Home Care Strategy Lab

The Build Infrastructure Blueprint for $0-2 Million Dollar Agencies (Debbie Miller)

#78 Does this sound like your agency? You’re still doing almost everything yourself. You have one or two office employees. Your processes are still evolving. Every new hire feels expensive. Growth still depends heavily on you, the owner. You know you need more help—but you also need to make the right hires, assign the right responsibilities, and build the right infrastructure before you and your team burn out. This session will help you understand what your agency needs now, what can wait, and how to build an office team that supports your next stage of growth. Debbie Miller on LinkedIn Download the Build Workbook Learn more about Helper Heroes VAs for home care Book a 1-1 with Helper Heroes team

The Revenue Cycle Controls Every Medicaid Agency Needs (Julio Barea)

#77 Most Medicaid billing problems begin long before a claim is submitted, with breakdowns in eligibility, authorization, scheduling, EVV, documentation, payer setup, or coding. Julio Barea, founder of the Home Care Revenue Institute, explains why agencies need to think beyond billing and manage the entire revenue cycle from intake through payment. He walks through the controls behind a clean claim, including how to verify authorized hours, reduce EVV exceptions, and catch problems before they become denials. Julio also shares the daily, weekly, and monthly cadence agencies should follow, along with critical KPIs like denial rate, payment time, EVV acceptance, and scheduled versus authorized hours. He closes with practical ways agency owners can better support their billers and develop them into trained revenue cycle management specialists. Julio Barea on LinkedIn Email: Julio@mycareoperator.com Home Care Revenue Institute Home Care Revenue Specialist Certifications Slide Deck that goes along with the episode Sponsors: Reel Home Care Consulting / reelhomecareconsulting.com

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Your Financing Options at Every Stage of Home Care Growth (Domenic Colavito)

#76 - More revenue doesn’t automatically solve cash flow—especially when payroll is weekly and payers can take 30, 60, or even 90 days to reimburse. Domenic Colavito, co-founder and COO of the $15 million OurCare Health, breaks down lines of credit, payroll funding, factoring, asset-based lending, SBA loans, and equity financing. He explains how an agency’s size, payer mix, profitability, collection time, and growth goals determine which options are actually available—and which are worth the cost. Domenic also explains factoring in simple terms and shares how predictable cash flow helped OurCare grow from roughly $6 million to $10 million without giving up equity or worrying about weekly payroll. The conversation covers the risks of financing, the billing problems it can expose, and what owners should clean up before approaching a financial partner. Domenic Colavito on LinkedIn dcolavito@greeleycapital.com Greeley Capital / www.greeleycapital.com/thelab Mention the LAB and get discounted financing for the first 3 months Sponsors: Helper Heroes / https://helperheroes.com

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How a First-Time Owner Built to 1,000 Weekly Hours in 20 Months (Keyur Shah)

#75 Keyur Shah entered home care with no ownership or healthcare experience and grew Senior Helpers of Coastal Orange County to 1,000 weekly hours in just 20 months. He walks through the agency’s growth month by month—from reaching 300 hours in Month 3 and becoming profitable in Month 9 to generating $700,000 in Year 1. Keyur explains why he opened with an office manager, added a VA recruiter in Month 4, hired a full-time scheduler near 500 hours, and waited until Month 18 to hand off client care. He also shares the ~$150,000 investment it took to reach operational breakeven, the impact of sudden client losses, and why consistent referrals took more than two years of networking. His biggest lesson applies to owners at every stage: don’t wait to grow before you hire—hire the team that can create and sustain the growth. Keyur Shah on LinkedIn Email: Kshah@seniorhelpers.com Senior Helpers of Coastal Orange County Sponsors: Vitable Reel Home Care Consulting

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How Tribute Is Building AI In-House and Saving 300+ Hours a Month (Andrew Dobson)

