as the top caregiver recruitment source, but it also has the highest turnover rate. This means that you need to double down on what makes your agency different, telling your personal story, and sharing why a caregiver should work for you (instead of the home care agency next door). 

Train your caregivers for compliance and productivity. Certain states have defined caregiver training requirements, while others don’t. Balance your training curriculum with a healthy dose of what keeps you compliant, while also surveying caregivers for what they want to learn more about that they can immediately use. 

Lastly, check out our ebook on growing your caregiver network. 

Choose your tech stack

Once you’ve got some caregivers up your sleeve and clients ready to start, you should have an idea of what you’re looking for from an evv software and agency management system. 

Here are a couple of care features to look for: 

• Billing and Receiving 
• Electronic Visit Verification (EVV)
• Customer Relationship Management (CRM)
• Care Planning 

These are the foundations that will set you up for compliance and to jumpstart your business growth. 

In addition to those, you’ll need:

• A training platform for your caregivers (Care Academy, Home Care Pulse, and Nevvon, are a few examples)
• A background check/criminal record screening platform (ScreeningOne is an example that we’re partnered with)

These technology platforms will keep you connected and prepared to navigate change. 

Marketing your home care business

Marketing is the engine that keeps your prospective clients moving down the pipeline, closer to scheduling an in-home assessment or signing a service agreement. 

Here are some strategies that can help you get started quickly: 

Set up your Google My Business (GMB) listing. This is a free listing that gets eyeballs on your business. Fill out as many fields as possible, and be sure to add some FAQs that help families in your area feel confident in your ability to serve them. It’s also going to be the hub for your clients to leave 5-star reviews. 

Assemble your first Google Ads campaign. Once you’ve filled out your GMB listing, create your Google Ads account. This does cost money, however, it’s one of the most effective ways to get traffic to your website and get calls from interested families—and caregivers. 

Assemble and distribute your initial marketing materials. This means stuff like: 

• Flyers 
• Business Cards 
• Posters 
• And more

Once you’ve got those pieces in hand, you can go to market and knock on doors with community partners such as nursing homes, active adult communities, doctor’s offices, hospitals, and more. This tip is probably the most intense, but it will likely be the most fruitful with the connections you build. 

Expanding your services

Once you’ve had a chance to settle into your new business and maintain consistent clients and new business, take some time to explore service expansion opportunities. 

We recently held a webinar with Polsinelli that went over 3 different models of care that you can run as a home care business owner, including: 

• Home Care Agency: The traditional W2 model of care that you’re already familiar with, where you are managing care plans and schedules for clients. 
• Caregiver Registry: A model of care that uses 1099 caregivers and matches caregivers with clients who are looking for care. They manage their relationship independent of the company.
• (State) Consumer-Directed: A care program administered by state Medicaid programs that enables clients to hire their own caregivers (could be friends or family). 

Although you’d need to set up a different business for a caregiver registry, adding service lines will help to differentiate your company from other brands and add value to clients who might not have been able to work with you before. 

A technology partner built for you, from start-up to acquisition

At CareTime, we’ve built an evv software and wraparound agency management platform that scales and moves with your home care agency. 

Check out this review from a satisfied CareTime user: “I am satisfied with the product and the recent upgrades. I have been using this product for almost 2 years and have not switched to the competitors that constantly contact us. It’s easy to use. The employees find it less complicated than some other systems that they have used with other companies in the past.” - Trena W. (Administrator)

As you start your home care business, make sure to keep your caregivers front and center. This will set you up for success. When they bring feedback from a client or family member situation, it’s critical to keep their perspective—being in homes all day—top of mind. And we’ll provide the technology and support you need to grow.