How FirstLight Home Care Is Juggling Growth, Transformation At The Same Time

Coming out of COVID-19, multiple home care franchise systems are really beginning to rev their growth engines again. That will likely be a theme in the broader home care industry this year.

One, in particular, is FirstLight Home Care. Kristen Duell, the VP of experience and innovation at FirstLight, said the company is primed for “extreme growth” in the near-term future and ready to “hit the ground running.”

“We have lots of open water,” Duell said. “Whenever you think about expansion, there’s expansion with new franchisee growth. But we’re also really focusing on diversifying our service sets and payer sets so that we can serve more of the population.”


Traditionally, the company has been more of a private-pay business. But, like many other home providers, FirstLight is recognizing a need to serve more of the senior population. At the same time, it sees that need as a massive opportunity to become more diverse, more future-facing and more sustainable in the long-run.

“Where we see the ball moving forward, in particular, is around how we address the Medicaid population and the VA population, which we’ve always done to a lesser extent,” Duell said.

Based in Cincinnati, FirstLight is a franchise system that includes nearly 200 independently owned and operated home care locations across the U.S.


Looking forward

With billing rates rising, some providers have gotten concerned about clients reducing length of stays, or cutting off services when one thing goes wrong.

FirstLight CEO Glee McAnanly said that the best way to avoid that is to keep the censuses under control at all locations.

“When we say yes, that we’re going to take care of a client, we better take care of him or her,” McAnanly said. “But we also have to know when to say no.”

As a home care franchise’s priorities change, the biggest hurdle is to get franchisees on board.

But in FirstLight’s case, McAnanly said the franchisees are “very cutting edge” – almost to the point where leadership has to protect them from themselves to ensure margins.

For instance, the company is currently exploring the best ways to work in Medicare Advantage (MA), to work with AI, and the best ways to schedule caregivers.

On the scheduling front, a caregiver’s preferred weekly schedule, for instance, doesn’t always line up with just one client’s needs, meaning the client will have to see multiple caregivers.

“I think that’s a problem we’re going to have to solve,” McAnanly said. “Because if you talk to caregivers, they say they want 30 hours. The average client is 20 hours, and so you’ve got a disconnected 10 hours. So, we talk about retention, but how are we going to [satisfy] that caregiver?”

One way to do that is by meeting caregivers’ scheduling needs, and then having more honest conversations with clients and their families on the other end.

“We talk to clients, and they say they don’t want to have more than one caregiver,” McAnanly said. “So, I say, ‘Well, how many kids do you have? Do you love one more than the other?’ Let’s figure out the model that works best for both.”

When they are able to match caregivers and clients one-on-one, some FirstLight locations are offering paid hours for caregivers to serve the leftover desired hours in office, upskilling and training.

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