At Comfort Keepers, the Ensuring Access to Medicaid Services rule is top of mind. Specifically, the rule’s 80-20 provision, which requires providers to earmark 80% of reimbursement for home- and community-based services (HCBS) to caregiver wages.

That provision is set to go into effect – barring challenges – over five years from now.

“The 80-20 rule is kind of hanging like this big cloud over us all year long,” Ramzi Abdine, chief operating officer of Comfort Keepers, said during a panel discussion at Home Health Care News’ FUTURE conference last month.

Irvine, California-based Comfort Keepers is one of the largest personal home care providers in the U.S. The company has more than 600 locations, and about 70 company-owned locations.

Indiana’s transition to managed care for certain Medicaid services is another factor that Comfort Keepers sees as a challenge.

“The switch in Indiana caused some issues for some of our Medicaid folk in Indiana,” Abdine said. “To give you an example, when the reimbursement was from the state directly, it took seven days to get the money. Now, if everything goes to plan, which never does, it’s 21 days. This just puts more stress on the working capital requirements of our franchisees.”

As a majority private-pay company, Nova Leap views staffing shortages as its biggest growth barrier.

“We’d be a lot bigger if we had more staff,” Nova Leap President and CEO Chris Dobbin said during the discussion.

Nova Leap is a Canada-based home care organization that has been growing in the U.S. The company has operations in Nova Scotia and 11 different states.

In addition to growth barriers, leaders are also focused on managing client retention as home care billing rates continue to increase.

“Being primarily private pay, we do lean heavily into the clients that are able to afford in-home care,” Melissa Reyes, president of the west division at TheKey, said during the discussion. “We are very transparent and upfront with our clients from the very beginning, around our annual rate increases due to inflation, pay pressure and other competing market pressures. We have found that just by having that conversation early – and making sure they understand the methodology behind what we’re doing – really has paid off for us in the long run. Our economics show that our clients today are long-tenured clients that use a high volume of hours.”

Delray, Florida-based TheKey provides home care, memory care and specialized care services in more than 100 markets throughout the U.S., Canada and Australia.

On his end, Abdine has noticed a slight slowdown in billing rate increases, compared to two years ago.

“That’s also a function of the inflation, which is kind of like leveling off,” he said. “We are very methodical about our rate increases, so we work closely with our franchisees to make sure they are basing those on market research. We know exactly where we want to be.”

Likewise, Dobbin believes that the rate of rising billing rates will continue to come down.

“We’re trying to be 20% below the very top, or something like that,” he said. “I do agree, though, that the pace of increases is probably going to slow down a bit, which probably ties directly into what’s happening with inflation.”

The post The Medicaid, Private-Pay Barriers That Could Slow Growth For Home Care Providers appeared first on Home Health Care News.

That contract language, dubbed a non-solicitation agreement, is a widely used clause in home care contracts to protect providers’ businesses.

On its end, the Irvine, California-based Comfort Keepers is a large franchise that offers non-medical in-home support, including meal preparation, companionship and personal assistance.

The company required each client to execute a care agreement containing this language before receiving services. California Attorney General Rob Bonta concluded that this agreement violated California law by restraining worker mobility, as caregivers could not be hired by any Comfort Keepers client, not just the client to whom they were assigned to provide services.

In a statement issued to Home Health Care News, Comfort Keepers wrote, “We value Comfort Keepers caregivers, who are the heart and soul of each of our franchises and the Comfort Keepers brand. “As a service-based company, the quality of our care is rooted in the dedication and expertise of the caregivers who serve as employees. We invest significantly in their development to ensure the success of our services, the satisfaction of clients and the wellbeing of the caregivers. While this investment comes at a cost, we believe protecting the caregivers who become invaluable to our clients through their training and expertise is essential. Comfort Keepers is not seeking to limit or restrict any employee’s ability to earn a living; rather, we believe in a business’s right to protect its assets, ensuring the continued excellence of the care we provide.

