Home is where the demand is

The owners of three new home health care franchises in town have no medical background, but that didn't stop them from making this burgeoning industry their top choice for a second career.

Home health care agencies send workers to homes, nursing homes and retirement facilities to deliver nursing and medical care for people with chronic diseases, infants, the disabled, patients recovering from surgery or injury, and the aging. Agencies might also supply employees to assist with daily living skills such as bathing, dressing and transportation.

The sector is appealing not only for its earnings potential, the owners say, but also because it gives them an opportunity to be altruistic.

Home health care has advanced from being a small segment of the health care industry to one of the fastest-growing parts of the economy, according to the U.S. Department of Labor, which projects the $54 billion industry to more than double in the next five years.

The nation's 76 million aging baby boomers are the primary reason, said Tana Sykes, chief executive officer of the Senior Resource Council in Colorado Springs.

"It's a supply-and-demand issue," she said. "We've seen an increase in home care agencies in the past few years in Colorado Springs, which has almost been necessary to keep up with the demand from the number of people entering senior age."

People often prefer to be at home when they need continued medical care or help with dressing, bathing and cooking, said Richard Monaghan, owner of Accessible Home Health Care of the Rockies.

It's less expensive and more comfortable that way, said Monaghan, a former computer-industry sales and marketing vice president who launched his franchise Feb. 1 in Colorado Springs.

"It's been well-documented that people do better if you keep them in their home environment, and the cost is far less than being in a residential treatment or hospital," he said.

Home health care costs patients $125 per visit on average, compared with about $5,000 a day for hospitalization and $535 a day for a skilled nursing facility, according to the National Association for Home Care & Hospice based in Washington, D.C.

Fees for home health care are either billed hourly or on a contracted rate for extended care and vary depending on the level of care needed.

In Colorado, there is no state licensing required for the industry, said Ellen Caruso, executive director of the Home Care Association of Colorado. Growth primarily is among companies such as Monaghan's that are not certified to accept Medicare and Medicaid patients. Instead, they serve self-paying patients and patients who have long-term care insurance, she said. Home health care agencies in Colorado provide about 3 million visits per year to more than 60,000 individuals, constituting nearly $400 million in expenditures, Caruso said.
Monaghan said he researched health care franchises for about a year before settling on one.

"I was trying to find something that would allow me to make a reasonable living and feel like I was investing in the community and giving back," he said.

That's why Maj. J. Renee Cunningham and her husband, Tim, bought a BrightStar Healthcare franchise, which they opened Oct. 1. Cunningham, 43, served four years in the U.S. Air Force and was stationed in Guam before returning stateside to serve in the Colorado National Guard. She's now commissioned as a major and works part time as chief of public affairs for the Joint Force Headquarters in Colorado, based in Centennial.

After 18 years in the military and completing a business management degree, she wanted to move into civilian life and still have time to spend with her two daughters, ages 13 and 8.

"This business and the Guard are service-oriented. That's my heart - I've served my country and my state, and now my community," she said. "This business is a neat balance of being aggressive and having compassion and understanding what people need."

Hired help

Because they have no medical training, the owners have hired registered nurses and other health care professionals, such as certified home health aides, certified nursing assistants and certified personal care companions, to do the hands-on work.

Their lack of medical background doesn't hinder business operations, say Wendy and Joe Farr, who opened ComForcare Home Care four years ago.

"Joe's business background and MBA helps with the financial end," Wendy Farr said. "I've realized business skills I never knew I had, and we both have a knack for the social, compassionate side."
The Farrs also recently became certified personal care professionals and work with patients as needed.

Like the Cunninghams and Monaghan, the Farrs are trying to carve a niche for their company in the local market, which they call "highly competitive but collaborative."

Locally, the number of home health care companies has increased 35 percent to 40 percent in the last few years, said the Senior Resource Council's Sykes. The council has 21 home health care agency members, she said, out of 115 member companies with 285 employee representatives.

Home health care agencies are part of a strong network of companies and nonprofit organizations that support seniors and often work together on events and special projects, said Joe Farr, vice president of the Senior Resource Council.

The Farrs provide nonmedical services, such as assistance with light housekeeping, meal preparation and feeding, bathroom aid, dressing and companionship. Clients include nursing homes, independent and assisted living facilities, elderly living in their homes, the disabled and new mothers. They guarantee service, or the next two visits are free. Charges generally range from $16 to $20 an hour and are covered by the patient or long-term care insurance.

The Farrs, parents of four children, operate one of nearly 100 offices in the chain. Wendy Farr, 41, had been a special education teacher, and Joe Farr, 45, who has a master's in business administration degree, had worked in information technology and retail sales management.

After Joe Farr's grandfather was diagnosed with Alzheimer's disease, the couple decided they wanted to help other caregivers facing the same situation.

The venture has been rewarding, Wendy Farr said, and business has been good enough for the Farrs to both work full time for their company, hire seven staff members and have about 100 independent contractors.

"We're doubling our business every year," Joe Farr said. "In our first year, we probably did 150 hours, the next year 300 to 400 hours, and now we're up to 800 to 1,000 hours."

Specific, individual care

All three new companies create individualized care plans after visiting with potential patients and their relatives, and strive to find the right employee to work with a patient.
Cunningham's service offers medical and nonmedical services, from companionship to care of children and quadriplegics.

"It's a fantastic business model that's holistic in that we can care for patients who are at a low level and keep caring for them as their needs increase," she said of the franchise, which has 40 offices in the nation.

She also had a personal reason for gravitating to home health care - her grandmother became infirm, and her mother and aunt became her caregivers.

"It's pretty dramatic to be thrust into that role - it's a heavy burden - and I wanted to help people in that situation," Cunningham said.

Monaghan's company, one of about 30 offices in the nation with the franchise, supplies medical and nonmedical services and hires caregivers with at least three years' experience. He specializes in chronic, longterm medical care and also helps clients handle long-term care insurance claims instead of asking for payment upfront.

"You have to bring something to the table other than the same thing everyone else is doing to be competitive," he said.