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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The private equity-backed franchiser’s rollout comes as more non-medical home care organizations boost their care capabilities to better serve potential payer and referral sources. Home Helper had spent much of the past two years testing and developing the new service offering, officially branded as “Cared-4,” CEO Emma Dickison told Home Health Care News.

“In-home care has been around for a long time: the concept of being able to help support individuals with their activities of daily living, helping them live a more independent lifestyle for as long as possible,” Dickison said. “However, we were looking around and saying, ‘You know, there’s more to it than this.’”

Headquartered in Cincinnati, Home Helpers and its network of local franchise owners deliver personal care, nutrition, companionship and other services to more than 1,000 U.S. communities. The company currently has “right around” 310 franchise agreements overall, according to Dickison.

Chicago-based PE firm RiverGlade Capital acquired H.H. Franchising Systems Inc. — the parent company that operates Home Helpers — in April.

Essentially, Cared-4 is a customizable, comprehensive package that Home Helpers clients can bundle alongside their traditional home care services. The goal of the new program, Dickison explained, is to make sure seniors have access to the necessary tools to stick to care plans and avoid key health risks in the home.

About 62% of all hospital readmissions for seniors are preventable, according to the American Geriatric Society. The top-four risks for readmission are falls, medication problems, nutritional deficiencies and failure to follow care plans following discharge.

“It’s the people who are at risk for falling or can’t manage their medication,” Dickison said. “They may have trouble with wellness with meals. We wanted to figure out a way to take and broaden that continuum of care and solve for those pain points for families.”

An industry trend

Several other home care giants have similarly launched dedicated programs to address hospital readmissions or care gaps in the past couple of years.

The Omaha, Nebraska-based Right at Home, for example, offers “RightTransitions,” a service to streamline communication between providers and support clients with meals, transportation and additional needs. Meanwhile, the Cincinnati-based FirstLight Home Care runs its “Readmission Rescue” program.

While such initiatives have been around for some time now, their importance has only grown following the COVID-19 emergency, Dickison noted.

“Cared-4 is an integral part of our plan,” she said. “We think it is very different from anything anyone else is doing in our space.”

If Home Helpers clients are likely to have trouble with medication adherence, they could include Direct Link monitoring technology as part of their Cared-4 package. Direct Link’s tech tools can also assist with fall detection and vital-sign monitoring.

If clients are prone to forgetting to drink, eat or exercise, they could also schedule regular check-in calls under Cared-4. Simple calls just to say “hello” can also be arranged, Dickison added.

“Adding wellness calls on days when caregivers aren’t in the home is important,” she said. “Most clients don’t need 24/7 in-person care. For those that don’t, [check-in calls] can be a reassurance for families and themselves — that they’re well, that they’ve had their meals, that they’ve done all of the things that they need to to stay healthy.”

The cost for Cared-4 varies depending on which services are included. Regardless of what’s included in the bundle, however, Cared-4 clients ultimately receive just one bill.

“We’ve developed it so that our agencies that are delivering the care can price it as a bundled package,” Dickison said. “As the client, you’re going to get an invoice for one thing.”

A year ‘unlike any other’

The roughly two-year pilot of Cared-4 took place in 21 strategic markets. Generally, it yielded positive feedback across discharge planners, geriatric care managers and continuing care community directors, according to Home Helpers.

“Readmissions unfortunately occur all too often with patients 65 and up, even when the initial emergency department visit was for something relatively minor,” Cynthia Gill, a nurse practitioner at Mills Peninsula Medical Center who participated in the Cared-4 pilot, said in a statement. “We talk with patients and family members about thoroughly following discharge and medication instructions. Patients who have a highly-trained and well-informed support system in place, like what I’ve seen with the Home Helpers Cared-4 program, means stricter adherence to the care plan and a likely better outcome for the patient.”

Following Monday’s announcement, Home Helpers will expand Cared-4 across its national footprint.

In addition to riding the momentum of Cared-4, Home Helpers has also been lifted by the rising demand for home-based care, Dickison said.

At the end of Q4 2020, Home Helpers was up about 18% in terms of system-wide revenue compared to the same period in 2019. In the first quarter of this year, the home care company was up 12% compared to Q1 2020.

“Last year was a year unlike any other that we’ve seen. Our sector, in general, was thriving,” the CEO said. “We’re an organization that has been around for 24 years now. We had good growth to begin with, and that has just continued. We’ve also seen a nice increase in those who are interested in Home Helper Home Care as a business opportunity, wanting to open agencies in markets that we aren’t servicing today.”

The post ‘There’s More to It Than This’: Home Helpers Launches Bundled-Services Program to Curb Hospitalizations appeared first on Home Health Care News.