Comfort Keepers maintains that direct hire provisions do not hinder workers from finding future employment. These provisions are designed to provide service-based businesses with compensation when the care recipient elects to hire a caregiver vetted, background-checked and trained by the agency in the form of a reasonable amount for the placement services it provided.

This is standard practice with service-based businesses across many industries. Furthermore, this is part of a larger and evolving issue being scrutinized by the U.S. Chamber of Commerce.”

Angelo Spinola, home health, home care and hospice chair at the Polsinelli law firm headquartered in Kansas City, Missouri, was involved in the case and told HHCN he thought the attorney general was incorrect in his position.

“They are applying a law that applies to non-compete agreements with employees to a client service agreement,” he said.

Non-compete and non-solicit agreements

In general, Spinola said that restrictive covenants are divided into confidentiality, non-compete and non-solicit agreements. These agreements are based on state laws, and certain states limit their use.

Non-solicitation agreements in home care are meant to prevent clients from hiring a caregiver directly and cutting out the agency. These agreements protect the agency’s business without restricting the caregivers’ mobility, providers believe. If the contract is violated, the agency may seek legal action and sometimes request damages.

“I can absolutely understand why [an agency] would want [an agreement] because there’s such a strong incentive to hire aids and home health care workers,” Jolie Apicella, partner at Wiggin and Dana Law Firm, told HHCN. “This is a time when staffing is already critically difficult after COVID-19. It’s never been harder to find good people who are qualified, who meet all the regulatory requirements and who you can really trust to go into people’s homes, which is the most intimate and vulnerable place. To lose those people… your whole business model would be canceled out if they’re able to be hired directly by patients and families.” 

Nearly one in five workers in the United States is bound by a non-compete agreement that prevents them from finding a new job or starting a business in their field when they leave their employer. Non-competes are currently governed at the state level, and research shows that they suppress wages, reduce job mobility and stifle innovation.

California, Minnesota, North Dakota and Oklahoma have completely banned non-compete agreements. Thirty-three states plus the District of Columbia restrict their use, according to the Economic Innovation Group. Recently, the FTC unsuccessfully tried to ban non-competes nationally.

However, non-compete agreements and non-solicitation clauses are not interchangeable, and the latter should not affect a caregiver’s mobility, according to Spinola.

“The non-compete is the most restrictive covenant,” he said. “For example, the term for which a non-compete applies generally might be shorter – a year instead of two years, like a non-solicit agreement. The territory in which it applies will be limited to the territory where the business operates.”

When they can be used, non-compete agreements are generally reserved for executives who could harm the business if they left and worked for a competitor. Non-solicit agreements are more commonly used for caregivers and other individual contributors.

“Non-solicit agreements shouldn’t impact the caregiver’s ability to work wherever they want and even for whomever they want to,” Spinola said. “If a client reaches out to a caregiver and says, ‘I’d like you to work for me,’ that’s not a violation of a non-solicit agreement. If the caregiver calls the agency’s client and says, ‘I want you to get services from me instead of the agency you’re with,’ that would be a violation.”

The post The Growing, Troublesome Issues Around Non-Solicitation Agreements In Home Care appeared first on Home Health Care News.

For TheKey, this means focusing on three main areas. One of these areas is the company’s “boots on the ground” sales force.

“That is in every market that we serve clients in today,” Melissa Reyes, president of the west division at TheKey, said during a panel discussion at Home Health Care News’ FUTURE conference last month. “That has always been a big part of our structure and our model. Currently, we have just over 85 sales representatives across the nation, and really they’re out there creating and growing the partnerships and relationships with the 3,000 referral partners that we have across the nation.”

Delray, Florida-based TheKey provides home care, memory care and specialized care services in more than 100 markets throughout the U.S., Canada and Australia.

TheKey is also throwing its weight behind digital marketing and its online presence. One of the reasons for this push is because TheKey wants to be a solution that is easy to discover in a crowded home care marketplace, according to Reyes.

“We’re seeing more and more that family members are involved in the decision making, and many times those family members … they’re a state or two away,” she said. “We want to ensure that when someone is looking for care for their loved one, we’re easy to find online, they can understand what it is that we do and what differentiates us, and also hear what our clients are saying about us.”