#74 Tribute Home Care has no engineers, so Andrew Dobson stepped up and is helping build AI tools in-house that collectively save 300+ hours per month. He explains how a scheduling dashboard evolved into an availability analyzer that helps staff new cases faster at 90–95% caregiver utilization. Tribute also used a Viv-built voice agent to fill 75% of its open weekend visits in an early test. Andrew shares how they condensed a five-system lead process into one workflow and reduced two days of financial reporting to a button press. He offers practical advice for finding the right AI projects, developing an internal champion, validating outputs, and keeping humans involved wherever judgment and relationships matter. Andrew Dobson on LinkedIn Andrew.Dobson@tributehomecare.com Tribute Home Care Claude Code Sponsors: Phoebe—AI scheduling teammate that fills 75% of shifts in under 15 minutes Reel Home Care Consulting—my recommended consultant for startups focused on differentiation and delivering a hospitality-like experience

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How Caregivers of America Rebuilt Operations Around the Client Journey (Jenni Scherer)

#73 After six home care companies merged, Caregivers of America was left with six ways of doing things, costly process gaps, and no clear ownership of the full client journey. Regional Administrator Jenni Scherer explains how the company rebuilt operations around five stages of the client journey: FirstTake, InTake, UpTake, CareTake, and ReTake. She breaks down the touch-points behind the model, including an in-home visit that converts close to 99% of prospects, five coordinator calls during the first 30 days, and regular in-person visits for VIP clients receiving 30 or more hours of care each week. Jenni also shares why the journey shouldn’t end at discharge: returning former clients have become Caregivers of America’s second-largest referral source, followed by referrals from clients’ families and friends. Jenni Scherer’s email: Jenni@caregiversofamerica.com Caregivers of America Take5 Model ’T’ Chart Sponsors: Reel Home Care Consulting // https://reelhomecareconsulting.com

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You Can’t Afford to Say Yes to the Wrong Client (Becky Reel)

#72 Saying yes to every family might increase revenue, but one wrong-fit client can cost your agency caregivers, reputation, and weeks of scheduling headaches. Becky Reel explains the waitlist mindset she used to protect her team, strengthen the client experience, and create demand—and why a true waitlist is fundamentally different from a staffing problem. She shares the hard lines her agency established around shift minimums, geography, caregiver safety, unrealistic expectations, and families who began negotiating from the first conversation. We also break down what a hospitality-driven intake call sounds like and why every office employee should be prepared to handle one. Becky closes with four super powerful mindset shifts that will help your agency become easier to refer, more memorable, and impossible to confuse with the competition. Becky Reel on LinkedIn becky@reelhomecareconsulting.com Reel Home Care Consulting Becky’s Dinner Series Sponsors: Vitable Health - https://learn.vitablehealth.com/lab

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Three Workforce Development Programs That Actually Support Caregivers (Daniel Stringer)

#71 Total Care Connections CEO Daniel Stringer shares how his team supports a workforce of roughly 1,000 active employees delivering 17,000 hours of care each week. He breaks down a paid-leave program that provides six weeks after childbirth plus two weeks of parental leave for birth, foster, and adoptive parents. He explains the company’s employee relief fund and how it has awarded 264 grants totaling more than $200,000, with employees eligible for up to $1,000 annually. Daniel also shares how moving to self-funded health insurance helped the company keep employee costs flat despite receiving a 76% renewal increase—and reduced some employees’ prescription costs from $500–$700 per month to $50 or even zero. This episode gives home care owners three tangible ways to invest in caregivers and start building benefits that meet our workforce needs. Connect with Daniel Daniel Stringer on LinkedIn Daniel’s email: DStringer@totalcareconnections.com Total Care Connections Employee Relief Fund Total Care Connections Grant Circle powered by Canary Canary—emergency relief fund solution to aide your team members in times of crisis Self-Insured Health Care Partners To set up Self Insured Health Plan Options: https://www.thegibsonedge.com/services/employee-benefits Vendors they use in the health plan: SHARX: https://sharxplan.com/ Auxient: https://www.auxiant.com/ Pareto: https://paretohealth.com/ Procedures/Imaging: https://www.valenzhealth.com/ Pharmacy Benefits Manager: https://truerx.com/ Sponsors: Vitable Health Helper Heroes—mention the LAB