If there’s one thing that has changed in the second calendar year of the pandemic, it’s that he can finally decipher what day it is.

But a lot else has changed too — both for Senior Helpers, its peers and the home care industry at large.

“Before, everything happened at once,” Ross told Home Health Care News. “We were trying to heat an ocean with a hot water bottle. You’re thinking, ‘What all can I actually affect at one time?’… Year 2 of COVID, to us, is about not wavering. I think people can get relaxed over time.”

Maryland-based Senior Helpers is a home care franchise with over 320 locations worldwide. Ross at least admits that his company has gotten into a groove from an operations standpoint, but it won’t let its guard down any time soon.

“Is this the new normal? I don’t know what that definition is anyway,” Ross said. “But I think when we look at how we’re doing it, we’ve been really very adamant about our system and how this continues to be a serious thing. And we’ve got to continue to do the things we’re doing.”

While home-based care operators like Ross have gained their footing over the last 10 months, the virus still looms large over the health care sector. Compared to when the public health emergency first started, the COVID-19 spread is objectively worse now, with new variants popping up across the globe.

On Jan. 8, over 300,000 new cases were reported in the U.S. Numbers have dipped since, but nearly More than 190,00 new cases were still confirmed Thursday, according to New York Times data.

“In some ways, Year 2 will be very much like Year 1, as long as the virus persists,” Synergy HomeCare CEO Charlie Young told HHCN. “But in other ways, it will be very different. … The use of PPE and safety measures put in place as a result of the pandemic will be the new norm and likely a standard of care that will be with us for a very long time.”

Arizona-based Synergy HomeCare is a non-medical home care franchise that offers companionship, personal assistance, housekeeping and live-in care services across 365 locations nationwide.

PPE’s place in home care specifically has changed indefinitely. Before, PPE may have meant as much as gloves while working. Now Senior Helpers employees, for instance, are donning face masks, gowns and even face shields in the new year.

The face shields are a relatively new update to Senior Helpers’ protocol. That extra precaution has everything to do with the new strains of COVID-19 that are continent-hopping.

New strains reportedly transmit more easily, so having the face shield offers more protection than just a mask, especially for caregivers’ eyes.

“That is something we just made the decision on based on getting good health information … because it’s all about protecting the family, but it’s also about protecting our caregivers,” Ross said. “At least the face shields can be reused. And we still wear a mask underneath them to protect everything.”

A different attitude

At first, there was a rush to secure PPE and implement protocols to protect seniors and caregivers. It was about taking a step back to ensure the welfare of everyone involved in the home care process.

This year should be different.

“Next year will continue to bring uncertainty, but this time we have a better sense of the roadmap — there is light at the end of the tunnel,” HouseWorks CEO Andrea Cohen told HHCN. “We will see a true investment in human capital, new models of care that seamlessly transition clients from one setting to the next and a focus on creating operational efficiencies that companies discovered during COVID.”

Massachusetts-based HouseWorks is a large provider of private-pay home care and home repair services. It has locations in Massachusetts, Pennsylvania and New Hampshire.

Cohen said that HouseWorks No. 1 priority in the new year is educating its workers and clients on the efficacy of COVID-19 vaccines.

Another Year 2 change has been the collective mindset of home care providers. That has now turned aggressive, as vaccines have entered the market and companies lean into innovation.

“I think the aggressiveness has to do with this opportunity that home care now has,” Ross said. “Home care can kind of be the tip of the spear. We’re in the home all the time. Everybody else just visits.”

Ross has worked hard on advocating for finding vaccines for his employees and clients through various organizations. Senior Helpers has yet to mandate vaccines for its workers, but has strongly encouraged it, as have many others have.

The opportunity doesn’t end with vaccines and the end of COVID-19 either. Year 2 — and Year 1 of COVID-19 — means increased demand for home care across the country.

“I think we’re getting a lot more exposure and more and more people are being discharged to the home,” Ross said. “People want to live out their life in their own home. I think that’s putting more focus and more visibility on what we do as an industry and how important we are, especially because the family caregivers are not growing as fast as the need is growing.”

Senior Helpers saw double-digit growth again in 2020 and has brought on about 30 new franchise owners.

The client and franchisee demand is through the roof. Ross is now more sure than ever that the business of home care is not only recession proof, but also pandemic proof.

“I think a lot of pressure was put on our industry to adapt and overcome, and we’ve got to continue to persevere through this process — don’t let up.” Ross said. “I still feel very fortunate and blessed that we’re in this industry and feel proud of how we were able to handle all of this.”

COVID-19 fatigue

While demand is surging for home care, those needs will have to be met by caregivers. And they’ve been through a grueling year.

Caregivers — and their clients — are dealing with pandemic fatigue.