Gathering and implementing feedback is also top of mind at TheKey. Reyes noted that consuming feedback can lead to better client satisfaction, and, in turn, lead to a boost in word-of-mouth referrals.

Re-franchising and organic growth

Irvine, California-based Comfort Keepers is one of the largest personal home care providers in the U.S. The company has more than 600 locations, and about 70 company-owned locations.

Much of the company’s growth efforts this year and next are focused on re-franchising these company-owned locations, according to Ramzi Abdine, chief operating officer of Comfort Keepers.

“That’s an exercise that takes away bandwidth from every department in the company — HR, legal, compliance, operations, franchise development — they’re all involved in that,” he said during the panel discussion. “It’s kind of like changing the wheels while driving.”

Aside from re-franchising Comfort Keepers’ company-owned locations — which Abdine described as a “herculean effort” — the organization is also looking to speciality care programs as a growth driver. The company has plans to launch a Alzheimer’s and dementia specialty care program, specifically.

Additionally, Comfort Keepers is launching a CRM for its franchise owners.

“We really want to understand what is going on with our consumers and our caregivers,” Abdine said. “We want to evolve to meet their needs.”

Nova Scotia-based Nova Leap, a company that has gained a reputation for being an active player on the acquisition market, is setting its sights on organic growth.

“We’re in the process of focusing on organic growth, which we think will come from our sales force, so we’re investing in that,” Chris Dobbin, president and CEO of Nova Leap, said during the discussion.

Nova Leap is a Canada-based home care organization that has been growing in the U.S. The company has operations in Nova Scotia and 11 different states.

Nova Leap’s focus on organic growth, however, doesn’t mean that the company is backing away from M&A completely.

“We’ll continue to make acquisitions as part of our growth strategy,” Dobbin said. “Historically, between 2017 to 2021, we averaged one acquisition per quarter … we paused that in 2022 and in 2023 we’re back in the acquisition trail. We just made a tiny one in Massachusetts, and expect to make more this year and in the coming years.”

The post Home Care Leaders Put ‘Boots On The Ground’ To Kickstart Growth appeared first on Home Health Care News.

On the Medicare-certified home health side, one factor that may have made investors hesitant to enter the space is the challenging payment landscape.

Despite this, Kaltroco — a family-owned private investment company — is attracted to home health care due to the firm’s belief in the fundamentals of the sector.

“It’s clear that the population is aging,” Kenneth Hammond, chief investment officer at Kaltroco, said during a panel discussion of Home Health Care News’ Capital + Strategy conference last month. “It is clear that treating patients in the home is an efficient and effective way to ensure good outcomes. It’s expensive to have people in hospitals who don’t need to be there. It’s expensive to have people in nursing homes who don’t need to be there. Treating people in the home is an imperative.”

Kaltroco is an investor in New Day Healthcare, a rapidly growing home health provider that serves patients in Texas, Missouri, Kansas and Illinois.

Hammond pointed out that, as a family backed investor, Kaltroco has the luxury to take a long-term view around the businesses that the firm builds.

“Our focus is on building the best scale platform we can to accommodate the way the market works,” he said. “We don’t use a ton of leverage. We think in a very long-term way, and we trust that, over time, the government will recognize the value home health brings.”

Indeed, The Halifax Group is making similar bets across the home-based care sector.

The Halifax Group is a Washington D.C.-based PE firm that focuses on lower middle-market businesses. The firm acquired the home care franchise company Comfort Keepers in 2023.

Like Medicare-certified home health, private-pay home care has its own challenges. One of the main pain points for potential investors is that billing rates continue to skyrocket.

Comfort Keepers is largely a private-pay company, but the franchise owners that are part of the network have a certain amount of autonomy when it comes to payer diversification. Allowing franchise owners – in states with favorable environments – to structure their businesses to address Medicaid or VA populations has helped ease some of the impact of this ongoing challenge.

“The government profile payer has become more attractive for many of our franchisees,” Scott Plumridge, managing partner at Halifax, said during the discussion.

