business plan elderly home care

Senior Home Care Business Plan [Sample Template]

By: Author Tony Martins Ajaero

Home » Business ideas » Healthcare and Medical » Home Healthcare for Seniors

Are you about starting a senior home care center ? If YES, here is a complete sample senior home care business plan template & feasibility report you can use for FREE .

Taking care of senior citizens in the United States, Canada and in most developed countries of the world is indeed brisk business.

As people grow old, they ensure that they put plans in place that will make them live the rest of their life with fully support from professionals who are trained to take care of elderly people.

Taking care of senior citizens involves, housing them and helping them handle basic day to day task like bathing, taking their drugs, exercising, cleaning them up amongst other tasks.

There are people that are gifted with the ability to take care of senior citizens. If you thing that you have flair for taking care of the elderly, then you should consider starting a senior care home in your city.

A Sample Senior Home Care Business Plan Template

1. industry overview.

Operators in the industry senior care franchise industry largely provide residential and personal-care services for elderly individuals (senior citizens) who are unable to fully care for themselves due to old age or one form of age related disability.

Demographic trends have supported growing demand for residential senior care franchises, and the industry has experienced strong growth over the last half a decade.

This growth is expected to improve, driven by an improving economic environment and the continued aging of the population, which will expand the industry’s markets.

The law in the united states and in some countries states that before a senior care facility can commence operations, there should be at least six residents and at least one trained caregiver there 24 hours a day and 7 days a week.

So also, a standard senior care facility is expected to have a house manager, night manager, weekend activity coordinator, and 2 or more caregivers depending on the size of the facility.

The Residential Senior Care Franchises Industry is indeed a very large industry and pretty much thriving in developed countries such as United States of America, Canada, United Kingdom, Germany, Australia and Italy et al.

Statistics has it that in the United States of America alone, there are about 1,467 licensed and registered Senior Care Facilities scattered all across the United States responsible for employing about 106,609 employees and the industry rakes in a whooping sum of $3bn annually with an annual growth rate projected at 11.7 percent between 2011 and 2016.

Beehive Homes can comfortably boast to won the greater percentage of the available market in this industry. A recent report published by IBISWORLD shows that the Residential Senior Care Franchises industry has boomed during the five years to 2015, driven by the aging population and a growing need for dementia care.

The report further stated that, the industry, which provides residential and personal-care services for elderly individuals who are unable to fully care for themselves, has been increasingly orienting itself toward the provision of dementia care as the population continues to age; this can include medical and social assistance with the activities of daily living, such as bathing, eating and dressing.

Although franchises that primarily provide inpatient nursing and rehabilitation services are excluded from this industry, many facilities provide some nursing care and other medical supervision.

Over and above, the senior care line of business in developed countries is still enjoying good patronage particularly if they are well positioned and if they know how to reach out to their target market; the aging population and those who can’t take care of themselves.

2. Executive Summary

Mary &Joseph® Senior Care Home, LLC is a standard and licensed senior care facility that will be located in the heart of Montgomery – Alabama in a neatly renovated and secured spacious housing facility.

Our senior care facility is specifically designed and equipped with the needed accommodation facilities / gadgets to give comfort and security to all our residence irrespective of the religious affiliations, their race, and health condition.

We are set to take care of senior citizens who can’t take care of themselves. Mary & Joseph® Senior Care Home, LLC is a family owned and managed business that believe in the passionate pursuit of excellence and financial success with uncompromising services and integrity which is why we have decided to venture into the hospitality industry by establishing our own senior care facility (assisted living facility business).

We are certain that our values will help us drive the business to enviable heights and also help us attract the numbers of residents that will make our facility fully occupied year in year out.

Despite the fact that we are a senior care facility, we are going to be a health conscious and customer-centric with a service culture that will be deeply rooted in the fabric of our organizational structure and indeed at all levels of the organization.

With that, we know that we will be able to consistently achieve our set business goals, increase our profitability and reinforce our positive long-term relationships with our clientele, partners (vendors), and all our employees as well.

Our accommodation facility will be decorated in an exquisite and elegant facade, so much so that it will be a conspicuous edifice in the city where it is located. Mary & Joseph® Senior Care Home, LLC will provide a conducive home for our residents.

We will engage in services that will help residents in our facility complete daily basic and simple tasks, such as taking medication or bathing, making dinners, having conversations, making appointments, and getting to work or a day service, budget their personal allowance, select photos for their room or album, meet neighbors and “carry out civic duties,” go grocery shopping, eat in restaurants, make emergency calls or inquiries, and exercise regularly amongst other activities.

Mary & Joseph® Senior Care Home, LLC will be equipped with everything that will make life comfortable for the elderly – senior citizens.

We will as build a fitness room and library et al. We will also install a free Wi-Fi that will enable our residents and guests surf the internet with their laptop in the room free of charge, and there will be wireless access in all the public area within the lodging facility.

Mary & Joseph® Senior Care Home, LLC will at all times demonstrate her commitment to sustainability, both individually and as a firm, by actively participating in our communities and integrating sustainable business practices wherever possible.

We will ensure that we hold ourselves accountable to the highest standards by meeting our customers’ needs precisely and completely whenever they patronize our products. We will cultivate a working environment that provides a human, sustainable approach to earning a living, and living in our world, for our partners, employees and for our customers.

Mary & Joseph® Senior Care Home, LLC is a family business that is owned and managed by Cloe Hayward and her immediate family members.

Mrs. Cloe Hayward is a licensed non – medical home care administrator and social health worker with well over 10 years of hands on experience working for leading brand in the industry.

She has a Master’s Degree in Public Health and she is truly passionate when it comes to taking care of the aging population and people with one form of disability or the other.

3. Our Products and Services

Mary & Joseph® Senior Care Home, LLC is set to operate a standard senior care facility in Montgomery – Alabama. The fact that we want to become a force to reckon with in the Senior Care Facility industry means that we will provide our resident a conducive and highly secured accommodation.

In all that we do, we will ensure that our residents are satisfied and are willing to recommend our facility to their family members and friends.

We are in the senior care business to deliver excellent services and to make profits and we are willing to go the extra mile within the law of the United States to achieve our business goals, aims and objectives. Mary & Joseph® Senior Care Home, LLC will provide the following services to her clients;

• Alzheimer’s disease and dementia care
• Respite care
• End-of-life care
• Interactive care and other services
• Providing room and board
• Nursing and other supervision
• Assistance in daily living
• Housekeeping services

4. Our Mission and Vision Statement

• Our vision is to become the number one choice when it comes to senior care facility in the whole of Alabama and also to be amongst the top 10 senior care facilities in the United States of America within the first 10 years of establishing the business.
• Our mission is to build a senior care facility that will meet and surpass the needs of all the residents of our facility; we want build a profitable and successfully business brand that in the nearest future will sell franchise all across the United States and Canada.

Our Business Structure

Mary & Joseph® Senior Care Home, LLC is a business that will be built on a solid foundation. From the outset, we have decided to recruit only qualified professionals (non – medical home care administrator, nurse’s aides, medication management counselors, county aging worker, rehabilitation counselors, and home caregivers) to man various job positions in our organization.

We are quite aware of the rules and regulations governing the senior care facility industry which is why we decided to recruit only well experienced and qualified employees as foundational staff of the organization. We hope to leverage on their expertise to build our business brand to be well accepted in Minnesota and the whole of the United States.

When hiring, we will look out for applicants that are not just qualified and experienced, but homely, honest, customer centric and are ready to work to help us build a prosperous business that will benefit all the stake holders (the owners, workforce, and customers).

As a matter of fact, profit-sharing arrangement will be made available to all our management staff and it will be based on their performance for a period of five years or more. These are the positions that will be available at Mary & Joseph® Senior Care Home, LLC;

• Chief Executive Officer
• Facility Administrator (Human Resources and Admin Manager)

Nurse’s Aides

• Home Caregivers /County Aging Workers
• Sales and Marketing Executive
• Accounting Officer
• Security Officer

5. Job Roles and Responsibilities

Chief Executive Officer:

• Increases management’s effectiveness by recruiting, selecting, orienting, training, coaching, counseling, and disciplining managers; communicating values, strategies, and objectives; assigning accountabilities; planning, monitoring, and appraising job results; developing incentives; developing a climate for offering information and opinions; providing educational opportunities.
• Creates, communicates, and implements the organization’s vision, mission, and overall direction – i.e. leading the development and implementation of the overall organization’s strategy.
• Responsible for fixing prices and signing business deals
• Responsible for providing direction for the business
• Responsible for signing checks and documents on behalf of the company
• Evaluates the success of the organization
• Reports to the board.

Facility Administrator (Admin and HR Manager)

• Responsible for overseeing the smooth running of HR and administrative tasks for the organization
• Design job descriptions with KPI to drive performance management for clients
• Regularly hold meetings with key stakeholders to review the effectiveness of HR Policies, Procedures and Processes
• Maintains office supplies by checking stocks; placing and expediting orders; evaluating new products.
• Ensures operation of equipment by completing preventive maintenance requirements; calling for repairs.
• Defines job positions for recruitment and managing interviewing process
• Carries out staff induction for new team members
• Responsible for training, evaluation and assessment of employees
• Responsible for arranging travel, meetings and appointments
• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
• Oversees the smooth running of the daily home activities.
• Responsible for managing our residents (senior citizens) in their various houses
• Handles personal injury case management
• Responsible for offering home medication management services.

Marketing and Sales Executive

• Identifies, prioritizes, and reaches out to new clients, and business opportunities et al
• Identifies development opportunities; follows up on development leads and contacts; participates in the structuring and financing of projects; assures the completion of projects.
• Writes winning proposal documents, negotiate fees and rates in line with organizations’ policy
• Responsible for handling business research, market surveys and feasibility studies for clients
• Responsible for supervising implementation, advocate for the customer’s needs, and communicate with clients
• Develops, executes and evaluates new plans for expanding increase sales
• Documents all customer contact and information
• Represents Mary & Joseph® Senior Care Home, LLC in strategic meetings
• Helps to increase sales and growth for Mary & Joseph® Senior Care Home, LLC.

Accountant / Cashier

• Responsible for preparing financial reports, budgets, and financial statements for the organization
• Provides managements with financial analyses, development budgets, and accounting reports; analyzes financial feasibility for the most complex proposed projects; conducts market research to forecast trends and business conditions.
• Responsible for financial forecasting and risks analysis.
• Performs cash management, general ledger accounting, and financial reporting for the organization
• Responsible for developing and managing financial systems and policies
• Responsible for administering payrolls
• Ensures compliance with taxation legislation
• Handles all financial transactions for Mary & Joseph® Senior Care Home, LLC
• Serves as internal auditor for Mary & Joseph® Senior Care Home, LLC.

Security Officers

• Ensures that the facility is secured at all time
• Controls traffic and organize parking
• Gives security tips to staff members from time to time
• Patrols around the building on a 24 hours’ basis
• Submits security reports weekly
• Any other duty as assigned by the facility administrator
• Responsible for cleaning the facility at all times
• Ensures that toiletries and supplies don’t run out of stock
• Assists our residents when they need to take their bath and carry out other household tasks
• Cleans both the interior and exterior of the facility
• Handles any other duty as assigned by the facility manager

6. SWOT Analysis

Mary & Joseph® Senior Care Home, LLC is set to become one of the leading senior care facilities in Montgomery – Alabama which is why we are willing to take our time to cross every ‘T’ and dot every ‘I’ as it relates to our business. We want our senior care facility to be the number one choice of all senior residents of Montgomery and other cities in Alabama.

We know that if we are going to achieve the goals that we have set for our business, then we must ensure that we build our business on a solid foundation. We must ensure that we follow due process as it relates to setting up a business.

Even though our Chief Executive Officer (owner) has a robust experience in social work and taking care of people with disability and the aging population, we still went ahead to hire the services of business consultants that are specialized in setting up new businesses to help our organization conduct detailed SWOT analysis and to also provide professional support in helping us structure our business to indeed become a leader in the senior care facility industry.

This is the summary of the SWOT analysis that was conducted for Mary & Joseph® Senior Care Home, LLC;

Our strength lies in the fact that we have a team of well qualified professionals manning various job positions in our organization. As a matter of fact, they are some of the best hands in the whole of Montgomery – Alabama and they are professionals who have what it takes to grow business from scratch to profitability in record time.

Our location, the Business model we will be operating on, well equipped facility and our excellent customer service culture will definitely count as a strong strength for us.

Mary & Joseph® Senior Care Home, LLC is a new business which is owned by an individual (family), and we may not have the financial muscle to sustain the kind of publicity we want to give our business and also to attract some of the highly – experienced hands in the senior care facility industry.

• Opportunities:

The opportunities that are available to senior care facilities are unlimited considering the fact that we have growing aging population in the United States and we are going to position our business to make the best out of the opportunities that will be available to us in Montgomery – Alabama.

Just like any other business, one of the major threats that we are likely going to face are economic downturn and unfavorable government policies . It is a fact that economic downturn affects purchasing / spending power. Another threat that may likely confront us is the arrival of a new and bigger / well established senior care facility, non – medical home care facility or group home facility brand in same location where ours is located.

7. MARKET ANALYSIS

• Market Trends

Because of the essential nature of services provided by businesses such as senior care homes, non – medical home care facilities and group homes et al, the industry was able to grow even in the face of economic stagnation. In addition, the continued growth of the aging population and people with one form of disability or the other has stimulated demand for industry services.

Since the aging population is more prone to injury and illness, and therefore requires more assistance with daily activities, the larger share of senior adults has propelled demand for senior care homes, non – medical home care facilities and of course nursing care facilities . Despite favorable demographic trends, unsatisfactory government funding has hindered industry growth.

The trend in the industry is that, players in the industry are now flexible enough to adjust their services and facilities to attract more knowledgeable and educated residents by incorporating more technology and adapting to new markets. It is now trendier to find senior care facilities with internet facility and Wi-Fi et al.

Another trend in the industry is that, in other to make senior care facility, non – medical home care facilities and group home facilities more affordable for low income individuals, many states in the United States of America are enacting changes to the portion of Medicaid which can be applied to senior care facilities and group Home Facilities.

Before now, only individuals living in nursing homes were typically provided Medicaid assistance, but in recent time, there are now a growing number of states that have recognized the importance of offering Medicaid dollars to senior citizens living in senior care facilities.

No doubt the Senior Care Facility industry will continue to grow and become more profitable because the aging baby-boomer generation in Unites States is expected to drive increasing demand for these specialized services and care for the elderly.

8. Our Target Market

Mary & Joseph® Senior Care Home, LLC is in business to service the aging population / senior citizens in Montgomery – Alabama and other cities in Alabama. We will ensure that we target both self – paying customers (who do not have Medicaid cover), and those who have Medicaid cover.

Generally, those who need the services of non-medical home care facilities are the aging population, people with one form of disabilities or the other and perhaps those who need daily help.

The fact that we are going to open our doors to a wide range of customers does not in any way stop us from abiding by the rules and regulations governing the senior care facility industry in the United States. Our employees are well – trained to effectively service our customers and give them value for their monies.

Our customers can be categorized into the following;

• The aging population / senior citizens
• The aged who might suffer from severe joint pains and every other age categories that fall under the conditions listed by the physician as people who do not necessarily need the services health workers to survive or carry out their daily task.

Our competitive advantage

Aside from the competitions that exist amongst players in the senior care facility line of business, they also compete against other home healthcare services providers such as non – medical home care facilities, assisted living facilities and nursing homes et al.

To be highly competitive in the senior care facility industry means that you should be able to secure a conducive and secured facility, deliver consistent quality service and should be able to meet the expectations of the children / family members paying for their loved elderly parents and senior citizens with disabilities in your facility.

Mary & Joseph® Senior Care Home, LLC is coming into the market well prepared to favorably compete in the industry. Our facility is well positioned (centrally positioned) and visible, we have good security and the right ambience for elderly people and senior citizens with one form of disability or the other.

Our employees are well groomed in all aspect of senior care facility services and all our employees are trained to provide customized customer service to all our residents. Our services will be carried out by highly trained professional nurse’s aides, county aging workers and home caregivers who know what it takes to give our highly – esteemed residents value for their money.

Lastly, all our employees will be well taken care of, and their welfare package will be among the best within our category (startups senior care facility business and other related businesses in the United States) in the industry. It will enable them to be more than willing to build the business with us and help deliver our set goals and achieve all our business aims and objectives.

9. SALES AND MARKETING STRATEGY

• Sources of Income

Mary & Joseph® Senior Care Home, LLC will ensure that we do all we can to maximize the business by generating income from every legal means within the scope of our industry.

We will generate income by providing a conducive home for our residents (senior citizens); we will engage in services that will help our residents complete daily basic and simple tasks, such as taking medication or bathing, making dinners, having conversations, making appointments, and getting to work or a day service, budget their personal allowance, select photos for their room or album, meet neighbors and “carry out civic duties,” go grocery shopping, eat in restaurants, make emergency calls or inquiries, and exercise regularly amongst other activities.

These are the services we will offer to generate income for the business;

10. Sales Forecast

One thing is certain, there would always be elderly people and senior citizens with one form of disability or the other who would need the services of senior care facility.

We are well positioned to take on the available market in Montgomery – Alabama and we are quite optimistic that we will meet our set target of generating enough income / profits from the first six month of operations and grow our senior care facility business and our residents’ base.

We have been able to critically examine the senior scare facility services market and we have analyzed our chances in the industry and we have been able to come up with the following sales forecast. The sales projections are based on information gathered on the field and some assumptions that are peculiar to similar startups in Montgomery – Alabama.

Below are the sales projection for Mary & Joseph® Senior Care Home, LLC, it is based on the location of our business and of course the wide range of related services that we will be offering;

• First Fiscal Year-: $100,000 (From Self – Pay Clients); $250,000 (From Medicaid Covers)
• Second Fiscal Year-: $250,000 (From Self – Pay Clients); $500,000 (From Medicaid Covers)
• Third Fiscal Year-: $500,000 (From Self – Pay Clients); $1,500,000 (From Medicaid Cover)

N.B : This projection is done based on what is obtainable in the industry and with the assumption that there won’t be any major economic meltdown and natural disasters within the period stated above. Please note that the above projection might be lower and at the same time it might be higher.

• Marketing Strategy and Sales Strategy

The marketing and sales strategy of Mary & Joseph® Senior Care Home, LLC will be based on generating long-term personalized relationships with our residents. In order to achieve that, we will ensure that we offer top notch all – round senior care facility services at affordable prices compare to what is obtainable in Montgomery – Alabama and other state in the US.

All our employees will be well trained and equipped to provide excellent and knowledgeable services as it relates to our business offerings. We know that if we are consistent with offering high quality senior care service delivery and excellent customer service, we will increase the number of our residents by more than 25 percent for the first year and then more than 40 percent in subsequent years.

Before choosing a location for Mary & Joseph® Senior Care Home, LLC, we conducted a thorough market survey and feasibility studies in order for us to be able to be able to penetrate the available market and become the preferred choice for residents of Montgomery and other cities in Alabama. We have detailed information and data that we were able to utilize to structure our business to attract the numbers of customers we want to attract per time.

We hired experts who have good understanding of the senior care facility industry to help us develop

In summary, Mary & Joseph® Senior Care Home, LLC will adopt the following sales and marketing approach to win customers over;

• Introduce our business by sending introductory letters to residents, clubs for elderly and senior citizens with disability and other stake holders in Montgomery – Alabama
• Advertise our business in community based newspapers, local TV and local radio stations
• List our business on yellow pages’ ads (local directories)
• Leverage on the internet to promote our business
• Engage in direct marketing
• Leverage on word of mouth marketing (referrals)
• Enter into business partnership with hospitals, government agencies and health insurance companies to canvas for clients via referrals.
• Attend healthcare related exhibitions / expos to market our services.

11. Publicity and Advertising Strategy

We are in the senior care facility business to become one of the market leaders and also to

• Place adverts on both print (community based newspapers and magazines) and electronic media platforms
• Sponsor relevant community programs that appeals to the aging population and senior citizens with disability
• Leverage on the internet and social media platforms like; Instagram, Facebook , twitter, YouTube, Google + et al to promote our brand
• Install our Bill Boards on strategic locations all around Montgomery – Alabama
• Engage in road show from time to time in location with growing aging population and senior citizens with disability
• Distribute our fliers and handbills in target areas with high concentration of aging population and senior citizens with disabilities
• Ensure that all our workers wear our branded shirts and all our vehicles are well branded with our company’s logo et al.

12. Our Pricing Strategy

Mary & Joseph® Senior Care Home, LLC will work towards ensuring that all our services are offered at highly competitive prices compare to what is obtainable in the United States of America.

On the average, senior care facilities and group home facility service providers usually leverage on the fact that a good number of their clients do not pay the service charge from their pockets; private insurance companies, Medicare and Medicaid are responsible for the payment.

In view of that, it is easier for senior care service providers to bill their clients based in their discretions. Be that as it may, we have put plans in place to offer discount services once in a while and also to reward our loyal residents especially when they refer clients to us.

• Payment Options

The payment policy adopted by Mary & Joseph® Senior Care Home, LLC is all inclusive because we are quite aware that different customers prefer different payment options as it suits them but at the same time, we will ensure that we abide by the financial rules and regulation of the United States of America.

