Your One Stop for Everything You Want to Know about Starting and Running a Home Health Care Business
This is a very important and serious question. While some entrepreneurs' choices are limited by external factors, there are many issues to consider and to some extent this first decision can set the tone for how successful your business will be. Even if your circumstances limit your choices, it is a good idea to read the information below just to see what some of the pitfalls may be with operating out of your home or a separate office.
The costs involved in establishing your business from your home will be much lower than organizing a separate commercial office space. Out of your home you can use or borrow from the rest of your house things like the phone line, computers, furniture, etc.
If you rent office space you will have additional expenses such as rent, new equipment such as new computers and furniture, insurance, alarm system installations if the premises do not already offer this, installation of phone lines and and internet connection, etc.
For some it will be just too expensive to rent a separate office space. For many entrepreneurs one of the main appeals of starting one's own Home Health Care business is the fact that the startup expenses are low.
Running the business from your home is certainly very convenient. For one, you will ensure that you have a very short commute! If you are going to be operating the business part-time initially it makes it easy to perform your daily errands that you may need to do as part of your personal life.
Family Obligations
It's no secret that many stay-at-home mothers and fathers start a Home Health Care business because it's an ideal way for them to watch the kids at home and make some extra money on the side. Having children around, however, can prove to be too disctracting for some. In fact, just being home at all many find too distracting to focus on their business.
Your business growth may be hampered at some point as eventually you will need to hire more employees as your business takes off. While many Home Health Care businesses remain being home-run operations for years, even after hiring several office staff, this does of course pose difficulties.
Firstly, many people would have a problem sharing their home with an employee. There is something to be said for keeping your personal life separate from your work life and it does impact on your image as a boss if your employees see you in your home setting dealing with your personal issues in the workplace.
Secondly, if you are hiring more than one office administrator it may be uncomfortable to have a stranger, or almost-stranger, around your home, particularly as there may be periods of time where you will not be home to monitor their actions.
It's also important to consider that many Home Health Care businesses operate by the cleaners arriving in the morning to pick up their schedules for the day. This may mean that you could easily have 10-20 employees going through your home. Many of whom you probably will not know very well.
Providing A Suitable Work Environment
Whether you operate your business from home or from an outside office it is vital that you do your best to create a suitable work environment. Of course you may have kids and pets around, which can be distracting enough, but even if you operate your business from home you can create a separate work environment by partitioning a part of a room and by setting it up adequately with a desk, phone and computer (all of which will be vital tools in running your new business).
We have not encountered any home situations where it is impossible to create a suitable work environment at home, but it may take some work on your part and you should be prepared for this if you are going to go this route.
Efficiency and Self-Discipline
Some people find it impossible for whatever reasons to work from home. It does require an enormous amount of self-discipline, but you should not be disheartened if you do not take to it immediately. It can take some time to get into the swing of things.
Procedures are important in your new business, but even more so if you are operating from home as they provide you with a certain amount of structure.
While you may face different problems and issues from running your business from an outside office, many people do find it easier to get themselves into a work frame-of-mind. Simply the commute from home to the office helps to create the distinction between work and home, but this becomes blurred when you do work from home.
Are you in love with the idea of working from home?
Working from home is a dream for many. You may have visions of yourself taking a leisurely jog around the block in the morning, reading the newspaper with your coffee at the kitchen table, taking lunch with your spouse in the middle of the day, but you should not delude yourself.
You should absolutely definitely not run your business from home just because you think it will be "easier" because in many respects it is not.
Just try to imagine it. Starting your business, that is those first few weeks, is the hardest. What will you do when you're sitting at your desk at home, waiting for the phone to ring? Will you turn on the TV and catch the midday movie to fill in the time? This is exactly the trap many fall into. If you had your separate office you could not just turn on the TV. You would be forced to turn your attentions elsewhere. Such as what about spending the wait-time brainstorming? The thing is that any time you are not actively working (that is answering phone calls or communicating with employees, etc.) can always be spent just thinking of new marketing techniques. There are always new things you can be doing in the way of marketing.
So after all this what should I do finally?
In the end noone knows your own situation better than you, so it is very difficult to advise others.
However, if you have the funding to rent a separate office and no other limitations, this is preferable.
But if you decide that you will try to run your business from home and you have thought about it carefully and weighed up the pros and cons mentioned above you should not feel bad. You are no less likely to succeed than if you rented a separate office.
Enthusiasm and dedication can make up for a lot. Having a separate office will not save your business if you are not committed to seeing it succeed and are not prepared to work hard at it.
Of course many successful Home Health Care business owners begin by operating out of home and graduate to a separate office later when they could really use the extra space.