Because Medicaid, for example, is still subject to the sway of policymakers, Plumridge stressed the importance of having a balanced book of business.

Aside from payment structure, The Halifax Group is focused on letting franchise owners run their business versus a more corporate-owned model.

“Over the course of our ownership period, we are already in the process of doing a U.S. re-franchising effort,” Plumridge said. “About $70 million of sales that were corporate-owned under previous ownership, we’re going to return those to both franchisees and we’ve got some employees who are buying locations from us. We’re [also] going to have new folks, new blood coming into our organization through acquisition to take on some of those locations. Hopefully, over the course of the next few years, you’re going to see Comfort Keepers returned to a 100% franchise business model.”

Plumridge also noted that M&A isn’t top of mind for Comfort Keepers. Instead, the company sees a huge opportunity for organic growth within its existing portfolio of assets.

On its end, Kaltroco believes that Medicare Advantage (MA) has become a big factor when it comes to investing in home health care.

“The way we’ve approached the skilled [home health] business is we have tried to acknowledge the reality that Medicare Advantage is a growing piece of the population,” Hammond said. “We need to have a solution that deals with that reality. We’re in a world where the businesses we see being sold are packaged around the idea that they have a very large FFS population as a credential. When I look at those businesses, I don’t tend to agree. I think you’ve built a business that can’t grow. Over the next 10 years, it’s going to be imperative that really good skilled home health businesses can execute in an MA landscape.”

For context, 30.8 million people are enrolled in a Medicare Advantage plan as of 2023. This is more than half of the eligible Medicare population, according to data from KFF.

Ultimately, Hammond is doubling down on home health as an area of continued investment for Kaltroco.

“Building a business that serves a population that needs to be served — that’s a big focus for us as a family-backed organization,” he said.

The post PE Sponsors Of Comfort Keepers, New Day Healthcare Are In Home-Based Care For The Long Haul appeared first on Home Health Care News.

The list is based on last year’s global systemwide sales — total sales for both franchise and company units — performance.

In order to earn a spot on the list, a company needs to be a legal U.S. franchise. It should also own at least 10% of the company’s total units.

At-home care franchise companies Home Instead Senior Care, Right at Home and Interim HealthCare managed to crack the top 100 portion of the list, alongside big name companies like McDonald’s (NYSE:MCD), Dunkin’ (Nasdaq:DNKN) and The UPS Store (UPS:NYSE).

Home Instead Senior Care

— Rank: 44

— System Sales: $2,400,000,000

— Total Locations: 1,217

— Home Instead is a Omaha, Nebraska-based personal care franchise company that has locations in over a dozen countries. In 2021, the home care technology company Honor acquired Home Instead.

Interim HealthCare

— Rank: 65

— System Sales: $1,288,000,000

— Total Locations: 655

— The Sunrise, Florida-based company – a part of Caring Brands International — provides personal care, hospice care, palliative care, pediatric care and staffing services.

Visiting Angels

— Rank: 90

— System Sales: $900,000,000

— Total Locations: 697

— Bryn Mawr, Pennsylvania-based Visiting Angels is an in-home senior care company that provides companion care, personal care services and more.

Right at Home

— Rank: 100

— System Sales: $778,386,711

— Total Locations: 712

— Omaha, Nebraska-based Right at Home is a home care franchise company with locations in the U.S. and six other countries.

BrightStar Care

— Rank: 117

— System Sales: $653,907,370

— Total Locations: 370

— Chicago-based BrightStar is a provider of home care, senior living and supplemental staffing. The organization has been deliberately increasing its company-owned footprint of late.

Comfort Keepers

— Rank: 124

— System Sales: $625,000,000*

— Total Locations: 645

— Irvine, California-based Comfort Keepers is one of the largest personal home care providers in the U.S. It recently was acquired by The Halifax Group.

Senior Helpers

— Rank: 176

— System Sales: $387,243,000

— Total Locations: 327

— Maryland-based Senior Helpers has a national personal care network, as well as adult day centers. The company was acquired by Advocate Health Enterprises in 2021.

