The Latest Big Burning Issues for Top Tier Home Care Leaders

Stephen Tweed | September 17, 2021 | Research & Trends
By Stephen Tweed  The sun was just peaking up over the campus as we walked through the tunnel onto the turf of the football stadium at Notre Dame University in South Bend Indiana.  Millions of college football fans have looked on in amazement at this hallowed ground, and here we were standing on the fifty…

By Stephen Tweed 

The sun was just peaking up over the campus as we walked through the tunnel onto the turf of the football stadium at Notre Dame University in South Bend Indiana.  Millions of college football fans have looked on in amazement at this hallowed ground, and here we were standing on the fifty yard line with our company logos flashing on the giant scoreboard.

We were blessed this past week to hold our semi-annual meeting of the Top 5% Home Care CEO Mastermind Group at Notre Dame University, hosted by long time member Senior1Care.  We held our actual mastermind meeting in a private conference room high in the press box building looking down on the playing field.  What better venue could you ask for to come together to discuss the big burning issues facing the home care industry?

The Big Burning Issues in the Top Tier of Home Care

Our approach to the Mastermind Principle is to give each member company a specific amount of time to present their Big Burning Issue, and how they are addressing this issue.  Then they ask the group for specific help in addressing their issue.  While each company has very specific issues and asked for very specific help, the issues we discussed fall into seven major categories:

  1. Caregiver Recruiting and Retention 
  2. New Models for Care
  3. Dealing with Vaccination Mandates
  4. Maintaining Margins amid COVID cost increases and Caregiver Shortages
  5. Balancing Sales and Recruiting
  6. Mergers and Acquisitions and industry Consolidation
  7. Strategic Decisions regarding Private Pay and Medicaid Waver payer sources

As you look at this list, there are no surprises.  Nearly every company in home care is facing these same issues.  The question is:  What can you do to address them?

Lessons from the Leaders

Each year we work with hundreds of home care agencies through our Home Care CEO Mastermind Groups, through our Caregiver Quality Assurance Mastermind Group, through our Strategic Advisory Services, and through speaking for home care association conferences.  This year, home care companies fall into three categories:

  1. Those that are growing their revenue year over year 
  2. Those that are flat in revenue growth
  3. Those that have declined in revenue

Where are you on this list?

As we have looked at the companies that are growing their revenue compared to those that are flat or declining, we see some very specific differences.  We then test those differences among our mastermind members and we are able to validate our observations.

Six Secrets of the Fastest Growing Companies in Home Care

While there is no silver bullet to solve the problems of these major burning issues, we have observed six specific things that leaders of these top tier companies are doing get ready for the future.

  1. Have a clear Vision for the Future – the growing companies all have a clear picture of where they want to be in five years
  2. Develop your Leadership Team – a growing trend among top tier companies is investing in hiring new leaders and developing current leaders.  A big emphasis is on soft skills, and the tools to craft your company culture.
  3. Put Systems in Place – as we have said for years, the growing companies in home care focus on systematizing their businesses.  The two big areas for creating systems are in marketing and in caregiver recruiting and retention.
  4. Analyze Data – the leaders of the fastest growing companies are making strategic decisions based on analyzing their own data, and comparing their performance in key areas with industry benchmarks. This week we heard some amazing insights that our members had received from analyzing their own data and taking action on what they had learned.
  5.  Create a Great Place to Work – we are in a place in our industry where if you can get the caregivers, you can get the clients.  All of the growing companies have been able to show a net gain in new hires, and part of that process is creating a great place to work. Today’s caregivers have many choices about where to work.  The very best caregivers are not on looking for work. They are already happily working for a company they appreciate.
  6. Reward the Behavior you want Repeated – much of our conversation has been about how we can reward office team members and caregivers for their performance. You’ve heard me say many many times – “What gets measured gets managed, what gets rewarded gets repeated.”  I’m adding a new phrase to that mantra – “The behavior you permit you promote.”  Leaders are defining the behavior they want repeated, and finding creative ways to reward that behavior.

And the Seventh Secret

And the seventh secret is …. “surround yourself with smart, successful people.”

One of things we have learned over the years working with leaders in the top tier of the home care industry is that they don’t do this themselves.  They surround themselves with other successful business owners. They share ideas, solve problems, and support one another.

My wife and business partner, Elizabeth Jeffries, RN, CSP, CPAE, is an award winning professional speaker and executive coach.  We met at the annual convention of the National Speakers Association in 1990, and we’ve been married for 29 years.  One of the amazing things we learned at NSA was about OPE – learning from Other People’s Experiences.  We learned about The Mastermind Concept, and we have belonged to several mastermind groups of other professional speakers.  Being part of those mastermind groups has changed our lives, and helped us be dramatically more successful as professional speakers and business owners.

In the fall of 2012, Andrew Huber, the COO of Martha’s Hands in St. Louis MO was driving through Louisville on his way to the University of Kentucky with his daughter. He stopped in our office to talk about the home care business.  He asked about other home care companies that he could connect with who were similar in size to Martha’s Hands.  Our conversation let to a discussion of the Mastermind Concept, and how we might introduce it to the home care industry.  In February of 2013, we held the first Home Care CEO Mastermind Group in Orlando, Florida. Five companies that were over $5 million in annual revenue came together to share ideas, solve problems, and support one another.  Martha’s Hands, the original charter member, is still an active member of the Top 5% Mastermind Group.  The other four owners have successfully sold their businesses and implemented their exit strategies.

If you are the owner or CEO of a growing home care company in the Top 10% of the industry, you may want to surround yourself of other smart successful people in your same industry who to not compete with you.  The best way to do that is to become a member of a Home Care CEO Mastermind Group.



Stephen Tweed
Stephen Tweed, CSP, began his journey as a business strategist in home health care in 1982. Today, Stephen is among the top thought leaders in Home Care strategy and management. He has worked with top 5% companies from across the US. He is a sought after speaker at from national and state association events.

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