Thrive: Always Best Care Owner Chases Double-Digit Growth in Saturated Market

In 2018, Marcus Gardner grew revenue at his Dallas-based Always Best Care location by 4% and added 50 new caregiver positions. The strong growth comes after the top performing Always Best Care agency was named the brand’s franchise of the year in 2017.

Gardner is making waves again this year, expanding his coverage territory and bringing the non-medical and assisted living placement services his agency offers to new locations across the rapidly aging Dallas-Fort Worth area.

The Always Best Care franchisee credits the agency’s customer service and caregiver strategies for making it possible — and projects both will help his business achieve even loftier goals in years to come.


“Our company is just one that has grown over the years,” Gardner said. “We put people first … and that’s going to be the way we will double in size in the next couple years. We’ll add more services on — like medical — but really the core of who we are is relationships.”

Gardner joined Always Best Care — which has more than 200 independently owned and operated franchises across the U.S. and Canada — in 2008. Since then, he’s slowly and strategically extended his services from Dallas to Fort Worth and several other nearby communities.

Currently, Gardner’s agency provides non-medical home care to about 100 clients with approximately 150 active caregivers, while another 80 to 100 caregivers are “ready to go,” he said.


“Every year, I just see more opportunity,” Gardner said. “[Right now] I see an opportunity to grab more partnerships with different facilities in the medical communities [so] to have a larger area strengthens our appeal to those partnerships.”

Customer service

Gardner’s ambition is in part a credit to his background.

After receiving a degree in civil engineering from Texas A&M University in 1999, Gardner joined Ernst & Young as a management consultant. Later, he went on to work as a project manager at Radio Shack and FedEx (NYSE: FDX).

“I was always inside companies seeing how they operated,” Gardner said. “It was nothing really special other than you solve problems every day, and that’s business. You get paid for solving a problem or coming up with a product or service.”

Eventually, Gardner decided to leverage those skills to start a business of his own, drawing on his passion for helping people, specifically older adults, to settle on home care.

The journey hasn’t been without challenges.

In Texas, where Gardner operates, the home-based care industry is saturated with hundreds of competitors. While there’s no hard data on how many private duty home care competitors occupy the Dallas area, there are 463 agencies offering medical home health — a service line Gardner eventually hopes to provide — in Dallas County, according to 2018 data from CMS, which has labeled saturation in the state as “extreme.”

“There’s a huge amount of competition, but how we stand out is simple,” Gardner said. “It’s customer service.”

He likened his clients’ experience to one they would receive in a five-star restaurant.

“We have a lower profit margin [of about 12%],” Gardner said. “We could easily accomplish 15% to 18%, but we have more staff in order to accomplish our goals.”

The franchise’s Dallas’ based office is staffed 12 hours a day, 365 days per year. When there’s no one to field calls in the office, an answering service forwards callers to Gardner or one of his staff members directly.

Additionally, potential clients are welcomed with several letters of reference and the opportunity to talk to current clients in similar situations, along with the opportunity to meet and choose several caregivers before starting service.

“If there’s a dispute [with the client], we’re not going to push blame to someone,” Gardner said. “We’re going to always say, ‘Yes, ma’am, we’re going to fix it right away.’”

‘Caregivers at heart’

A big part of Gardner’s customer-is-always-right mentality comes down to hiring and retaining the right caregivers, as they do the most interfacing with clients.

Despite the agency’s financial success, Gardner’s Always Best Care location had a caregiver turnover rate of about 50% last year, a figure that’s improving little-by-little, he said.

“We have two people in our office [who] all they do is hire individuals,” Gardner said, noting that his caregivers range in age from young adults to seniors in their 70s. “We’re looking to hire 13 caregivers per week. That’s a goal we have because we also want the client to have the best person for them.”

The Always Best Care location’s caregiver recruiting strategy focuses more on personality and skill set than on scheduling, he noted.

“It’s not about finding someone and saying, ‘Hey, can you work nights?’” Gardner said. “They may do that, but that leads to a lot of turnover.”

Instead, Gardner’s staff looks to hire “caregivers at heart,” who care more about helping people than making money.

“They can go make more working for Amazon or driving for Uber,” Gardner said. “That really has not affected us so much … [because] they’re caregivers by heart.”

Online retail giant Amazon (Nasdaq: AMZN) pledged to increase its minimum wage to $15 last year, a move that added pressure to home care agencies’s struggle to attract and retain workers.

In addition to catering to caregivers needs, the agency also offers professional development and yearly bonuses, which included $20,000 in total to caregivers last Christmas. It also tries to specifically match caregivers and clients based on individual personalities and preferences.

“We pay them appropriately,” Gardner said. “We give them clients that match what they want. We ask them, ‘What kind of clients make you happy?’”

Thrive is a HHCN series that explores the successes, struggles and strategies of home care owners and operators on the local level.

Companies featured in this article: