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Non-medical home-care franchises growing in Greater Des Moines


Each morning, 96-year-old Lois Vernon starts her day at the Lodge of Ashworth with a little assistance from her home-care companion, Kathy Anderson.

For Vernon, who has difficulty seeing, having Anderson come to her apartment for two hours to fix her breakfast and assist her with getting dressed and getting down to the exercise room is “a big help,” she said.

“She’s wonderful,” Vernon said of Anderson, who is employed by Comfort Keepers, one of three national home-care franchises that operate in Greater Des Moines.

As the number of seniors continues to grow across the United States, the demand for non-medical services that can help people stay in their homes longer will multiply, experts say. More than 33 million U.S. residents, or 13 percent of the population, are already over age 65, and their ranks are expected to double by 2030, when an estimated one in five Americans will be over 65.

The need for the services, which range from light housekeeping, cooking and running errands to personal services such as baths, is particularly great in Iowa, which in 2000 had the fourth-highest percentage of over-65 residents in the country.

There are at least seven national home-care franchisors ranked on Entrepreneur magazine’s annual Franchise 500 list, and three of those, Comfort Keepers, Home Instead Inc. and Right at Home, are already doing business in Greater Des Moines. Other top franchisors say it’s only a matter of time before investors bring their brands to Central Iowa.

Franchise owners who have already entered the home-care market in Greater Des Moines say the growth has been slow but steady for their services, which range in price from about $15 to $18 per hour. The biggest challenge initially, they say, has been getting client referrals and finding and retaining good employees.

“We’re always hiring,” said Paul Storbeck, who nine years ago invested in a Home Instead franchise and opened an office in West Des Moines. He now employs nearly 90 caregivers, supported by an office staff of eight employees.

“I don’t have a problem finding people; I have a problem finding the right people,” Storbeck said. “The elderly population can be very specific in what they want, and they’ve earned that. They’re going to tell us what they want and when they want it.”

A large part of Greater Des Moines’ home-care market is served by Iowa Health Homecare-InTrust and Mercy Home Health Services. However, the influx of for-profit, franchise-based services has generally been positive for those needing them, said Joel Olah, executive director of Aging Resources of Central Iowa, a public-private partnership that addresses the social service and nutritional needs of seniors.

“Generally speaking, we need those forces coming into the state, because we don’t have enough as it is,” Olah said. “When you do have competition, people have a choice and the agencies that have been around will probably pay more attention to the quality of care. There have been some territorial concerns because people haven’t had competitors before. But when they find out it’s not medical or clinical care, but chore services, the concern kind of goes down a little more.”

From Aging Resources’ perspective, there’s room for growth in the home-care industry.

“It’s an industry that will continue to increase, because the population is simply going to demand it,” Olah said. “The numbers will overwhelm the system if we don’t generate good quality at-home options.”

The challenge for the business “is not growth, but managed growth, said Forrest Beck, national director for business relations for Visiting Angels, a home-care franchise company that last year opened 90 new locations. Based in Havertown, Pa., the company has more than 250 franchises in the United States and Canada.

“We’ve gotten a lot stricter in who’s allowed to obtain a franchise,” he said. “It takes a certain kind of person to be in the home-care business. It’s not just a business; it takes heart, if you will. We’re trying to grow at a manageable rate so that all of our offices are supported.”

Beck said Des Moines’ population is large enough to support two or more Visiting Angel franchises, but that their timing depends on finding the right people. “If the opportunity presents itself and individuals are interested, then we put them in the business,” he said.

Besides being a relatively inexpensive business to get into, home-care services is also a satisfying career because you’re helping people, said Tony Vola, who with his wife, Marcia, opened a Right at Home franchise in Clive two years ago. “From a ‘go home at night feeling good’ perspective, you can’t find a better one, in my mind,” he said.

In contrast to the constraints that Medicare imposes on how long a caregiver can take to perform specific tasks, a non-medical home-care approach allows for better scheduling between caregivers and clients, Vola said.

“What we try to do is make sure we always get the same person back with the same client,” he said. “Once we have a personality match, then I think we’re much, much better than the medical model.”

Maintaining good communications with the clients and their families is important, he added. “We try to set aside every Friday to go out and visit our clients; we have a rotating schedule to make sure they’re OK and that they’re being taken care of. And that gives them someone else who’s visiting them as well.”

After two years in business, the Volas are considering expanding into the personal-care side of the business later this year. That option, which involves services such as bathing, is an option that Omaha-based Right at Home offers to its franchisees.

“Not having a medical background, I wasn’t ready to get into the personal-care side right away,” said Vola, who has passed a national examination to become a Certified Senior Advisor, a program to educate professionals in the senior-care industry. “We’ll probably get into that side in another quarter. That demand is there, and it ties a lot into what we’re doing.”

Getting their name out and gaining trust has been the biggest challenge, he said.

“This is not something like a McDonald’s, where you set up on the corner and they come flooding into your doorway. This is something where they have to know you; they have to trust you. You have to deliver the service, and I think you have to deliver a very high quality of service. You have to become one that people look at and say, ‘Yes, they’re good, we know them, I’d recommend them.’”

Another home-care provider, Christine Anders, became sold on Comfort Keepers, a Dayton, Ohio-based company with more than 400 franchisees, after her brother and sister-in-law opened a franchise in Indiana and had a good experience with it.

“They said, ‘You would love this, because you love working with older people,’” she said. “So two years ago, I took the plunge.”

A former state employee, Anders had never run a business before, but found her earlier background in teaching home economics useful.

“Our goal is to keep people in their homes,” she said. “So it’s been a really good fit, because I can go in and look at the home to see what needs to be done in order for someone to stay there. Do they need light housekeeping, are they able to prepare meals, do they need someone to plan meals for them so they’re getting what they’re supposed to have?”    Comfort Keepers offers both homemaker-companions and personal-care assistants, with the hourly rates varying depending on the number of hours booked per week and the tasks performed.

After slow growth, Anders’ franchise is beginning to pick up momentum as it gains referrals.

“We’re growing, and it’s growing fairly fast all of a sudden,” she said. “We kind of plodded along for three years, and then all of a sudden you hit this point where it starts going. So it takes a long time to get a business going.

The business currently employs about 35 caregivers, and Anders is now looking to hire an office manager and move to a larger office.

Establishing a good reputation is critical, Anders said.

“There’s a lot of room for growth, and the demand is not going to do anything but get bigger,” she said. “But I’m very careful never to take on anybody unless I know I can have someone there every time I’m promising them, and that they’ll do a good job. So I’ve had to turn down people when I was down on staff a little bit. I’d rather say no than do a bad job.”

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