ComForCare Home Care

— Rank: 225

— System Sales: $238,000,000

— Total Locations: 223

— ComForCare is a home care franchise organization that has 270 territories independently-owned and operated in Canada and the U.S. ComForCare operates as At Your Side in Houston, Texas.

Home Helpers Home Care

— Rank: 230

— System Sales: $231,856,454

— Total Locations: 304

— The Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship services, among others. It serves over 1,000 communities in the U.S.

Synergy HomeCare

— Rank: 236

— System Sales: $223,257,894

— Total Locations: 417

— Synergy is a Gilbert, Arizona-based non-medical home care franchise. The company offers companionship services, in addition to personal assistance, housekeeping, live-in care and 24-hour home care services.

Always Best Care

— Rank: 245

— System Sales: $212,591,506

— Total Locations: 232

— Roseville, California-based Always Best Care is a home care franchise company that operates across 225 territories in 30 states and Canada.

Homewatch CareGivers

— Rank: 246

— System Sales: $211,550,548

— Total Locations: 224

— Denver-based Homewatch CareGivers is a home care franchise company that operates in over 30 states and seven countries. The franchise employs over 4,500 caregivers.

Griswold

— Rank: 251

— System Sales: $199,100,000

— Total Locations: 178

— The Blue Bell, Pennsylvania-based Griswold is also a home care franchise. It provides personal care services in 30 states.

FirstLight Home Care

— Rank: 257

— System Sales: $188,207,247

— Total Locations: 195

— Cincinnati-based FirstLight Home Care is a provider of non-medical home care. The company also has a specialized care program aimed at seniors with dementia.

Assisting Hands Home Care

— Rank: 299

— System Sales: $124,305,162

— Total Locations: 175

— Assisting Hands Home Care offers both medical and non-medical assistance for seniors, including meal preparation, companionship, chores and more.

Caring Senior Service

— Rank: 475

— System Sales: $35,050,000

— Total Locations: 51

— San Antonio, Texas-based home care franchise company Caring Senior Service offers personal care, meal preparation, transportation, companionship, housekeeping and more.

The post 16 Home-Based Care Companies Earn Spots On The Franchise Times’ Top 400 List appeared first on Home Health Care News.

Overall, more than 700 home-based care locations across the world are included in the deal.

The transaction is expected to close in the fourth quarter. Financial details were not disclosed.

“We just love the [home care] space and and wanted to want to continue to be active there,” Halifax Managing Partner Scott Plumridge told Home Health Care News.

The Irvine, California-based Comfort Keepers is one of the largest personal home care providers in the U.S. A franchise, the company has more than 700 locations across eight countries. Sodexo originally acquired the brand in 2009.

Specifically, Halifax will now have a home care footprint across the U.S., U.K., Ireland, France, Denmark, Norway, Sweden and Brazil.

“There’s a long-term trend, where the fastest part of the population growth is with the elderly,” Plumridge said. “For most countries, the most cost-effective place for them to age is in their own home setting versus institutional.”

Based in Washington, D.C., Halifax is a private equity firm that generally invests in lower middle-market businesses with enterprise values between $100 million and $300 million. It was an investor in the home-based care company Interim HealthCare from 2012 to 2015.

Halifax acquired the U.K.-based Bluebird Care and Australia-based Just Better Care during that investment period, eventually pairing the two with Interim to form Caring Brands International in 2013.

Its portfolio also includes mobility and accessibility equipment companies, Harmar and 101 Mobility. It previously invested in PromptCare Companies, which is a provider of specialty respiratory and infusion-therapy services.

“In our learnings over the years, home care also tends to be the preference,” Plumridge said. “That seems to be a fairly common characteristic. There’s kind of a natural push for folks to age in place moving forward.”

Comfort Keepers’ portfolio includes 535 franchised territories and 105 company-owned territories. Though it provides clinical care abroad, its focus in the U.S. is personal care, primarily of the private-pay variety.

The company recently named the Sodexo veteran Ramzi Abdine as its next CEO. He replaced Carl McManus, who had served in the role since 2017.