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A Financial Framework to Run Before Your Next Growth Move (Adam Shriver)

#70 A typical $4-5M home care agency usually has the team, infrastructure, and capital to consider their next growth move—opening a new office, adding a new payer contract, or investing in a strategic leader. Adam Shriver, Client CFO at The Home Care CPAs works with dozens of agencies to evaluate revenue, profitability, and operational stability going into making these large growth decisions. He walks through the evaluation he conducts, the questions he asks, gross margin vs operating margin, and the other factors agencies should consider before going down a specific growth path—if you’re considering a new office or new payer contract, this episode is highly relevant. Adam Shriver on LinkedIn Adam’s email: ashriver@thehomecarecpas.com The Home Care CPAs Margin Matters—a home care-specific online financial community for owners or finance roles (free until the end of ’26) Sponsors: Phoebe—best AI scheduling agent for home care Vitable Health—health plans for home care that your team will actually use

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The Only Home Care Scorecard You Need (Krystal Wilkinson)

#69 Most home care agencies are drowning in reports but still struggling to identify problems before they impact growth. Krystal Wilkinson, President of Adultcare Assistance Home Care, shares the 18 core KPIs she and her leadership team review every week across recruiting, scheduling, care management, sales, and HR & finance—and explains why leading indicators matter far more than monthly reports. You'll learn why her agency targets a 25–27 hour average client census, aims to hire caregivers in under 7 days (currently averaging 9 days), tracks 25 meaningful referral visits per week, and uses data to predict staffing needs, revenue dips, and referral trends before they happen. Krystal also explains how her team uses AI-powered dashboards, why every department owns specific numbers, and how they've refined their scorecard over 15 years of trial and error. Krystal Wilkinson / KDW@adultcareassistance.com Adultcare Assistance Sponsors: Vitable Health - learn.vitablehealth.com/lab

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Four Ways for Caregivers to Increase Their Pay Rate (Kimberly Jones)

#68 When a caregiver asks, “when do I get my next raise?”, do you have a good answer? Kimberly Jones, Vice President of Help at Home Senior Care, shares the transparent four-part compensation framework her team uses to reward skill development, specialized training, long-term commitment, and leadership. We break down hands-on competency evaluations, dementia skill assessments, certification pathways, longevity bonuses, and why clear career progression has helped the agency retain caregivers for many years. Kimberly also shares the retention data behind the program, including why 66% of their caregivers have stayed for more than two years and why their highest-paid caregivers average 6.5 years with the company. Kimberly Jones Help at Home Senior Care Grade Us—feedback loop tool Sponsor: Vitable Health - learn.vitablehealth.com/lab

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How to Build an Advanced Dementia Care Program (Ryan Whittington)

#67 Ryan Whittington, CEO of Seniors Home Care in St. Louis, shares how one struggling dementia client led his team to build Sage In-home Memory Care—a completely separate brand dedicated to serving advanced dementia clients with a fundamentally different care model. Instead of treating dementia as another service line, Ryan explains how specialized caregivers, weekly care management visits, life story assessments, individualized activity calendars, and intensive training have created better outcomes for clients, families, and caregivers alike. We also discuss why consistency matters more than flexibility, how to overcome resistance to care, why advanced dementia clients require a true team approach, and the business decisions that make this model sustainable. Ryan Whittington Seniors Home Care Sage In-home Memory Care Life Story Assessment - provided by Sage Best Practices Booklet--Dementia Home Care (Alzheimer’s Association) Teepa Snow’s 6 GEMS You Need to Know For A Positive Approach to Dementia Care

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What It Looks Like to Sell to a Home Care Roll-Up And Stay On

#66 Adam Berry built As Close as Family over nearly a decade before realizing the business had outgrown what he could sustainably manage on his own. Rather than walking away, he sold the agency to Avenues Home Care and stayed on to focus on the work he enjoys most while gaining the back-office support he was missing. In this episode, Adam and Avenues CEO Doug Markham break down how they found the right acquisition fit, what due diligence actually looked like, and why culture mattered more than valuation. They also share how they divide responsibilities after the sale, which functions are centralized versus kept local, and why giving operators autonomy has been critical to continued growth. Adam Berry / adam@ascloseasfamily.com As Close as Family Doug Markham / doug.markham@avenueshomecare.com Avenues Home Care Sponsors: Phoebe.work - A self-driving alternative that fills shifts in minutes