“Many of our Caregivers continue to be the only access to the outside world that our clients experience,” Emma Dickison, the CEO and president of Home Helpers Home Care, told HHCN. “Our goal is to help them persist through this final push until they are vaccinated and can safely resume more of the activities they love. In some cases, our caregivers are even assisting in navigating the vaccination process.”

Ohio-based Home Helpers is an in-home care franchise company that has over 300 locations across the U.S.

Meanwhile, staffing questions persist. Unemployment benefits could increase again in March. Some caregivers are still worried about going into work or, in some cases, leaving their loved ones at home.

HouseWorks has a plan to combat that, however, and the company is working on building “caregiver consistency” in 2021.

“We’re going to use our team of caregiver engagement specialists and appoint caregiver ambassadors to proactively reach out, teach and support our caregivers throughout their journey,” Cohen said. “We have created a variety of growth opportunities to provide career paths for our caregivers so they can become directors and managers as well as provide peer support. Our goal is to have a robust pool of engaged caregivers whose primary allegiance is to HouseWorks.”

On Home Helpers’ end, Dickison is hoping to gain displaced workers from other fields that lost their jobs during the pandemic.

“We continue to innovate our training programs by making them even more accessible,” Dickison said. “Our hope is to help those displaced by the pandemic to find a new, rewarding career in an essential position with Home Helpers Home Care.”

The post Home Care Operators Prepare for Year 2 of COVID-19 appeared first on Home Health Care News.

Translation: An already tight labor market is getting even tighter for in-home care providers.

“We are in a full-employment economy,” Emma Dickison, CEO of Home Helpers Home Care, told Home Health Care News during an in-person interview last month. “I saw another statistic about a month or two ago that said we are officially at a place where there are more jobs open than there are individuals looking to be employed. That’s a really scary place to be if you’re a busy owner or a corporation that relies heavily on any type of employment, particularly caregivers.”

Founded in 1997, Cincinnati-based Home Helpers has more than 315 total locations in its network, 100% of which are franchised units. Among its offerings, Home Helpers delivers a mix of non-medical and medical home care services, with some locations offering specialty care for clients living with a range of conditions.

Due to the overall tight labor market, Home Helpers is doubling down on its recruitment and retention efforts.

As part of those efforts, it’s shifting some of its strategies to become more proactive on the hiring front, especially for in-demand, high-quality caregivers. 

“In the caregiver space, we’ve been able to fish in the past,” Dickison said. “Now, we have to go hunt.”

Home Helpers 2.0

PHI, the New York-based direct care workforce advocacy organization, projects that there will be 8.2 million job openings by 2028.

There are several drivers behind that huge number, including an aging population that’s keeping service demand high and a low-wage workforce being lured away by more lucrative jobs in retail or fast food.

“As an industry, we need to find ways to advance on the workforce front, to find new opportunities in employment,” Dickison said.

At Home Helpers, that has partly meant treating caregivers — and potential caregivers — as clients.

Similar to how most home care providers strive for a seamless start of care for clients, Home Helpers is working to create a system that ensures a seamless start of care for prospective hires. 

“If we get a caregiver application through any of our web channels, the goal is for us to be able to contact them quickly using whatever method they [prefer],” Dickison said. “Then we get them into an interview and make a decision for a conditional hire within 72 hours. Letting them know that they’re going to be working in a very short time means they aren’t interviewing somewhere else.”

Once hired, Home Helpers is also implementing a policy where a veteran employee teams up with a new caregiver during his or her first day into the home.

Additionally, the home care franchiser touches base with both the client and new caregiver, making sure each party feels comfortable in the relationship. 

For veteran employees looking to add to their skill sets, Home Helpers University offers caregivers a chance to obtain additional training and designations. Such a strategy — often referred to as “upskilling” — is often cited as a powerful tool in providers’ recruitment and retention toolbox.

“To achieve quality care to meet today’s demand — and growing, future demands — there must be a change in how the home care workforce is valued,” author Angelina Drake, COO at PHI, wrote last year in a Health Affairs blog post. “Demonstrating that value through upskilling and optimal deployment will show that these workers can do more, and deserve more, than the current system imagines.”

Broadly, the previously mentioned approaches are part of the Home Helpers 2.0 initiative, said Dickison, who was named as the new president of the Home Care Association of America (HCAOA) board of directors at the onset of 2020. 

“A lot of organizations define what exceptional care looks like and what that does to retain your client or patient base,” she said. “We’re doing something similar to the caregiver journey.”

Growth goals

In total, Home Helpers added 27 new units in 2019. The additions followed a 2018 that saw Home Helpers “open more units than anyone,” according to Dickison.

