In Conversation with Jennifer Axelrod on Overcoming Hurdles and Embracing Trends in Home Care Franchising

Embarking on the journey of home care franchising is both a promising and demanding endeavor. New franchise owners often find themselves wearing many hats — from managing caregiver recruitment and client engagement to overseeing compliance, marketing, and financial operations.

The stakes are high, and the learning curve can be steep. Each decision shapes the trajectory of the business, making reliable guidance essential. To illuminate the real-world challenges and uncover actionable strategies for long-term success, we connected with a seasoned franchise coach who has spent over a decade helping entrepreneurs navigate the nuanced landscape of home care franchising.

Her insights offer a valuable roadmap for building not just a business but a trusted, mission-driven presence in the community.

To shed some light on the same, we interviewed a home care industry expert to bring her perspective on the intricacies of building a successful home care franchise.

Let us now delve into what she has to say about the evolving landscape of home care franchising:

Question 1: Drawing on your 13+ years of experience, what are the top 2-3 operational hurdles new home care franchisees typically encounter, and what is your primary coaching approach to overcome them?

With over 15+ years of franchising experience and working with franchisees, operational hurdles no matter the industry are usually very similar, but specifically in Home Care are the following:

• Recruiting and Retaining Caregivers: Building a dependable caregiver team is one of the biggest challenges early on. Many owners are surprised by how much ongoing effort it takes to attract, onboard, and retain quality caregivers. I coach franchisees to treat caregiver recruitment as a daily discipline, not just a reactive task when needs arise. Together, we establish proactive recruiting strategies — including CNA school partnerships, referral programs, and a strong local presence — to ensure they are always building their pipeline. Recruiting in this time now requires us to approach it as we do with finding new families to serve. It requires marketing and thinking outside the box using multiple channels.
• Scheduling for Profitability: New franchisees often approach scheduling from a customer service mindset, which is important, but they also need to understand how scheduling impacts the overall health and profitability of their business. I guide owners through setting minimum scheduling standards, evaluating client profitability, and using their scheduling software to support both client satisfaction and strong financial outcomes. It’s about being intentional, not just reactive. Scheduling needs a great problem solver, as it can be seen as a puzzle a lot of the time. When the owner can delegate and hire for this position it really helps with the growth and stability of the operations.
• Time Management and Operational Focus: In the early stages, owners are pulled in many directions — marketing, operations, caregiver management, and client relationships. Without clear prioritization, the most critical activities can get sidelined. I work closely with owners to establish a strong daily rhythm, keeping recruiting, marketing, and relationship-building at the forefront, supported by simple operational tools like weekly scorecards to drive consistent performance. Forming healthy habits and a clear cadence each week, especially time in the field, and building referral partners is so important.

My overall coaching approach centers around building a strong operational structure early. By establishing scalable systems from the beginning, owners gain more freedom and control as they grow. I focus on keeping strategies clear, actionable, and tied directly to their business goals, ensuring they have a solid foundation for long-term success. Proactive, not reactive, always.

Question 2: Regarding profitability, which key financial metrics do you emphasize most for franchisees to track for sustainable business health?

• Gross Margin (by Client and Overall): I coach franchisees to track gross margin both at the client level and across their entire business. Understanding the margin on each case — not just overall — helps owners make smarter scheduling, pricing, and staffing decisions. If a client is priced too low or scheduled inefficiently, it can quickly drag down overall profitability.
• Caregiver Cost Percentage: One of the biggest expenses in home care is direct labor. I help franchisees monitor their caregiver wages and total labor costs as a percentage of revenue, making sure it stays within healthy target ranges. This helps them stay competitive in caregiver pay while protecting their bottom line. Overtime sometimes cannot be avoided but should be monitored.
• Billable Hours Growth: Revenue in home care is tied directly to billable hours. I have franchisees track weekly and monthly billable hours, not just revenue, to ensure they’re steadily growing their client base and caregiver capacity. Watching billable hours also highlights early warning signs if retention — on the client or caregiver side — needs attention.
• Client Profitability and Minimum Standards: I stress the importance of setting minimum weekly hour requirements and evaluating each new client for profitability from day one. Not every case is a good case, and sometimes saying “no” to low-hour, low-margin clients protects the business long-term.

Ultimately, I coach franchisees to understand their numbers, not fear them.

When you use your financial data to guide decisions — from staffing to scheduling to marketing — you build a healthier, stronger, and more scalable home care business.

Question 3: What specific local marketing tactics prove most effective for home care franchisees in building community trust and attracting clients?