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Why You Might Be Headed For 6-Figure Fines (And How to Avoid Them)

#65 Many home care agencies don't realize they've crossed the Affordable Care Act threshold until the IRS comes knocking. Brendan Mullins, CRO of Vitable Health, explains why agencies with as early as $1–2M in annual revenue can already qualify as Applicable Large Employers, how 30 hours per week (not 40) triggers eligibility, and why variable caregiver schedules make ACA compliance especially difficult. We break down how the 50 Full-Time Equivalent (FTE) threshold is calculated, the misconceptions that lead agencies into trouble, and why penalties can quickly climb into the six figures. Brendan also walks through how ACA audits typically unfold, why compliance issues often surface years later, and the common mistakes agencies make along the way. Brendan Mullins on LinkedIn Vitablehealth.com ACA Penalty Calculator

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Can Your Agency Survive Losing Its Best Scheduler? (Corey Grissom)

We cover: Why home care leaders are moving from AI exploration to real-world adoption. The buy-vs-build debate and why many agencies are choosing AI partnerships. Helping schedulers spend less time chasing call-outs and more time supporting people. Supporting owner-operators as they scale from zero schedulers to their first hire. How AI can fill open shifts in minutes instead of hours. Moving from reactive scheduling to planning weeks in advance. Capturing caregiver preferences and scheduling knowledge through AI memory. Preventing tribal knowledge from walking out the door with staff turnover. Why AI works best as an amplifier—not a replacement—for great schedulers. Lessons learned from overcoming office-team skepticism and driving adoption. The surprising ways caregivers are embracing AI-powered communication. How AI is creating more proactive and human-centered operations. Extras: Connect with Corey Grissom / corey@phoebe.work See how Phoebe can transform your scheduler’s daily life

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The Hidden Cost of Bad Data in Home Care (Brady Schwab)

We cover: Brady's journey from audiology to home care innovation. Right at Home's growth to 600+ franchises across four countries. Staying focused on non-medical home care. Why AI is exposing long-standing data quality issues. The importance of data hygiene and integrity. How bad data can erode trust and create risk. Common gaps in referral tracking, scheduling, and workflows. Making care documentation easier through voice-to-text technology. Aligning caregiver incentives with better documentation. Combining in-home observations with vital sign data. Moving from documentation to predictive care. Piloting RespirAI to identify COPD exacerbations earlier. Using technology to reduce avoidable hospitalizations. Why strong documentation is the foundation for predictive analytics. Solving for affordability, workforce shortages, and chronic disease. How home care can become the preferred model for aging in place. Navigating the realities of aging while embracing innovation. Some extras: Connect with Brady Schwab / bschwab@rightathome.net Learn more about Right at Home RespirAI—the COPD pilot that Right at Home is conducting See how Phoebe AI can eliminate missed clock in/outs and save your team hours each week

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How Team Select Is Predicting Readmissions Before They Happen (Meghan Willson)

We cover: Team Select's growth across 15 states, 9,000 employees, and 5,000 patients. Meghan's transition from physical therapist to technology leader. Using operational technology to reinvest dollars into patients and caregivers. Building a new enterprise data warehouse from the ground up. Why successful AI starts with a strong data foundation. The launch of CareSight AI and Team Select's partnership with Questa. Using AI to identify patient deterioration sooner. Predicting potential readmissions 3–5 days in advance. Combining vitals, documentation, and AI-driven insights. Reducing avoidable hospitalizations through earlier intervention. How clinician buy-in accelerated adoption. Lessons learned from implementing AI at scale. Overcoming AI skepticism and technology resistance. Why clinicians should lead healthcare innovation. Start: Put clinicians first and solve their biggest workflow challenges. Stop: Boiling the ocean—focus on one problem at a time. Some Extras: Connect with Meghan Willson / mwillson@tshc.com Learn more about Team Select Home Care See how Phoebe AI can nearly eliminate scheduling call-outs