You will absolutely need a desk with enough space for a computer, telephone and drawer space including filing space.
You will absolutely need a telephone. Perhaps this is the most important part of the business as this is where your clients will contact you.
Ideally you will be able to answer your phone any time of the day. Especially during the initial setup of your business you may be out of the office quite a lot, even doing some of the caring work yourself. If this is the case then you really should have your home phone diverted to your cell phone, or use your cell phone number as your business number in the first place.
If you are going to be using your house phone you will definitely need to change your machine message to reflect your business. It is absolutely vital that you have a professional-sounding answering machine message. Your kids may be very cute on your answering machine but they will definitely not inspire confidence in your prospective clients that you are a professional.
A good example of an appropriate answering machine message is:
"You've reached Happy Home Health Care.
Thanks for calling.
Sorry we are not available to take your call at the present time, but it is important to us so please leave your name and number and we will return your call promptly."
You will definitely need a computer with internet to be used for composing various documents, searching and posting ads on the web, checking email and for your special Home Health Care business software.
Having a good software is very important for assisting you with the running of your new business. A good software will not only assist you with running your business but it can be very instructive as well.
Thoughtful Systems' Scheduling Manager
The Scheduling Manager, produced by Thoughtful Systems, Inc., is a great software for Home Health Care businesses. It will assist you with storing all information about your customers, setting up with your recurring schedules, billing and payroll, but will also help you with your marketing with its sophisticated email module. It also includes several letters such as gift certificates, thank you letters, etc. which can be very useful.
They will also work with you on financing by setting up a payment plan for you so that you can afford the software so there really is no excuse for you to begin without adequate software.
Click here for more information about the Thoughtful Systems' home health care software.
Your Company Name
Your company name is important. You need to consider what type of image your company will have. You should also consider whether there are any competitors using the name already. This may cause problems later and may take away some of the uniqueness of your company.
It's also a good idea to make sure that the name can be easily understood when spoken over the phone. It sounds silly, but some names may look good on paper but not sound quite so good when spoken out loud.
Your Company Logo
If possible you should have your logo created for you early on. This way, you can begin to establish your company presence as you can use your logo on your flyers and other marketing pieces.
A well-designed logo, however, can be expensive and if money is an issue you may wish to opt for a plain text logo intially. You can still choose your company colors and incorporate these into your temporary logo.
Your Company Web Site
It really is important for your company to have a web site. These days it is a must for any kind of business, but especially yours where prospective clients are likely to visit it to find out more information about your company.
In addition to this, many customers these days will search for a Home Health Care business online, so it is vital that you have some kind of web presence.
Having your own company email address as opposed to an AOL or Hotmail email address will also add to increase your company's professionalism.

It can be expensive to have a web site created, but there are several companies around that offer inexpensive web site templates.

Thoughtful Systems offers one such template and they will work with you to allow you to customize it somewhat and will assist you with setting up your company email addresses and submitting your site to Google.
Click here to find out more about Thoughtful Systems' web design services.
Of course, the people you hire to do the Home Health Care work are going to be a critical aspect of the success of your Home Health Care business. You’re going to want to set up a list of desired characteristics for your prospective employees. You’re going to want to define a set of core competencies for your employees. These employees will have access to your clients’ houses, so you want to make sure they’re honest and reliable. It’s a good idea to do a background check on each applicant, to check if they have any criminal convictions, etc.
In some areas of the country it is harder to find good employees than others. In these such areas there is a tendency to "settle" for less-than-ideal employees. This may seem a good idea at the time as advertising and interviewing candidates can be very time consuming, but will hurt you much more in the long run. If the employee leaves or you fire them you will have to start back at square 1! Often, it is worth the hunt to find a good employee that hopefully will be with you for years to come.
Besides this, you’re going to want to decide whether your employees should have the competence to read and speak English. If you’re going to be giving them printed job tickets (generated from your specialized home health care software), they're going to have to be able to read and understand English. However, if employees are going to be working in teams, it’s sufficient of only the team leader has this competence. Also, some specialized software applications for Home Health Care businesses will print job tickets in Spanish, or some other language. Ask your software vendor whether their software does this.
There are a variety of methods for training your staff. One popular method is to have new employees watch a few videos, which show in detail what they are expected to do in the customers’ houses, what chemicals they should or shouldn’t use for each part of the house, what to do and what to avoid doing, etc.
It's also a good idea to send your employees out in groups, such as in pairs or in threes. Not only does this make training easier, as your new employees can accompany more experienced employees and learn from observation, but also sending them out in groups means they can watch over each other. It has been shown that this leads to lower instances of accusations of theft and other errors on the employees' part.