“We look forward to working with the leadership team to build on the company’s impressive market position and accelerate its growth,” Halifax Vice President Molly Fitzpatrick said in a statement. “Halifax has a long history of investing in home care services as well as franchisors, and we understand the advantages for all stakeholders of providing these care services in the lower-cost and comfortable home setting.”

The post The Halifax Group Acquires Home Care Franchise Comfort Keepers appeared first on Home Health Care News.

Over the last nine months, they’ve seen their referrals fluctuate and their personal protective equipment (PPE) supplies run dry. Many have had to overhaul their virtual care strategies and infection control protocols while also finding innovative ways to recruit new workers.

The journeys of on-the-ground franchise owners have been told more infrequently. Some are now sharing their stories, recalling how they’ve battled the COVID-19 virus on a local level.

“It’s definitely been a wild ride,” Katie Fielmann, a Comfort Keepers franchise owner, said during the Franchise Forum hosted by Home Health Care News last month. “It’s been one of the longest years of my life, but it’s also been one of the fastest, if that makes any sense.”

Irvin, California-based Comfort Keepers, a division of the quality-of-life company Sodexo, is an in-home care franchise that has over 700 locations across the world. Fielmann first became an owner within the network in 2002, and now operates five locations in the Chicagoland area.

Recessions have been a historically popular time for more individuals to get into home-based care, particularly as a franchisee. But for the ones that have lived through it, the year has been a trying, yet revolutionary one.

For Fielmann, the key to getting through 2020 has been an adaptation to methods previously foreign to her and her team, as well as support from Comfort Keepers itself.

“Being part of a franchise, you just have so much support that you wouldn’t otherwise have,” Fielmann said. “Being able to navigate day-to-day, knowing that you have people to reach out to — that are experts in the field and their main job is to support you as a franchisee — is worth every penny.”

Additionally, Fielmann has been meeting with other franchisees on a quarterly basis from across the country. That’s helped ease the burden of COVID-19 on her and the employees that work at her locations, who also benefit from that wealth of knowledge that those sessions provide.

Karen Stephenson, another franchise owner out of Chicago, feels the same way about the help that Omaha, Nebraska-based Home Instead Senior Care has provided.

“Home Instead has been my godsend, during this COVID time in particular,” Stephenson said during the forum. “When I have questions, I can call, and they have massive resources when it comes to government affairs, lobbying and all the things that are going on federally and locally. That is very [helpful].”

Home Instead Senior Care is a home care franchise company with more than 1,200 independently owned and operated offices worldwide. Stephenson runs two locations in the Chicagoland area.

Lessons learned

Both Stephenson and Fielmann have reaped the benefits of the home care business in the years since they entered into the space. Even during the COVID-19 crisis, they’re happy they got into the business.

“It’s been the best decision I’ve made in my career — getting into home care,” Stephenson said. “Not only do I feel like I’ve been helping and doing good for people, … but it has also been a good decision from a profit and business standpoint.”

In fact, both have noticed not only an increase in demand for home care, but also an improvement to their bottom lines since COVID-19 became an issue in the U.S. and Illinois, specifically.

But it hasn’t come without change. COVID-19 has brought lessons in its wake, forcing Fielmann and Stephenson to rethink their traditional ways of doing business.

“I almost want to say I have been forced into this, but I have certainly learned to run my business more virtually and digitally,” Fielmann said. “I never realized how old school I was until COVID-19 hit.”

Fielmann’s Comfort Keepers locations have had to learn to work remotely, and also communicate with clients and caregivers in a more effective way with less person-to-person interaction. Fielmann fought remote work for a long time, but has eventually become accustomed to it, she said.

In the end, it has opened up her business mind, increased her locations’ digital and virtual capabilities, and also increased communication.

“I think COVID has helped me be more open to change, to understand that there’s more than one way to do it,” Fielmann said. “And I also think it’s — as crazy as this might sound — It’s kind of increased the communication that we have with our clients and caregivers. Right now, I feel like we are communicating at a whole other level because of COVID. There’s a lot of benefits to that.”

