Care to Continue — Home Care Business Report

Care to Continue breaks into the Athens-Clarke County Home Care Industry

The health services industry is rapidly growing in anticipation of the future needs of the increasing number of elderly people in the population.

By 2030 nearly one in five adults in the United States will be over the age of 65, according the U.S. Census Bureau. Shifts in age demographics means changes in demands and services for the home care market.

“We believe home is sacred, we believe seniors are worthy of our care, and we want to empower them to keep living,” said Tyler Jefcoat executive director of one of Oconee County’s newest home care agencies, Care to Continue.

Located in Watkinsville, Ga., Care to Continue is a private non-medical home care business, meaning it does not provide medical services to its clients. Launched in July of 2013, by founder Dave Stearns and executive director Tyler Jefcoat Care to Continue provides in-home daily living assistance for the elderly.

Care to Continue services includes, “help with light housekeeping, meal preparation, appointments, entertainment, and some limited personal services, including grooming, dressing, and self-administered medications,” according to its website.

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The Homepage for Care to Continue. http://caretocontinue.com/

Growth of the Home Care Industy

The opportunity to enter home care now is huge. Employment rates of home care workers are projected to grow by 70 percent between 2010 and 2020, according to the Bureau of Labor Statistics. With the largest segment of the population, the baby boomers, becoming seniors, home care is one of the fastest growing industry in the U.S, according to Business Insider.

“We’re so young that I wouldn’t say we are kicking butt with any of our large competitors, but we have not lost any clients to any of our competitors,” said Jefcoat, “every client we have had the privilege of serving has increased the number of hours and services that they have used us for.”

Jefcoat and Stearns entered the home care business with an idea of the growing need in this industry, but an unclear understanding of what makes a successful home care agency.

“We really did a lot of industry analysis, and what we knew right off the bat was, 10,000 people turn 65 every day,” said Jefcoat. “What we didn’t know right off the bat was, what would differentiate us from other competitors, because it seemed from the outside like a pretty simple business, you get the right people, they provide good care [and] you charge a fee for it.”

Stearns and Jefcoat discovered the bar was pretty low for quality service. They decided if they could develop a business that focused on good communication and supported a well-trained and dedicated staff of caregivers, they could be competitive in the home care industry, said Jefcoat.

The Development of Care to Continue 

Stearns provided the initial idea and finances for Care to Continue, while Jefcoat contributed the detailed business plan and initial paperwork to establish their business.

“I am more at a look at these charts guy than Dave is,” Jefcoat said, “Dave is more of, I love these people, the opportunity is there, let’s do it. Which is actually why we are a really good team.”

Stearns is the owner of a financial strategies and insurance agency in Watkinsville that serves retried or near retired clients. Stearns asked Jefcoat if he would be willing to leave his job as a bank manager and take on the leading role in creating and running Care to Continue. Now Jefcoat sits in an office right next to Stearns, working to grow the business their joint passion launched.

The “aha moment” in the creation of Care to Continue, Jefcoat said, was the decision to turn down a contract to open their business as a franchise and instead develop their own private company.

“We want to treat our brand differently, we want to treat our clients differently,” Jefcoat said, the choice to pursue a private home care business on our own was difficult, but the right decision.

Franchising allows a new business to piggyback on many of the resources an established company already has, like marketing, licensing assistance, website quality and name recognition.

“We did not want someone to tell us: ‘these are the counties you can serve, and you can have our name and here is how you are going to do business,’” Jefcoat said. “We wanted the freedom to do it better.”

The major problems the home care industry faces today are poor client and family communication, and a high turnover rate of caregiver employees. Stearns and Jefcoat wanted to distinguish Care to Continue by being one of the home care agencies that solves these problems.

“We understood our part. We understood the business,”Jefcoat said, “but what we did not know was how we should enter your home, how we can talk to your mom and how we can earn your trust.”

Senior Summit

Stearns and Jefcoat, decided best way to learn about building a business in this industry was to talk to the population that it served, so they invited a group of seniors to a focus group called the Senior Summit.

The summit aimed to find out, “what is the senior population saying that maybe others in the market aren’t addressing, and how can we be informed by this information to then build the essence of our product and our service,” said Jefcoat.

The overarching message from seniors that came out of the summit was this idea of bringing good people in that are empowered to help seniors live the best life they can, where they want to live it, which is at home, said Jefcoat.

With this message in mind Jefcoat met with caregivers to get an insight into how a business could be best run to not only serve its clients, but also its employees. He found that there was a desire for a company to invest in their caregivers.

