The face of home care ownership is changing.
In recent months, a number of home care franchise companies have seen a surge in interest from front-line caregivers and nurses who want to make the transition to the franchisee-ownership level. There has always been an interest in becoming home care owners among the front-line workforce, but the COVID-19 emergency has accelerated this trend, industry leaders told Home Health Care News.
“I think it’s an ideal next step for those who want to transition out of the day-to-day patient care but are still committed to servant leadership and improving patients’ lives in their communities for the better,” Jennifer Sheets, president and CEO of Caring Brands International and Interim HealthCare Inc., told HHCN.
In addition to Interim, Caring Brands International includes the U.K.-based Bluebird Care and Australia-based Just Better Care. Interim is a Sunrise, Florida-based in-home care franchise company with more than 300 locations across the U.S.
At Interim, 65.83% of the company’s ownership groups have an owner or operator who is a registered nurse (RN) or a licensed practical nurse (LPN), according to Sheets.
Nurse Next Door, another large in-home care franchise company, has likewise seen several front-line workers turn into owners. And when the company noticed this trend picking up, it moved to create an official pipeline.
Today, it even has a “front line to franchise” campaign designed to bring more caregivers and nurses into the ranks of home care ownership.
“Three years ago, we really started talking about caregiving as a career,” Cathy Thorpe, CEO of Nurse Next Door, told HHCN. “How do we elevate that role in the industry and the community?”
Vancouver, Canada-based Nurse Next Door operates roughly 200 locations across the U.S., Canada and Australia. As an organization, the company provides personal care, companionship care, homemaking services, dementia care and more.
The overarching goal of the Nurse Next Door campaign is to make home care business ownership more accessible to front-line nurses and caregivers, Thorpe noted.
Broadly, the franchise business model allows an individual or franchisee to buy the right to sell products or services under the brand of an established company. Ongoing franchise fees are a crucial part of most franchisers’ business models.
One way Nurse Next Door’s “front line to franchise” campaign lifts barriers is by waiving the initial franchising fee, allowing new owners to eventually pay this off after they’ve started their business. Nurse Next Door’s fee is $58,000, plus an $8,000 tech fee in the U.S.
“We know there’s a lot of them who would have started a franchise business, but that initial fee is what held them back,” Thorpe said. “We have said, ‘Let’s not ask them for that fee up front.’ We know that they’re going to bring their blood, sweat and tears into the business.”
Home care franchising fees vary depending on the company. Typically, franchise fees range from $20,000 to $50,000, according to the U.S. Small Business Administration. That’s not the total overall startup cost, however.
In addition to postponing the initial franchising fee, Nurse Next Door’s campaign supports new franchisees by placing them in an extensive training program prior to launch.
Although the campaign has only been around for two months, Nurse Next Door has already had thousands of interested parties reach out about participating. Thorpe hopes that the company’s industry peers will follow in their footsteps.
“I know we are disrupting the industry in terms of putting the focus on the caregiver,” she said. “Caregivers and nurses are the most dedicated and passionate people and this program is allowing us to recognize that and put them in a position to use those strengths and really create a very meaningful business for themselves.”
Similar to Nurse Next Door, Interim has made it a priority to elevate the role of the caregiver. Creating a path to home care ownership is one avenue for doing that, according to Sheets, a former hospital ICU nurse.
“We look to help people,” Sheets said. “Where do you want to go next? Maybe you want to go down the business-ownership route or the operations route. Maybe you want to further your clinical career.”
Generally, caregivers and nurses already have a number of qualities that position them to be successful business leaders, Interim’s CEO explained.
“Everything that I learned in my nursing career — things like empathy, problem-solving, communication and advocacy — are all attributes that I use every single day in my role as a CEO,” she said. “[My background] taught me that good leadership is a commitment to service and a call to impacting the world for the better. I always say I don’t want to ever forget what it was like to work in the ICU at night on Christmas Eve.”
Sheets believes that this new class of leaders, given their previous experience, also has the potential to help solve some of the issues that have long plagued the home care industry. Those issues include retention challenges.
“I think there is absolutely a recognition of the value that somebody from the outside brings in,” she said.
The median caregiver turnover rate for home care providers was 64.3% in 2020, according to data from Home Care Pulse. While this rate isn’t as dire as the all-time high of 82% in 2018, turnover is still a major pain point for companies.
Looking ahead, it’s likely that the home care industry continues to see caregivers and nurses move into leadership roles for years to come.
“It’s not only the ability to lead and have a real impact in your community, but you also have the ability to connect all the dots,” Sheets said. “I think that is why clinicians are attracted to begin with. I think we are going to continue to see this.”
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