What roles should I hire for in my home care agency's office staff and when should I hire them?

I could give the cop-out answer by saying it depends on the circumstances of every agency and I’d be right, but we’re not here for cop-out answers. :)

While it does depend on the circumstances of every agency, we interviewed Brett Ringold, an experienced agency administrator in Pennsylvania, to get the dirty details on exactly when and why he hired for each role, and what he’d do differently if he went back.

Brett is the VP at A Long Term Companion, an agency he runs alongside Michele Kilstein, his mother. They’ve been in business since 2010 and are handling over 6000 weekly billable hours.

Here’s how we’ll break this down:

Eight key roles in a home care agency
What division of roles might look like with only two administrative staff
When A Long Term Companion hired each role and what prompted the hire
What ALTC’s org chart looks like today

Eight key office staff roles in a home care agency

A Long Term Companion (ALTC) has hired eight roles over the years:

Director of Operations—the administrator or executive. Typically this is filled by the owner until they reach a point where they hand off management of daily operations.
Sales/Marketing—including the intake process, business development, community relations, and either handling consumer-focused marketing (like Google Ads) or being the liaison to a marketing agency that handles it.
People—human resources and recruiting.
Wellness—nursing.
Quality management—Brett identifies this function as focusing on using feedback and data, typically from surveys, to identify where quality of care can be improved
Scheduling
Billing and payroll
On-call

Early on, it’s helpful to view these as distinct hats that you’ll wear. It’s understood that no startup home care agency will have eight staff members to individually fill each of these rolls, but it’s helpful to think of them independently as it’ll help you to focus on each one more intentionally.

Dividing roles between two admin staff

Early on, your org chart will probably look less like an org chart and more like a Venn diagram that separates roles/duties between two or three people at max.

While the Venn Diagram of your agency’s responsibilities will obviously depend on the strengths that you and your employees bring to the table, here’s how A Long Term Companion split up the roles early on:

In my experience, this is a fairly logical/typical breakdown of roles with an agency that has two admin employees.

When A Long Term Companion hired each role and what prompted the hire

Here’s the general overview of their growth and hiring timeline:

One of the earliest roles to hire for is sales and marketing; Brett discusses hiring for sales and marketing essentially when two things happened: 1) they came across the right person whose skillset and local network fit their needs, and 2) they reached the point where Michele, who was filling the marketing role, was simply needed more urgently in other parts of the business.

A few related pieces that might help you plan future hiring decisions:

When to hire a marketer, according to the sales and marketing experts at corecubed (includes benchmark of revenue and billable hours)

When to hire a recruiter, according to the Rachel Gartner, CEO of caregiver recruitment company Carework

What ALTC’s org chart looks like today

In case you’re wondering, these screenshots come from Brett’s presentation on Careswitch’s Home Care Success Summit in November.

Hope this was helpful!

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