Here are the payment options that Mary & Joseph® Senior Care Home, LLC will make available to her clients;

• Payment via bank transfer
• Payment with cash
• Payment via credit cards / Point of Sale Machines (POS Machines)
• Payment via online bank transfer
• Payment via check
• Payment via mobile money transfer
• Payment via bank draft

In view of the above, we have chosen banking platforms that will enable our client make payment for farm produces purchase without any stress on their part. Our bank account numbers will be made available on our website and promotional materials to clients who may want to deposit cash or make online transfer for our services.

13. Startup Expenditure (Budget)

If you are looking towards starting a senior care facility business, then you should be ready to go all out to ensure that you raise enough capital to cover some of the basic expenditure that you are going to incur. The truth is that starting this type of business does not come cheap.

You would need money to secure a standard residential facility big enough to accommodate the number of people you plan accommodating per time, you will also need money to acquire supplies and to pay your workforce and pay bills for a while until the revenue you generate from the business becomes enough to pay take of the daily running cost and overhead.

The items listed below are the basics that we would need when starting our senior care facility business in the United States;

• The total fee for registering the business in the United States – $750.
• Legal expenses for obtaining licenses and permits – $1,500.
• Marketing promotion expenses for the grand opening of Mary & Joseph® Senior Care Home, LLC in the amount of $3,500 and as well as flyer printing (2,000 flyers at $0.04 per copy) for the total amount of – $3,580.
• The cost for hiring Consultant – $2,500.
• The cost for the purchase of insurance (general liability, workers’ compensation and property casualty) coverage at a total premium – $3,400.
• The cost for leasing a standard and secured facility in Montgomery – Alabama for 2 years – $250,000
• The cost for facility remodeling – $50,000.
• Other start-up expenses including stationery ( $500 ) and phone and utility deposits – ( $2,500 ).
• Operational cost for the first 3 months (salaries of employees, payments of bills et al) – $100,000
• The cost for start-up inventory (stocking with a wide range of products such as toiletries, food stuffs and drugs et al) – $50,000
• Cost for the purchase of storage hardware (bins, rack, shelves,) – $3,720
• The cost for the purchase of furniture and gadgets (Beds, Computers, Printers, Telephone, TVs, tables and chairs et al): $4,000.
• The cost of Launching our official website: $700
• Miscellaneous: $10,000

We would need an estimate of $750,000 to successfully set up our senior care facility in Montgomery – Alabama. Please note that this amount includes the salaries of all the staff for the first month of operation.

Generating Fund / Startup Capital for Mary & Joseph® Senior Care Home, LLC

Mary & Joseph® Senior Care Home, LLC is a family business that is solely owned and financed by Mrs. Cole Hayward and her immediate family members. We do not intend to welcome any external business partners, which is why he has decided to restrict the sourcing of the start – up capital to 3 major sources.

These are the areas Mary & Joseph® Senior Care Home; LLC intends to generate our start – up capital;

• Generate part of the start – up capital from personal savings
• Source for soft loans from family members and friends
• Apply for loan from my Bank

N.B: We have been able to generate about $200,000 ( Personal savings $150,000 and soft loan from family members $50,000 ) and we are at the final stages of obtaining a loan facility of $550,000 from our bank. All the papers and document have been signed and submitted, the loan has been approved and any moment from now our account will be credited with the amount.

14. Sustainability and Expansion Strategy

The future of a business lies in the numbers of loyal customers that they have the capacity and competence of the employees, their investment strategy and the business structure. If all of these factors are missing from a business (company), then it won’t be too long before the business close shop.

One of our major goals of starting Mary & Joseph® Senior Care Home, LLC is to build a business that will survive off its own cash flow without the need for injecting finance from external sources once the business is officially running.

We know that one of the ways of gaining approval and winning customers over is to offer our senior care services a little bit cheaper than what is obtainable in the industry and we are well prepared to survive on lower profit margin for a while.

Mary & Joseph® Senior Care Home, LLC will make sure that the right foundation, structures and processes are put in place to ensure that our staff welfare are well taken of. Our company’s corporate culture is designed to drive our business to greater heights and training and re – training of our workforce is at the top burner.

As a matter of fact, profit-sharing arrangement will be made available to all our management staff and it will be based on their performance for a period of three years or more. We know that if that is put in place, we will be able to successfully hire and retain the best hands we can get in the industry; they will be more committed to help us build the business of our dreams.

Check List / Milestone

• Business Name Availability Check: Completed
• Business Registration: Completed
• Opening of Corporate Bank Accounts: Completed
• Securing Point of Sales (POS) Machines: Completed
• Opening Mobile Money Accounts: Completed
• Opening Online Payment Platforms: Completed
• Application and Obtaining Tax Payer’s ID: In Progress
• Application for business license and permit: Completed
• Purchase of Insurance for the Business: Completed
• Leasing of facility and remodeling the facility: In Progress
• Conducting Feasibility Studies: Completed
• Generating capital from family members: Completed
• Applications for Loan from the bank: In Progress
• Writing of Business Plan: Completed
• Drafting of Employee’s Handbook: Completed
• Drafting of Contract Documents and other relevant Legal Documents: In Progress
• Design of The Company’s Logo: Completed
• Graphic Designs and Printing of Packaging Marketing / Promotional Materials: In Progress
• Recruitment of employees: In Progress
• Purchase of Medical Equipment and vans et al: In Progress
• Purchase of the Needed furniture, racks, shelves, computers, electronic appliances, office appliances and CCTV: In progress
• Creating Official Website for the Company: In Progress
• Creating Awareness for the business both online and around the community: In Progress
• Health and Safety and Fire Safety Arrangement (License): Secured
• Opening party / launching party planning: In Progress
• Establishing business relationship with clubs for the elderly, hospitals, government agencies and health insurance companies in the United States of America: In Progress

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• Non-Medical Home Care Business Plan [Sample Template]
• How Much Do Home Healthcare Agencies Make Yearly? [Profit Margin]
• How Much Do Non-Medical Home Care Businesses Make Yearly?
• 10 Best Non-Medical Home Care Software

How to Start an Elderly Care Business

Elderly care facilities serve an ongoing need for care in our society. As the life expectancy age continues to rise, the need for elderly care continues to grow. Few individuals are able to spend their final years caring for themselves alone at home. Rather than struggling and getting frustrated, many seniors and their families turn to retirement communities to make the last years of life some of the best.

These communities may be as complex or simple as the owner chooses. Some may specialize in providing complicated care routines, while others are designed to feel like a home. Regardless, the owner of this community must have qualified and trained staff to care for the customers who call the retirement community their home.

Learn how to start your own Elderly Care Business and whether it is the right fit for you.

Ready to form your LLC? Check out the Top LLC Formation Services .

Start an Elderly Care Business by following these 10 steps:

• Plan your Elderly Care Business
• Form your Elderly Care Business into a Legal Entity
• Register your Elderly Care Business for Taxes
• Open a Business Bank Account & Credit Card
• Set up Accounting for your Elderly Care Business
• Get the Necessary Permits & Licenses for your Elderly Care Business
• Get Elderly Care Business Insurance
• Define your Elderly Care Business Brand
• Create your Elderly Care Business Website
• Set up your Business Phone System

We have put together this simple guide to starting your Elderly Care Business. These steps will ensure that your new business is well planned out, registered properly and legally compliant.

Exploring your options? Check out other small business ideas .

STEP 1: Plan your business

A clear plan is essential for success as an entrepreneur. It will help you map out the specifics of your business and discover some unknowns. A few important topics to consider are:

What will you name your business?

• What are the startup and ongoing costs?
• Who is your target market?

How much can you charge customers?

Luckily we have done a lot of this research for you.

Choosing the right name is very important. Read our detailed guide on how to name your business . We recommend checking if the business name you choose is available as a web domain and securing it early so no one else can take it.

Want some help naming your Elderly Care Business?

Business name generator, what are the costs involved in opening an elderly care business.

Some of the initial costs include real estate, state licensing, marketing collateral, and staffing. Additional medical equipment may be required, depending on the level of care the community is designed to provide. Furthermore, compliance with the Americans with Disabilities Act (ADA) is absolutely required.

What are the ongoing expenses for an Elderly Care Business?

The largest ongoing expenses will involve food for the residents and salaries for the staff. A large staff will be required in order to provide the around-the-clock care that is required for residents. In order to retain the best employees, competitive compensation is needed. Aside from these expenses, utilities, building maintenance, and any required licenses or certifications will also be ongoing costs.

Who is the target market?

The target market will include families of senior citizens and medical care providers. Families will know if/when it is time to put their elderly family member in a care home. Medical care providers can provide options to family members when it becomes obvious that an elderly patient can no longer care for themselves.

How does an Elderly Care Business make money?

A retirement community makes money by filling rooms with senior citizens. Either the seniors themselves or their families will coordinate monthly or annual payments. Some payments may also be collected through insurance companies.

The monthly charge for staying at an elderly care home will depend on the level of care needed. A range from $1,200 to $3,000 per month is average. This price is all-inclusive, which means it covers medications, care, housing, food, bathing, 24/7 medical care, and other personal needs.

How much profit can an Elderly Care Business make?

At least half of the annual revenue will go toward food and staffing costs. Another 10% to 25% percent will go toward land, real estate, and recurring medical equipment costs. This means profit can be expected to be 25% to 40% of annual revenue.

How can you make your business more profitable?

This business becomes more profitable as long-term expenses are paid off. Medical equipment, land, and real estate that can be paid off faster allows the business to accrue more profit annually.

Want a more guided approach? Access TRUiC's free Small Business Startup Guide - a step-by-step course for turning your business idea into reality. Get started today!

STEP 2: Form a legal entity

The most common business structure types are the sole proprietorship , partnership , limited liability company (LLC) , and corporation .

Establishing a legal business entity such as an LLC or corporation protects you from being held personally liable if your Elderly Care Business is sued.

Form Your LLC

Read our Guide to Form Your Own LLC

Have a Professional Service Form your LLC for You

Two such reliable services:

You can form an LLC yourself and pay only the minimal state LLC costs or hire one of the Best LLC Services for a small, additional fee.

Recommended: You will need to elect a registered agent for your LLC. LLC formation packages usually include a free year of registered agent services . You can choose to hire a registered agent or act as your own.

STEP 3: Register for taxes

You will need to register for a variety of state and federal taxes before you can open for business.

In order to register for taxes you will need to apply for an EIN. It's really easy and free!

You can acquire your EIN through the IRS website . If you would like to learn more about EINs, read our article, What is an EIN?

There are specific state taxes that might apply to your business. Learn more about state sales tax and franchise taxes in our state sales tax guides.

STEP 4: Open a business bank account & credit card

Using dedicated business banking and credit accounts is essential for personal asset protection.

When your personal and business accounts are mixed, your personal assets (your home, car, and other valuables) are at risk in the event your business is sued. In business law, this is referred to as piercing your corporate veil .

Open a business bank account

Besides being a requirement when applying for business loans, opening a business bank account:

• Separates your personal assets from your company's assets, which is necessary for personal asset protection.
• Makes accounting and tax filing easier.

Recommended: Read our Best Banks for Small Business review to find the best national bank or credit union.

Get a business credit card

Getting a business credit card helps you:

• Separate personal and business expenses by putting your business' expenses all in one place.
• Build your company's credit history , which can be useful to raise money later on.

Recommended: Apply for an easy approval business credit card from BILL and build your business credit quickly.

STEP 5: Set up business accounting

Recording your various expenses and sources of income is critical to understanding the financial performance of your business. Keeping accurate and detailed accounts also greatly simplifies your annual tax filing.

Make LLC accounting easy with our LLC Expenses Cheat Sheet.

STEP 6: Obtain necessary permits and licenses

Failure to acquire necessary permits and licenses can result in hefty fines, or even cause your business to be shut down.

STEP 7: Get business insurance

Just as with licenses and permits, your business needs insurance in order to operate safely and lawfully. Business Insurance protects your company’s financial wellbeing in the event of a covered loss.

There are several types of insurance policies created for different types of businesses with different risks. If you’re unsure of the types of risks that your business may face, begin with General Liability Insurance . This is the most common coverage that small businesses need, so it’s a great place to start for your business.

Another notable insurance policy that many businesses need is Workers’ Compensation Insurance . If your business will have employees, it’s a good chance that your state will require you to carry Workers' Compensation Coverage.

STEP 8: Define your brand

Your brand is what your company stands for, as well as how your business is perceived by the public. A strong brand will help your business stand out from competitors.

If you aren't feeling confident about designing your small business logo, then check out our Design Guides for Beginners , we'll give you helpful tips and advice for creating the best unique logo for your business.

Recommended : Get a logo using Truic's free logo Generator no email or sign up required, or use a Premium Logo Maker .

If you already have a logo, you can also add it to a QR code with our Free QR Code Generator . Choose from 13 QR code types to create a code for your business cards and publications, or to help spread awareness for your new website.

How to promote & market an Elderly Care Business

Printed materials, like leaflets, postcards, and flyers, will be crucial for marketing this business. This printed collateral can be mailed to senior citizens or left at medical care facilities. In addition, representatives from the elderly care home should visit medical care facilities in person and speak more about the services it can provide.

How to keep customers coming back

The best way to attract customers is to provide as much information as possible. Family members and care providers will want to see the facility before making a decision. In order to retain customers, all care needs must be met. Safety and health are of the utmost importance.

STEP 9: Create your business website

After defining your brand and creating your logo the next step is to create a website for your business .

While creating a website is an essential step, some may fear that it’s out of their reach because they don’t have any website-building experience. While this may have been a reasonable fear back in 2015, web technology has seen huge advancements in the past few years that makes the lives of small business owners much simpler.

Here are the main reasons why you shouldn’t delay building your website:

• All legitimate businesses have websites - full stop. The size or industry of your business does not matter when it comes to getting your business online.
• Social media accounts like Facebook pages or LinkedIn business profiles are not a replacement for a business website that you own.
• Website builder tools like the GoDaddy Website Builder have made creating a basic website extremely simple. You don’t need to hire a web developer or designer to create a website that you can be proud of.

Recommended : Get started today using our recommended website builder or check out our review of the Best Website Builders .

Other popular website builders are: WordPress , WIX , Weebly , Squarespace , and Shopify .

STEP 10: Set up your business phone system

Getting a phone set up for your business is one of the best ways to help keep your personal life and business life separate and private. That’s not the only benefit; it also helps you make your business more automated, gives your business legitimacy, and makes it easier for potential customers to find and contact you.

There are many services available to entrepreneurs who want to set up a business phone system. We’ve reviewed the top companies and rated them based on price, features, and ease of use. Check out our review of the Best Business Phone Systems 2023 to find the best phone service for your small business.

Recommended Business Phone Service: Phone.com

Phone.com is our top choice for small business phone numbers because of all the features it offers for small businesses and it's fair pricing.

Is this Business Right For You?

This business is right for an individual who genuinely cares about seniors’ quality of life. Not every day will be filled with hearing old stories and reliving the glory days. There will be times that weigh heavy on the owner’s heart. Those who have a thick skin and genuinely care for others will excel as a retirement community business owner.

In elderly care, death is an inevitable part of the business. This is also a vital aspect that must be handled with care. Those who cannot handle death or grieving families may not be the best fit for this business.

Want to know if you are cut out to be an entrepreneur?

Take our Entrepreneurship Quiz to find out!

Entrepreneurship Quiz

What happens during a typical day at an Elderly Care Business?

A typical day involves waking seniors for breakfast and ensuring they take their morning medication. Morning to midday typically involves light activities to keep the body and brain active. When lunch rolls around, another round of medication may follow. At some point, visitors will come to visit their family at the facility. By the time dinner begins, rooms will have been cleaned, and laundry will be completed by community staff. After dinner, baths will be administered along with the final round of medication for the day.

There will come a time where a resident of the facility passes. When that comes, careful plans must be followed to ensure the wishes of the individual and their family are respected. Communication plans must be followed to notify the family.

What are some skills and experiences that will help you build a successful Elderly Care Business?

Experience caring for those who are older will be incredibly important. Whether it is from personal experience with grandparents or through experience working at a medical facility, it is important to have this knowledge. Additional skills include community organizing, communicating with family members about difficult subjects, and time management.

What is the growth potential for an Elderly Care Business?

The growth potential for a retirement community is currently high. The baby boomers are reaching an age where they no longer can care for themselves at home as well as they used to. Once the baby boomer generation passes, there will be a slight decrease in demand. Once the millennials begin to reach their elderly years, the growth potential will rise again.

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For fun informative videos about starting a business visit the TRUiC YouTube Channel or subscribe to view later.

Take the Next Step

Find a business mentor.

One of the greatest resources an entrepreneur can have is quality mentorship. As you start planning your business, connect with a free business resource near you to get the help you need.

Having a support network in place to turn to during tough times is a major factor of success for new business owners.

Learn from other business owners

Want to learn more about starting a business from entrepreneurs themselves? Visit Startup Savant’s startup founder series to gain entrepreneurial insights, lessons, and advice from founders themselves.

Resources to Help Women in Business

There are many resources out there specifically for women entrepreneurs. We’ve gathered necessary and useful information to help you succeed both professionally and personally:

If you’re a woman looking for some guidance in entrepreneurship, check out this great new series Women in Business created by the women of our partner Startup Savant.

What are some insider tips for jump starting an Elderly Care Business?

Facilities can always be expanded to include more activities. However, the rooms and care facilities may not always have a time where they can be upgraded. Create the best housing and medical care areas possible at the beginning to avoid complicated remodeling projects in the future.

How and when to build a team

A team will be crucial from the very beginning. Nurses and doctors will need to be on-site to provide around-the-clock care. These individuals must be licensed and certified to provide care in the state. Speaking with medical schools and posting jobs online will help attract the right individuals for the team.

Useful Links

Industry opportunities.

• Starting a Senior Home Care Business for $900

Further Reading

• Senior Home Care FAQ
• Elderly Care Business Ideas

Have a Question? Leave a Comment!

How to craft a successful home care business plan

Claim your free Nextdoor business page

Claim your business page to get discovered by customers and manage your recommendations

As a home care provider, you run your business with compassion and knowledge of the job and the local community you work with. After you’ve learned more about how to become a caregiver and how to start a home care business , you’re ready to formalize your ideas with a business plan.

How to create a home care business plan

Your business plan is an essential part of the portfolio you’ll present to banks, investors, and partners before launching your company. Every entrepreneur can benefit from a business plan that helps you turn your vision into action and strategize for success. For home care professionals, there are unique additions and considerations for your business plan. From determining your core local clients to developing the marketing plan to reach them, this guide will walk you through nine sections for your home care business plan.

1. The executive summary

The executive summary kicks off your business plan and hooks whoever’s reading it to learn more about your company and your proposal. Think of it a little like a sales pitch for your business and a preview of everything you lay out in your business plan.

A home care business summary should include:

• Your mission and the populations your business will serve 
• A list of your primary services 
• The demand for these services in your community
• What sets your home care business apart from competitors
• Your vision 
• A summary of funding needs

2. The company description

As a home care business working with clients in need, your professional background should be front and center. Your company description offers a snapshot of you and your business, and should include:

• The registered (or intended registered) name of your business
• The location of your company headquarters, and the neighborhoods, area, or city your business will reach
• Management, primary personnel, and their professional backgrounds
• Any licenses or certifications your staff has

Different types of home care services will need different certifications, like medical home care companies compared with senior transportation providers, for example. Make sure to research and include the requirements in your county, city, and state. 

If you’re in the preliminary stages of creating your home care business and haven’t secured the required licenses yet, mention any certifications you’re pursuing in this description.

3. Your business mission and goals

The mission and goals section of a business plan outlines the primary objectives of your company and how you plan to achieve them.

As more Americans advance into the senior age bracket, demand for credible home care businesses is rising. This need can help position your business for success and give you more opportunities to refine your mission and select specific populations to focus on. 

The need for home care help for senior relatives in particular has grown. As home care professional Christine Friedberg reflects, “I used to get on the phone and talk with clients about home care being an option for them or for their loved one, but it was like a new concept…For a long time, we were trying to educate the community about what home care was. Demand is greater than ever now.”

Medicare’s Triple Aim program may provide general inspiration for your own company goals. Their three pillars are :

• Centering and improving patients’ experience of care
• Improving health outcomes of patients served
• Mitigating the cost of care for individuals

From a business perspective, working with specific demographics may give you a leg up on funding. Based in Alexandria, VA, Griswold Home Care works with the area’s large population of aging veterans. To reach more of them, Griswold joined the cross-regional VA Community Care Network to provide in-home services to veterans needing extra support at home.

Not only was Griswold able to reach a specific community in need, but the program also helped this local home care business secure funding directly from the Department of Veterans Affairs . “We’ll see anywhere from 5 to 20 hours a week that the VA is covering, in terms of actually contracting with us directly. They pay us directly…so it’s very easy for the veteran to get in, take advantage of this program and take advantage of this care.”

In the home care industry, other demographics include:

• LGBTQ senior citizens
• People with Alzheimer’s
• People living with disabilities
• Non-seniors living with disabilities
• Adults whose first language isn’t English

Keep your demographic in mind as you refine your company’s identity and plan for growth. It will determine the steps you’ll take to fund your business and reach the neighbors who need you most.

