Why Staying Small Is a Strength for Broad Street Home Care

In today’s hyper-competitive, ultra-fragmented home care industry, scale is often seen as a strength, especially when it comes to forming relationships with health systems and Medicare Advantage (MA) plans.

But Wilmette, Illinois-based Broad Street Home Care is bucking that idea, demonstrating there’s no single path for building a profitable business in the home care market.

Launched in 2014, Broad Street provides a mix of traditional home care offerings, as well as specialized services for clients with certain medical conditions, including Parkinson’s disease, Alzheimer’s and other forms of dementia.


While many home care agencies try to work with a large number of clients at any given time, Broad Street only works with a few dozen throughout the Chicagoland area, according to Sam Cross, the company’s founder and administrator.

“We’re fewer clients, deeper engagement,” Cross told Home Health Care News. “Your typical home care client is, on average, maybe 10 to 20 hours per week. We’re more like 90 hours a week for our clients.”

For the most part, Broad Street has been able to keep its client totals low and engagement levels high through a concierge strategy, where the home care provider creates detailed personalized care plans for seniors.


Starting with physicians and hospitals, concierge medicine has exploded in popularity over the past two decades.

More and more home care agencies are also now starting to take the concierge medicine approach, Cross said.

“With the growing senior population, people want a more personalized approach — I don’t think it’s any more complicated than that,” he said. “And in the long run, if you want more personalized care and more quality care, you’re going to have to pull out your wallet.”

The business

Under its concierge business model, Broad Street invests in targeted, medically-focused training for its caregivers, supported by collaborative oversight from registered nurses.

For a senior with Parkinson’s disease, for example, Broad Street will help with speech and physical therapy exercises, making sure the client is following his or her plan of care. Medication assistance is also a typical service for a Parkinson’s client, Cross said, noting that the disease is one of the more common conditions Broad Street helps manage.

“With Parkinson’s, it’s really important to take your pills right on time, and that you don’t consume proteins around taking that medication because it conflicts with absorption,” he said. “Our caregivers know all that because of all the training they receive.”

Currently, Broad Street — paid for on a private-pay basis or through long-term care insurance — has roughly 100 caregivers.

The company’s caregiver total doubled from 2017 to 2018, according to Cross. It’s on pace to double again this year.

“But we’re not overtly trying to do that.” Cross said. “We’re actually trying to pace growth. Our caregivers require a lot of training, so it’s a fine balance.”

In addition to Parkinson’s disease and other forms of dementia, Broad Street regularly cares for clients with diabetes, COPD and congestive heart failure. Additionally, the fact that Broad Street operates with nurse oversight helps keep that care connected to clients’ other health care providers, Cross said.

“Home care is sometimes viewed as the bottom of the totem pole in the health care system,” he said. “In a lot of cases, it operates in isolation and isn’t really connected to anything else. With our nurse oversight, we try to bridge that gap.”

Cross declined to comment on the company’s annual revenue.

The backstory

Like many home care agency owners and operators, Cross launched his business out of a personal experience.

In 2013, Cross’s uncle — a former marine — was diagnosed with end-stage lung cancer. At the same time, Cross’s aunt — his marine uncle’s wife — was diagnosed with Alzheimer’s disease. The couple ended up moving in with Cross’s mother in Colorado, while Cross shuttled back and forth from his home in Chicago to assist.

“It was all sudden and hectic,” Cross said. “I moved out there to help, and it ended up being a six-month process.”

For additional support, the family hired professional caregivers. The actual support they provided left all parties involved feeling largely disappointed, however.

“We ended up getting some services in place, and I was a little surprised that there wasn’t something more developed,” Cross said. “We had some people come into the home who were helpful, but they were really just another set of hands. I knew more could be done, so I started researching the [industry] and decided this was a calling for me.”

After his uncle passed away, Cross founded Broad Street.

Apart from personalized care that goes beyond light housekeeping or companionship services, Broad Street also takes an almost militaristic or no-nonsense approach to care, Cross, a former investment banker, said.

“I kind of came from a long line of marines, with my father also having served in the marines,” he said. “A lot of people don’t need or want somebody to come in and ‘love them.’ They want somebody to come in and provide a real service, a professional service that offers very defined support.”

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