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Why Response Time is Your Most Important Sales Metric (Brad Gilmore)

Bonus episode recorded live @ Home Care Innovation Forum in Palm Springs, CA Key topics include: Why weekly new revenue is the most important sales measurement and how it provides a real-time view of where new business is coming from. Ensuring sales activity stays aligned with referral accounts that are actively generating new business. What success looks like for new sales reps, including tracking the number of new referral accounts established. Brad's "controlled shotgun" approach to account management: Tier A: 10 key accounts Tier B: 10–15 growth accounts Tier C: 15–20 contingency or "just in case" accounts The role of sales, operations, and branch leadership in building referral partner relationships and ensuring smooth transitions to start of care. Why great sales professionals focus on being present, not just visible, when engaging referral partners. How leaders can better equip sales teams with meaningful data that supports conversations and decision-making. The growing complexity of patient care and why sales professionals need a stronger understanding of clinical and complex-care scenarios. Positioning home care organizations as outcome-driven partners who help referral sources solve patient care challenges. Why organizations with service models that solve the widest range of problems are positioned to win. What to stop and start measuring: Stop: Overloading sales teams with insignificant data. Start: Viewing revenue as a measurement of performance rather than the sole metric of success. How experienced reps focus on long-term referral source retention and relationship management. Why response time may be the most important quality assurance metric in home care sales—and why speed matters. Extras: Connect with Brad Gilmore on LinkedIn or via email: brad.gilmore@familytreecares.com Learn more about Family Tree Private Care See how Phoebe AI can double your scheduling output Home Care Innovation Forum 2027 / Pasadena, CA on May 16-18 for Orgs $30M+

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Nearly 100% Show Rates When AI Handles 830 Caregiver Touches a Week (Nate West)

#64 Most home care agencies are still operating the old way: phone calls, spreadsheets, reactive scheduling, and constant firefighting. Nate West, owner of Heritage Home Care in Arizona, joins me to discuss how he's transformed a well-established agency from what he jokingly calls "the Stone Age" into a modern, tech-enabled operation in just two years. He talks about eliminating edge cases, transitioning from reactive scheduling to proactively filling shifts days and weeks in advance, and the role AI is playing in caregiver communication, shift confirmations, and open shift management. And maybe more importantly, we discuss what happens when technology frees schedulers from constant firefighting and allows them to focus on relationships, retention, and the overall client/caregiver experience. Nate explains the results Heritage has seen after six months of using Phoebe, including: • Median open shift fill time of just 9.7 minutes • No-call/no-shows reduced from 8 to just 1 year-over-year • 830 caregiver touch points per week handled by AI • 2,800+ shifts confirmed with a 97.8% confirmation rate Nate West / nate@heritagehomecareaz.com Heritage Home Care Phoebe—AI scheduling assistant for home care, mention the ‘LAB’ for a discount

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The Gold Standard for Dementia Home Care (Jim Kimzey)

#63 Most home care agencies treat dementia care as a service line. Full Bloom built an entire company around it. Jim Kimzey, Co-Founder of Full Bloom Home Care, shares the systems, training, and care philosophy that allow his team to successfully serve some of the most challenging dementia clients while helping caregivers, families, and staff thrive. Jim breaks down the three levers that drive better dementia outcomes, an eight-step process for overcoming care refusal, and the gold standard for supporting complex dementia clients at home. He also explains how a dementia-first approach can reduce caregiver burnout, ease operational strain, and create better experiences for clients and families. This conversation is a practical roadmap for delivering better care to anyone serving dementia clients and families. Jim Kimzey Full Bloom Memory Care Breakthrough: The Full Bloom Method for Overcoming Resistance to Care Best Practices Booklet—Dementia Home Care (Alzheimer’s Association) Danny Meyer's Salt Shaker Theory of Leadership Sponsors: Mertz Taggart—Home Care M&A Experts

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