4. Your services

The services section of your home care business plan sets the vision for what your business will specifically do. There are two main types of home care companies and services:

• Non-medical home care services – This type of home care business is not licensed to administer medical services or healthcare to its clients. Instead, they provide support, companionship, and home assistance. Services may include driving clients to doctor’s appointments, taking them to the park, or preparing meals.
• Medical home care services – Medical home care providers are staffed by nurses or other medical professionals licensed to administer medical care to their clients.

With the growing need for at-home healthcare businesses, some of the most common home care services include:

• Assistance with dressing, bathing, and using the toilet
• Companionship and diversion
• House cleaning and support with daily chores
• Transportation
• Hospice care
• Continued education for older adults
• Physical therapy and rehabilitation
• Prescription fulfillment services
• Administering medication
• Tracking vital physical or psychological health 
• Senior citizen relocation assistance
• Specialty nursing for a long-term illness or disability
• 24-hour emergency services

Get specific about what caregiver duties you’ll provide your clients, narrowing down your list with the most needed services in your local community. With 1 in 3 U.S. households on Nextdoor , you’ll be able to connect with neighbors, and your most important clients, with a free business page.

5. Your management structure

This section of your business plan establishes the legal status of your company, which affects other details, from the extent of your liability as the owner to how you’ll file taxes.

The most common business structures for home care providers are:

• Limited liability company (LLC)
• Sole proprietorship
• Partnership
• Corporation

To choose the right business structure for you, consider:

• Liability – Every business is financially and legally liable to compensate for injuries committed on their watch. Consult with an accountant to take stock of your personal assets to choose a framework that gives you adequate protection.
• Taxes – Your home healthcare business structure will determine how the profits you earn are taxed, whether through your business, on your individual tax returns, or a hybrid of both. As a general rule, the larger your company is, or the more shareholders it has, the more complex the tax process will be.
• Growth expectations – Whether your home care company will focus on your neighborhood or expand nationwide, your business structure should reflect your desired administrative capacity and set the stage for investors who want to scale alongside you. 

While S corporations and C corporations are often better suited for larger-scale companies, it’s possible to change the legal structure of your organization as it grows. Consider hiring experts, like a lawyer and an accountant, to help you with this stage of the process, especially if they have advised other local businesses in your area.

6. Your marketing plan

Show potential funding partners you know the modern home care market and set your local business up for success with marketing goals that cover the following bases:

• Digital marketing - In a job as intimate as home care, any new caregiver business begins on the local level. Sign up for a free business page with Nextdoor to instantly unlock a network of verified neighbors near you. Keep your business page updated with your story, photos, and contact information so local clients can find you and easily get in touch. Introduce yourself, share job listings, and keep neighbors updated on your business with free posts or hyperlocal advertising tools to reach more clients in specific ZIP codes you want to grow your business in.
• Partnerships – Qualified home care providers may be eligible to partner with care networks already plugged into local consumer demand. If properly licensed, apply to enroll as a Medicaid or Medicare partner. 
• Word-of-mouth marketing – Since home care professionals are a part of their clients’ and families’ lives, your local reputation will be important. Build trust in you and your services with testimonials on your website and recommendations on Nextdoor. 72% of neighbors there have been influenced by a business recommendation and 71% have shared one. Consider sharing your website and Nextdoor page with former clients to ask them for a recommendation.

Anything that makes your home care business unique, include in this section of your business plan. With a growing population of aging Americans, entrepreneurs are getting creative about the types of care they offer to suit different lifestyles.

Take Dr. Bill Thomas . He thought there should be a senior care option in place of the traditional nursing home so he created Minka, a company that builds small dwellings tailormade for seniors who want extra assistance, community, and autonomy in their advanced years. Says Thomas, “I think there will continue to be congregate housing, but the more choices people find in front of them, the more they’ll find something that suits them best.”

7. Your core financials

The next two sections cover your financial history with projections for your home care business’s future. This will be important for your business strategy, as well as for potential lenders, investors, or partners. 

The finance section of your home care business plan should include:

• Income statement
• Balance sheet
• Expected revenue
• A list of your assets and debts
• A summary of company expenses
• Desired loans

If you plan to enroll as a provider through a network like Medicare, mention in this section of your business plan.

8. Financial projections

This section of your home care business plan is important if you’re asking for an investment of any kind as it covers the funding you’re requesting, what you’ll use it for, and your plan to pay it back.

Financial projections should cover at least three years. Fortunately, the home care industry is slated for financial growth in the coming years. In the U.S. alone, the compound annual growth rate for home health care is projected to be 14.2% between 2021 and 2027.

However you plan to grow your company, speak with your local bank to discuss the full spectrum of financial options before finalizing your business plan. 

You can also connect with fellow home care professionals through Nextdoor for more information on the local home care industry in and around your neighborhood. This will help you get a realistic sense of your financial plan and the next few years operating your business.

9. Appendix

Your business plan’s appendix is where you’ll include any supporting or miscellaneous information for your business goals that didn’t have a place in the earlier sections.

Consider including:

• The resumes or educational and professional backgrounds of you, the owner, and your core staff
• Medical or non-medical licensing, or the licenses you plan to secure
• Any legal permits your business needs or the ones you plan to secure
• Bank statements, loans, and personal or professional credit history
• Real estate information about your business’ headquarters, if applicable

Make local connections through Nextdoor

As more Americans age, local caregivers are increasingly integral to the health of their communities. An effective home care business plan should tell this compelling narrative, sharing why there’s a need for your services and what you’ll do to fulfill them in your area. 

If you’re just building your local home care business, start close to home with a Nextdoor Business Page. Signing up is free, takes just a few minutes, and will help you spread the word, turning your neighbors into your first clients. 

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Home Health Care Business Plan Template

Written by Dave Lavinsky

Home Health Care Business Plan

You’ve come to the right place to create your Home Health Care business plan.

We have helped over 10,000 entrepreneurs and business owners create business plans and many have used them to start or grow their home health care businesses.

Home Care Business Plan Example

Below is a template to help you create each section of your home health agency business plan.

Executive Summary

Business overview.

St. Helen’s Home Care is a new home healthcare business that serves the aging population of Austin, Texas. As individuals age, they are more susceptible to diseases and other conditions and need extra help to receive health care. However, many individuals wish to receive care in the comfort of their homes instead of going to a nursing home or hospital. St. Helen’s will provide this population with the care they need without them needing to travel. Our nursing services include physical therapy, skilled nursing care and other healthcare services that can be conducted in the home. We also provide warmth, compassion, and companionship to create lasting relationships with our clients.

St. Helen’s Home Care is run by Helen Parker, who has been a nurse for twenty years. She has specialized in working with aging populations and has extensive knowledge of the common conditions and needs of this age group. Her experience and connections have helped her find other medical professionals who want to join our company. Furthermore, she was able to establish an initial client base from the list of patients she has been helping for years.

Services Offered

St. Helen’s Home Care offers a variety of home health care services that serve the aging population of Austin, Texas. These services include but are not limited to:

• Physical therapy
• Occupational therapy
• Speech-language therapy
• Skilled Nursing Services
• Personal care and housekeeping

Customer Focus

St. Helen’s Home Care will serve the aging population of Austin, Texas, primarily residents over the age of 65. This population is susceptible to many conditions that make daily living difficult such as Alzheimer’s, dementia, arthritis, and diabetes. This population needs more health care than other age groups, but not all services require a visit to the hospital or doctor’s office. St. Helen’s will provide any medical service that can easily be conducted in a home setting.

Management Team

St. Helen’s Home Care is owned and operated by Helen Parker, a local nurse who has worked at local hospitals for over the past twenty years. She has worked with hundreds of elderly patients and their families and has helped them find adequate and affordable home health care upon being released from the hospital. Helen Parker has realized there is a lack of quality and affordable home healthcare agencies in Austin. She aims to provide the best in-home health care services while also being affordable for the patient and their families.

Aside from the medical professionals she will have on staff, Helen has also employed an Administrative Assistant, Accountant, and Marketing Specialist to help her operate the company.

Success Factors

St. Helen’s Home Care will be able to achieve success by offering the following competitive advantages:

• Compassionate Staff: Helen’s will employ a compassionate and friendly staff of nurses, therapists, aides, and social workers who are highly knowledgeable and experienced in their field.
• Quality Care: Helen’s will provide expert nursing services so that the patients are at the highest comfort level.
• Pricing: Helen’s pricing will be more affordable than other home health care agencies. They will also work on payment arrangements with the patient and their family so that the patient won’t have to sacrifice any type of care because the cost is too high. The company is also working to partner with local and national insurance companies so that our patients can have their care partially or fully covered by their insurance plans.

Financial Highlights

St. Helen’s Home Care is seeking $340,000 in funding to launch the home healthcare business. The capital will be used for funding equipment and supplies, staffing, marketing expenses, and working capital.

The breakdown of the funding may be seen below:

• Equipment and supplies (such as computers and medical equipment): $150,000
• Marketing costs: $50,000
• Staffing costs: $60,000
• Working capital (to include three months of overhead expenditures): $80,000

The following graph outlines the pro forma financial projections for St. Helens’ Home Care over the next five years:

Company Overview

Who is St. Helen’s Home Care?

St. Helen’s Home Care is a new home healthcare business that serves the aging population of Austin, Texas. As individuals age, they are more susceptible to diseases and other conditions and need extra help to receive health care. However, many individuals wish to receive care in the comfort of their homes instead of going to a nursing home or hospital. St. Helen’s will provide this population with the care they need without them needing to travel. Our services include physical therapy, nursing, and other healthcare services that can be conducted in the home. We also provide warmth, compassion, and companionship to create lasting relationships with our clients.

St. Helen’s Home Care History

Helen Parker has worked with thousands of elderly patients during her career as a nurse. She often found that many people did not need to travel to a doctor’s office or hospital for their care. Instead, these patients often enjoyed a higher quality of life when they received care from their homes. This revelation inspired her to start a business where she and other professionals could provide care to local elderly patients in the comfort of their homes. After conducting the research needed to establish the company, Helen incorporated St. Helen’s Home Care as an S-corporation on May 15th, 2022.

Since incorporation, St. Helen’s has achieved the following milestones:

• Found an office location and signed a Letter of Intent to lease it
• Developed the logo and website for the company
• Finalized list of services the company will be able to provide
• Determined the office equipment and inventory requirements
• Created an initial client base from Helen’s pre-existing patient list
• Started creating partnerships with local and national medical insurance companies
• Began recruiting key employees, including medical and administrative staff

St. Helen’s Home Care Services

Industry Analysis

According to Grand View Research, the global home health care industry was valued at $336 billion USD in 2021. It is also expected to grow at a compound annual growth rate of 7.93% from 2022 to 2030 and reach a value of $666.9 billion USD by 2030. This shows that these services will be in great demand, which means it is a great time to start a home healthcare business.

This growth is primarily driven by a growing geriatric population. People are living longer than ever before, and therefore, they will need comfortable healthcare services for much longer. Furthermore, baby boomers comprise a large population and are now entering their retirement years. It is expected that this enormous population will have a significant need for healthcare (whether in the home or doctor’s office) and may create a strain on the current industry. However, this also means there is an enormous opportunity for healthcare businesses to be extremely profitable in the near future.

This is especially true for home healthcare services, which are increasing in demand. Most aging people would rather receive medical care at home than go to a nursing home or hospital. Therefore, there is an incredible demand for these particular services.

The only challenge affecting the industry is a lack of properly trained staff who can take on a healthcare career. However, this will only mean that home healthcare services will be even more valued. These industry trends will only help boost the popularity and success of St. Helen’s Home Care.

Customer Analysis

Demographic profile of target market.

St. Helen’s Home Care will primarily target the aging population of Austin, Texas. This includes anyone over the age of 65, especially those who live with diabetes, Alzheimer’s, arthritis, or other conditions that affect their quality of life.

The precise demographics of Austin, Texas, are:

Customer Segmentation

St. Helen’s will primarily target the following customer profiles:

• Aging individuals over the age of 65
• Individuals living with Alzheimer’s and dementia
• Elderly individuals with other health conditions

Competitive Analysis

Direct and indirect competitors.

St. Helen’s Home Care will face competition from other home health care agencies with similar business profiles. A description of each competitor company is below.

Travis County Home Health

Travis County Memorial Hospital’s Home Health & Hospice has provided home health services for over a decade. Their staff is composed of dedicated professionals who are committed to providing quality care in the comfort and convenience of their patients’ homes. Their home health aides can assist the patient with grooming and light chores around their home. Home health care will verify if home health aide services are covered by their insurance policy. They accept Medicare, Insurance/HMO/PPO, Medicaid, and Private Pay. The home health care team works closely with the physician to plan the care and monitor the patients’ progress. The nurse will contact the physician with any laboratory results, medication changes, or alterations in their health status.

Elara Caring

Elara Caring is one of the nation’s largest providers of home-based care, with a footprint in most regions of the United States. Elara Caring brings together three award-winning organizations – Great Lakes Caring, National Home Health Care, and Jordan Health Services, into one transformational company. They provide the highest-quality comprehensive care continuum of personal care, skilled home health, hospice care, and behavioral health. Their intimate understanding of their patients’ needs allows them to apply proprietary platforms to deliver proactive, customized care that improves quality of life and keeps patients in their homes.

Encompass Health

Encompass Health is one of the nation’s leading providers of home health services. They continually set the standard of homecare through their people, their approach, and their outcomes.

The patient experience is at the core of everything they do. That’s why they work collaboratively with the patient’s team of experts to craft a plan of care that meets their specific needs. Their skilled nurses, physical therapists, occupational therapists, speech-language pathologists, medical social workers, and home health aides use a coordinated, interprofessional approach to deliver compassionate, specialized care in the comfort of home. Whether recovering from a surgery, a recent hospital stay, or managing a disease or injury, Encompass Health’s services are designed to meet patients where they are.

Competitive Advantage

• Quality Care: Helen’s will provide expert services so that the patients are at the highest comfort level.
• Pricing: Helen’s will provide affordable home health care. They will also work on payment arrangements with the patient and their family so that the patient won’t have to sacrifice any type of care because the cost is too high. The company is also working to partner with local and national insurance companies so that our patients can have their care partially or fully covered by their insurance plans.

Marketing Plan

Brand & value proposition.

The St. Helen’s brand will focus on the company’s unique value proposition:

• Knowledgeable, friendly, compassionate staff of healthcare professionals.
• Quality level of service and care.
• Offering the best nursing, therapy, social worker, and home aide services at competitive prices.

Promotions Strategy

St Helen’s Home Care will target elderly residents living in the Austin, Texas area. The company’s promotions strategy to reach the most clientele include:

Local Hospitals

Helen Parker already has great relationships with the local hospitals. She will work to make sure the hospitals send referrals and highly recommend the company to its patients and their families upon releasing them from the hospital.

Website/SEO Marketing

St. Helen’s has a website that is well-organized and informative and lists all our available services. The website also lists the company’s contact information and information about the medical professionals who provide our services.  We will utilize SEO marketing tactics so that anytime someone types in the Google or Bing search engine “Austin home health care” or “Austin health care,” St. Helen’s will be listed at the top of the search results.

St. Helen’s Home Care will have a billboard at a busy intersection where thousands of cars and pedestrians pass daily. The location of the billboard will be in an area of town where there are a lot of doctors’ offices, rehab facilities, and a hospital nearby.

Insurance Partnerships

St. Helens will partner with local and national insurance companies so that our patients can be partially or fully covered for the services we provide. We will ask the insurance companies to recommend our services to their customers and have our business listed on their websites.

St Helen’s pricing will be moderate so customers feel they receive great value when purchasing its services. Services will either be charged directly to the patient or to their insurance plan.

Operations Plan

The following will be the operations plan for St. Helen’s Home Care.

Operation Functions:

• Helen Parker will be the Chief Executive Officer of the company. She will be in charge of the business operations side of the business and provide home healthcare services until we have a full staff of medical professionals.
• Helen is assisted by her longtime colleague Mary Green. Mary will be the Administrative Assistant and help with all general administration tasks, including taking phone calls and scheduling appointments.
• Keith O’Reilly will serve as the Staff Accountant. He will provide all accounting, tax payments, and monthly financial reporting.
• Betty Lopez will work as the Marketing Specialist. She will run the website, social media, and other marketing efforts.
• Helen will hire a large team of medical professionals to serve our growing client base. So far, some of her former colleagues have agreed to work for her business.

Milestones:

St. Helen’s Home Care will have the following milestones completed in the next six months.

8/1/202X – Finalize lease for the office space.

8/15/202X – Finalize personnel and staff employment contracts.

9/1/202X – Begin refurbishment and furnishing of the office space.

9/15/202X – Begin networking at medical industry events.

9/22/202X – Begin marketing campaign to attract the first clients.

11/1/202X – St. Helen’s Home Care opens for business.

Financial Plan

Key revenue & costs.

The revenues for St. Helen’s Home Care will come from the fees it will charge the patients and their insurance for the provided health care services.

The major cost drivers for the company will be the staff payroll, marketing expenses, lease, and office equipment.

Funding Requirements and Use of Funds

Key assumptions.

The following outlines the key assumptions required in order to achieve the revenue and cost numbers in the financials as well as pay off the startup business loan.

• Number of clients per month: 100
• Annual lease: $50,000
• Overhead costs per year: $100,000

Financial Projections

Income statement, balance sheet, cash flow statement, home health care business plan faqs, what is a home health care business plan.

A home health care business plan is a plan to start and/or grow your home health care business. Among other things, it outlines your business concept, identifies your target customers, presents your marketing plan and details your financial projections.

You can easily complete your Home Health Care business plan using our Home Health Care Business Plan Template here .

What are the Main Types of Home Health Care businesses?

There are a number of different kinds of Home Health Care businesses , some examples include: Nursing care business, Physical home health care business, and Home health care aides.

How Do You Get Funding for Your Home Health Care Company?

Home Health Care businesses are often funded through small business loans. Personal savings, credit card financing and angel investors are also popular forms of funding.

What are the Steps To Start a Home Health Care Business?

Starting a home health care business can be an exciting endeavor. Having a clear roadmap of the steps to start a business will help you stay focused on your goals and get started faster.

1. Develop A Home Health Care Business Plan - The first step in starting a business is to create a detailed home health care business plan that outlines all aspects of the venture. This should include market research on the home health care industry and potential target market size, information on the home health care services you will offer, marketing strategies, pricing detailed and your financial forecast.  

2. Choose Your Legal Structure - It's important to select an appropriate legal entity for your home health care business. This could be a limited liability company (LLC), corporation, partnership, or sole proprietorship. Each type has its own benefits and drawbacks so it’s important to do research and choose wisely so that your home health care business is in compliance with local laws.

3. Register Your Home Health Care Business - Once you have chosen a legal structure, the next step is to register your home health care business with the government or state where you’re operating from. This includes obtaining licenses and permits as required by federal, state, and local laws. 

4. Identify Financing Options - It’s likely that you’ll need some capital to start your home health care business, so take some time to identify what financing options are available such as bank loans, investor funding, grants, or crowdfunding platforms. 

5. Choose a Location - Whether you plan on operating out of a physical location or not, you should always have an idea of where you’ll be based should it become necessary in the future as well as what kind of space would be suitable for your operations. 

6. Hire Employees - There are several ways to find qualified employees including job boards like LinkedIn or Indeed as well as hiring agencies if needed – depending on what type of employees you need it might also be more effective to reach out directly through networking events. 

7. Acquire Necessary Home Health Care Equipment & Supplies - In order to start your home health care business, you'll need to purchase all of the necessary equipment and supplies to run a successful operation. 

8. Market & Promote Your Business - Once you have all the necessary pieces in place, it’s time to start promoting and marketing your home health care business. This includes creating a website, utilizing social media platforms like Facebook or Twitter, and having an effective Search Engine Optimization (SEO) strategy. You should also consider traditional marketing techniques such as radio or print advertising. 

Learn more about how to start a successful home health care business:

• How to Start a Home Health Care Business

How To Create a Business Plan for Elderly Home Care: Checklist

By alex ryzhkov, resources on elderly home care service.

• Financial Model
• Business Plan
• Value Proposition
• One-Page Business Plan
• SWOT Analysis
• Business Model
• Marketing Plan

Welcome to our blog post on how to write a business plan for an elderly home care service! As the population continues to age, the demand for quality care services for seniors is on the rise. In fact, according to the Market Research Future , the global elderly care services market is expected to reach a value of $1,744.6 billion by the year 2025, with a compound annual growth rate (CAGR) of 8.2% . With this immense potential for growth and the opportunity to make a meaningful impact on the lives of seniors, starting an elderly home care service can be a rewarding and lucrative venture.

In order to successfully launch and operate an elderly home care service, there are several crucial steps to follow. By following our checklist and implementing the nine key steps outlined below, you can ensure that your business plan is comprehensive and well-prepared.

• Step 1: Identify the target market and understand their specific needs and preferences.
• Step 2: Conduct thorough market research to analyze the demand for elderly home care services in the desired location.
• Step 3: Define the unique value proposition and competitive advantage of the business.
• Step 4: Develop a comprehensive business model and outline the key services to be offered.
• Step 5: Determine the pricing strategy and create financial projections for the business.
• Step 6: Establish partnerships and network with local healthcare providers, hospitals, and other organizations to generate referrals.
• Step 7: Identify the legal and regulatory requirements for operating an elderly home care service in the chosen location.
• Step 8: Assess the required resources and create a detailed budget for the initial startup and ongoing operations.
• Step 9: Develop a preliminary marketing and advertising plan to reach potential clients and build brand awareness.