“We realize you can brand this thing all day long, but what we really need is good people, and people who believe in the mission of empowering folks to live at home,” said Jefcoat. In order to have the best people he said Care to Continue uses an in-depth hiring and training process, as well as an intentional care and follow-up process for all employees.

“That is probably what I am most proud of, how amazing our team is,” Jefcoat said. In the five months Care to Continue has been in business it has hired and trained 13 caregivers and serves 12 clients. “Right now I just have to over staff and be ready to work,” Jefcoat said, because Care to Continue is such a new agency it needs to have the staff to serve a growing client base.

Once Jefcoat and Stearns established the mission they wanted their home care agency to serve, they looked at successful agencies in the business that they admired. They spent time in Arizona, shadowing and talking to managers of the Cypress Homecare Solutions Agency, the number one ranked home care agency in Arizona.

Cypress Homecare served as a model for Care to Continue because of its success and belief in homegrown  and hands-on ownership, said Jefcoat. Part of what Care to Continue wants to do is ensure that there is a strong relationship between management, employees and the families and clients being served.

“We’re the responsible parties, every teammate comes through us, I personally go into each of my clients homes,” Jefcoats said. “I have even worked some shift. We are not going to let a client not get served because I have not fully trained somebody, I’ll go do it myself.”

While Care to Continue is very focused on a mission of service, it is still a business that must make money in order to operate. It charges for its services through private pay, billing individuals directly with no insurance assistance, and long-term care insurance.

Care to Continue Business Model

“We decided we wanted to be long-term care insurance and private pay, a model that allows us to not be dependent on the government,” Jefcoat said. “Our company can bill long-term care insurance, and once we have been licensed for a year the state of Georgia will allow us to bill Medicaid for some clients, kind of the lowest income clients.”

As a non-medical home care agency that is not affiliated with medicaid, Care to Continue, is limited in the services it provides and does not compete with hospitals, rehabilitation facilities or hospice.

All home care agencies in Georgia must be licensed through the State of Georgia Health Care Facilities Regulation Division. Jefcoat said the hardest part of the licensing process for Care to Continue was filing all the paperwork on their own and then waiting for the state to actually issue them their license. “We started the licensing process in January, we submitted the packet in February and we were licensed in May,” he said.

Jefcoat said after talking with similar businesses about the licensing process, he found that processing time period for Care to Continue’s license was relatively fast. But he added that this waiting period was one of the hardest parts for him in launching Care to Continue.

Care to Continue is licensed to serve 10 counties in Athens-Oconee county and surrounding areas. “We have taken clients aways from more than one of our competitors,” Jefcoat said, and some of the really critical referral sources are starting to list Care to Continue as one of their prefered agencies.

Including Jefcoat and Stearns Care to Continue has a staff of 16 employees including 13 caregivers, an administrative assistant who serve 12 clients.  The goal of the agency is to reach 21 clients by the end of the year.

“Here is the thing, this is a trust industry, we are going to earn credibility by doing one great thing at a time for each client,” Jefcoat said. “As a result we don’t have 50 clients, but I don’t want 50 clients right now I want 15.” Jefcoat did not comment on the cost of Care to Continues services.

Jefcoat said that in developing a business in a trust industry like home care, companies have to take to time up front to establish themselves with their clients and wait to develop and gain profits as their name becomes more established and trusted.

“Set realistic and sober expectations for how to grow a business in a trust industry,” said Jefcoat. “When you start and you are paying your director a little bit to work, you don’t make money for the first few months.” In September and October Care to Continue will have a positive cash flow for the first time, meaning their profit number will be positive.

Jefcoat did not disclose how much Care to Continue cost to launch. However, the average franchised home care company requires an investment of $66,148, according to Franchise Business Review. It is not uncommon among the top senior care franchises to build gross revenues to a million dollars or more, with gross margins of 30 to 40 percent, according to Franchise Business Review’s 2012 Senior Care Report.

While Care to Continue chose not to pursue the franchising route, its founders hope that their more personal and relationship based approach will turn into a thriving business. “We hope to be very efficient, even if we are not a $20 million company, we hope to be a few million and have a nice profit margin, one day. At this point we are starting to see that budding, and that is encouraging,”  said Jefcoat.

Though Jefcoat notes that the marketing size and reach of the company is smaller than he would like, he feels that it is the inner workings of the business that are driving its success and helping it grow.

“Certainly this has been the hardest thing we have ever done, but it has been so worth it, because we get to see our values, our principles and our faith lived out in the business world,” said Jefcoat. “We get to set the culture and for that reason I couldn’t be more thankful.”

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