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.

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Chicago-based BrightStar Care, a national in-home care franchise provider, has acquired HomeChoice Senior Care, a home care agency based in Iowa. HomeChoice is operating as BrightStar Care as of April 1.

HomeChoice was founded in 2009 and is led by executive director Koleene Herlocker. The company provides non-medical home care, housekeeping and 24-hour assistance in Cedar Rapids, Iowa City, Des Moines and surrounding communities.

Prior to working with HomeChoice, Herlocker owned and operated several Sylvan Learning Centers across Iowa before transitioning to become a consultant for small- to medium-sized businesses throughout the United States. She became owner and executive director of HomeChoice Senior Care in 2009.

BrightStar has more than 330 locations in the U.S. and Canada.

Denver-Based Select Home Care Sold

Select Home Care, a home care provider based in Denver, Colorado, with more than 80 clients, has been sold for an undisclosed price

Blueprint Healthcare Real Estate Advisors represented the seller in the deal. The transaction was led by Hayden Behnke and Pamela Pyms.

Acuity Link Partners with Lyft

Acuity Link and Lyft have partnered up to run more efficient non-emergency medical transportation systems (NEMT) for hospitals and other medical care providers. Acuity Link operates a HIPAA-compliant NEMT logistic management dashboard that now supports Lyft’s ride-hailing functionality.

With Lyft integrated into Acuity Link’s software, patients being discharged from any health care provider who do not need special transportation accommodations have the option to be discharged through this service. Providers can arrange one-time or recurring non-emergency rides for homebound or inbound patients.

Acuity Link was founded in 2015 and is headquartered in Massachusetts, serving various health care institutions.

Nova Leap Acquires Eastern Canada Home Care Company

Nova Leap Health Corp. (TSX NLH) acquired a private home care services company located in Eastern Canada “from an arm’s length party.” The acquisition of shares is to be made for total consideration of $2.144 million, of which $1.875 million is payable with cash on closing and $0.269 million is by way of a promissory note repayable over a two-year period.

The company reported unaudited revenues of approximately $2.42 million, net income of $0.14 million and adjusted EDITBA of $.043 million.

Closing the acquisition will be subject to financing, final due diligence and TSX Venture Exchange approval. Upon closing, Nova Leap’s annual revenue run rate is expected to approach $11.4 million, an approximate 63% increase over the current run rate.

Written by Amy Baxter

The post Transactions: BrightStar Acquires Iowa Agency appeared first on Home Health Care News.

Amazon’s expanding workforce now is giving the home care industry a run for its money as providers already face a tight labor market, rising wage pressures and a caregiver shortage.

Amazon labor squeeze

Finding qualified caregivers is frequently cited as the top challenge by home care providers, and future estimates reveal that demand for in-home care services will only continue to rise as 10,000 baby boomers turn 65 every day. The labor market has already forced some providers to raise prices on services, and some caregivers or potential caregivers could simply turn to Amazon for higher wages without having to learn new skills.

In fact, Amazon’s presence in a number of markets has already impacted home care, with 10% of caregivers having interviewed or worked for the company, according to a recent report from myCNAjobs.com. Chicago-based myCNAjobs, which provides a suite of recruitment tools for senior care workers, drew from two studies to conduct the report, including a pay analysis of more than 1 million caregivers across the country from a survey in December 2017

By the end of the third quarter of 2017, Amazon employed 566,000 people, according to the company’s fourth quarter 2017 financial results. As of 2018, Amazon operates 214 facilities across the country, and regularly holds hiring events that recruit 50,000 people in one day, according to myCNAjobs. On average, Amazon’s centers pay workers 30% higher than traditional retail.

With that kind of hiring power, some home care providers are feeling the squeeze from a tight labor market and nursing shortage coupled with the lure of working for Amazon.

“Amazon right now is building these large distribution plants. We are seeing it in Maryland where we operate company-owned offices and franchises,” Mike Magid, COO of Griswold Home Care, told Home Health Care News. “They’re offering sign-on bonuses and a good starting hourly rate, promising overtime. I think what we are seeing, at least anecdotally, is that if you can go to Amazon you don’t need [to be a] high-skilled worker in their distribution plants. Where people would be working in this industry, they don’t need a new skill set [at Amazon].”

Griswold Home Care, based in Pennsylvania, is a non-medical home care company with more than 200 locations in 32 states, including franchise and company-owned operations.

Executive Care, a New Jersey-based in-home care service provider with roughly 20 franchise locations, is another company dealing with Amazon as a workforce competitor. However, CEO Lenny Verkhoglaz believes the meaningfulness of home care services will help retain caregivers.

“We will compete with them in the workforce,” Verkhoglaz said of Amazon. “That is to be expected. We already compete with retail stores, restaurants and warehouses today. I don’t think everyone is a fit to work in windowless, large distribution centers moving boxes around. Many employees will continue to want to work in meaningful and caring positions as caregivers.”

Home care challenges

Conversely, the very nature of home care, which often leaves workers with unsteady hours and occasionally without work, depending on client needs and available cases, could also be compounding the problem. This is also one reason why some home care workers tend to work for more than one agency.

“If [Amazon] keeps their promises, they will start to shift the workforce a bit,” Magid said. “Just because you’re a caregiver, it doesn’t mean guaranteed work—it depends on the clients and caseload and hours. If they can’t get consistent work based on the hours they want to work and need to, [there are] places like Amazon opening up a center and offering sign-on bonuses.”

Indeed, the majority of caregivers—80%—would prefer to work for one company if they can get the hours they want, and doing so is easier in the retail and fast food industry, according to myCNAjobs.com.

Many providers call this issue the 48-hour rule; meaning if they don’t get a caregiver a new case within 48 hours of one ending, the caregiver is likely to go elsewhere for work.

“The disruption comes from when you can’t provide the steady hours they want,” Magid said.

At the same time, providers are dealing with rising minimum wages in some states. While the federal minimum wage stands at $7.25 per hour, many states and cities already have wages near $15 per hour. With Amazon potentially entering these markets as a major employer, companies may be forced to raise their wages to stay competitive—above minimum wage.

Amazon recently announced it had narrowed down the potential cities for its new $5 billion headquarters to a list of 20. Some cities are even bending over backwards to attract Amazon and competing by offering major tax breaks, seeking an economic boom from the activity and boost to the labor market. A new corporate office could draw a different workforce than distribution centers, but it still could create additional competition for home care.

“I would love to see the D.C. region win the bid for their new headquarters even though it will likely bring labor competition in an already tight work force. By the time it happens though, D.C. will likely be at a $15.00 minimum wage,” John Bradshaw, CEO of Georgetown Home Care, told HHCN. “We are paying right around that rate to caregivers now, so we won’t have to raise wages because of the minimum wage increase. However, our industry has always provided higher paying jobs than many other industries with similar skill levels. If other industries are forced to pay the same as us in a tight labor market, that may force us to raise wages higher and, unfortunately raise prices on clients, as well.”

Others are similarly not seeing an issue with Amazon at the moment, thanks, in part, to their pay scale.

“We haven’t experienced it because we pay so much more above minimum wage or the fulfillment [center wage],” Shelly Sun, CEO of Gurnee, Illinois-based BrightStar Care, told HHCN. “It’s an issue I’ve heard on the companion side but not as much on the certified assistant side.”

Despite Amazon’s latest moves, in-home care providers are increasingly seeing more integration—and potential competition—with the company, including opportunities within its new health care insurance aims, hypothesized bid into the pharmacy space, or Amazon’s voice-enabled technology offerings.

Written by Amy Baxter

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