By following these steps, you will be well-equipped to create a solid business plan that addresses the unique needs of the aging population and positions your elderly home care service for success. Stay tuned for our upcoming blog posts, where we will dive deeper into each step to provide you with valuable insights and practical tips.

Remember, providing compassionate care and enhancing the quality of life for seniors is not just a business opportunity, but a chance to make a difference in their lives and the lives of their families. With proper planning and execution, your elderly home care service can become a trusted and sought-after resource in your community.

Identify The Target Market And Understand Their Specific Needs And Preferences.

One of the first and most crucial steps in writing a business plan for an elderly home care service is to identify the target market that you will be serving. This involves understanding the specific needs and preferences of the aging population in your desired location.

Start by conducting thorough market research to gain insight into the demographic characteristics of your target market, such as age range, income level, and geographic location. This information will help you tailor your services to meet their unique needs.

Additionally, it is essential to understand the specific needs and preferences of the elderly individuals you will be serving. This may include determining the level of assistance they require with daily activities, their preferences for companionship and social interaction, their medication management needs, and any specific healthcare requirements they may have.

• Tip 1: Reach out to local senior centers, retirement communities, and healthcare facilities to gather insights and feedback from the aging population directly.
• Tip 2: Consider conducting surveys or focus groups to gather information on the specific needs and preferences of potential clients.
• Tip 3: Take into account cultural, ethnic, and religious considerations that may influence the care needs and preferences of your target market.

By taking the time to identify the target market and understand their specific needs and preferences, you will be better equipped to develop a comprehensive business model that effectively meets their requirements and sets your elderly home care service apart from the competition.

Conduct Thorough Market Research To Analyze The Demand For Elderly Home Care Services In The Desired Location

Conducting thorough market research is crucial when starting an elderly home care service. It allows you to gain insights into the demand for such services in your desired location, ensuring that there is a viable market for your business. Here are some important steps to take:

• Identify the target market: Determine the specific demographic you will be targeting, such as seniors aging in place, individuals with disabilities, or those in need of post-hospitalization care. Understanding your target market's specific needs and preferences is essential in tailoring your services accordingly.
• Collect industry data: Gather information on the overall size of the elderly population in your desired location, the projected growth rate, and the prevalence of chronic illnesses or disabilities that may require home care services. This data will provide valuable insights into the potential demand for your services.
• Analyze the competition: Research existing elderly home care service providers in the area and assess their service offerings, pricing strategies, and market share. Understanding the competitive landscape will help you identify gaps in the market and differentiate your business.
• Identify market trends: Look for emerging trends in the elderly home care industry, such as the preference for personalized care plans, advancements in technology to enhance caregiving, or the demand for specialized services like dementia care. Staying updated on these trends will allow you to adapt your services to meet the evolving needs of your target market.
• Engage with potential clients and healthcare professionals: Conduct interviews or surveys with potential clients and their families to gather insights into their care needs, preferences, and pain points. Additionally, engage with local healthcare professionals, such as doctors or discharge planners, to understand their perspectives on the demand for home care services and potential referrals.
• Utilize online research tools, such as government statistical databases or industry reports, to gather reliable data on the demographics and healthcare needs of your target market.
• Attend industry conferences or networking events to connect with other professionals in the elderly home care sector and learn about their experiences and market insights.
• Consider partnering with local senior centers, retirement communities, or healthcare facilities to gain access to a diverse pool of potential clients and establish referral relationships.

Define The Unique Value Proposition And Competitive Advantage Of The Business.

Defining a unique value proposition and identifying competitive advantages are crucial steps in developing a successful business plan for an elderly home care service. These aspects will set your business apart from competitors and attract potential clients. When defining your unique value proposition, it is important to consider the specific needs and preferences of the target market as well as the gaps or challenges in existing services.

One important aspect of the unique value proposition is to highlight the comprehensive and compassionate nature of your elderly home care service. Emphasize that your caregivers will not only assist with daily activities but will also provide companionship, medication management, transportation, and personalized care plans. This holistic approach ensures that the aging population receives the support they need to maintain their independence and enhance their overall quality of life.

Another key aspect to consider is the experience and expertise of your caregivers. Highlight the fact that your team consists of highly trained and experienced professionals who have a deep understanding of the unique challenges faced by elderly individuals. This will give potential clients confidence in the quality of care their loved ones will receive.

In addition to the specific services and expertise offered, it is also important to identify competitive advantages that differentiate your business from others in the market. For example, you might highlight your flexible scheduling options that cater to the individual needs and preferences of clients. Other advantages could include convenient online booking systems, personalized care plans, or specialized programs tailored to specific conditions or needs.

Tips for defining your unique value proposition and competitive advantage:

• Conduct market research to identify gaps or challenges in existing elderly home care services.
• Consider the specific needs and preferences of the target market and tailor your services accordingly.
• Highlight the comprehensive and compassionate nature of your service, emphasizing the holistic approach to elderly care.
• Showcase the expertise and experience of your caregivers.
• Identify competitive advantages such as flexible scheduling options, convenient booking systems, personalized care plans, or specialized programs.

Develop A Comprehensive Business Model And Outline The Key Services To Be Offered.

Developing a comprehensive business model is essential for the success of your elderly home care service. This involves identifying the key services that will be offered and outlining how they will be provided to clients. The following steps will help you in developing a strong business model:

• Identify the specific services: Start by determining the specific services that your elderly home care service will offer. This can include assistance with daily activities such as bathing, dressing, and meal preparation, as well as companionship and medication management. It is important to tailor these services to the specific needs of your target market.
• Set service standards: Establish clear standards for the quality of care that will be provided. This includes training your caregivers to provide compassionate and professional support to the clients. Clearly define and communicate these standards to ensure consistency in the service delivery.
• Create personalized care plans: Each client will have unique needs and preferences. Develop processes to assess the individual requirements of each client and create personalized care plans. This will involve conducting initial assessments, regular reevaluations, and ongoing communication with the clients and their families.
• Offer additional services: Consider offering additional services that can enhance the overall experience for your clients. This can include transportation services, access to social activities, and coordination with healthcare providers. These additional services can set your business apart from competitors and provide value to your clients.
• Ensure flexibility: Flexibility is key in the elderly home care industry as clients' needs may change over time. Develop processes and systems that allow you to adapt and modify the services based on the evolving needs of your clients.

Tips for developing a comprehensive business model:

• Research other successful home care service providers to understand their business models and learn from their strategies.
• Consider incorporating technology solutions, such as electronic health records and remote monitoring systems, to improve efficiency and enhance the quality of care.
• Regularly evaluate and update your business model to stay relevant and competitive in the evolving healthcare landscape.

Determine The Pricing Strategy And Create Financial Projections For The Business

One of the essential factors in starting an elderly home care service is determining the pricing strategy and creating comprehensive financial projections for the business. This step is crucial as it ensures that your services are priced appropriately to cover costs while remaining competitive in the market.

1. Assess your costs: Begin by identifying all the costs associated with running your elderly home care service. This may include expenses such as employee salaries, insurance, marketing, administrative fees, transportation, and any additional overhead costs. Conduct a thorough analysis to gain a clear understanding of your total financial obligations.

2. Research pricing in the industry: Study the pricing structures of other elderly home care services in your chosen location or similar markets. This will help you understand the average rates charged for various services and allow you to position your pricing strategy competitively.

3. Determine your pricing model: Decide whether you will charge an hourly rate, a flat fee, or offer different pricing options depending on the level of care required. Consider the complexity and time investment involved in providing each service when establishing your pricing model.

4. Create financial projections: Utilize the information gathered in the previous steps to create realistic financial projections for your business. This should include revenue forecasts, expenses, and cash flow analysis. Identify the breakeven point and set measurable financial goals for the short and long term.

• Consider offering tiered pricing options for different levels of care to accommodate varying budgets.
• Factor in the potential for increased costs as the business grows and adjusts your projections accordingly.
• Regularly review and update your financial projections to ensure they remain aligned with the evolving needs and goals of your business.

By determining the pricing strategy and creating financial projections, you will gain a comprehensive understanding of the financial viability and sustainability of your elderly home care service. This step will also help you make informed decisions about the pricing of your services and set the foundation for successful business planning.

Establish Partnerships And Network With Local Healthcare Providers, Hospitals, And Other Organizations To Generate Referrals

One of the most crucial steps in starting an elderly home care service is establishing partnerships and networks with local healthcare providers, hospitals, and other organizations. These connections can play a pivotal role in generating referrals and building a strong client base. Here are some important considerations to keep in mind:

• Research and identify potential partners: Begin by researching and identifying local healthcare providers, hospitals, and organizations that cater to the aging population. Look for those with a similar mission and commitment to providing quality care.
• Make initial contact: Reach out to these potential partners and introduce your elderly home care service. Explain the services you offer, the unique value proposition of your business, and how a partnership could be mutually beneficial.
• Emphasize collaboration and communication: Highlight the importance of collaboration and communication in ensuring the well-being of clients. Stress the need for a seamless flow of information between your care team and the partnering healthcare providers to provide the best possible care.
• Create formal agreements: Once you have established a mutual interest, work on creating formal agreements or contracts that outline the terms of the partnership. This can include referral processes, communication protocols, and how both parties will work together to meet the needs of the clients.
• Attend networking events: Look for local networking events or conferences where you can meet and connect with healthcare providers, hospitals, and other organizations in person. Networking can often lead to valuable partnerships and provide opportunities for referrals.
• Develop a compelling pitch: Craft a concise and compelling pitch that showcases the benefits of partnering with your elderly home care service. Highlight your expertise, quality of care, and track record.
• Offer incentives: Consider offering incentives to healthcare providers or hospitals for referring clients to your service. This could include discounts, special rates, or other perks.
• Stay engaged and build relationships: Building strong relationships with partners is essential for successful collaborations. Stay engaged, provide updates, and always prioritize clear communication.

Remember, establishing partnerships and networks with local healthcare providers, hospitals, and other organizations can significantly contribute to the growth and success of an elderly home care service. These partnerships can provide a steady stream of referrals and enhance the quality of care that you offer to your clients.

Identify The Legal And Regulatory Requirements For Operating An Elderly Home Care Service In The Chosen Location.

When starting an elderly home care service, it is crucial to identify and comply with all the legal and regulatory requirements in the chosen location. This ensures that your business operates legally, ethically, and in the best interest of the clients. Here are some important steps to consider:

• Research and understand the specific licensing and certification requirements for providing elderly home care services in your chosen location. Each jurisdiction may have different regulations, so it is essential to thoroughly examine the rules and guidelines set forth by the local government or licensing bodies.
• Contact the appropriate regulatory agency or governing body responsible for overseeing home care services in your area. They can provide you with detailed information regarding the application process, required documentation, and any specific criteria or standards that need to be met.
• Ensure that your caregivers meet the necessary qualifications and obtain any required certifications or licenses. This may include background checks, first aid training, and specific healthcare certifications.
• Develop policies and procedures that align with the legal and regulatory requirements. This includes documentation and record-keeping practices, client confidentiality protocols, and guidelines for medication management and administration.
• Implement rigorous employee training programs that address not only the requirements set forth by regulatory bodies but also focus on providing quality care and maintaining ethical standards.
• Consider obtaining liability insurance to protect your business and clients from potential risks and lawsuits. Consult with an insurance professional to determine the appropriate coverage for your specific needs.
• Stay up-to-date with changes in regulations and compliance requirements in your area. Regularly review updates from regulatory agencies and attend relevant seminars or workshops.
• Network and connect with other home care service providers in your region. They can offer insights and guidance on navigating the legal and regulatory landscape.
• Consider consulting with legal professionals who specialize in healthcare or elder law to ensure your business is fully compliant and protected.

Assess The Required Resources And Create A Detailed Budget For The Initial Startup And Ongoing Operations.

Once you have determined the target market, outlined the key services, and established the legal requirements for your elderly home care service, it is crucial to assess the resources needed and create a detailed budget for both the initial startup and ongoing operations. This financial planning step will help ensure that you have a clear understanding of the costs involved and can allocate resources efficiently.

1. Identify the necessary resources:

• Determine the staff requirements, including caregivers, administrative staff, and any specialized professionals such as nurses or therapists.
• Assess the equipment and supplies needed for providing quality care, such as mobility aids, safety equipment, medication management tools, and communication devices.
• Consider the technological infrastructure required, including computers, software, and communication systems for managing client records, scheduling, billing, and communication.
• Evaluate the transportation needs, such as vehicles for caregivers to travel to clients' homes or to accompany them to appointments or social outings.
• Calculate the costs associated with office space or a physical location, including rent, utilities, and furnishings.

2. Create a detailed budget:

• Estimate the costs for each resource identified in the previous step and allocate a monthly or annual budget accordingly.
• Consider both fixed costs (expenses that remain constant, such as rent) and variable costs (expenses that fluctuate based on the number of clients or services provided, such as caregiver wages).
• Include additional expenses, such as insurance coverage, licensing fees, marketing expenses, and ongoing training for the staff.
• Factor in any financial projections for growth or expansion in the future.
• Research the average costs and reimbursement rates for elderly home care services in your area to ensure your budget is realistic.
• Consider seeking guidance from a financial advisor or accountant to help you create an accurate and comprehensive budget.
• Regularly review and update your budget as the business progresses to account for any changes or unexpected expenses.

By thoroughly assessing the required resources and creating a detailed budget, you will have a clear roadmap for the financial aspects of your elderly home care service. This step will help you make informed decisions, manage costs effectively, and ensure the long-term viability and success of your business.

Develop A Preliminary Marketing And Advertising Plan To Reach Potential Clients And Build Brand Awareness.

Marketing and advertising play a crucial role in attracting potential clients and building brand awareness for your elderly home care service. Developing a comprehensive and targeted plan will help ensure that your business reaches the right audience and effectively communicates the unique value it offers. Here are some key steps to consider:

• Identify the target audience:

Understand the demographics and characteristics of your potential clients, including their age, location, income level, and specific needs. This will help you tailor your marketing efforts and ensure they resonate with your desired audience.

• Create a strong brand identity:

Develop a compelling brand identity that reflects the values and mission of your elderly home care service. This includes designing a logo, choosing a color palette, and creating a consistent visual and verbal identity that sets your business apart from competitors.

• Build an online presence:

In today's digital age, having a strong online presence is essential. Create a user-friendly website that showcases your services, testimonials, and contact information. Leverage search engine optimization (SEO) techniques to improve your website's visibility in search engine results.

• Utilize social media:

Engage with potential clients and their families on popular social media platforms such as Facebook, Instagram, and Twitter. Share valuable content related to elderly care, promote your services, and interact with your audience to build trust and establish credibility.

• Establish strategic partnerships:

Collaborate with local healthcare providers, hospitals, and community organizations to generate referrals and gain credibility. Offer to provide educational sessions or workshops on elderly care to establish yourself as an industry expert.

• Implement targeted advertising:

Consider running targeted advertisements on platforms such as Google Ads or Facebook Ads to reach potential clients directly. Utilize relevant keywords and demographics to ensure your ads are shown to those who may require elderly home care services.

• Monitor your marketing efforts:

Regularly analyze the performance of your marketing campaigns and adjust your strategies accordingly. Utilize analytics tools to track website traffic, social media engagement, and the effectiveness of your advertising efforts.

• Leverage client testimonials:

Showcase positive reviews and testimonials from satisfied clients and their families. This can help build trust and credibility among potential clients who may be hesitant about seeking elderly home care services.

• Attend local community events:

Participate in local community events or health fairs to connect with potential clients and their families face-to-face. Distribute brochures or promotional materials, engage in conversations, and provide information about your services.

In conclusion, writing a business plan for an elderly home care service requires careful consideration of the target market, market research, value proposition, business model, pricing strategy, partnerships, legal requirements, resources, and marketing plan. By following these 9 steps outlined in the checklist, you can create a comprehensive plan to start and operate a successful elderly home care service.

By providing compassionate and personalized care, our elderly home care service aims to improve the quality of life for aging individuals while promoting their independence and well-being. Our highly trained caregivers will ensure the safety and dignity of our clients and build strong partnerships with local healthcare providers, hospitals, and organizations in order to generate referrals.

• Identify the target market and understand their specific needs and preferences.
• Conduct thorough market research to analyze the demand for elderly home care services in the desired location.
• Define the unique value proposition and competitive advantage of the business.
• Develop a comprehensive business model and outline the key services to be offered.
• Determine the pricing strategy and create financial projections for the business.
• Establish partnerships and network with local healthcare providers, hospitals, and other organizations to generate referrals.
• Identify the legal and regulatory requirements for operating an elderly home care service in the chosen location.
• Assess the required resources and create a detailed budget for the initial startup and ongoing operations.
• Develop a preliminary marketing and advertising plan to reach potential clients and build brand awareness.

Starting and operating an elderly home care service can be a fulfilling and rewarding venture, knowing that you are making a difference in the lives of aging individuals. By following these steps, you can create a solid business plan that sets the foundation for your success in this growing industry.

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Nursing Home Business Plan

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Bright House

Executive summary executive summary is a brief introduction to your business plan. it describes your business, the problem that it solves, your target market, and financial highlights.">, opportunity.

There is a lack of full-time assisted living facilities available that offer skilled and respectful care to residents. In addition, there are not enough medically skilled short-term care facilities for patients in CT.

Bright House aims to be that home for 14 lucky full-time assisted living residents, offering medically-skilled care in a respectful, self-sustaining community, and offering skilled nursing care for short-term residents. On our beautiful, newly remodeled 6 acre property (the former Wayfield Bed and Breakfast) in the small college town of Middletown, CT, Bright House brings together decades of experience and innovative, alternative visions of the potential in our elderly family members’ latest years.

The aging of the Baby Boomers is a well-known and much discussed fact of our times. More and more of this population, many of whom were instrumental in creating the counter-culture of the 1960’s and 70’s, are unhappily surprised about the options available to them as they age. Fortunately, just as AARP (formerly known as the American Association of Retired Persons) has become a major representative of this non-traditional group, elder-care alternatives along the Eden Care model are being founded.

Residents’/Patients’ Needs

Our own experience, based on years of caring for elderly patients, is that people seeking assisted living care and skilled nursing care have many of the same needs:

• To be treated with respect and dignity
• To be actively engaged in a community of some kind
• To be involved in his/her own treatment and living plan
• To be cared for by skilled, medically-knowledgeable clinicians and caregivers, working as a team

You may notice that our list of "needs" seems to go in the opposite order to that of most hospital-model nursing homes; this is not an accident. Unfortunately, most of our elderly population who need care are treated with the billing system’s needs, and not their own, in mind. 

Families’ Needs

Similarly, the families of people seeking caring environments have their own set of needs they are seeking to fulfill:

• Peace of mind about their loved-ones’ physical and mental state
• Relief from the time-consuming job of caring for their family members themselves
• Relief from the feelings of guilt which often overcome them when they find they do not have the physical, emotional, or intellectual resources to personally provide appropriate care for those they love

The big, unstated elephant-in-the-room for families seeking care is the feeling of being a bad daughter or son or spouse, who is not willing or able to put her life on hold to take care of a much-loved family member. At Bright House, we do not seek to dismiss this feeling, but to reassure families in everything we do that the choice to let us take care of their family member is a loving, kind, and generous act.

Competition

There are a number of different options for families seeking nursing home care, from in-hospital recovery centers, to for-profit chains, to specialized care for people with Alzheimer’s, AIDS, diabetes, and so on. The specialized care facilities, which are usually nonprofit, and offer individualized nursing care, come closest to our care model, but are usually reserved for people with a particular ailment in need of intensive medical assistance.

At Bright House, we promote the dignity and self-worth of all of our residents, and strive to give them excellent quality of life, as defined by the residents, individually and as a group. To that end, we encourage resident group decision-making through the House Councils, access to all areas of their homes here at Bright House, and self-determination in activities, socialization, and food preferences. Bright House is not just a caregiving facility—it is their home, and their community.​​​​​​

Expectations

Financial highlights by year, problem & solution, problem worth solving, our solution, target market, market size & segments.

We are basing our Market Analysis on data from Middlesex and Hartford counties, affluent portions of which, such as Glastonbury, are within a short drive of our facility.

Base Numbers for private residents:

The current total population of residents 65 and older, according to the 2000 U.S. Census, is 155,071 in Middlesex County, and 857,183 for the same group in nearby Hartford County. (The percentage of elderly in both counties is slightly higher than the 12.4% of the overall Connecticut population.) Our projections reduce that number by 70% to account for those healthy enough to care for themselves, or with family members able to care for them, leaving us with a total potential market of 303,676. We then reduce that number again by half to get the total potential customers living within a 35 minute drive of Middletown (these are small counties, and we are situated at their juncture), leaving us with 151,838. Of these, we estimate roughly 8.5% will have the means ($150,000 or more family income) to pay for full-time private care at our facility (based on the 2000 census data about Connecticut income).

This leaves us with roughly 12,906 nearby upper-income residents of Hartford and Middlesex County who are 65 or older, and in need of medical or other daily assistance in their living situation. To project into the future, we again looked to the 2000 Census. The Census’ Projected Population of Connecticut is as follows:

While the overall population of Connecticut is projected to decline over the next five years, before rising again, we know that the proportion of the overall population age 75 and older (our target market age) is slowly rising. We therefore include a modest projected increase in potential customers of 1% over the next five years.

