Thrive: ‘Maniacal’ Finances, Companion Care Help Homewatch CareGivers Agency Ramp Up Revenue

When Reena Sharma opened her Long Island, New York-based Homewatch CareGivers franchise location in 2013, the odds were stacked against her.

New York was coming out of a moratorium, which froze licensing for new agencies. Though the state’s Department of Health was accepting applications from new home-based care providers, there was a processing backlog, leaving Sharma’s agency without permission to provide personal care services until 2016.

Rather than put the business on hold, Sharma operated the Homewatch CareGivers as a companion care-only agency for nearly three years.


“We couldn’t bathe,” Sharma told Home Health Care News. “We couldn’t dress. But we said, ‘Listen, we could build this business serving folks who have Alzheimer’s and dementia — [who] don’t need personal care — but really need safety and oversight. We tapped into that very early.”

Since then, Sharma has grown her agency — which now serves more than 400 clients per day with about 300 caregivers in New York’s Nassau, Sussex and Queens counties — to become one of the top revenue generating Homewatch CareGivers franchises in the country, according to the franchiser.

Sharma declined to disclose her agency’s revenue or profit margins but attributed much of her success to her background: Before entering the home-based care industry, she spent decades working in management consulting and investment management.


Ultimately, the experiences taught her to identify untapped opportunities and pursue them in a profitable way — while also inspiring her to pursue her passion in the first place.

“After spending 20 years in corporate, I just said, ‘Am I happy?’” Sharma said. “‘Am I really fulfilled? Am I doing something I just truly feel passionate about?’”

After realizing the answer was no, Sharma quit her job and began looking for business opportunities that would allow her to help people.

Because her husband worked in the pharmacy industry, health care seemed like the perfect fit. She chose home care after determining it had the most growth potential.

Globally, the home health care market is expected to exceed more than $7 billion by 2024. And that figure is only projected to grow in the future, with 10,000 baby boomers in the U.S. turning 65 every day and the nation’s aging population expected to double in the next 20 years.

Sharma’s ability to stay nimble and find a niche in the face of licensing challenges helped get her agency going — and eventually thrive. Her story serves as a lesson for other home care providers today, many of whom are also dealing with regulatory uncertainty and administrative backlogs.

Untapped opportunities and ‘maniacal’ finances

Since entering the industry, Sharma’s strategy has always revolved around pursuing untapped opportunities with a “maniacal” eye toward finances, she said.

It started when she chose to offer companion care while her personal care license was pending. Six years later, several industry players are making similar moves, catering to the needs of seniors, one in three of whom dies with dementia, according to the Alzheimer’s Association.

For example, Maryland-based home care agency Regent Healthcare announced the development of its dementia caregiver training programs in November. Also last year, Sunrise, Florida-based Interim HealthCare and Omaha, Nebraska-based Right at Home rolled out dementia programs, with a big perk being creating specialized caregiving positions while also catering to clients’ specialized needs.

Once Sharma’s Long Island-based Homewatch CareGivers location earned a license to offer personal care services, it expanded its focus beyond companion care.

It’s next goal became winning market share of several different ethnic groups in the New York City metro area.

“As the licensure came, again I tapped into, ‘Where are the opportunities?’” Sharma said. “I happen to be of South Asian background, a born-and-raised New Yorker, and I said to myself, “I want to help my community.’”

She began reaching out to different religious and community groups and hiring bilingual caregivers.

Currently, Sharma’s agency provides companion care, personal care and, occasionally, nursing services. Although the bulk of the agency’s payments come from Medicaid, a “good portion” of services are also paid privately or with long-term care insurance, Sharma said.

Additionally, the agency offers a bevy of community services.

“[We have] a very open door policy with the community,” Sharma said. “It doesn’t matter what you need help with. We’re here. Bring your letters. Bring your stuff you’re confused with. Bring your food stamp application. We may not be able to help you on the spot, but we’ll guide you in the right direction.”

At the end of the day, the agency’s success lies in its finances, Sharma said.

“Anything can go wrong with Medicaid or even with your clients,” she said. “So we are … maniacal about our finances because you could go under within weeks. Your payroll is huge.”

As such, Sharma operates by a cardinal rule from her corporate days: You cannot manage what you cannot measure.

“I’ve been maniacal about making a process out of everything and knowing every part of the pipeline of my office operations and measuring every aspect of it,” Sharma said. “If we’re going way into overtime, I want to understand why. If people are challenging us with rates and we’re missing visits, I want to know why. Your success will be around managing your numbers.”

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

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