Thrive: How a West Coast Home Care Provider Rebounded After a Wildfire Disaster

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

Renee Rand knows all about persevering and moving forward. She lost dozens of clients and caregivers after Camp Fire — the deadly wildfire that swept through Northern California in 2018.

Since then, the Interim HealthCare of North California co-owner has managed to slowly rebuild her business.


Interim HealthCare of North California is made up of five offices, with locations in Chico, Yuba City, Grass Valley, Campbell and Redding. Rand oversees all but the Redding location, which serve a total of 584 clients.

Interim HealthCare of North California provides home health, hospice and personal care services.

After the wildfire, which destroyed thousands of Butte County homes, schools and businesses while killing 86 people, Interim HealthCare of North California was left in flux. The disaster drastically impacted the franchise’s Chico, California, location — and left several staff members without homes.


As a result, a number of caregivers left the agency, and the franchise lost nearly 40% of its referral source business. Additionally, many involved are still suffering from post-traumatic stress disorder, Rand said. That includes clients and caregivers alike.

“[Camp Fire] is still very emotional for all of us,” Rand told Home Health Care News. “We lost 42 clients and 16 of our caregivers. We’ve worked really hard to keep the morale up.”

For Rand, part of that has meant spending more time in the office with her team trying to “keep them pumped up,” she said. Maintaining a positive outlook despite the circumstances is critical, especially because home care is already plagued by extremely high turnover and burnout rates.

Rather than closing the Chico location or hanging her head because of the disaster, Rand pushed forward. Rebuilding efforts included assistance from sister offices as well, which helped the Chico agency find placements for clients and some of its caregivers.

Founded in 1966, Sunrise, Florida-based Interim HealthCare has more than 325 franchise locations worldwide. The home care company provides a variety of home-based offerings, including a number of specialty services for complex conditions such as congestive heart failure, dementia, diabetes and several others.

“We are fortunate, in that my business partners have been so supportive,” Rand said. “They were very generous in financial donations for our caregivers. In the office, we set up food supply, clothing supply, and kitchen supplies for both caregivers and clients.”

Rand first caught the “franchise bug” in the mid-90s during her time as a nurse working for a Moline, Illinois-based Option Care franchise. In 2001, she left the Midwest and moved to Redding, where she partnered with Robert Seawright, who opened the Redding Interim franchise location in 1995.

Today, Interim HealthCare of North California is locally owned and operated by Rand, Robert Seawright and Cindy Seawright. The trio also owns franchises in Oregon and Nevada.

Since the disaster, Rand has taken the steps to revamp the Chico location financially.

“We started the groundwork to increase our staffing operation,” Rand said. “And that just started to take off for us, but that office is still down in revenue for us, about a good 25%.”

In 2018, the locations that Rand oversees brought in about $9.4 million combined.

Rand declined to disclose her agency’s profit margins but attributed the steady turnaround to the support of her organization and caregivers that went above and beyond in their service.

“One of our clients actually lived with one of our caregivers for a while,” she said. “In this disaster, there were people opening their hearts and homes.”

In preparation for situations like Camp Fire, the Centers for Medicare & Medicaid Services (CMS) requires home health agencies to have emergency plans in place that include following up with patients and informing state and local officials of on-duty staff or patients that they are unable to contact.

Home care providers aren’t held to the same CMS standard, though many maintain similar in-house emergency plans.

The next phase

While still grappling with the aftereffects of Camp Fire, the industry-wide caregiver shortage remains top of mind for Rand.

However, the average caregiver turnover rate at the franchise owner’s locations is well below industry average at 12.5%.

Rand has begun forming what she calls “referral partnerships” with competitors to combat the shortage.

“I am looking at adding a new category of people into what we call our referral partnerships,” she said. “I’m looking at adding a competitor that we feel has similar business values and that we can trust in each market. I feel like together we are better serving our referral sources, clients and employees. And that’s something five years ago you’d probably never think of.”

Additionally, Rand plans on expanding the scope of her agency’s caregiver’s service through new staffing opportunities.

“There’s quite a few of them that would maybe like diversity in their work environment,” Rand said. “If they can add a higher skill level of working in a skilled nursing facility (SNF) or an assisted living facility to complement the care that they do in a client’s home, they feel like they’re staying relevant and current. Plus if their client goes to the hospital or passes away, I have more work opportunities for them immediately by adding that staffing component.”

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