Medicare residents and short stays:

A study published recently in the journal Health Affairs by Morrissey, Sloan, and Valvona found that the proportion of Medicare patients transferred to post-hospital care has doubled since the Prospective Payment System (PPS) was introduced. Rather than staying in the hospital until recuperated, the current system preferentially delegates recovery care to private non-hospital facilities, leaving room in hospitals for urgent or crisis care. We base our projections for Medicare residents on the same figures listed above, but looking at the percentage of elderly with family incomes between $30,000 and $75,000 dollars,* rather than just the highest bracket, we get 40% of the population, or 60,735. We apply the same conservative 1% growth rate, below.

This income range was chosen because it correlates with the kind of higher education levels that most families choosing non-hospital model skilled nursing care report. Although residents with lower incomes may have a need for our service, they are traditionally less likely to seek out alternative care.

Market Segmentation

Although we have broken our target population into two groups based on income, our marketing strategies rely on another level of breakdown—marketing to potential residents, and marketing to the families of potential residents, who may or may not have similar needs.

Target Market Segment Strategy

The overall populations we wish to serve are older people (65 and older), in need of daily assistance, who value community and the contributions of their peers. Since Bright House will become their home, we especially are seeking residents willing to make this house a home, and learn from and teach each other.

We also recognize that we must meet the somewhat different needs of our residents’ families, who will help them make the decision to live with us, or recuperate here, and who will almost certainly be contributing to the monthly payments necessary to provide for their care.

Current alternatives

 Alternatives and Usage Patterns

Families choose one elder care facility over another for a variety of reasons. The most common issues involved in their decision are distance from their home(s), affordability, quality of staff and facilities, and particular medical specialties necessary for their family member. Families will usually choose the highest level of care affordable within 45 minutes to one hour of their homes, in order to make visiting their family member easier.

Main Alternatives

The following three organizations are representative of the types described above:

Fox Hill Center, Rockville

• For-profit, part of a chain
• 3.37 nursing staff hours/resident day
• 150 beds (not 150 rooms)
• 11 deficiencies in Medicare inspection

Fox Hill Center is typical of the hospital-model nursing home. It is large (150 beds), for-profit, and has a fairly low rate of nursing hours per resident day. Its size makes it able to care for many patients, but often at the expense of individual attention.

Sister Anne Virginie Grimes Health Center, New Haven

• Nonprofit, religious based, located in a hospital
• 3 deficiencies

The Grimes Health Center, like many religious care centers, is nonprofit, and has a slightly higher rate of nursing hours per resident day than the for-profit centers, despite its large size. Quality of care, however, is noticeably higher (3 deficiencies in inspection, compared to 11 at Fox Hill).

Leeway, Inc., New Haven

• 4 deficiencies

Leeway is a typical specialized private (not in a hospital) nonprofit care facility. It is much smaller than the other two described, has the highest rate of nursing care per resident day, and high quality marks in inspection. Its small size and nonprofit status allow it to focus on providing individual attention. Leeway is Connecticut’s first and only skilled nursing home dedicated solely to the treatment of people living with AIDS.

Our advantages

Although the hospital model of care practiced in most nursing homes provides good results for Medicaid and Medicare billing purposes—that is, easily quantifiable lists of procedures and medicines administered, test results, and billable nursing hours—it does not provide good quality of life for residents (or "patients," as they are referred to in the hospital model).

At Bright House, we see a different way of assisting our elderly members through a new stage in their lives. Acknowledging that where they live is their home, and belongs to them, not to the medical staff, we have established a facility that not only meets their medical and physical needs, but one that also nourishes their social connections, individual dignity, and personal preferences. Each resident has a private room with bath, opening onto a central shared common area containing the kitchen, living room, and dining room, where all meals are shared communally at our 15 foot farm-style dining table.

Far more devastating than physical illness to our elders, is lack of purpose. Studies have shown over and over that seniors who are engaged in activities they find meaningful are far more likely to retain mental acuity, physical health, and emotional well-being. Although the hospital model tries to provide such stimulation, its "activities" are usually organized by staff, with little or no input from "patients," and become just one more set of required tasks for all involved. At Bright House, we have already begun working with prospective residents to identify areas of interest and methods of community involvement that will appeal to them.

Keys to Success

We have identified four keys to success for Bright House:

• We offer more resident-oriented, small-scale, home-model care than our competitors;
• Our innovative use of Elder Assistants lowers the cost of providing this care considerably;
• Our fair wages and team structure lower dissatisfaction, and thus turnover rates among our staff;
• Our on-site Skilled Nursing Facility ensures continuity of care when our residents need more intensive assistance.

Marketing & Sales

Marketing plan.

The main means of marketing for Bright House is through word of mouth. Due to our respectful and medically skilled staff we trust our business to speak for itself. Therefore, we don’t need much marketing. In addition to word of mouth, we will offer tours Monday-Friday. These tours will allow us to show off our beautiful facilities, and will hopefully draw in more potential residents. Lastly we will have a website that we will use to promote our tours and will serve as marketing to our more tech-oriented customers.

Our sales will mostly come from tours, but some will come from our website as well. Our space is limited, especially for full-time residents, so potential customers will need to go through an application process. People are able to fill out an application in person at our main office, or can submit an application online. If the application is approved, we can talk to the family about the specific needs of the resident and when they can move in!

Locations & Facilities

We have now nearly completed the five-month renovation of the former Wayfield Bed and Breakfast into our two main facilities. The main building will house our privately insured, assisted-living residents. The skilled nursing facility across the courtyard offers more intensive care for post-operative and recovering temporary residents, as well as providing a setting for increased care for our residents as needed.

Each resident in our assisted living retreat will have a private bedroom and bath, opening onto a central social area containing the living room, dining room, and kitchen. We have two larger rooms that can accommodate married couples who move in at the same time, for a total of 12 rooms, holding up to 14 residents. Each room is wheelchair accessible, and can accommodate maintenance machines such as oxygen.

The skilled nursing facility to the left of the main building can house up to eleven adults, and is the only area of the facilities which will house residents receiving Medicare or Medicaid payments. This part of Bright House has two purposes: as a short-term rehabilitation center for community members recovering from surgery or medical emergencies; and as a full-service nursing facility for residents who can no longer take care of their own needs sufficiently in the main building. The continuity of location, social contact, and quality of care ensures that our residents will remain in the best possible surroundings when their needs are greatest.

Middletown, where we are situated, is centrally located 25 minutes from Hartford, and 30 minutes from New Haven. Middletown is a small college town, with an ethnically and economically-varied population.

In addition to our advanced medical equipment, the main use of technology at Bright House will be the installation and use of our computerized medical record system. The benefits of this system (described in the Start-up Summary, above) are numerous. The system will also allow residents to access their own individual records with a password at will, to ensure that they understand as much as they can about their own situation, and how to maintain their health.

We are working carefully with DigInfoMedTel to ensure that all of our technology meets Health Insurance Portability and Accountability Act (HIPAA) standards before implementation. We will hold a series of HIPAA trainings with the software in mid-December to ensure that our staff is fully-knowledgeable in this area.

Milestones & Metrics

Milestones table, key metrics.

Key Metrics 

• cost effective housing and prcing 
• pharmacy inventory 
• twitter reviews and retweets 
• radio advertisements 

Ownership & Structure

Bright House is chartered as a nonprofit 501(C)(3) corporation in Middletown, CT, with the goal of providing holistic and respectful assisted living and skilled nursing home care to a small group of elderly residents. Our primary location is the old Wayfield Bed and Breakfast, on Farmer’s Road, which we have spent the last five months converting into a two building nursing home facility in line with Eden Alternatives "Greenhouse" model for enlightened elder living. (See architectural drawing, attached.)

Management team

Caregiving Management

Bright House offers a different management structure from that of the typical hospital-model nursing home. Our primary caregivers, the 6 Elder Assistants, work as a self-managed team, meeting with the Medical Director and the nurse on-call every morning to coordinate care for the coming day.

Although the Medical Director has the ultimate responsibility for the health and well-being of all residents and visitors, the nursing and caregiving staff, with their different kinds of knowledge about the residents’ physical, social, and mental well-being, are expected to note, discuss, and recommend courses of action for all residents who, in their combined estimation, need help.

A 2001 study by the Robert Wood Johnson Foundation found that the small percentage of Chief Nursing Officers reporting no nursing shortages in their facilities at the time of the study cited formalized programs focused on the needs of, and professional recognition for, their nursing staffs as the reason for their adequate staffing. Our compensation packages, management structure, and caregiving requirements are designed to continually remind our LPNs and Elder Assistants how very valuable they are. 

Dr. Mildred Johnson is our Medical Director. Dr. Johnson has served as the head of Gerontology for six years at The Connecticut Hospital, and oversaw the creation, last year, of their Elder Assistant training program, which provides certification for Certified Nursing Assistants (CNA) to provide in-home hospice and respite care. Dr. Johnson has 20 years of experience working with elderly patients in this area, and has been integral in designing the physical layout, management structure, and priorities of Bright House.

The rest of our already-hired caregiving staff brings a whopping collective 75 years of professional experience in caring for elderly patients.

Financial Management:

Madeleine Morgan has been overseeing financial management of nonprofit organizations in Connecticut for 27 years. She became involved in our project when her mother developed a long-term care plan with Dr. Johnson which included home-based hospice care. "I wish everyone could have the same love and attention Dr. Johnson showed to my mother," Madeleine said. Ms. Morgan will be in charge of all financial operations at Bright House, overseeing billing, personnel payment and benefits, and development efforts.

Advertising and Marketing:

We are fortunate to have a skilled public relations officer in our group. Janice Ruthers is a retired ad executive living in Middletown with her husband (a professor at the university). She will be working 20 hours per week in our offices as a volunteer for the first two years of our plan, helping us design advertisements and brochures, and to plan events like our Open House in December to let the public see the results of our efforts.

5.1 Management Team Gaps

We still need to hire one swing-shift LPN, and one Elder Assistant. We are currently recruiting through Dr. Johnson’s connections at The Connecticut Hospital, and expect to complete our team by mid-December, at the latest.

Financial Plan investor-ready personnel plan .">

Key assumptions.

A "full" elder care facility is generally 90% to 95% full. Our non-standard model allows us to forecast for full occupancy in the main building, since turnover rates for assisted living residents are expected to be quite low (1-2 per year, at most). The skilled nursing facility, on the other hand, requires a certain number of empty beds to offer the flexibility needed to accommodate shorter stays. We therefore are projecting reaching "capacity" of our eleven-bed facility at 10 full beds.

Our resident monthly prices are based on the current Medicare nursing-hours-per-resident-day rates for our kind of services. Medicare patients are billed at roughly $135/day for nursing care, not including the cost of any medication to be administered by our staff. Our private patients are billed at a slightly higher rate to account for the low Medicare reimbursement rate, but also to pay for the extra benefits they receive as part of living at Bright House. Our rates are roughly 2/3 of our nearest competitors, the difference being made up for in donations, and savings gained through staff retention and the use of highly trained, flexible, Elder Assistants.

The small size of our facility allows us a cost savings on maintenance and grounds.

One other important assumption concerns payables: We have assumed collection days of 60, which averages our private residents’ monthly up-front payment, and the typical 60-90 day reimbursement rate from Medicare.

Revenue by Month

Expenses by month, net profit (or loss) by year, use of funds.

Start-up Expenses

One of the largest items in our Start-up budget is a computerized medical records system. Preliminary designs of this system have already been constructed by DigInfoMedTel. In addition to the obvious benefit of allowing multiple care-team members to easily exchange information as they change shifts, this system will allow our residents and staff to keep track of chronic conditions, monitor gradual but serious changes in condition which might be overlooked in day-to-day interactions, and corroborate quantifiable medical data for our Medicare patients in the skilled nursing facility.

Start-up Assets

Current (Short-term) Assets include $6,000 of start-up inventory (bedding, cleaning and disposable medical supplies) and non-expensed, smaller medical equipment that will depreciate quickly, and will need to be replaced in year four or five.

Long-term assets include our existing location, the former Wayfield Bed and Breakfast, currently assessed at $400,000 including renovations. The location was willed to us by Evelyn and Jack Bright last February, with the condition that we include a small Medicare facility as part of the overall plan. This category includes new Long-term Assets needed as follows: $200,000 for (long-term, resalable) medical equipment, and $150,000 for initial furnishings, after the renovation.

Medical Equipment:

• 1 Fully-loaded Crash Cart
• Standard monitoring equipment (blood pressure, sugar, etc.)
• Call-button system

Furnishings:

For the common areas of both buildings, we will need couches, self-lifting recliners, tables, and chairs suitable to our residents’ needs. We have allocated $35,000 for furnishing the four common rooms.

Each private room will need a hospital-capable bed, linens, a dresser, and a phone, at the minimum. With the remaining funding, that leaves just over $6,000 per room. This budget will allow us to provide attractive, functional, and comfortable surroundings to our residents in their new homes. Each bedroom in the main building will have enough remaining space that residents can bring plenty of familiar furniture with them (up to two side tables and wingback/reclining chairs, and a second dressing table or its equivalent).

Sources of Funds

We will get a low interest loan for $210,000. We have collected donations and pledges of $291,000 Our founders will provide $407,000 

Projected Profit and Loss

Projected balance sheet, projected cash flow statement.

Tax Season Savings

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Senior Service Business

The Best Home-Based Senior Service Businesses You Can Start On A Shoestring

How To Start An Eldercare Business in 9 Easy Steps

By Craig Wallin

Step 1. Choose services to offer.

Making a list of the services you plan to offer is an essential first step, so you need to think about what may be needed and what is in demand in your area. Some folks specialize in respite care, others enjoy housekeeping, and others love to run errands. Ask other senior care providers what services are most needed in your town. When you’re done, make up a list that can be a part of your flyer or brochure, or an advertisement on Craigslist or on a website. It’s a good idea to add this at the end of the list: “If you don’t see a service you need – just call and ask if we offer it.” This allows you to make sure you are meeting the needs of all your prospective clients, as you’re bound to miss a few in-demand services when you make up that list.

Step 2. Name your eldercare business.

Now you’re ready to name your eldercare business. Think of something catchy and memorable. Examples include: “Senior Helpers,” “Loving Caregivers,” and “Eldercare Angels.” Consider adding the name of your town, or even your own name, in the business name. Check with your state to make sure no one else is using your name, and that it hasn’t been registered or trademarked already.

Step 3. Don’t spend money!

Resist the urge to spend money when you’re starting your business. Ask yourself “Do I really need this?” before you buy anything. If you have a reliable vehicle and a cellphone, you’ve already got the essentials you need. Keep your office at home to avoid spending money on rent, utilities and other costs for a separate office. Think and act like a miser until your business income is steady and solid.

Step 4. Legal structure.

When you start an eldercare business, it’s important to pick the right legal structure for the new business. Most eldercare businesses operate as a sole proprietor or as an L.L. C. You’ll find lots of free advice about the picking the right option for you at Nolo.com. Whatever you decide, get this pinned down first, before you apply for a business license, or get a federal tax number.

Step 5. Insurance.

The right coverage is essential for protection in case of a lawsuit or claim. Talk to a local independent insurance agent to find out what is required in your state.

Step 6. Set your rates.

Many new eldercare business providers make the mistake of not charging enough to cover all their costs, as they haven’t been in business long enough to be aware of all the little costs, like licenses, bookkeeping fees, social security taxes, vehicle maintenance or insurance, all of which can add up over time. A good rule of thumb is to add about 30-35% to the wages you’ll be paying yourself, to arrive at a reasonable rate that allows you a profit and still makes your clients happy.

Step 7. Finding customers.

After you’ve set up your eldercare business and listed the services you plan to offer, start looking for customers. You’ll only need a few, and with the huge demand for capable caregivers, you can usually pick and choose your clients. Local senior service providers are often a good source of referrals. You can run a free ad on Craigslist, or sign up at one of the online marketplaces such as Care.com

Step 7. Referrals.

Once you have your first few clients and have treated them well for a while, ask them for referrals. Tell them you’re still growing your business, and could use a few more good clients like them. Offer a reward, like a free shopping trip, in return for a recommendation that becomes a regular client.

Step 8. Provide exceptional service.

If you take care of your senior clients, they will tell others and you’ll never have to advertise again. It’s true! Always try to practice the Golden Rule and treat your clients they way you would want to be cared for if you were in their shoes.

Step 9. Stay organized and save money.

There are several online programs that help you keep up with your business bookkeeping and your job schedule. My favorite, which makes keeping track of your small business finances easy, even if you can’t add or subtract, is Outright.com, now part of GoDaddy. The cost is way below what you would pay a bookkeeper, or around $12 a month, and it has a built-in scheduling feature that can track your work hours and prepare an invoice for a client. . It even reminds you when taxes are due, or when you miss a deduction, like the 55 cents a mile for business mileage that I often forget!

How to Start an Elderly Home Care Business: Full Steps & Requirements

By: Amber Dixon

Last Updated: May 11, 2023

The demand for medical and personal care is growing year after year. Learn how to start an elderly home care business to cater to that growth today!

There’s an increasing need for medical and personal care every year.

This is because of aging baby boomers (and other older adults) as well as a long life expectancy.

These factors present an excellent opportunity for anyone looking to enter the healthcare industry — particularly the home health care sector.

If this is something that appeals to you, we’ll tell you all about how to start your own home health care business.

What Is a Home Health Care Business?

A home health care business, also known as a home health care agency, hires home care providers to give in-home care to the elderly. 

These providers can range from medical professionals to non-skilled providers.

This kind of business can offer simple day-to-day assistance .

It can also be a medical service, which is especially great for seniors recently discharged from the hospital. But it’s also good if their health simply needs closer monitoring.

Overall, this kind of business helps senior citizens age in peace .

The Services Home Health Care Businesses Can Offer to Senior Citizens

You can offer many different kinds of home health care services for fair pricing like:

• Personal care – This involves helping the elderly with daily living activities . Professional caregivers can help prepare meals, bathe, or dress their clients. It can also be limited assistance, such as giving medication reminders.
• Health care – Trained professionals (like certified nursing assistants and occupational therapists) will provide at-home services like therapy or other checkups.
• Transportation – The elderly might have trouble driving themselves, or they have difficulty with public transit. You can offer them transportation services , such as going back and forth to doctors’ appointments.
• Household maintenance – You can help seniors stay on top of household chores — like gardening, doing laundry, and grocery shopping. Household maintenance can also involve financial and health care management.
• Home modifications – Mobility tends to become harder the older we get. As such, you can offer home modification services to help the elderly move around their house safer. For instance, you can suggest adding grab bars or anti-slip mats in the shower.
• Day programs – Day programs are mostly social in nature. This keeps seniors cognitively engaged by letting them interact with other senior citizens or caregivers. You can also add activities like playing cards and board games to these day programs.
• 24-hour home health care – Two caregivers will work 12-hour shifts to ensure that a senior is safe and has all their basic needs met around the clock.

Home Care Business Requirements

A home healthcare agency license certification is the first thing you’ll need before you can run your business.

However, the processes and additional requirements differ per state . But in general, you’ll need to:

• Take a specific training course
• Get certified for CPR/AED

For some states, like Alabama and Arkansas, you don’t need anything else. But some states require more caregiver training hours and licensing.

In Connecticut, for instance, you’ll also need personal care licensing and an 8-hour course recommended by the Professional Association of Caregivers.

You can check the exact licensing and training requirements of your state here .

How to Start a Home Care Business for the Elderly in 9 Steps

Here are the steps that will lead to building a successful home healthcare agency:

Step 1: Start Drafting a Formal Business Plan

You don’t need to write down your whole business plan in one sitting.

But the most important things you need to figure out first at this point are:

• Business name – The name will be the first thing people see (and should remember) about your company. So try to make it catchy while making it obviously connected to your business.
• Company description – This part sums up what your home healthcare agency does. It also shows what makes your company unique . Some things to include are the company’s goals, target customers, and mission & vision statement.
• Business ownership structure – This will determine many things — from how much tax you pay to any personal obligations you might assume.

Step 2: Get Your Employer ID Number

As the name suggests, the employer identification number (EIN) is used to identify business entities operating in the U.S.

You can get this nine-digit number from the Internal Revenue Service (IRS).

The EIN is also known as:

• Federal Employer Identification Number (FEIN)
• Federal Tax Identification Number

Step 3: Register With Your State

To formalize your business entity , you should register with the Secretary of State.

Your location and business structure determine how you should register your business.

Normally, this can be as quick as filing your company name with the local and state governments. This is especially the case with a small business or sole proprietorship.

But for an LLC, corporation, or partnership, you’ll need other things:

• Registered agent – This person will hold official papers and other legal documents sent to your company. Agency owners can choose to be their own agent .
• Certificate of Authority – If your home health care agency expands to other states, you’ll need to file for this certificate in that state. Some states may also require a Certificate of Good Standing from where your business originated.
• State documents and fees – The total cost for registering a business is usually less than $300. But it still depends on the state and structure of your company.

Once you’ve registered your agency, you can now open a business checking account and credit card account.

Step 4: Make a Solid Financial Plan

This is another crucial part of your business plan. After all, it’s what will keep your business operations going .

Things to include here are:

• Cash flow forecast
• Balance sheet snapshot
• Break-even point analysis

A balance sheet snapshot is especially important here since it shows the company’s financial position at a certain point in time.

