If you’re still chasing caregiver applicants and manually filling shifts, you have already fallen behind the game.

Let’s be frank: there are 29,000 home care agencies going after the same caregivers, clients, and referrals. Only 5% of the agencies are achieving $10M+ in revenue, putting together world-class leadership teams, and getting acquired by private equity.

What do they know that you don’t?

That was the question Stephen Tweed, founder of the Home Care CEO Forum, decided to answer. He took the lessons he learned from spending decades coaching the largest independent home care agencies in North America, and created seven critical best practices of the best in the business.

Whether you are a home care operator, a tech-enabled provider, or a healthcare SaaS leader like Ankota, these best practices are your roadmap to sustainable, scalable growth in 2025 and beyond.

1. Think Bigger Than Your Current Size

The best agencies don’t set goals based on last year’s revenue—they start with a vision of the company they want to become.

“These leaders see themselves running a much bigger business,” says Tweed.
“They’re not guessing—they’re building toward a clear future.”

This mindset drives everything: tech investments, hiring, service lines, and even exit strategies.

Ankota is an end-to-end home care software that gives you the base to grow: Enterprise-grade software scheduling Billing & payroll EVV compliance Role-based dashboards KPI visibility You don’t need to be big, to act like a top agency.

To learn more about protecting your margins, check out Home Care Agencies are Leaking Profits Without Knowing It

2. Your Culture Is Either a Growth Engine Or a Hidden Liability

Why do some agencies keep their caregivers for many years, while others can’t keep them for 3 months past training?

Tweed highlights four aspects of the culture:
- Clear leadership
- 3 memorable core values
- Defined behaviors
- Zero tolerance for inconsistencies

“What you permit, you promote.”

What Ankota Does to Help: Your culture is built through really being a system. Ankota establishes accountability with the following:

- Shift tracking & documentation compliance
- No-show alerts
- Caregiver performance insights
- In-app communication

When the expectations are clear, culture can scale.

To learn more about building your team, check out Cracking the Code: Building a Resilient Home Care Workforce

3. Stand Out or Stay Stuck

There are thousands of agencies providing a very similar service. Differentiation is critical for survival.

The high-performing agencies focus on:

Specialty programs

(dementia, Parkinson's, post-op recovery, etc.)
The "ideal client" profile

The high-touch experience for families and referral sources
Tweed refers to this as "the oldest daughter syndrome," since 60% of care decisions are made by adult daughters, who want reliability and continuity.

How Ankota Helps
Ankota's configurable workflows and caregiver matching tools will help you:

- Deliver specialty care
- Facilitate caregiver consistency
- Increase satisfaction and retention
- Differentiate your agency

4. Lead With Purpose. Share Your Story.

Every great agency has a "why." The best ones leverage it to build trust - with caregivers, clients, and referral sources.

"Stories create emotion, and emotion drives behavior."
How Ankota Can Help:
Use Ankota's communications and CRM capabilities to:

Share your story with prospects
Align your staff with your mission.
Infusing purpose into every interaction
Clients and caregivers are not just looking for services - they are looking to be a part of something.

5. Stop Hiring, Start Building an Amazing Team

Leading 5% agencies of Tweed are changing their agency culture from a client-first culture to a caregiver-first culture - and it's working. They put time and effort into their middle managers, and they don't offer short shifts that drive staff to their limits.

“People don't quit companies. They quit their manager.” 

How Ankota Helps:
We give your managers the tools to be leaders:

Role based dashboards
Real time attendance and shift reports
Schedule flexibility with client and caregiver availability
Metrics to support coaching and accountability.

6. Be a Systems Thinker—With Scheduling in Particular

In Tweed’s recent Future of Home Care report, scheduling was identified as the number one system that agencies are focusing on in 2025.

Why? Because it has a direct impact on:
- Caregiver satisfaction
- Continuity of care
- Operational costs
- Revenue per shift

How Ankota Assists:
Ankota’s intelligent caregiver scheduling software considers caregiver preferences, geography, availability, and shift history to auto-optimize schedules.

Bottom line: fewer gaps, higher continuity, and happier teams.

To learn more about leveraging AI in your agency, check out AI in Home Care: What's Next (and What to Watch Carefully)

7. Measure Constantly. Communicate Often.

Growth agencies don’t just monitor performance, they also share it with their Teams. This cultivates a culture of clarity and consistency. 

Tweed connects communication to retention.
"Turnover is not a caregiver issue, it is a leadership communication issue."

How Ankota helps: 
Our dashboards provide visibility for leaders into the following:

- Caregiver reliability
- Client satisfaction
- Visits completed
- Revenue per case
- Staffing coverage

With alerting and reporting options, clarity of expectations is maintained.

Last Thought: Scale Isn’t Luck, it is Leadership + Systems. A smart agency doesn’t just work harder – they work smarter with systems in place that allow for discipline, focus, and growth.

If you are ready to scale beyond the daily chaos, and just run a good, profitable business then Ankota is your partner in that journey.

Ankota's mission is to enable the Heroes who keep older and disabled people living at home to focus on care because we take care of the tech. If you need software for home care, EVV, I/DD Services, Self-Direction FMS, Adult Day Care centers, or Caregiver Recruiting, please Contact Ankota.