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How to Scale Your Home Health Care Agency

Author: Andy Andress, Chief Operating Officer

Home health care is unique in the service industry, and it’s certainly different than owning a retail or restaurant concept. Whereas you could invest in a fast-food restaurant and hire an operations manager to oversee multiple locations, an absentee-ownership model doesn’t really work in a home health care agency.

The BrightStar Care system requires an owner/operator model when first-time franchisees initially get started. We look for franchisees who believe in the mission and are also motivated to build a profitable business.

Home Health Care Agency Owners Invest in Hard Work – and Heart Work

Home health care businesses aren’t a 9-to-5 business model. You’re investing in a career and you’ll be richly rewarded for it depending on how much you put into the business. That goes beyond the financial investment necessary to operate a home health care agency and speaks to the personal or human capital investment needed to be successful.

And the reward isn’t just the income you earn, but rather is seen in the equity you’re able to build as you grow your business and the impact you make on lives within your community.

That’s why we look for people with a passion for the business model. Someone who approaches a home health care agency from purely a financial perspective isn’t likely going to be as successful as someone who puts their heart into the business. In reality, you need a good balance of both.

If you approach the investment from this perspective, there are some pretty straightforward steps you can take to scale your business. These include:

Step 1 – Follow the Model

Growth with a home health care agency like BrightStar Care is a well-defined process. One of the things that BrightStar Care brings to the table is a proven model not just in the policy handbook, but in the brand standards. These include having Joint Commission accreditation, having a Registered Nurse to oversee all client care, having a full-time salesperson at each location and numerous other protocols.

When you buy into the BrightStar Care model, you’re in a better position to get up and running and to a point of sustainability faster than if you were trying to do it on your own.

Step 2 – Lean on the Support System

We’ve got general business coaches who help franchisees get up and running, and then support them once the agency is operational. But we’ve also got specialists for things like national accounts and the clinical component of the business. For instance, we offer you and your team guidance on: clinical quality, marketing, sales effectiveness, national accounts, talent management (recruiting and retention), technical training and general business.

For most startup home health care business models, support like this is lacking. You may have to go through a painful learning curve or a lot of trial and error by going through it on your own.

At the same time, there are over 200 other home health care agency owners that you’ll be connected with through a variety of different means, including online chat, local market get-togethers and Performance Groups through which franchisees are paired with eight to 10 other owners who act as a board of directors for their agency.

Step 3 – Grow Within Your Territory

Growing your home health care agency doesn’t necessarily equate to immediately investing in additional territories. In fact, you should consider adding a new territory last when scaling your business.

To that point, an individual territory is where you grow your business. When you first get started, you’re able to focus on your individual territory. In fact, many BrightStar Care franchisees are able to build their enterprises by leveraging multiple revenue streams in a single territory.[i]

The primary factor involved in scaling a business is taking advantage of the full continuum of services that owners can provide in their individual territory. They should first focus on building their personal and companion care private duty business through networking and referrals. They can then focus on other parts of the model like skilled care, national accounts, medical staffing to other health care facilities and other lines of business.

Lastly, in today’s employment market, it’s equally important to always be recruiting. In order to keep your agency’s operations in balance, you must maintain your focus on sales and recruiting.

Operating a BrightStar Care agency in accordance with the model and best practices helps facilitate growth. The systems, standards and support put in place enable owners to scale their businesses.

The most important takeaway, however, is ensuring you’re 100-percent invested in your business and are taking full advantage of the support structures offered to you as you seek avenues to scale your business.

For more insights on the home health care business ownership, read about the top metrics agency owners should track.


[i] Multi-unit enterprises are able to take advantage of in the case of an existing owner who’s selling their agencies. If they’re healthy locations, new owners can take over multiple territories.