You can quickly determine if your assets are equal to your liabilities and any shareholders’ equities.

Related to having a financial plan is getting good funding . Opening a business bank account makes it easier to track and manage your finances.

There are many ways you can fund your business:

• Traditional bank loans
• Angel investors
• Venture capital firms
• Government grants and subsidies

Failing to secure funding means your working capital can be in danger . That can make it difficult for your now-small business to take off and expand.

Step 5: Have Adequate Business Insurance

Business insurance will cover any costs connected to property damage and liability claims.

Not having insurance means a business owner will pay out-of-pocket for any damages or legal claims against their company.

The kinds of insurance you should consider are:

• Professional liability insurance – This is also known as the “errors and omissions” insurance. It will protect your agency from claims of incompetence and malpractice. This would make professional liability insurance the most important insurance to have.
• General liability insurance – This will protect you against claims that involve bodily and property damage (concerning third parties) due to your service. General liability insurance can also cover medical payments for injuries that a non-employee sustains on your premises.
• Cybersecurity insurance – A first-party coverage will answer for your company’s financial losses following a data breach or cyber event. Meanwhile, third-party coverage will protect you against claims made by others affected by the event. For instance, that can cover lawsuit expenses or HIPAA penalties due to a client’s accidentally-exposed Personal Identifiable Information (PII).

Step 6: Create a Sales and Marketing Plan

This is another essential part of your business plan. If you’re not sure you can make (and execute) a good marketing plan alone, you can enlist the help of a marketing agency.

The market segments or target audience of your marketing plan should include:

• The baby boomers and other older adults themselves
• Their adult children
• Relatives of the seniors

Build a Website

Having a website is a quick way to be visible online.

You can build just a basic website at first to tell the world that your company exists. Make sure it’s easy to read and fits any device screen.

Put your agency’s name and basic information out there. This can include your company description, mission, and vision to give potential clients a good idea of your home health care agency.

You can always come back later on to improve how your website looks.

Try to create a blog on your site too.

You can also eventually publish reviews to give others social proof that you’re running a trustworthy agency.

Be on Social Media

Social media is another great way to establish your online presence.

You can share the articles on your blog or create bite-sized content that your target audience can interact with.

One way to run ads is through Google Ads . You’ll need to bid on keywords, but if you win, you get immediate visibility for that keyword.

For instance, your business can show at the top of the page if someone searches “home health care agency in [your location].”

You can also run ads in local newspapers, TV, and radio stations.

You can get clients through a referral system — and this is especially helpful if you’re just starting out.

Connect with healthcare facilities and professionals such as:

• Long-term care facilities
• Hospital discharge social workers
• Rehab outpatient centers
• Senior centers
• Local physicians

Ask them if they can refer patients to your home health care business.

You can also ask if you can leave leaflets or other advertising materials in their offices.

If your first wave of clients is pleased , they can refer other people who need your service.

Step 7: Write Your Company’s Policies and Procedures

Policies and procedures will ensure smooth office operations . They also help you assess risk and perform compliance-related work.

Some things to cover in your policies and procedures are:

• Hiring practices
• Orientation and training
• Employee and payroll records
• New client admissions
• Client billing
• Client rights and responsibilities

Step 8: Hire Great Founding Staff

The home healthcare business is all about creating personalized care services. As such, you should find staff that perfectly represents your company’s vision.

The most commonly-employed healthcare professionals are certified nursing assistants and home health aides .

You can also enlist the help of other medical professionals like doctors, therapists, and medical social workers.

Together with hiring, you should also develop a good retention plan to keep your employees motivated to stay with you.

Step 9: Meet Compliance Requirements

When your new business eventually gets up and running, you should still continuously meet compliance requirements.

Part of this means your employees should undergo annual education in topics such as cultural diversity and emergency/disaster training.

For an idea of what to audit in your home health care agency, take a look at this checklist .

But remember that the checklist will NOT guarantee that you’ll get a successful accreditation decision. It’s only to give you a gist of some laws and regulations you should follow.

To ensure your healthcare agency is on the right path, check what your local laws require.

Why Should You Start a Home Healthcare Business?

Home health care agencies are big in the healthcare market. In fact, they actually make up the fastest-growing healthcare industries.

In 2019 alone, around 1.4 million people worked in the home healthcare industry.

This demand is pushed by aging baby boomers — which comprise around 25% of the U.S. population.

A longer life expectancy and record low birth rates also contribute to an aging population.

In-home care service is also a more attractive option to people compared to assisted living facilities. After all, it allows them to maintain some independence or age in place.

Already, 12 million people have been receiving in-home care compared to living in other care facilities like nursing homes since the COVID-19 pandemic hit.

How Profitable Is a Home Care Business?

A home health care agency is very profitable.

How much you earn in a year will depend on:

• How much you charge for your services 
• What services you offer
• How many clients you have 

But the national average hourly cost for at-home non- medical care is $27 per client.

Your expenses might go up if you expand the business, but that also means more profit — for you and all your employees.

Frequently Asked Questions

We’ll cover a few related questions to home health care businesses:

What’s the Difference Between a Caregiver and Home Care?

Home care is the service that caregivers give.

Home care services are all about making sure the elderly are safe and comfortable in their own homes.

Professional caregivers can prepare meals, help seniors stay on top of bills, and offer transportation, among other things.

What’s the Difference Between a Medical and Non-Medical Home Care Business?

Medical home care and a home health business are the same. This business is more concerned about the elderly’s health.

Services here are provided by medical professionals and can range from monitoring blood pressure to checking the senior’s mental state.

Meanwhile, non-medical home care can simply be called home care .

Services are provided by non-medical professionals and are centered around day-to-day assistance. These include anything from helping the senior get changed to scheduling doctors’ appointments.

Together, medical and non-medical home care can collectively be called home health care.

How Much Does It Cost to Start a Private Home Care Business?

Starting a home health care agency can cost anywhere from $40,000 to $350,000 , depending on your services and certifications.

When planning your startup costs, you should take into consideration the following:

• Accreditation and certification – Accreditation and certification fees differ per state and ownership structure. Accreditation, in particular, can be tedious because of the criteria you need to hit. These include services, types of patients, and operations.
• Equipment – This can be more expensive for a home health care agency since you’ll need to invest in specialized medical equipment too. Aside from equipment, it would be best if you also have good software to streamline processes. You may need technical support for this part too.
• Commercial office space – You should also find a good place as your base of operations. Other business owners might try to use their homes as an office, but this might not be the wisest decision — especially if you need to store equipment.

If you’re a first-time business owner, you’ll be relieved that non-medical home care agencies are relatively inexpensive to start.

You can expect to spend $40,000 to $80,000 depending on how big your operation is and what services you’re offering.

For a medical home care agency, not being Medicare-certified means you might spend $60,000 to $100,000.

But if you are Medicare-certified (which is more common), you can shell out $150,000 to $350,000.

Do I Need Medicare and Medicaid Certifications?

It’s NOT required, but most agency owners prefer to get these certifications.

Getting certified basically means you can bill Medicare and Medicaid for reimbursements . Having these certifications also assures your clients that your business meets the minimum health and safety standards.

However, the process can take as much as a year .

The Center for Medicare & Medicaid Services has an enrollment guide you can follow. Some states also require the business owner to pass a jurisprudence exam.

The home health care business is a profitable industry that continues to grow as life expectancy increases.

Starting your own agency might sound overwhelming, but having a good business plan helps you solidify your vision and put you on the right path.

Licensing and accreditation might take a long time too. However, when you have them, potential clients can see your company as a trustworthy one that passes standards.

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Starting a home care business can be a lucrative opportunity for anyone with health care experience. Learn the seven steps you’ll need to take to get started.

Home care businesses provide a valuable service to the community, which is why the industry is expected to double in size over the next 15 years. But the job is demanding, and it’s essential to perform your due diligence before getting started.

What is a home care business?

Home care businesses offer home health and medical services to aging or sick individuals. It’s an umbrella term used to refer to multiple types of services.

A home care business could provide the following services:

• Companionship to seniors.
• Assisting clients with daily activities like housekeeping and cooking.
• Home therapy services, like physical and occupational therapy.
• Hospice care.

7 tips to starting a home care business

Find out what certifications you need.

Before starting a home care business, you must certify your business through the state and obtain a license. It’s also a good idea to check your local health department to find out if you need any additional licenses. This is not an overnight process and could take as long as a year to complete.

Decide what services you’ll offer

Home care businesses can cover a wide variety of services. You want to decide which type of services you will provide based on your experience and your staff.

If you’re not sure what service you want to offer, spend some time researching the top growing trends in the health care field. This can be an excellent way to match your skills with the current market demand.

As a home care worker, you cannot discuss health records with family or friends.

Identify your target market

Next, you’ll want to spend some time thinking about your target market. This is not necessarily the clients you’ll be serving, but the individuals who will be hiring you. For instance, if you offer hospice services, your target market is the adult children who will hire you to care for their parents.

Create a business plan

The best way to set yourself up for success is by coming up with a detailed business plan. A business plan will outline your target market, your financial plan and how you plan to market your business.

Having a business plan can make it easier to qualify for a small business loan. A loan can help you get your business off the ground faster and let you avoid having to dip into your savings.

[ Read more: How to Write a One-Page Business Plan in a Hurry ]

Make sure you understand HIPAA laws

HIPAA compliance can be one of the most challenging aspects of starting a home care business. HIPAA laws protect the patient's privacy and ensure that third parties can’t access their records without their consent.

As a home care worker, you cannot discuss health records with family or friends. This could frustrate some family members and friends and make it harder for you to do your job. Make sure you have a thorough understanding of HIPAA laws before starting your business.

Come up with a marketing plan

Once you have your business set up and have applied for the appropriate licenses, you should begin marketing your business. You can promote your business on social media and invest in local advertising.

And don’t forget to ask current clients for referrals. Referrals are an excellent―and free―way to grow your business.

[ Read more: The Difference Between Sales and Marketing ]

Hire your staff

If you want to grow your home care business, then at some point you’ll have to bring on staff. You should choose your employees carefully since they directly represent the quality care you will provide.

Conduct a thorough interview process and run background checks on all employees. You can find potential employees through a staffing agency or through personal recommendations.

[ Read more: The Best Interview Questions to Ask, According to Franchise Owners ]

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Home Care Business Plan PDF Example

• February 28, 2024
• Business Plan

Creating a comprehensive business plan is crucial for launching and running a successful home care business. This plan serves as your roadmap, detailing your vision, operational strategies, and financial plan. It helps establish your home care business’s identity, navigate the competitive market, and secure funding for growth.

This article not only breaks down the critical components of a home care business business plan, but also provides an example of a business plan to help you craft your own.

Whether you’re an experienced entrepreneur or new to the healthcare industry, this guide, complete with a business plan example, lays the groundwork for turning your home care business concept into reality. Let’s dive in!

Our Home Care business plan is designed to address all vital elements necessary for a detailed and effective operational strategy. This plan encompasses the scope of our home care services, marketing approaches, the environment in which we operate, an analysis of our competitors, the structure of our management team, and financial projections. 

• Executive Summary : Offers a succinct overview of the Home Care business’s unique proposition, highlighting personalized and professional in-home care services tailored for seniors, market analysis showcasing the sector’s growth and demand, management’s expertise in senior care, and a financial strategy that outlines investment opportunities and revenue expectations.
• Services & Area Coverage: Describes the array of in-home care services, including personal care, medication management, specialized care for dementia, and emergency response, all delivered within a specified service radius to meet the unique needs of each senior.
• Pricing: Details the pricing strategy , designed to be transparent and competitive, offering flexible options to cater to various financial situations of clients, including hourly and flat-rate packages tailored to different care needs.
• Key Stats: Presents data underscoring the market size , growth trends, and demographics that illustrate the potential and necessity of home care services.
• Key Trends: Highlights significant trends such as the increasing preference for aging in place, the integration of technology in care, and a shift towards personalized care.
• Key Competitors : Analyzes the main competitors within the service area, their offerings, and how the business’s unique approach and technology set it apart.
• SWOT Analysis : Conducts a comprehensive analysis of Strengths, Weaknesses, Opportunities, and Threats to strategically position the business.
• Marketing Plan : Outlines marketing strategies aimed at building brand awareness, attracting new clients, and retaining them through superior service, patient satisfaction programs, and targeted marketing efforts.
• Timeline : Sets forth key milestones and objectives from the business setup to its launch and key growth phases.
• Management: Highlights the experienced team leading the business, from caregiving professionals to administrative management, emphasizing their roles in ensuring high-quality care and operational success.
• Financial Plan: Projects the financial outlook for the business over the next five years, detailing revenue models from various services, cost management strategies, profit margins, and expected return on investment, ensuring a clear route to financial sustainability and growth.

Home Care Business Plan

Download an expert-built 30+ slides Powerpoint business plan template

Executive Summary

The Executive Summary introduces your home care business plan, offering a concise overview of your agency and its services. It should detail your market positioning, the range of home care services you offer, including personal care, nursing care, and companion services, its service area, and an outline of day-to-day operations. 

This section should also explore how your home care agency will integrate into the local community, including the number of direct competitors within the area, identifying who they are, along with your agency’s unique selling points that differentiate it from these competitors. 

Furthermore, you should include information about the management and co-founding team, detailing their roles and contributions to the agency’s success. Additionally, a summary of your financial projections, including revenue and profits over the next five years, should be presented here to provide a clear picture of your agency’s financial plan.

Make sure to cover here _ Business Overview _ Market Overview _ Management Team _ Financial Plan

Dive deeper into Executive Summary

Business Overview

For a Home Care Business, the Business Overview section can be effectively divided into 2 main slides:

Services & Area Coverage

Briefly describe the range of home care services your agency offers, emphasizing the personalized and compassionate care provided to clients in the comfort of their own homes. This can include personal care services like bathing and dressing, skilled nursing care, physical therapy, and companion services such as meal preparation and light housekeeping.

Then, mention the geographic area your agency covers, highlighting the convenience and accessibility of your services to clients within this area. Explain why your service area is strategically chosen to meet the needs of your target clientele, considering factors like population demographics and the presence of community resources.

Pricing & Payment Options

Detail your pricing structure for the various home care services offered, ensuring it reflects the quality of care provided and is competitive within the market you’re targeting. Your pricing strategy should be transparent, making it easy for clients and their families to understand the cost of care.

Also,highlight any flexible payment options, insurance partnerships, or programs that can help offset the cost for clients, such as Medicaid, Medicare, or private insurance coverage. Emphasize any packages or special programs that provide added value to your clients, such as customized care plans or discounted rates for long-term services, encouraging long-term relationships and client loyalty.

Make sure to cover here _ Services & Area Coverage _ Pricing & Payment Options

Market Overview

Industry size & growth.

In the Market Overview of your home care business plan, start by examining the size of the home care industry and its growth potential.

This analysis is crucial for understanding the market’s scope and identifying expansion opportunities, particularly in the context of an aging population and increasing preference for aging in place.

Key market trends

Proceed to discuss recent market trends , such as the growing consumer interest in personalized home care services, the use of technology to improve service delivery, and the emphasis on holistic care that encompasses physical, emotional, and social well-being.

For example, highlight the demand for services tailored to specific health conditions or preferences, alongside the rising popularity of integrated care models that coordinate across different healthcare providers.

Key competitors

Then, consider the competitive landscape, which includes a range of providers from large national chains to local independent agencies, as well as emerging tech-based care solutions.

Emphasize what makes your agency distinctive, whether it’s through exceptional caregiver training, a comprehensive range of services, or specialization in certain types of care (e.g., dementia care, post-operative care).

Make sure to cover here _ Industry size & growth _ Key market trends _ Key competitors

Dive deeper into Key competitors

First, conduct a SWOT analysis for the home care business, highlighting Strengths (such as compassionate and well-trained caregivers, a comprehensive range of services), Weaknesses (including potential regulatory challenges or staffing issues), Opportunities (for example, an aging population and increasing preference for home-based care), and Threats (such as changes in healthcare policies that may affect funding or reimbursement).

Marketing Plan

Next, develop a marketing strategy that outlines how to attract and retain clients through targeted outreach, informative and empathetic communication, engaging online presence, and community partnerships. Emphasize the importance of building trust with clients and their families, showcasing testimonials, and highlighting the qualifications and dedication of your caregiving team.

Finally, create a detailed timeline that outlines critical milestones for the home care agency’s launch, client acquisition efforts, service expansion, and strategic objectives, ensuring the business advances with clear direction and purpose. Include key benchmarks for assessing the quality of care, client satisfaction, and operational efficiency to continually improve and grow your agency.

Make sure to cover here _ SWOT _ Marketing Plan _ Timeline

Dive deeper into SWOT

Dive deeper into Marketing Plan

The Management section focuses on the home care business’s management and their direct roles in daily operations and strategic direction. This part is crucial for understanding who is responsible for making key decisions and driving the home care business towards its financial and operational goals.

For your home care business plan, list the core team members, their specific responsibilities, and how their expertise supports the business.

Financial Plan

The Financial Plan section is a comprehensive analysis of your financial projections for revenue, expenses, and profitability. It lays out your home care business’s approach to securing funding, managing cash flow, and achieving breakeven.

This section typically includes detailed forecasts for the first 5 years of operation, highlighting expected revenue, operating costs and capital expenditures.

For your home care business plan, provide a snapshot of your financial statement (profit and loss, balance sheet, cash flow statement), as well as your key assumptions (e.g. number of customers and prices, expenses, etc.).

Make sure to cover here _ Profit and Loss _ Cash Flow Statement _ Balance Sheet _ Use of Funds

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Nursing Home Business Plan Template

Written by Dave Lavinsky

Nursing Home Business Plan

Over the past 20+ years, we have helped over 1,000 entrepreneurs and business owners create business plans to start and grow their nursing homes. On this page, we will first give you some background information with regards to the importance of business planning. We will then go through a nursing home business plan template step-by-step so you can create your plan today.

Download our Ultimate Business Plan Template here >

What Is a Business Plan?

A business plan provides a snapshot of your nursing homes as it stands today, and lays out your growth plan for the next five years. It explains your business goals and your strategy for reaching them. It also includes market research to support your plans.

Why You Need a Business Plan

If you’re looking to start a nursing homes, or grow your existing nursing homes, you need a business plan. A business plan will help you raise funding, if needed, and plan out the growth of your nursing facilities in order to improve your chances of success. Your nursing home business plan is a living document that should be updated annually as your company grows and changes.

Sources of Funding for Nursing Home Businesses

With regards to funding, the main sources of funding for a nursing homes are personal savings, credit cards, bank loans and angel investors. With regards to bank loans, banks will want to review your business plan and gain confidence that you will be able to repay your loan and interest. To acquire this confidence, the loan officer will not only want to confirm that your financials are reasonable, but they will also want to see a professional plan. Such a plan will give them the confidence that you can successfully and professionally operate a business. Personal savings and bank loans are the most common funding paths for nursing homes.

Finish Your Business Plan Today!

How to write a business plan for a nursing home.

If you want to start a nursing home or expand your current one, you need a business plan. Below we detail a sample of what should be included in each section of a business plan for a nursing home.

Executive Summary

Your executive summary provides an introduction to your business plan, but it is normally the last section you write because it provides a summary of each key section of your plan.

The goal of your Executive Summary is to quickly engage the reader. Explain to them the type of nursing homes you are operating and the status. For example, are you a startup, do you have nursing homes that you would like to grow, or are you operating nursing facilities in multiple markets?

Next, provide an overview of each of the subsequent sections of your plan. For example, give a brief overview of the senior care industry. Discuss the type of nursing homes you are operating. Detail your direct competitors. Give an overview of your target market. Provide a snapshot of your marketing plan. Identify the key members of your team. And offer an overview of your financial plan.  

Company Analysis

In your company analysis, you will detail the type of nursing homes you are operating.

For example, you might operate one of the following types of nursing homes:

• Skilled Nursing Care Facilities : this type of nursing home provides skilled nursing care, rehabilitation, activities, meals, supervision, etc.
• Assisted Living Facilities: this type of nursing home provides 24-hour supervision, including meals, assistance with daily activities, healthcare service, and common services that include assistance with eating, bathing, dressing, using the bathroom, taking medication, transportation, and housekeeping.
• Independent Living Facilities: this type of nursing home are communities that offer fully equipped homes or apartments to residents. They are ideal for seniors who can maintain their independence with few medical issues impeding them.
• Alzheimer’s & Specialty Care Facilities : this type of nursing home offers 24-hour support for residents suffering from Alzheimer’s or dementia.

In addition to explaining the type of nursing facility you will operate, the Company Analysis section needs to provide background on the business.

Include answers to question such as:

• When and why did you start the business?
• What milestones have you achieved to date? Milestones could include the number of patients in care, number of positive reviews, reaching X amount of patients served, etc.
• Your legal structure. Are you incorporated as an S-Corp? An LLC? A sole proprietorship? Explain your legal structure here.

Industry Analysis

In your industry analysis, you need to provide an overview of the nursing home industry.

While this may seem unnecessary, it serves multiple purposes.

First, researching the senior care industry educates you. It helps you understand the market in which you are operating.

Secondly, market research can improve your strategy, particularly if your research identifies market trends.

The third reason for market research is to prove to readers that you are an expert in your industry. By conducting the research and presenting it in your plan, you achieve just that.