Those lessons learned have made Fielmann reconsider aspects of her businesses’ workflow. After running her five locations out of two offices for years, she’s been able to be as efficient using one office during the pandemic — a potential cost-saver down the road.

For Stephenson, it similarly helped her Home Instead locations learn how to deal with challenges more swiftly. With increasing demand and a looming pandemic, they had to adjust quickly.

“I learned how to pivot on a dime,” she said.

The post ‘I Learned How to Pivot on a Dime’: Home Care Owners Share Lessons from 2020 appeared first on Home Health Care News.

That’s according to the latest Top 200+ ranking from Franchise Times, an annual compilation of top-selling franchises based on systemwide sales. Other home care franchises winning the sales game include Interim HealthCare, Visiting Angels and Comfort Keepers, among others. 

At No. 72 overall, Omaha, Nebraska-based Home Instead once again led all home care agencies in systemwide sales, with global sales of $1.77 billion in 2018. Home instead previously checked in at No. 77 in last year’s Top 200+ ranking.

At least part of its sales success can be traced back to its creative advertising approach. In October 2018, the franchise company teamed up with advertising powerhouse Energy BBDO on its “The Third Stair” video, an evocative and informative ad that earned lofty praise from AdWeek, Biz Journals and other outlets.

“[Home care] is a service that you don’t think about until you really need it,” Katie Cox, Home Instead’s director of advertising and marketing research, previously told Home Health Care News. “The oldest boomer is 72 and the average Home Instead client is about 78, so we’re just on the edge of this demographic shift. One of the challenges we face is really getting across this idea of choice and that there’s this option to stay at home.”

Home Instead’s sales success can likewise be linked to its embrace of technology to complement in-person care. In January, CEO Jeff Huber informed HHCN that the franchise company made a “significant” minority investment in senior-friendly tablet startup GrandPad.

“We’ve been looking at the macro picture and understanding where technology is going in the aging space,” Huber said at the time. “We’ve been looking for the right solution for many, many years to bring together high-tech capabilities with our high-touch approach to caregiving.”

Home Instead has more than 1,000 franchise locations, with more than 600 in the United States.

With about $1.17 billion in systemwide sales, Sunrise, Florida-based Interim took the No. 92 spot on the latest Top 200+ list from Franchise Times. Interim, which actually held the No. 91 spot on last year’s ranking, has more than 600 franchise locations worldwide, with more than 340 based in the U.S.

Interim’s staffing business, data initiatives and new overarching strategy focused on holistic care will be keys to the franchise company’s growth moving forward, CEO Jennifer Sheets recently told HHCN during a Disrupt conversation. 

Bryn Mawr, Pennsylvania-based Visting Angels — an in-home senior care franchiser that provides companion care and personal care services — recorded systemwide sales of $725 million in 2018, good for the No. 120 spot on the Top 200+ list. The franchise company has 584 locations, the vast majority of which are based in the U.S.

Comfort Keepers (No. 138), Right at Home (No. 140), BrightStar Care (No. 175) and Senior Helpers (No. 188) rounded out home care franchise placement within the top-200 spots. The companies had 2018 systemwide sales of $545 million, $540 million, $434 million and $362 million, respectively, according to Franchise Times.

Although it’s called the Top 200+ list, Franchise Times recognizes a total of 500 companies in its annual ranking. In addition to the previously named home care franchises that all fell within the top 200, a handful of other providers made the trailing section of the list.

They included, for example, ComForCare (No. 247), Home Helpers (No. 256), Synergy HomeCare (No. 274) and Always Best Care (No. 281).

To qualify for the Franchise Times’ Top 200+ ranking, companies must be a legally based U.S. franchise, with franchisees owning at least 15% of the company’s total units.

Systemwide sales are defined as the total sales for both franchise and company units.

The post Home Care Franchises Winning the Sales Game appeared first on Home Health Care News.

In their suit, the plaintiffs, represented by Littler Mendelson, claim that the state policy is unconstitutional, as labor organizing is regulated by federal law through the National Labor Relations Act, which the United States Supreme Court found constitutional in 1937. 

