Within the home care franchising world, there aren’t too many independent, founder-led organizations left.
Caring Senior Service, founded in 1991 by CEO Jeff Salter, is one of the rare exceptions. The San Antonio, Texas-based home care franchise has grown fairly rapidly over the past 30 years, and it now boasts roughly 50 locations across nearly 20 states.
In 2022, the mainly private-pay Caring Senior Service wants to use that scale to expand its relationships with payers such as Veterans Affairs (VA) and Medicaid, in turn diversifying its revenue stream, Salter told Home Health Care News. The provider is likewise looking to double down on some of its unique offerings, with its “Close the Gap” program aimed at fall prevention being a great example.
“Historically, we’ve provided services – and we’ll continue to provide services – from traditional payments sources,” the CEO said. “That’s individuals paying directly out of pocket or by using their long-term care insurance. The VA and Medicaid have been small parts of our business, but we’re looking to really expand our payment sources by forming alliances with more national providers.”
In terms of its service mix, Caring Senior Service mostly delivers assistance with activities of daily living (ADLs). The company’s caregivers serve “thousands of clients every single day,” Salter explained, helping with errands, meal preparation, personal hygiene and more.
Like others, Salter has seen a greater appreciation for non-medical home care over the past few years. That’s partly why he’s so bullish on Caring Senior Service’s outlook and its chances at striking a few new strategic partnerships this year.
“While we’re not big enough yet to cover the entire 50 states, or at least the lower 48, we do have some regions where we really have a good footprint,” he said. “And we’re looking for relationships that make sense for us, and for others, as it relates to their needs in helping their clients, members or patients stay home.”
Getting started
Before opening Caring Senior Service’s first location in Odessa, Texas, over 30 years ago, Salter worked as a “front-desk person” for a home health company that did not offer non-medical home care.
Just 20 years old at the time, he picked up on a clear market need after fielding seemingly countless calls from people seeking ADL support for a loved one.
“They didn’t provide any of the services that people often called about, which was someone to be with their mother for hours at a time – 12 hours at night, over the weekend or during the day when they couldn’t be there,” Salter recalled. “And I just recognized there was a need for that.”
Initially, the plan was to “help a few families,” but that quickly snowballed into several.
Not too long after opening in Odessa, Salter launched another office in Midland, then a third in McAllen. Next came a location in Corpus Christi, with the San Antonio branch coming after that in 1996.
“I kind of thought that was probably where I was going to be for a while,” Salter said. “But I recognized that the work that I’d done, the success that I’d found, could be something others could follow and emulate. So I started franchising our company in 2003.”
Since 2015, Caring Senior Service has added about 10 locations, with record-breaking revenue numbers each year as well. In 2021, the company’s system-wide revenue checked in at about $34 million, according to the CEO.
More growth is likely on the way, too, with Caring Senior Service recently recognized as one of the 200 best franchise opportunities in the U.S. by market research firm Franchise Business Review.
Staying nimble
M&A activity involving home care franchise networks like Caring Senior Service has been at an all-time high.
There were multiple home care franchise companies that sold in 2021, with the headliners being Senior Helpers, Home Helpers, Home Instead, Caring Brands International and Executive Care. Only a few franchise-related transactions took place in the five years prior.
Private equity has often been the main catalyst in that dealmaking, a recent report from M&A advisory firm Mertz Taggart notes.
“Before 2021, you could count the number of franchiser transactions [in] the previous five years on one hand,” Mertz Taggart Managing Partner Cory Mertz said. “Private equity loves the industry, but have had a hard time finding targets with scale.”
Despite that demand, Salter and co-owner Ian Klaes aren’t interested in bringing on a PE partner – at least not yet.
“For us, it’s been important that we’ve been able to control our own destiny and make our own decisions,” Salter said. “Self-funding all of our growth has been a very positive experience. And it allows us to really look at the future and decide where we want to take our company.”
Technology is a big piece of the future puzzle for Caring Senior Service, he said.
Already, for example, the provider gives each of its clients an internet-enabled tablet to help them learn about their care plans, while also giving staff a way to better document the services they’re delivering in a consistent way. Caring Senior Service developed the software that powers those tablets as well.
“We really took a different track there and developed our own technology,” Salter said. “We’re continually looking for opportunities where our technology can integrate with other things that are happening in senior care.”