In terms of revenue, Home Helpers finished the year with around 9% to 10% of growth. For context, Home Helpers recorded system-wide sales of about $172.4 million in 2018, Franchise Times previously reported.

While it’s moving toward Home Helpers 2.0, the franchise company already added 30 new programs for its owners and operators last year.

Some of those programs have to do with helping franchisees with Medicare Advantage (MA). Others, including a program with the 10-million-member-strong Catholic Golden Age, support new referral streams. 

Catholic Golden Age provides health insurance and home health care services to seniors 50 and over.

“We’re one of only four home care companies they’re providing referrals for,” Dickison said. “It’s a huge referral opportunity.”

The post Home Helpers CEO: Labor-Starved Providers Must ‘Hunt,’ Not ‘Fish’ for Caregivers appeared first on Home Health Care News.

That’s according to a list compiled by Franchise Business Review, a market research firm that focuses on satisfaction and performance in the franchise industry. From June 2017 to November 2018, the firm surveyed more than 30,000 franchisees from more than 300 brands on qualities such as leadership, training, values and more.

Visiting Angels took the No. 1 spot when compared to other home care franchises, with franchisees responding that they were most satisfied overall. With more than 600 franchise locations throughout the U.S., the private duty home care company is the most frequently searched for home care name on Google, according to the company’s page on Franchise Business Review.

The total startup investment for a Visiting Angels franchise location is between $84,085 and $125,885.

This recognition comes after Visiting Angels also made its way onto Entrepreneur’s Franchise 500 Rankings earlier this year.

To create the list, the magazine reviewed more than 1,000 companies. For each, editors weighed “five pillars”: costs and fees; size and growth; support; brand strength; and financial strength and stability. Visiting Angels ranked No. 2 in senior care and No. 169 on the list overall.

Meanwhile, FirstLight Home Care was another strong performer on Franchise Business Review’s list.

Since its creation in 2010, the home care company has grown quickly, with a 29% increase in revenue and 24% increase in location growth in 2017 alone. Now, with about 260 franchise locations across the country, the company is also seeking franchisees to open offices in select countries.

The total startup investment for a FirstLight franchise location is between $99,681 and $152,926.

Other home care companies ranked on the list among the best franchises to invest in include:

• Qualicare Family Homecare
• Home Helpers Home Care
• Homewatch CareGivers
• Amada Senior Care
• Care Patrol
• Senior Care Authority

Across all categories, the top-ranked franchises are Kona Ice, Wild Birds Unlimited and MaidPro, according to Franchise Business Review.

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After being named as a top franchise investment choice by Forbes earlier this year, home care franchise companies join the list alongside McDonald’s, Hyatt and Dunkin’ Donuts.

This is the 20th year that Franchise Times has produced the list that includes over 500 franchise systems and ranks them based on sales and number of locations.

Among the top 10 franchises in the health/medical category, Home Instead Senior Care came in No. 1, followed by Interim HealthCare at No. 2. Both franchises offer non-medical in-home care services.

Nestled between Motel 6 and Massage Envy on the Top 200+ list, Home Instead Senior Care took 79th place overall on the list. Founded in 1994 in Omaha, Nebraska, Home Instead has grown to be the largest senior care franchise in the world. The company has more than 1,000 independently owned and operated locations in 14 countries including Canada, Brazil, China, Ireland and Australia.

Founded in 1966 as a division of Labor Pool of America called Medical Personnel Pool, Interim HealthCare was given its current name in 1992. Interim HealthCare was ranked 89th overall, in between some notable names like Steak ’n Shake and Anytime Fitness. Headquartered in Sunrise, Florida, Interim HealthCare now has 550 units with more than 300 independently owned franchise locations in 43 states and seven countries.

Other home care franchises that made the top 10 list in the health/medical category include Right at Home, BrightStar Care and Senior Helpers, each of which has seen extreme growth in the last year.

Right at Home, based in Omaha, Nebraska, recently announced the change of ownership to grow the company even more in the coming years. And Chicago-based BrightStar and Timmonium, Maryland-based Senior Helpers have expanded into the Canadian market.

The list of the top 10 home health franchises in the health/medical category are as follows:

1. Home Instead Senior Care (Rank overall: 79)

2. Interim HealthCare (Rank overall: 89)

3. Visiting Angels (Rank overall: 130)

4. Comfort Keepers (Rank overall: 149)

5. American Family Care (Rank overall: 157)

6. Right at Home (Rank overall: 168)

7. BrightStar Care (Rank overall: 189)

8. Senior Helpers (Rank overall: 221)

9. ComForCare Home Care (Rank overall: 277)

10. Home Helpers Home Care (Rank overall: 290)

See the full list of the Franchise Times Top 200+.

Written by Alana Stramowski

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