The following questions should be answered in the industry analysis section:

• How big is the senior care industry (in dollars)?
• Is the market declining or increasing?
• Who are the key competitors in the market?
• Who are the key suppliers in the market?
• What trends are affecting the industry?
• What is the industry’s growth forecast over the next 5 – 10 years?
• What is the relevant market size? That is, how big is the potential market for your nursing homes? You can extrapolate such a figure by assessing the size of the market in the entire country and then applying that figure to your local population.

Customer Analysis

The customer analysis section must detail the customers you serve and/or expect to serve.

The following are examples of customer segments: elderly and aging adults, retirees, those suffering from Alzheimer’s or dementia, etc.

As you can imagine, the customer segment(s) you choose will have a great impact on the type of business you operate. Clearly, Alzheimer’s or dementia patients would respond to different marketing promotions than recent retirees, for example.

Try to break out your target customers in terms of their demographic and psychographic profiles. With regards to demographics, include a discussion of the ages, genders, locations and income levels of the customers you seek to serve.

Psychographic profiles explain the wants and needs of your target customers. The more you can understand and define these needs, the better you will do in attracting and retaining your customers.

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Competitive Analysis

Your competitive analysis should identify the indirect and direct competitors your business faces and then focus on the latter.

Direct competitors are other nursing homes.

Indirect competitors are other options that customers have to purchase from that aren’t direct competitors. This includes rehabilitation facilities, adult daycare programs, family of the aging adult, etc. You need to mention such competition as well.

With regards to direct competition, you want to describe the other nursing homes with which you compete. Most likely, your direct competitors will be nursing homes located very close to your location.

For each such competitor, provide an overview of their businesses and document their strengths and weaknesses. Unless you once worked at your competitors’ businesses, it will be impossible to know everything about them. But you should be able to find out key things about them such as:

• What types of elderly care do they provide?
• What type of nursing home are they?
• What is their pricing (premium, low, etc.)?
• What are they good at?
• What are their weaknesses?

With regards to the last two questions, think about your answers from the customers’ perspective. And don’t be afraid to ask your competitors’ customers what they like most and least about them.

The final part of your competitive analysis section is to document your areas of competitive advantage. For example:

• Will you provide exercise and activities for the elderly?
• Will you provide services that your competitors don’t offer?
• Will you provide better customer service?
• Will you offer better pricing?

Think about ways you will outperform your competition and document them in this section of your plan.  

Marketing Plan

Traditionally, a marketing plan includes the four P’s: Product, Price, Place, and Promotion. For a residential care home business plan, your marketing plan should include the following:

Product : In the product section, you should reiterate the type of nursing home company that you documented in your Company Analysis. Then, detail the specific products you will be offering. For example, in addition to a nursing home, will you provide nutritional advice and meal preparation, daily activities, rehabilitation, and any other services?

Price : Document the prices you will offer and how they compare to your competitors. Essentially in the product and price sub-sections of your marketing plan, you are presenting the services you offer and their prices.

Place : Place refers to the location of your nursing home company. Document your location and mention how the location will impact your success. For example, is your nursing homes located in a busy retail district, a residential neighborhood, near a hospital, etc. Discuss how your location might be the ideal location for your customers.

Promotions : The final part of your nursing home marketing plan is the promotions section. Here you will document how you will drive customers to your location(s). The following are some promotional methods you might consider:

• Advertising in local papers and magazines
• Reaching out to websites
• Partnering with hospitals and rehab facilities
• Social media marketing
• Local radio advertising

Operations Plan

While the earlier sections explained your goals, your operations plan describes how you will meet them. Your operations plan should have two distinct sections as follows.

Everyday short-term processes include all of the tasks involved in running your nursing homes, including coordinating nurses’ patient schedules, coordinating with doctors, communicating with family and loved ones of the elderly, managing staff duties, etc.

Long-term goals are the milestones you hope to achieve. These could include the dates when you expect to acquire your Xth patient, or when you hope to reach $X in revenue. It could also be when you expect to expand your nursing homes to a new city.  

Management Team

To demonstrate your nursing homes’ ability to succeed, a strong management team is essential. Highlight your key players’ backgrounds, emphasizing those skills and experiences that prove their ability to grow a company.

Ideally you and/or your team members have direct experience in managing nursing homes. If so, highlight this experience and expertise. But also highlight any experience that you think will help your business succeed.

If your team is lacking, consider assembling an advisory board. An advisory board would include 2 to 8 individuals who would act like mentors to your business. They would help answer questions and provide strategic guidance. If needed, look for advisory board members with experience in managing a nursing home or successfully running a hospital or rehabilitation facility .  

Financial Plan

Your financial plan should include your 5-year financial statement broken out both monthly or quarterly for the first year and then annually. Your financial statements include your income statement, balance sheet and cash flow statements.  

Income Statement

: an income statement is more commonly called a Profit and Loss statement or P&L. It shows your revenues and then subtracts your costs to show whether you turned a profit or not.

In developing your income statement, you need to devise assumptions. For example, will you take on one new patient at a time or multiple new patients ? And will sales grow by 2% or 10% per year? As you can imagine, your choice of assumptions will greatly impact the financial forecasts for your business. As much as possible, conduct research to try to root your assumptions in reality.  

Balance Sheets

: Balance sheets show your assets and liabilities. While balance sheets can include much information, try to simplify them to the key items you need to know about. For instance, if you spend $50,000 on building out your nursing homes, this will not give you immediate profits. Rather it is an asset that will hopefully help you generate profits for years to come. Likewise, if a bank writes you a check for $50,000, you don’t need to pay it back immediately. Rather, that is a liability you will pay back over time.  

Cash Flow Statement

: Your cash flow statement will help determine how much money you need to start or grow your business, and make sure you never run out of money. What most entrepreneurs and business owners don’t realize is that you can turn a profit but run out of money and go bankrupt.

In developing your Income Statement and Balance Sheets be sure to include several of the key costs needed in starting or growing a nursing homes:

• Cost of licensing and training
• Cost of equipment and supplies
• Payroll or salaries paid to staff
• Business insurance
• Taxes and permits
• Legal expenses

Attach your full financial projections in the appendix of your plan along with any supporting documents that make your plan more compelling. For example, you might include your nursing home location lease or list of nursing, assisted living, and rehab services you are working on.  

Putting together a business plan for your nursing home is a worthwhile endeavor. If you follow the sample template above, by the time you are done, you will truly be an expert. You will really understand the senior care industry, your competition, and your customers. You will have developed a marketing plan and will really understand what it takes to launch and grow a successful nursing homes.  

Nursing Home Business Plan FAQs

What is the easiest way to complete my nursing home business plan.

Growthink's Ultimate Business Plan Template allows you to quickly and easily complete your Nursing Home Business Plan.

What is the Goal of a Business Plan's Executive Summary?

The goal of your Executive Summary is to quickly engage the reader. Explain to them the type of nursing home you are operating and the status; for example, are you a startup, do you have a nursing home that you would like to grow, or are you operating a chain of nursing homes?

Don’t you wish there was a faster, easier way to finish your Nursing Home business plan?

OR, Let Us Develop Your Plan For You

Since 1999, Growthink has developed business plans for thousands of companies who have gone on to achieve tremendous success.   Click here to see how Growthink’s professional business plan consulting services can create your business plan for you.

Other Helpful Business Plan Articles & Templates

Assisted living managers say an algorithm prevented hiring enough staff

The nation’s largest assisted-living chain uses a staffing algorithm; some managers say they quit or were fired after they complained it left facilities dangerously short-handed.

Two decades ago, a group of senior-housing executives came up with a way to raise revenue and reduce costs at assisted-living homes. Using stopwatches, they timed caregivers performing various tasks, from making beds to changing soiled briefs, and fed the information into a program they began using to determine staffing.

Brookdale Senior Living, the leading operator of senior homes with 652 facilities, acquired the algorithm-based system and used it to set staffing at its properties across the nation. But as Brookdale’s empire grew, employees complained the system, known as “Service Alignment,” failed to capture the nuances of caring for vulnerable seniors, documents and interviews show.

At a Brookdale facility in Chicago, tiny elevators prevented residents from being herded en masse to dinner, necessitating more trips and more time than Service Alignment allotted. At a facility in New Port Richey, Fla., the algorithm recommended fewer caregivers than buildings, making it impossible to monitor all residents at all times. And at a facility near Fort Worth, residents often could not undress, shower and get dressed again within the allotted 20 minutes — constantly putting caregivers behind in their tasks.

In emails and phone calls to Brookdale executives, building managers repeatedly complained that the company’s algorithm underestimated the amount of labor they needed to meet resident needs, according to court records, internal company documents reviewed by The Washington Post, and interviews with more than 35 current and former Brookdale employees. Several managers said they quit or were fired after objecting to the system, including Patricia McNeal, 53, who spent six years overseeing Brookdale facilities in Ohio and Florida.

“Brookdale is handing you this thing that says, ‘This is what it says you need, hire for that,’” McNeal said. “My eyes told me that we weren’t getting enough” staff to care for residents.

While assisted-living chains promote their properties like all-inclusive resorts with round-the-clock care, many operate more like assembly lines, where low-wage workers perform a series of discrete, predictable tasks, documents and interviews with industry veterans show. Brookdale, based in Brentwood, Tenn., pioneered staffing systems based on algorithmic formulas, an approach experts say is ill-suited to caring for the elderly, who are growing more frail and are more likely to suffer from chronic conditions than previous generations.

In two civil lawsuits against Brookdale — one in Tennessee, one in California — a dozen residents or relatives of residents claim they suffered due to short-staffing caused by an overreliance on algorithms. Sunrise Senior Living, a rival which in 2016 directed all of its facilities to follow its own staffing formula, is also defending a lawsuit by a group of customers who allege similar concerns. A spokeswoman for Sunrise declined to comment, citing pending litigation.

In a statement to The Post, Brookdale spokeswoman Jackie Dickson disputed the allegations in the lawsuits and said that Brookdale empowers local facility managers to set staffing levels as they see fit. Last year, a federal judge denied class-action certification for some of the claims in the California lawsuit, in part because plaintiffs failed to show that facilities are “similarly staffed.”

“Service Alignment is a resource offered to community leaders to assist them with appropriately staffing communities,” Dickson said. “This tool accounts for community-specific layouts and features, the ever-changing needs of residents, as well as applicable regulatory requirements, and is customized based on feedback from local community leaders.”

However, when the company began rolling the algorithm out to all its facilities, in 2013, then-CEO Andrew Smith told financial analysts one of the main goals was “to make sure that we don’t over-staff."

In the fall of 2020, McNeal said she begged her superiors to send help as she scrambled to care for the rapidly declining health of residents in a Jacksonville facility she managed during the covid pandemic. When help didn’t arrive, McNeal scheduled additional workers as “training” staff without company approval — an action for which Brookdale fired her, documents show, saying she didn’t “demonstrate good stewardship to the company’s resources.”

A few weeks after her termination, Louise Walker, 89, died after falling in her room at the Jacksonville facility. State investigators cited Brookdale for medical neglect, saying workers failed to adequately supervise Walker, a high fall risk who was diagnosed with dementia. At the time, two employees were tending to more than a dozen residents in the dementia care unit, and neither had training on traumatic brain injuries, court records show.

“I don’t blame a lot of the people who work there,” said Jane Millan, 72, Walker’s daughter, whose wrongful-death lawsuit against Brookdale is set for trial in May. “They don’t have enough staff to do the duties they have to do, so something has got to slide.”

Dickson, the Brookdale spokesperson, said McNeal’s account is “inaccurate” but declined to comment on confidential employment matters. She said the company denies any wrongdoing in Walker’s death and declined further comment, citing the litigation.

There are no federal laws regulating assisted-living facilities, and only 13 states require staffing minimums. Brookdale says its algorithm sets staffing levels above statutory minimums in states that require them — a claim disputed by plaintiffs in the Tennessee lawsuit, which has requested class-action certification.

Using time sheet data provided by Brookdale covering seven facilities in North Carolina, an expert for the plaintiffs found that all failed to meet the state’s clinical care staffing minimums during at least 10 percent of shifts from 2016 to 2022. Four facilities fell short of state minimums during at least one out of every three shifts.

An expert hired by Brookdale said in a court filing that the North Carolina analysis failed to account for employees who clock in under one department, such as a cook, but then contributed to caregiving tasks when they had extra time.

In the California lawsuit, relatives of Brookdale residents claimed understaffing contributed to their loved ones being found covered in feces, breaking bones or wandering away unattended. One woman was hospitalized for extreme dehydration because staff had left food and water outside her door for three days straight without checking to see if she consumed any of it, according to her son, who provided a sworn statement in the lawsuit.

The case is scheduled for trial in October.

On Christmas Day 2020, a man was found lying facedown in the courtyard of a Brookdale facility in Destin, Fla. — frozen to death after being left unattended for more than 12 hours, a police investigation found. A caregiver working there that day told police the facility was unsafe because “the staff to resident ratio is horrible” and “they need to have more people working in the facility to keep up” with residents. She said she raised her concerns with Brookdale executives and “nothing was done,” according to the police report. It’s unclear whether this incident led to a lawsuit or whether the company’s algorithm played any role.

Dickson declined to comment on individual residents or facilities but said Brookdale is regularly cited by industry surveys as having high customer satisfaction.

“Brookdale needs to get

rid of Service Alignment

and get more staff in here

on each shift... It’s not

safe and it’s not right.

Something bad is going

to happen and I just

don’twant to be here

when that happens.”

June 2021 email from Virginia Steinman,

former health andwellness director at

Brookdale Morehead City, North Carolina

“Brookdale needs to get rid of Service

Alignment and get more staff in here on

each shift… It's not safe and it's not right.

Something bad is going to happen and I just don't want to be here when that happens.”

June 2021 email from Virginia Steinman, former health and

wellness director at Brookdale Morehead City, North Carolina

The problems of understaffing and questionable levels of care pervade the assisted-living industry. Since 2018, more than 100 residents died after wandering away from such facilities or being left unattended outside, a Post investigation found .

Brookdale, Sunrise and Atria Senior Living, another top chain, were questioned as part of a congressional committee inquiry into concerns about the costs and quality of care at senior living facilities raised by The Post’s reporting. A spokesman for Sen. Bob Casey (D-Pa.), chairman of the Senate’s Special Committee on Aging, said the companies provided some responses to the lawmakers’ questions but the committee has declined to make them public. A spokesperson for Atria said the company prioritizes the safety and well-being of residents.

Brookdale became the industry giant through a wave of mergers between 2005 and 2014. Among them was Alterra Healthcare, which had invented the system for determining staff levels based on stopwatch studies. Brookdale believed the program could help it rein in ballooning expenses and manage its growing empire from afar, according to interviews with former executives and transcripts of the company’s quarterly earnings calls with analysts.

It began rolling out Service Alignment to all its properties between 2013 and 2016 — during which its portfolio ballooned to nearly 1,200 senior homes — executives said on earnings calls. Under the new system, Brookdale would assess the health of every resident and determine exactly which tasks were needed to meet their needs. Using these assessments and the stopwatch time studies, the algorithm promised to tell building managers exactly how many minutes were needed to care for all residents each shift — and, therefore, the number of employees they were permitted to schedule.

Businesses have been timing tasks to improve worker efficiency for over a century. Frederick Taylor, one of the fathers of management consulting, devised the first time study in the late 1800s, when he noticed workers at a steel mill were intentionally doing as little work as they could, said Naren Agrawal, a professor of supply chain management and analytics at Santa Clara University. By understanding the times it took to perform individual tasks, businesses could catch workers who were slacking off and get a clearer picture of the total labor needed to build a product or perform a service, Agrawal said.

Such rigid systems can fail for tasks with wide variability, said Carri Chan, a Columbia Business School professor who researches health-care management and operations. “When you are taking care of patients, all of whom have unique needs, there is going to be a lot of variation,” she said.

In interviews, McNeal and nine other former executive directors of Brookdale facilities said Service Alignment failed to capture the complexities of working with seniors with cognitive decline. For instance, helping dementia patients take showers may take two or three times as long as other residents, because they often refuse to get undressed in front of caregivers they may not remember and need to be patiently guided through the process.

Each time a caregiver runs over time in one task, it takes away from the total caregiving hours for the entire building. As a result, some residents go without showers, rooms are left uncleaned and people needing close supervision are ignored, some of the former managers said.

When Service Alignment was rolled out, the algorithm forced many Brookdale facilities to reduce their staff, documents and interviews show. At other facilities, where the algorithm suggested more staff was needed, Brookdale intervened.

“We are talking about

missing showers and

time gaps on putting

residents in their beds

... I am wide awake at

night thinking about

anything else that may

get overlooked...

I cannot stress to

you how bad it is...

I am asking for help?

August 2021 email from Brenda Jarmer,

district director of operations in Florida.

In a message to The Post, Jarmer said

she wrote that email amid staffing

challenges brought on by the COVID

pandemic and that she believes Brookdale,

where she still works, is a "great company."

“We are talking about missing showers

and time gaps on putting residents in

their beds… I am wide awake at night

thinking about anything else that may

get overlooked… I cannot stress to you

how bad it is… I am asking for help.”

August 2021 email from Brenda Jarmer, district director of operations in Florida.

In a message to The Post, Jarmer said she wrote that email amid staffing challenges

brought on by the COVID pandemic and that she believes Brookdale,

Kelly Rubin, a senior director overseeing the staffing system, sent an email to regional managers warning of the likelihood the algorithm would show “favorable variances” in needed labor for some facilities — meaning, they needed more staff. Rubin said no facility would be granted more than two additional full-time employees, regardless of what the algorithm said.

“Just by virtue of flipping a switch from one platform to another does not justify additional labor because the platforms calculate differently,” Rubin wrote in the email, which, like other internal communications quoted in this story, was made public as part of a court record.

Rubin, who still works at Brookdale, said in a message to The Post that Brookdale tended to staff facilities at a “higher level” than the roughly 500 newly acquired properties that it was moving onto Service Alignment so she expected staff increases. Her message was intended to help local managers “evaluate the new platform’s guidance and make any adjustments they felt appropriate based on actual resident needs.”

Staff complaints started pouring in.

In 2016, Sarah Jenkins, a night-shift medication technician at a Brookdale in Jensen Beach, Fla., complained to the company’s internal tip line that short staffing was causing caregivers to cut corners, according to notes from the call included in a court record. Jenkins said her co-workers were applying wet-wipes to residents in lieu of giving them showers and set the thermostat to 64 degrees “because it keeps the residents in bed.” Jenkins, who no longer works for Brookdale, did not respond to a request for comment.

The following year, Jackie Smedley, a divisional director of sales and marketing, emailed a regional manager that “extreme action” was needed to improve resident safety at a facility in Clearwater, Fla., that was “very short on care staff” and had “no clinical oversight.” A resident had arrived at an emergency room with impacted fecal matter stuck to his skin. “The ER reported to Brookdale that this was the worst case of resident abuse they ever witnessed,” she wrote in an email that was included in court papers. Smedley, who no longer works for Brookdale, declined to comment.

Brookdale managers who scheduled more employees than the algorithm advised were required to propose a plan of correction, former employees said. Repeat offenders risked losing portions of their annual bonus. Brookdale’s Dickson called the employees’ description of these practices “inaccurate” but declined to elaborate.

Some managers told their bosses that Service Alignment assumptions must be wrong and asked for exceptions — which they sometimes got.

One example was the facility in Chicago with the small elevators. After sending someone to the building to study transport times, Brookdale agreed to reinstate the staffing level before Service Alignment, according to one of the building’s former managers, who declined to be named because they still work in the industry.

“I am concerned about

the safety and welfare

of our current residents.

If we can't meet the needs

of current residents,

how can we meet the

needs of new residents?”

July 2017 email from Jackie Smedley,

formersoutheast divisional director

of sales and marketing

“I am concerned about the safety and

welfare of our current residents. If we can't

meet the needs of current residents, how can

we meet the needs of new residents?”

July 2017 email from Jackie Smedley, former

southeast divisional director of sales and marketing

Other managers said their warnings were not heeded. Greg Brown quit three months after taking a job heading a Brookdale facility in Denver in 2019 because, he said, the algorithm didn’t recognize there were four different buildings and that leaving some of the buildings unattended would be dangerous.

“I quickly realized and explained in my resignation that I didn’t feel they were staffing the community in a correct and safe manner and that I wouldn’t be able to continue,” Brown, who has worked at various senior living homes for over 15 years, said in a direct message on LinkedIn. Brookdale no longer owns the property.

Brookdale’s solution to the wide variation in resident conditions was to charge more when they needed more time for any task than Service Alignment allotted. For example, if a resident routinely took long showers, caregivers were supposed to report that to their managers, who would reassess the resident’s needs, potentially increasing fees.

However, many employees found it difficult to constantly raise prices on the residents with whom they worked every day and who already were paying steep fees, said Saralyn Kerrigan, who ran a Brookdale building in Connecticut from 2011 to 2014.

“Rather than it being like advocating for seniors, making sure they had what they need, it became, what more could we get out of them?” Kerrigan said. “We were really encouraged to be upselling.”

Brookdale charged an extra $156 a month for residents who needed help laying out their clothes and toiletries in the morning, and an extra $703 a month if a resident routinely wandered the hallways and required periodic redirection, according to a pricing sheet for one Texas facility the company provided in a court filing this year.