A good software, such as Thoughtful Systems' Scheduling Manager, will allow you to group your employees together into teams to schedule.
It’s costly and time-consuming to train new employees, so you’re going to want to do what you can to retain the good employees.
I have heard several home health care business operators complain about the unreliability of employees, and claim that this is the prime source of the failure or stagnation of their Home Health Care business.
Several of our more successful Home Health Care business owners have established a bonus system for employees who perform well, who show up when scheduled, who get few complaints, etc. By encouraging good and efficient work and by showing appreciation through payment of bonuses, these employers have greater success in retaining good employees, thus ensuring good, efficient service to customers and fewer complaints.
Note: Check that the software you purchase has a facility for recording Quality Control information about employees. With this feature, you can make a record each time an employee receives a complaint or compliment and make decisions about which employees to reward, and which need more training (based on the Quality Control reports generated by your professional Home Health Care software).
For your software, try the Scheduling Manager, which has been specially designed for Home Health Care businesses. This will be of enormous help to you when you start our Home Health Care business.
Paying Your Employees
There are several ways you can pay your employees:
Fixed amount per job.
How should you pay your employees? Well some owners devise a complex method of a combination of the above, but it is actually quite important, in our experience, that the pay method should be relatively simple. This makes it easy for your payroll person to do payroll (which can take hours) and also easy for your employees to understand.
Commission is a nice way to pay your employees as it feels to them that they have a stake in how successful your business is. If you earn more, they get more. The downside of this is that you will need to tell your employees what you are charging. This may make them start questioning whether they are getting a big enough commission. Why do they only get 40% of the job when they are doing all the work? Many companies do not want their employees to know what they are charging for exactly this reason. But it is unlikely that you can keep your employees in the dark for long if they really really want to know.
It’s important to consider how you’re going to market your new Home Health Care business. You can have excellent employees who are well-trained and have excellent administrative back-office systems in place, but if no one knows about you you’re not going to get any business.
I’ve found in working with a variety of Home Health Care businesses that frequently marketing doesn’t get enough attention and business suffers as a result. Therefore, make sure you have allocated enough money in your initial budget (which is part of your business plan) to launch your marketing initiatives.
You’ll probably want to consider all or some of the following advertising media:
Yellow Pages Listings
Although the Yellow Pages is not as important a source as it once was, it still remains a basic source of advertising – letting people know that you’re there and open for business.
Web Site
Nowadays more and more people search for services and products on the internet. In my experience, people under 30 rarely, if ever, use the Yellow Pages and this also just happens to be the latest generation of young professionals, just the type of people that need a Home Health Care service! They grew up with the internet and are familiar and comfortable with it. So make sure you have a web site where people can find you.
There are many web designers out there who can design a web site for you. Getting your personalized web page for your Home Health Care business launched involves several steps, from conception to implementation.
Search Engine Optimization
It's not enough just to have a web site. After all, what's the point of having a site if noone can find it online? The first thing you’ll need to do is submit your site to all the major search engines – Google, Yahoo, MSN, ASK, etc. This can be time-consuming to do yourself. You might want to arrange to have your web designer do this for you.

Search Engine Optimization (SEO) is a new field of endeavor related to the web that is becoming a specialized industry in itself. Once your web page has been created and is now sitting on the web, along with a billion others, you may want to consider finding ways to have your listing do better in the search engines. An SEO specialist can help you do this. Try Quetzal Info Systems at, for example.

Pay-Per-Click (PPC) Campaigns
Most people searching the web with a search engine, Google for example, which will read through only the first ten or twenty listings that appear in response to the search term they entered. Fortunately, you can pay Google a certain amount to arrange to have your listing/s appear in the “Paid listings” section of their site. How do you think Google makes those enormous annual sales figures and why do their stocks keep soaring upwards? PPC is a huge multi-million dollar business!
Costs for this will vary. First you need to sign up with Google and then you’ll need to decide how much you want to bid for individual search terms. You can also set a daily limit, defining how much you’re prepared to spend a day for clicks.
It can be much easier and more economical in the long run to pay an SEO expert to assist you with raising your natural (free) listings in the search engines. There are various techniques with regards to improving the content of your site to improve its natural listings. This is a largely an untapped resource when it comes to Home Health Care businesses. Home Health Care businesses have not, traditionally, been the most up-to-date with the lates technologies and have been slow to adapt to new marketing techniques. This means that you can take advantage of this yourself.