In this home care space, I always share that local referral marketing is 80% of where our leads come from, and 20% is everything else – SEO, Digital Google Ads (PPC), and social media. In my experience, the most effective local marketing tactics for home care franchisees focus on building genuine relationships and establishing the business as a trusted resource in the community. Here are the strategies I emphasize:

• Consistent Community Engagement: I advise franchisees to actively participate in senior-focused organizations, such as assisted living communities, skilled nursing facilities, hospitals, and aging-in-place groups. Regular attendance at networking events and relationship-building meetings helps position them as trusted partners rather than just service providers.
• Educational Workshops and Events: Hosting free workshops on topics like fall prevention, dementia care, or navigating senior care options builds credibility and provides value to families and professionals. These events offer a platform to engage with the community without a hard sales pitch, fostering trust and awareness. Thinking outside the box, owners can educate on topics that others may not focus on, like learning AI or ChatGPT, Elder Abuse, or protecting seniors from scams can go a long way.
• Professional Referral Partnerships: Identifying and nurturing relationships with key referral partners—such as discharge planners, social workers, and elder law attorneys—is crucial. These partnerships, built on mutual trust and consistent follow-up, can become significant sources of client referrals.
• Personalized Follow-Up and Visibility: Personal touches, like handwritten thank-you notes after meetings, sponsoring senior events, or involving caregivers in facility activities, make a lasting impact. Being visible, reliable, and value-driven over time ultimately generates referrals and strengthens community ties.

In general, the most effective marketing strategies are those that prioritize personal connections and consistent community involvement. By showing up regularly, providing genuine value, and becoming a known and trusted name in the local senior care network, franchisees can build a strong foundation for sustained growth.

Question 4: What is your primary compliance consideration when looking at the Canadian home care market?


When considering the Canadian home care market, a primary compliance consideration is understanding and adhering to the specific legal and regulatory frameworks that govern home care operations in Canada.

This includes employment standards, privacy laws, and healthcare regulations, which can vary across provinces. It’s crucial for any franchise looking to expand into Canada to conduct thorough due diligence to ensure full compliance with all applicable local requirements to protect both the business and the clients it serves.

Question 5: In practical terms, how are AI and technology currently enhancing operational efficiency or client care within your franchisees?


In practical terms, AI and technology are helping our franchisees enhance both operational efficiency and client care in some very real, hands-on ways:

• Smarter Scheduling and Staffing: Many of our scheduling platforms now use AI-powered features to match caregivers to clients based on skills, availability, and even preferences. This speeds up scheduling, reduces mismatches, and improves both caregiver and client satisfaction — all while saving the office team a tremendous amount of time.
• Predictive Insights for Client Care: Technology is giving us earlier warning signs when a client’s needs may be changing. For example, through digital caregiver notes, daily check-ins, and certain remote monitoring tools, we can spot patterns — like missed medications or mobility concerns — before they become major issues. It’s helping franchisees provide more proactive care and build stronger trust with families.
• Streamlined Communication: AI-driven texting platforms and CRM automations are helping owners and their teams stay connected with caregivers, clients, and referral partners without losing the personal touch. Whether it’s sending reminders, gathering quick feedback, or nurturing relationships, technology is allowing them to be more responsive without overwhelming their bandwidth.

At the end of the day, I coach franchisees to view AI and tech as tools that enhance — not replace — the human connection that makes home care special.

The agencies that are succeeding are the ones using technology to create more time and space for the personal relationships that drive both client satisfaction and business growth.

Question 6: Looking at the remainder of 2025, what emerging home care trend do you believe franchisees need to prepare for most proactively?

Looking ahead at the remainder of 2025, I believe the biggest emerging trend franchisees need to prepare for is the growing demand for specialized care services — especially around dementia care, chronic condition management, and aging-in-place support.

Families are becoming more educated and more specific about the kind of care they want for their loved ones. It’s no longer just about providing companionship or basic personal care — it’s about offering specialized, skilled, and customized services that truly meet the evolving needs of seniors. We focus on finding a professional solution that can be consistent, we are not just checking off tasks.

I’m coaching franchisees to be proactive by:

• Investing in caregiver training around dementia, mobility challenges, chronic disease support, and palliative care.
• Building strong clinical partnerships with therapy providers, home health agencies, and healthcare navigators.
• Marketing their expertise — not just that they offer care, but that they offer care with real depth, skill, and compassion.

Agencies that position themselves as true experts in senior-focused, specialized care — not just generalists — are going to be the ones families trust and turn to first.

At the end of the day, families are looking for partners, not just providers — and franchisees who prepare for that shift will build stronger, more resilient businesses for the future.

In Conclusion

Jennifer Axelrod’s extensive experience and insightful perspectives offer valuable guidance for both new and established home care franchisees. Her emphasis on building strong operational structures, understanding key financial metrics, leveraging local marketing, navigating compliance (especially in the Canadian market), embracing technology, and proactively preparing for the growing demand for specialized care paints a clear roadmap for success in this evolving industry. Her coaching philosophy, centered on creating scalable systems and fostering a proactive mindset, empowers franchise owners to build healthy, profitable, and sustainable businesses that meet the increasing needs of seniors and their families.