At one facility earlier this year, Brookdale charged each customer with special cognitive or psychological needs an extra $468 to $703 a month for what averaged to about 14 minutes of additional care per day, according to a daily Service Alignment plan reviewed by The Post. The Post analysis was based on the total number of minutes Brookdale’s algorithm allocated for dementia-related assistance, divided by the number of people in the facility billed for those services.

As managers struggled under the new staffing system, the company’s finances got worse. More than three-quarters of Americans 50 and older want to remain in their homes for the long term, according to a 2021 survey by AARP — a number that has remained constant for more than a decade despite the industry’s marketing efforts and the aging of the nation’s demographics. Until recently, that trend left Brookdale and other industry leaders with too many buildings and not enough residents.

Brookdale lost money in each of the past 19 years except 2020, and its stock price, which peaked at $53 a share in 2006, has petered to just $7.

When McNeal started at Brookdale Southpoint in January 2020, the Jacksonville facility already had difficulty caring for its residents.

The one-story building, sandwiched between a busy intersection and a small pond in a commercial neighborhood south of the city, had been cited by regulators in 2018 for failing to properly supervise a misbehaving male resident who forced his way into the beds of female residents, state documents show. An employee interviewed by state inspectors at the time said “she felt there is nothing they can do to stop him because he is ‘out of his mind’ and he does not understand,” the inspector wrote in the report.

Adding to McNeal’s challenges, covid lockdowns forced residents to spend most of their days alone in their rooms, causing some to rapidly decline. One man became so disoriented he was peeling linoleum off the floor of his room and eating it, McNeal said.

Brookdale Southpoint typically had two to three caregivers assisting more than a dozen residents of the locked memory care unit and another one to two serving more than a dozen additional assisted-living residents, according to former employees and facility records. Because the building had very few dedicated housekeepers and dining staff, caregivers also had to do laundry, clean rooms and help serve meals in between making their rounds delivering medicine and assisting residents with grooming, bathing and going to the bathroom.

Brookdale has defended its practice of “universal caregivers” combining these roles as innovative and efficient. “You’re trying to find useful things that the associates can do overnight, in addition to ensuring that the residents are safe and cared for,” Smith, the former Brookdale CEO, said on a call with financial analysts in 2013. But as residents and their families have discovered, the wide-ranging responsibilities of these workers can take away from their ability to complete their caregiving duties.

A few months after starting at Brookdale Southpoint, McNeal said she discovered that a memory care resident wandered outside at about 11:30 p.m. while her caregiver was doing laundry. The resident remained alone in a wooded area until she was found at close to 7 a.m. the next day.

McNeal said she repeatedly pushed for additional help in conversations with her managers. Several times, Brookdale sent people to help McNeal conduct new health assessments of her residents, but each time, she said, it did not result in her facility getting more hours for additional employees.

Walker, the resident who died at Brookdale Southpoint, moved into the facility in June 2020 and paid $4,650 per month. In April 2021, Walker’s great-granddaughter, Brandi Faison, came by to give her Nannie a pedicure and was startled by the sight of her feet — hardened, yellow and cracking, with thick, curling toenails three to four times their normal length. She was so horrified that she took a photo and shared it with her family, and later shared it with The Post.

Walker, embarrassed by her appearance, told her great-granddaughter that “nobody ever came” to do her nails, Faison recalled.

Shortly after McNeal was fired, a Brookdale caregiver discovered Walker bleeding on the floor of her room. A police investigation found she had been left alone for two hours and 40 minutes, despite a facility policy of checking residents at least every two hours. Walker required extra attention due to “difficulty standing, ambulating, and safely functioning” on her own, according to a nurse practitioner’s note.

Though the hospital was a two-minute drive across the street, Walker was not received by the emergency room until nearly two hours after she was discovered, documents show. She died of a brain hemorrhage four days later. In their report, state investigators cited Brookdale’s failure to properly supervise Walker and the facility’s slow response time as evidence of neglect.

The night of Walker’s fall, the medication technician on duty had been allowed to go home early, leaving Marie Berleus — a Haitian immigrant who spoke limited English working her fourth 12-hour graveyard shift of the week — to puzzle through the medical crisis. Berleus exchanged text messages with her boss and searched for paperwork before finally calling a non-emergency ambulance service, rather than 911, 40 minutes after finding Walker, according to court records from a lawsuit Walker’s family filed against Brookdale. Berleus did not respond to a request for comment.

In court records, Brookdale’s lawyers denied that any of the facility’s actions caused Walker’s death, pointing out that a medical expert hired by the family could not say that a quicker response would have necessarily saved her life.

“I’m so tired,” Berleus wrote in one of her text messages to her boss that night.

The Washington Post is continuing to report on the assisted-living industry, and we want to know your experiences with elder care, assisted living and dementia care. Tell us about your experience here .

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As Gen X-ers Inch Toward Retirement, They’re Considering Where to Live

The oldest members of Generation X are several years from stopping work, but some are already seeking homes that will suit their later years.

By Gregory Schmidt

When they were raising their four children, Billy and Erin Shipley had space for their family to grow: a two-story, five-bedroom house in Sugar Land, Texas, with a large yard and a pool. But as the children became adults and moved out, the second floor was deserted and maintaining the lawn and pool became a burden.

Like many members of Generation X facing an empty nest, the Shipleys decided to look for a home better suited to their needs where they could eventually live in retirement. They chose a three-bedroom, single-story house in Bridgeland, a planned community about 35 miles away. “I did not look at it as a temporary exercise,” Mrs. Shipley, 46, said. “We could live here forever.”

Mr. Shipley, 54, added that the single story was a draw. “It’s going to be great not having to walk up stairs later,” he said.

Gen X is typically defined as those born between 1965 and 1980. Its oldest members are several years away from retirement, but they are already starting to think about where they will live in their 70s, 80s and even 90s.

The desire to grow older in one’s own home — rather than having to move in with family or to a retirement home — is common among many generations. In 2021, 88 percent of older adults, defined as people at least 65 years old, lived in their own home, according to a report from the Harvard Joint Center for Housing Studies.

“Overall demand is for maintaining quality of life as you age,” said Joanna Frank, chief executive and president of the Center for Active Design, a nonprofit organization that developed the Fitwel standard used by architects, designers and developers to foster wellness at home and in the workplace.

But home builders say they are starting to see rising demand among Gen X-ers for homes they can age into.

“We are at the cusp,” said David O’Reilly, the chief executive of Howard Hughes Holdings, which builds planned communities, including Bridgeland in Texas. Many Gen X-ers still have children at home, he said, but they will soon be empty nesters. “That’s normally the tipping point,” he added.

Those who can afford it are willing to pay for extra space in case they need to take care of other family members, like grandchildren, adult children and aging parents — and in many cases, they already are. In new developments, they are seeking access to health and wellness amenities, like hiking trails and tennis courts, as well as opting for home features like showers instead of bathtubs, for instance, and asking for the latest gadgets to help them as they age.

“They have more market power than younger buyers,” said Jennifer Molinsky, director of the Housing an Aging Society Program at the Harvard Joint Center for Housing Studies. “They have a lot of wealth and are ready to make changes.”

Gen X home buyers have a median income of $126,900, according to a report released Wednesday by the National Association of Realtors , or NAR, a trade group, and they are still amassing wealth. “They are in their peak earning years,” said Jessica Lautz, the group’s deputy chief economist and vice president of research.

They are also sitting on a pile of home equity. Homeownership among Gen X-ers was 72 percent in 2023, which was significantly higher than for millennials, at 55 percent, according to a report from Redfin , a real estate services company.

Another factor prompting Gen X to consider moving sooner to purchase a home for their retirement years is the crunch in the housing market , which was stuck in a deep freeze for most of 2023 as high interest rates kept many buyers and sellers on the sidelines. Home prices rose 6 percent in January from the same month a year ago, according to the Case-Shiller home price index , and many potential buyers worry that prices will continue to soar, hampering their ability to afford a home later.

“If they are shopping for homes, given the tightness of the market and remote work, I do believe you see more Gen X-ers seeing a home purchase as a home for the rest of their lives,” said Cristian deRitis, deputy chief economist at Moody’s Analytics.

They are not necessarily trading down in terms of space or quality, he added. In fact, some may be looking to trade up, especially if they are buying what will be their last home. “‘This is my 30-year home, not my five-year home,’” he said.

Many members of Gen X find themselves in the sandwich generation, or simultaneously supporting children (some of whom are adults themselves) and parents. To manage caregiving, some home buyers are choosing three- and four-bedroom homes to accommodate their multigenerational households.

“It’s a stubborn trend; it’s not a flash in the pan,” said Dr. Lautz, the economist at NAR, which found that 19 percent of Gen X-ers who bought a home in 2023 purchased a multigenerational home. “Gen X-ers seem to be caring for parents and having younger adults boomeranging back into their homes.”

Now that their children are grown and have moved out, the Shipleys in Texas have to care only for their labradoodle, Clyde, but having three bedrooms means they can accommodate family if necessary. “We want our kids to come back and have a place to sleep when they visit,” said Mr. Shipley, who added that he and his wife have room for their parents, who are in their 70s and may have to live with them someday.

GL Homes, a developer in Sunrise, Fla., with a dozen planned communities in the state, has noticed a shift in demand, the company’s president, Misha Ezratti, said.

“People are moving to their forever home a little earlier,” he said. “You would think they would downsize, but after the pandemic, they still need the space.”

GL Homes has responded by designing floor plans that cater to Gen X-ers, including Melissa Radin, a career coach in Livingston, N.J., who owns several rental properties in Florida. When she found out recently that her real estate investments had doubled in value, she and her husband, Michael, decided to buy their retirement home now.

“I wasn’t going to buy a house this early, but I know I would have to pay more, so I jumped,” said Ms. Radin, 57. She scooped up a three-bedroom house in a community developed by GL Homes in Port St. Lucie, Fla.

Thinking ahead to a time when their bodies might not work as well, Gen X-ers are asking for features like raised electrical outlets and toilets with higher seats.

“I requested custom pullouts because I don’t want to bend to open a cabinet,” Ms. Radin said. She wanted a shower in the primary bathroom, but made a concession for younger family members. “I’m going to have grandchildren, and I need a bathtub in the house,” she said.

Part of the customization also includes incorporating technology to help people as they age, like sensors in floorboards that can tell if someone has fallen and even send alerts for help, said Ms. Frank of the Center for Active Design. “Developers are aware that this generation is health conscious and much more tech savvy,” she said.

Frank C. Parker III, a certified financial planner for Wells Fargo Advisors in Cincinnati, said he and his wife, Mika, sought a state-of-the-art setup for their retirement home in Boca Raton, Fla., to help them regulate lights, music and a security alarm.

“We wanted a smart home that we could control from phones and apps and the wall,” Mr. Parker, 49, said.

He added that the Florida lifestyle was also a draw. “We are tennis players,” he said. “We like the beach, the ocean and the pool.”

Others say they want to stay healthy as they approach retirement. Mr. Shipley said he and his wife liked to stay fit, and Bridgeland had amenities like pools, biking trails and fitness classes within walking distance.

GL Homes is adding more amenities for active adults, including a cold plunge tub and pickleball courts.

“We did not expect fitness to be such a big thing,” Mr. Ezratti said.

An earlier version of this article referred incorrectly to the median income earned by members of Generation X. People within this age group who are home buyers have a median income of $126,900; that is not the median income of the entire age group.

How we handle corrections

Gregory Schmidt covers breaking news and real estate and is the editor of the Square Feet column. More about Gregory Schmidt

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It's time to stop downsizing health care, the Pentagon says. This couple can't wait

Quil Lawrence

Matt and Helen Perry at their home in Yulee, Fla. Michelle Bruzzese for NPR hide caption

Matt and Helen Perry at their home in Yulee, Fla.

When Matt and Helen Perry first met in 2010, he had been a U.S. Marine long enough to form two strong opinions. He didn't like the U.S. Army, and he didn't like officers — which he told her on their first date.

"And I was, you know, an Army medical officer," Helen recalls.

They got married anyhow, and Matt went on the last of his four combat deployments while Helen worked at Walter Reed National Military Medical Center outside Washington, D.C. Her worst fear — that she'd see Matt come in on a medevac — never came to pass. She did start to worry though, about the military medical system that was treating troops and their families. In 2013 the Perrys were stationed at Fort Stewart, Ga.

U.S. Marine Sgt. Matt Perry on deployment in Djibouti, 2012 Matt and Helen Perry hide caption

"They were looking at closing Winn Army Medical Community Medical Hospital," says Perry.

Winn Hospital cares for tens of thousands of troops and more than twice that many family members and military retirees living near Fort Stewart. But the Pentagon was abuzz with plans to cut military medical costs, especially on families and retirees, by outsourcing them to local private health care — much to the chagrin of local providers, Helen Perry recalls.

"I vividly remember them putting out an article in the newspaper that was like ... 'We cannot absorb your obstetrical care. We can't absorb your inpatient care. We do not have the resources to absorb the amount of care that you would then be pushing out into the community,'" says Perry.

Obstetrics may not spring to mind when people think about military medicine, but troops get to have families. With the Pentagon pushing them off base to find care, the military hospitals lost the patient base they needed to justify keeping specialty clinicians. It didn't make sense to Perry.

"I was saying, well, why don't we just get the services? Why don't we get cardiology? We had it at one time, why did we lose it? Oh, well, we weren't seeing enough patients," she says.

The business end of cost-cutting

To Perry it looked like a death spiral — downsizing to the point where the military hospital is no longer viable . She even suspected some of the hospitals were attempting to avoid closure by keeping hold of patients they couldn't actually treat, to keep up numbers and justify staying open. When Perry asked questions, as a critical care nurse and junior officer, no one wanted to hear it.

"It's like, 'Lt. Perry, that's beyond you. Do your job. Stay quiet,'" she says.

She wasn't wrong though. She was just on the business end of a decades-long realignment, where the four branches of the military combined their medical services under one health agency and tried to cut costs. This year the Department of Defense has finally admitted that it's not going as planned.

"All these challenges and changes have created and affected our ability to generate and sustain a medically ready force and a ready medical force," says Dr. David Smith, deputy assistant secretary of Defense for health.

Army Capt. and critical care nurse Helen Perry at the Combat Support Hospital in Fort Eisenhower, Ga., in 2018. Matt and Helen Perry hide caption

Army Capt. and critical care nurse Helen Perry at the Combat Support Hospital in Fort Eisenhower, Ga., in 2018.

Smith is talking about two of the three missions of military health. A "medically ready force" means keeping the country's army in good health. A "ready medical force" means training up enough doctors and nurses to keep that army healthy and treat the wounds of war. There's a third part though: taking care of all the military family members who get dragged across the country every time a service member gets ordered to a new base.

The Pentagon has been trying to outsource the less war-related parts, says John Whitley, former acting secretary of the Army.

"We don't want to go back to the days of ... not having the trauma surgeons, the emergency medicine physicians, the critical care physicians we need, and instead having a force of pediatricians and obstetricians and family practice docs," he told NPR.

Of course, troops might not agree that keeping their families healthy is a lower priority.

"As if it doesn't matter to the war fighter whether or not their family members can access quality care," says Karen Ruedisueli with the Military Officers Association of America.

National Security

The self-proclaimed 'bipolar general' is waging war on the stigma of mental illness.

"If they're hearing from the family back home that they're struggling to get medical care, they can't focus on the mission," she says.

"And then my husband started having seizures"

Americans join the military for patriotic, but also practical, reasons and the quality of health care affects recruiting. In recent years, surveys show that health care is a growing concern for active duty families and also retirees as Helen and Matt Perry soon discovered.

"I stayed for two years at Fort Stewart, and I was seeing the results of families not having good access to care. And then my husband started having seizures," she says.

Matt's seizures hit in July of 2014, six years after a series of blast injuries in Afghanistan had left him with a traumatic brain injury.

"We knew he had a TBI. He got blown up three times in Afghanistan in 2008, like big booms. And we knew things were a little bit harder to learn for him after that. He was a little bit more forgetful. I mean, he had all of the classic sort of early TBI stuff that we see from, from most of our guys who've been blown up, but we just didn't know how bad it was," she says.

His first seizure lasted several minutes and he stopped breathing. A few hours later, he seized again and Helen took him to the nearest emergency room.

"He woke up in the ICU. He didn't know me, didn't know his name, didn't know anything," she says.

"We were not at a military facility. So they kept asking me like, did he ever have infantile seizures as a child? I would say, he got blown up really bad. And they would say, you know, all those explosions you see on television, that's not really how it happens," she says.

Matt's debilitating injuries sent the Perrys on a painful odyssey of seeking care within the military, trying to get Helen's Army superiors to assign her near the Marine base where Matt could get treated, and finally getting Matt the right medical discharge and the benefits he'd earned. Helen eventually left active duty and became his full-time caregiver.

"That's where we started to kind of find out all of the challenges with Tricare," she says.

Tricare is the military health care program for troops, families and retirees - which used to mean just going to almost any doctor and Tricare paid for it. In recent years the cost to military families has shot up , and millions of troops rely on Medicaid in addition to Tricare. And as the Perrys discovered, it's gotten harder to find doctors who accept it. They moved to Daytona Beach for a nursing job Helen landed, but it didn't work for Matt's care, or Helen's, or their newly arrived baby boy in 2021.

"We could not find anyone to accept Tricare, period. I work in health care so I knew all the people, so I was calling around trying to find a primary care provider," says Helen.

But the answer was consistent.

" 'Sorry, we don't take Tricare.' 'Sorry, we're not open to new patients.' We couldn't find a pediatrician for our son. Same thing — 'Sorry, we don't take Tricare,' " she says.

Not only is there a nationwide shortage of health care professionals after that pandemic, but, like Medicaid, Tricare reimburses at a lower rate than private health insurance. Helen says doctors told her they just couldn't afford to take Tricare patients. And she was hearing the same thing from other military caregivers nationwide.

"I got onto our little online forum, and I said, is anybody else having problems finding providers accepting Tricare?"

The replies came in a tidal wave.

"Can't find anybody to take us, we're commuting two hours, we're commuting five hours," she says.

The Perrys moved to the Jacksonville area in large part because that's where they found providers. In the meantime though, Helen was making lists of military communities where people can't find care, including many bases located in federally designated health care shortage areas.

NPR contacted a dozen families with similar complaints. Notably, the majority declined to be interviewed on the record, out of concern they'd get in trouble with their command. They told the same stories: They can't get care on base, and they can't find Tricare appointments in town. A Pentagon Inspector General Report echoed their complaints.

"Well, you can't get care at the military, so now you're gonna get care through Tricare. When they both fail, which is what they're currently doing, where are service members expected to go?" says Helen Perry.

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Pentagon about-face on private care.

David Smith, the deputy assistant secretary of Defense, says the Pentagon has realized the private sector doesn't have any extra capacity to lean on, and after a decade of pushing private care, the Pentagon will now do the opposite.

"We're having difficulties with access across the system. And so what we've concluded is bringing more into our system will actually have the best benefit. I think that's part of the epiphany," he told NPR.

That epiphany took the form of a recent DOD internal memo titled " Stabilizing and Improving the Military Health System ." The memo looks back at a decade's worth of downsizing and outsourcing and concludes, "This has resulted in increasing overall health care costs for the Department and missing readiness opportunities for the Force."

The memo calls on the Military Health System to grow and attract more patients back on to base for their health care. Smith says the Pentagon will train or hire more doctors and nurses to re-fill its clinics. The memo directs the Pentagon to review all medical staffing levels by June 30th. It may be the start of another long and monumental attempt to change military health care.

New memories

Helen Perry is glad to hear a fix is coming, but she hasn't seen any sign of that memo in action yet. Matt is making new memories with their son and now a baby daughter. He's seems at peace with the memories that he's lost.

"Stuff from way, way back there, that's kind of wiped clean. That hard drive's gone," he says.

Helen and Matt Perry at Helen's promotion to captain in July 2015, at San Antonio Military Medical Center, Texas. Matt and Helen Perry hide caption

Helen and Matt Perry at Helen's promotion to captain in July 2015, at San Antonio Military Medical Center, Texas.

That's a blessing in one way. Matt doesn't remember his time at war, so he doesn't have PTSD. When he gets frustrated, he calls one of his Marine battle-buddies. They remember.

"When I get a lot of anxiety or I just need to get away, I talk to them. I used to see a ... therapist. And that was OK, but they don't understand what I went through. Once I started talking to my buddies, man, that is the best therapy you can have right there. And it's free," says Matt.

Matt knows his biggest champion is Helen. Now retired from the reserves, she does aid work in conflict zones, like Ukraine, as a critical care nurse. Still, Matt worries that he's holding her back.

"There's a lot of stuff I wish was different. Like I know she wanted to become a doctor. I know she wants to do a lot more humanitarian work, but ... there's always that worry that something happens to me while she's gone," he says.

They juggle their two young kids between them, but being Matt's caregiver can be a full-time job. That, along with having been an Army nurse and a Tricare patient gives Helen some expertise she thinks the Pentagon and Congress might lack.

"I can speak to it from an active duty officer, from a reserve officer ... I can speak to it as a medical provider currently working in the health care system, and as a caregiver. I can speak to it from every angle, and I want to know that they know because I don't think that they do. Because I think if they did, they would be doing different things," she says.

Recently, Matt's condition has gotten unstable again. That means they are looking, again, for a new medical team that accepts Tricare.

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