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Don’t Only Focus On Gross Profit. What To Do Instead — Gregory Bean

Release Date: 02/11/2025

What I Wish Every Home Care Owner Knew – Steven Gonzales

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack is joined by Steven Gonzales, CEO of HealthView Home Health & Hospice, to demystify the world of home health. Steven breaks down the core function of home health, its role in the care continuum post-hospital discharge, and the critical financial challenges driven by payer mix and Medicare Advantage. He shares invaluable insights on how home care agencies can become essential partners by understanding clinical needs, tracking client payer data, and focusing on true care coordination. Steven also looks to the future, discussing...

I Wasted Hiring 7 Salespeople Before I Got It Right – Gregg Mazza

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack welcomes Gregg Mazza, former home care agency owner and current coach to home care entrepreneurs. Gregg shares his journey from building a successful agency from scratch to selling it and now helping other owners avoid the pitfalls he experienced. He opens up about his biggest mistake: hiring seven salespeople who failed before he finally cracked the code on building a sales team that drives growth. Gregg emphasizes the importance of hiring for traits over industry experience, implementing clear systems, and holding teams accountable. He...

Find Someone 2-3 Years Ahead of You (Here’s Why) – Lucas Carroll

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack sits down with Lucas Carroll, CEO of The Business of Senior Care. Lucas specializes in guiding home care startups, change of ownerships, and expansions through the complex world of state licensing and compliance. He shares his unexpected journey from law school dropout to becoming a key resource in the home care industry. Lucas dives into a significant opportunity for agencies: diversifying into private duty nursing to retain clients, offer premium services, and increase revenue. He also emphasizes the profound value of building...

The Two Jobs I Wish I’d Focused On Sooner – Chuck Bailey

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack welcomes Chuck Bailey, founder and CEO of True North Holdings, to discuss the realities of being a small business owner in the home care industry. With decades of experience as a corporate executive, franchisee, franchisor, and now a service provider to franchisees, Chuck shares invaluable insights on the challenges of entrepreneurship, the importance of financial discipline, and the two critical roles every business owner must master: driving revenue and building a team. He also reflects on his biggest mistake: trying to control...

Stop Thinking Like a Manager when You’re an Owner – Emily Isbell

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack sits down with Emily Isbell, founder of EI and Company, to discuss her impressive journey from caregiver at 19 to a successful home care consultant and bestselling author. They talk about Emily's early career, the evolution of her business, and the release of her book, 'The 24/7 Solution.' Emily shares valuable insights on correcting mistakes, the importance of consistently executing strategies, and the necessity of looking for talent within your existing workforce. They also explore the challenges of maintaining emotional maturity in a...

Why I Stopped Trying to Lead Alone – Guy Tommasi

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack welcomes Guy Tommasi, a seasoned leader in the home care industry with over 25 years of experience. Guy shares his journey from hospital care to pioneering innovative, data-driven strategies in non-medical home care. He takes us to a discussion of the importance of differentiating your agency by aligning with stakeholders' needs, leveraging data to demonstrate outcomes, and the pitfalls of overemphasizing "scaling" as a measure of success. Guy also highlights the transformative power of collaboration, both within teams and with clinical...

Blind Optimism Cost Me Two Years (Here’s How We Fixed It) — Randy Platt & Rodney Burris

Home Care Hindsight

Randy Platt and Rodney Burris, co-founders of Care Partners, reveal how blind optimism and over-reliance on culture nearly derailed their home care startup, and the pivotal shifts that turned their $0M mistake into 40% growth. In this transparent conversation, the duo unpacks their early missteps: from chasing unrealistic budgets to hiring for "culture fit" over performance. Discover how they transformed their partnership through radical transparency ("no barnacles"), why EQ now trumps IQ in their hiring, and the surprising metric that proves their team’s resilience. From solving healthcare...

Don’t Forget Owner Involved Employee Recognition (like I did) – Rachel Gartner

Home Care Hindsight

In this episode of Home Care Hindsight, host David Knack interviews Rachel Gartner, founder and CEO of Carework. They discuss Rachel's life in rural South Georgia as an Army wife and mother, her passion for hiring military spouses, and the unique challenges in the home care recruitment industry. Rachel shares insights on building effective systems for employee recognition, managing rapid company growth, and the importance of maintaining a caregiver-first mindset. They explore the difficulties of balancing recruitment intentions with execution and the significance of analyzing recruitment...

I Wasted Two Years on the Wrong Thing (Here’s How I Pivoted) — John Soltys

Home Care Hindsight

John Soltys, founder of Project Senior Care, shares his hard-won lessons from wasting two years (and resources) on an overcomplicated tech vision—and how a pivot to caregiver training and mentorship unlocked explosive growth. In this raw conversation, John reveals how his "big idea" mentality almost sank the business, why 96% of seniors fall into an unaffordable care gap, and the partnerships now helping agencies serve everyone—regardless of income. From rebuilding trust with his team to rethinking caregiver recruitment (hint: stop recycling the same hires), John breaks down the "no one...

I Overcomplicated Medicare Advantage (And Found a Simple Fix That Worked) — Fady Sahhar

Home Care Hindsight

Fady Sahhar, a disability advocate and home care strategist with decades of experience, unveils how Medicare Advantage is reshaping home care—and why agencies must rethink caregiver training to thrive. In this eye-opening conversation with host David Knack, Fady shares: Why 750+ Medicare Advantage plans now cover home care (and how to tap into this growing market). The "lifetime value" mindset shift that turns clients into long-term partners. How peer coaching solves EVV resistance and caregiver retention challenges. Fady also reveals common cultural blindspots when expanding into new...

More Episodes

In this episode of Home Care Hindsight, host David Knack sits down with Gregory Bean, Vice President of Paradigm Senior Services. With 30 years in home care, Gregory shares invaluable insights on the industry's evolution, the importance of third-party payers, and why treating caregivers as your most valuable asset leads to better retention and client outcomes. They discuss the shift from private pay to Medicaid and VA-funded services, the benefits of Medicare Advantage, and how home care agencies can remain profitable despite economic challenges.

Lesson Takeaways:

Agencies should prioritize caregiver appreciation and retention beyond just pay.
Expanding into Medicaid, VA benefits, and Medicare Advantage can provide financial stability.
Managing family expectations is key to ensuring smooth home care operations.
Keeping consistent caregivers improves client satisfaction and reduces turnover.
Agencies should focus on lifetime client value rather than just hourly profit margins.

Timestamps:

[00:01:00] Introduction to Gregory Bean and Paradigm Senior Services
[00:02:30] The biggest shifts in home care over the last decade
[00:06:45] Why Gregory’s biggest "mistake" was starting a home care business
[00:10:00] Managing family expectations vs. client satisfaction
[00:12:30] The three key reasons caregivers stay: work, pay, and appreciation
[00:17:30] Why third-party payers like Medicaid and VA benefits are underutilized
[00:21:00] The administrative burden of third-party payers (and how to simplify it)
[00:26:00] The challenge of rising caregiver wages and private pay rate limits
[00:30:00] The future of Medicare Advantage in home care
[00:37:00] Why the most reliable caregivers are the real heroes
[00:41:30] How home care agencies can improve retention through recognition

Quotes

Gregory Bean: "I wish every agency saw their caregivers as their greatest asset, not just employees."
Gregory Bean: "The biggest mistake agencies make is focusing on hourly margins rather than lifetime client value."
David Knack: "If every caregiver was consistent and reliable, home care would change overnight."

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