Hi Fastlane Forum,
My name is Rich and I'm going to startup an In home Care agency in California and my goal is to be on the fast lane as opposed to most operators who are on the slow lane. Quick on me and then I want to run my business through CENTS and get your feedback.
I'm in the process of launching an in Home Care, a private-pay, non-medical home care agency in Southern California (Palm Springs area). Private pay only. No Medicaid, no Medicare, no insurance billing for now. I come from a family of caregivers - Mom, Dad, sister(nurse) and I, so there's hands-on operational knowledge behind me.
Background:
Now the part I actually want feedback on. Running home care through CENTS:
Control. Went independent instead of buying a franchise. Franchise route means making someone else richer and losing control of the operation, which MJ hammers. The one real risk is state and federal regulations. If my paperwork, licensing, or insurance slips, the state can shut me down. Right now I'm deep in the California HCO application (HCS 281 packet), lining up workers' comp and the $10K dishonesty bond. No shortcuts here.
Entry. Barriers are real. Licensing, insurance, and the "know-how" filter (the state won't license you without a baseline understanding of the business) keep a lot of people out. Plenty of agencies come and go, which actually helps me.
Need. People want to retire at home, and the population is aging, so demand isn't the problem. The problem is why me over the other 20-30 agencies in my market. Two angles I'm leaning into:
Time. This is the trickiest commandment for this model. Home care is 24/7 by definition. Middle-of-the-night calls when a family member's mom with dementia has a crisis, or a caregiver unable to locate their client when they wake up. My play is to outsource after-hours answering early, then bring on a strong general manager once operations can support it. Systems and SOPs are the only way this commandment doesn't eat you alive.
Scale. Home care isn't as scalable as SaaS or a digital product. But it's a lot more scalable than most people assume. I can always add more care providers, more clients, and more management. With strong systems in place there's real leverage, and franchising is a path most successful operators eventually take. Compared to a sandwich shop or a one-location service biz, the ceiling is genuinely high. Would love to hear from anyone who's scaled a service business past the point where the owner is the bottleneck.
Has anyone run this playbook or something similar (Nanny agencies are very similar)? What would you target? And if anyone here has worked as a discharge planner or hospital case manager, I'd love to interview you.
Appreciate any feedback, pushback, or war stories. Excited to contribute once I've got real results to share.
My name is Rich and I'm going to startup an In home Care agency in California and my goal is to be on the fast lane as opposed to most operators who are on the slow lane. Quick on me and then I want to run my business through CENTS and get your feedback.
I'm in the process of launching an in Home Care, a private-pay, non-medical home care agency in Southern California (Palm Springs area). Private pay only. No Medicaid, no Medicare, no insurance billing for now. I come from a family of caregivers - Mom, Dad, sister(nurse) and I, so there's hands-on operational knowledge behind me.
Background:
- Started a SEM agency for in home care companies (CareBoost.ai) for about 4 months. Cold called Home Care Agency owners -> Booked meetings -> Closed deals. My offer was getting Leads through Google PPC and landing pages. However, a few months into that business I was offered a 24/7 job from a referral and decided to shut the business down to focus on that. I understand that MJ states that trading time for money is a BAD deal. I'm sure he would especially cringe at the idea of selling all of your time (24/7) compared to 5 days for 2 days. But I don't regret it because it gave me a way to get starting capital. Now that I have some money to startup, I want to do in-home care myself.
- No college degree. Education came from CourseCareers (tech sales), Fox Web School, Seth Hymes' digital marketing course, and books.Namely, How to Win Friends and Influence People, Fanatical Prospecting, and The E-Myth. That last one changed how I think about building the agency.
- Signed up for a SCORE mentor.
- Baby on the way, which is the real clock I'm running against.
Now the part I actually want feedback on. Running home care through CENTS:
Control. Went independent instead of buying a franchise. Franchise route means making someone else richer and losing control of the operation, which MJ hammers. The one real risk is state and federal regulations. If my paperwork, licensing, or insurance slips, the state can shut me down. Right now I'm deep in the California HCO application (HCS 281 packet), lining up workers' comp and the $10K dishonesty bond. No shortcuts here.
Entry. Barriers are real. Licensing, insurance, and the "know-how" filter (the state won't license you without a baseline understanding of the business) keep a lot of people out. Plenty of agencies come and go, which actually helps me.
Need. People want to retire at home, and the population is aging, so demand isn't the problem. The problem is why me over the other 20-30 agencies in my market. Two angles I'm leaning into:
- Caregiver retention. Industry standard caregiver turnover sits at 75%. If I can build an agency caregivers actually want to stay at, that flows straight into client experience. Same faces showing up, real relationships with the client and family, fewer missed shifts. Agencies that rank word of mouth as their top recruitment source report turnover closer to 59%, which tells me the culture side actually moves the needle.
- Sales and marketing. When I was running the SEM agency, I noticed most operators weren't tech savvy and had no real sales pipeline. Consultative selling and business development are where I think I can out-execute the local competition. Most of these agencies are still running on word-of-mouth and referrals.
Time. This is the trickiest commandment for this model. Home care is 24/7 by definition. Middle-of-the-night calls when a family member's mom with dementia has a crisis, or a caregiver unable to locate their client when they wake up. My play is to outsource after-hours answering early, then bring on a strong general manager once operations can support it. Systems and SOPs are the only way this commandment doesn't eat you alive.
Scale. Home care isn't as scalable as SaaS or a digital product. But it's a lot more scalable than most people assume. I can always add more care providers, more clients, and more management. With strong systems in place there's real leverage, and franchising is a path most successful operators eventually take. Compared to a sandwich shop or a one-location service biz, the ceiling is genuinely high. Would love to hear from anyone who's scaled a service business past the point where the owner is the bottleneck.
Has anyone run this playbook or something similar (Nanny agencies are very similar)? What would you target? And if anyone here has worked as a discharge planner or hospital case manager, I'd love to interview you.
Appreciate any feedback, pushback, or war stories. Excited to contribute once I've got real results to share.
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