Flyers, Mailers and Door Hangers
Leaflets are an old standard for marketing any service business. Many home health care businesses around the country use leaflets from time to time to advertise their services. One of our clients spent between $30,000 and $50,000 on leaflets and door hangers in the first few months after opening his doors, to attract new customers. He was successful in giving his home health care business a good, quick kick start. However, this was before the days of the internet, when internet advertising wasn’t available. This doesn’t mean, however, that leaflets and door hangers won’t continue to be effective in this day and age!
Car Advertising
It is a great idea to have your company name and contact information placed on your car and your employees' cars. This is a great way to advertize as you take your car out and about throughout the day people will see you and come to recognize you as the Home Health Care company.
It's also a great way to get interest from neighbors, which is great as it means you're in the area anyway.
Referrals and Word-of-Mouth
You should do what you can to encourage referrals and word-of-mouth. A great way to do this is to award discounts and coupons to your clients who refer a friend. You can send a mailing or an e-mailing to your present customers telling them about your incentive programs.
Thoughtful Systems' Scheduling Manager can assist you bulk emailings to your customers. They provide you with several attractive templates to choose from, or you can create your own. Click here to read more about the Scheduling Manager.
Your Office Procedures
You will soon discover that the success of running any office depends upon procedures and rules. Very often when running a business there will be a tendency to break or bend your own rules from time to time. Very often when this happens it backfires and reminds you why the rule you broke was so important in the first place!
Some of the procedures you will need to think about and write down will be:
1) The rules for answering the phone and for speaking to clients.
This may sound pretty obvious, but you'd be surprised at how many people take for granted that others know the correct telephone etiquette. There are the basics such as:
Always answer with the company name. For example "ABC Cleaners how can I help you?"
Never put the customer on hold for a great length of time.
Always get their name and number before you quote them any prices. This is not as difficult as it may sound. Many people do not mind these questions. You can offer to add them to your mailing list to be notified of specials. The reason for this of course is that if you qutoe someone the price and they hang up and you have no way to follow up with them there is no way you can do any research about your competition and on what people think of your prices.
If they ask your assistant a question they are not sure how to answer, there is no need for them to get flustered. They should simply tell the caller they are not sure and ask if they would mind holding for a few moments while they find out the answer.
You can download a sample New Client Form below:
Download Employment Application Microsoft Word 38 KB
2) The rules for handling complaints.
No matter how good your business is there will always be complaints. You must make sure your office assistants are well-prepared to handle complaints when customers call.
For less serious complaints (the cleaner forgot to vacuum behind the couch, etc.):
The first thing to do is to apologize! Say you are terribly sorry that the work was not done to their satisfaction and, unless this customer has a habit of complaining a lot, you should offer to do the next visit at least at half price - perhaps even free! In this situation it is incredibly important that you follow up with the customer after the next visit to make sure they are happy. This will impress them and will show that you are committed to providing good services.
Again, a software package such as the Scheduling Manager by Thoughtful Systems allows you to not only record complaints received from customers, which enable you to run reports to see your cleaners' average ratings, but you can also schedule pop-up reminders, which you can set to appear after the customer's next visit to remind you to call them to follow up.
To read more about Thoughtful's home health care software click here.
For more serious complaints (the cleaner stole my earrings, etc.):
These complaints are a little more tricky. Probably your assistant should pass the phone to you, the owner, to handle at this point. If you are not available, the assistant should take as many details as possible about what was stolen, allegedly by who and when.
You as the owner will then need to confront the cleaner. It can be very difficult to determine in these situations who is telling the truth and who is lying or mistaken. It has happened before that customers have been mistaken and they actually left their earrings somewhere else, for example. These exact situations are why it is a good idea to send your cleaners out in teams. It means they can watch each other and, unless they happen to be very good friends, it is unlikely they will turn a blind eye.
If your employee has been working for you for a long time and you trust them a great deal well this definitely counts for a lot. In this situation it is probably best to call the customer back and ask them if they are sure, or if they could double-check that the earrings are definitely gone and explain to them how trustworthy your cleaner is.
If your employee could have taken the item, and if in fact you are quite certain they did, often simply a threat of contacting the police can make them confess. A reassurance to not call the police if the item is returned will often resolve the situation. Of course this employee is not going to be working for you anymore, but the main thing is that you have the item back to return to the customer.
Rules For Hiring Employees
Hiring employees is very important. It can be a big mistake to hire the wrong employees, so it is a great idea to think about and to create your own application.
It is a good idea also to get references from your employees. Whoever they are and whatever their background, if they cannot supply you with at 3 least former employees or even family members or friends who are willing to vouch for their character this is a bad sign and you should definitely not hire them. Once you have the references you should contact them also.
You can download an Employment Application below:
Download Employment Application Microsoft Word 38 KB
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