“We have no general concern with the fact that we have organizing laws in this country that allow for unions to organize,” Phil Bongiorno, Executive Director of HCAOA, told Home Health Care News. “However, going about it in this manner is something we have a concern with: usurping the federal law and developing a process that doesn’t protect caregiver privacy.”

The suit comes following a legal change that went into effect July 1. It allows labor unions to access caregivers’ contact information via the California caregiver registry, which was originally created to give families the ability to check their caregivers’ qualifications.

But because of the new policy, the plaintiffs worry the registry will now do more harm than good.

“We’re concerned about caregiver privacy,” Bongiorno said. “Even though caregivers do have an opt-out process here, they’re defaulted to opt in.”

To opt-out of having their information shared, caregivers must fill out a form on the California Department of Social Services website. Upon each recertification, they must repeat the process. 

Bongiorno worries the hassle, along with privacy concerns, could deter people from entering the industry, which is plagued by an 82% caregiver turnover rate to begin with.

“That’s a big concern,” Bongiorno said. “Just imagine someone has your cell and personal number, and they can call you at any time. There’s no restrictions on what unions can do.”

Even before the change took effect, industry insiders in California voiced their concerns to HHCN.

Take Jorge Preciado — who operates a Comfort Keepers franchise location in Woodland, California — for example. He sees the rule change as another bureaucratic hurdle in operating a home care business. 

Preciado previously told HHCN he worries the registry isn’t doing what it’s meant to, as only industry insiders know about it, he said.

“Since [few consumers are] educated on it, if I’m going to hire a private caregiver, eight times out of 10, I don’t even know to check the registry,” Preciado told HHCN.

Meanwhile, Dean Chalios, president of the CAHSAH, voiced concerns regarding privacy and legality of the new policy. 

“We were fine with the registry being created [in 2016] so consumers can check to see if caregivers are registered, but we object to that information going to labor unions for organizational reasons,” Dean Chalios, president of the CAHSAH, previously told HHCN.

Chalios is confident a federal judge will see it that way, too, he told HHCN after the suit was filed.

“It’s obvious to us that [the policy] is a clearly unconstitutional overreach by the state in this area, and we’re confident that the federal court will therefore rule in our favor on the suit,” Chalios said.

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“We strongly believe the health, safety, and comfort of our elderly or persons with disabilities should not be disrupted by an employer limiting their employees with unfair practices,” a spokesperson for Connecticut Governor Ned Lamont told the Hartford Courant. “We look forward to this prohibition becoming state law and ending a practice that diminishes the quality of life for some of our most vulnerable communities.”

The provision, which was written into the Connecticut state budget last minute in the final days of session, bans home care agencies from enforcing any sort of noncompete or non-solicitation agreements with its caregivers.

Noncompete agreements typically prohibit caregivers from working for an agency’s competitors. However, industry leaders usually advise against these types of contracts, deeming them unfair to caregivers.

Non-solicitation agreements, on the other hand, are frequently used in the home care industry. They’re encouraged — and often billed as a way to protect an agency’s clients without hurting caregivers.

Non-solicitation agreements generally ask caregivers to pay a fee if they choose to leave the agency and take a caregiver with them when they go. If passed, this Connecticut provision would make such contracts unenforceable.

In other words, a caregiver could cut the agency who matched them with a client out of the picture with no recourse.

More than 130 home care agencies in the state have formed a coalition to fight the legislation. Opponents have called the legislation bad for home care agencies and the clients they serve. Some have even gone as far as to call the provision “anti-small business.”

“It will harm a growing sector of the state’s economy — something the state cannot afford to do in Connecticut’s current economy,” Mark McGoldrick — who owns six Comfort Keepers offices in the state — told HHCN in an email. “It will have the unintended effect of putting seniors and caregivers at risk, undermine the employer-based model of home care and ultimately generate less revenue to the state.”

Opponents are asking Lamont to change the language of the legislation or veto the line item completely.

Once the governor signs the budget, the provision will become law.

The post Home Care Legislation Allowing Client Poaching Moves Closer to Becoming Law  appeared first on Home Health Care News.