Biz Flash: What to Know Before Starting a Private Home Care Business

“There are consulting companies and attorneys that can assist you. But this is a field where you also have to constantly be educating yourself and learning the rules.”

Yelena Sokolsky, CEO, Owner, and Director of Patient Services at Galaxy Home Care

Home healthcare is a broad term that encompasses a wide range of medical and support services delivered in a home setting. This type of care is designed to assist individuals, particularly seniors, who need help with daily activities or require medical assistance due to illness, injury, or chronic conditions. According to the National Association for Home Care & Hospice, approximately 12 million individuals in the United States currently receive some form of home healthcare.

The types of services that can be delivered at home can vary widely. “You can receive all kinds of services at home, from a visiting doctor to labs and x-rays. However, most people who have home healthcare are receiving assistance with personal care and activities of daily living,” shares Yelena Sokolsky, CEO of Galaxy Home Care, an NYC-based home care agency. “This service is provided by home health aides or personal care workers, depending on the state and regulation, and is paid for by the federal or state government.”

Home health is projected to grow from $94.17 billion in 2022 to $153.19 billion by 2029 and, according to a study by the American Association of Retired Persons (AARP), more than 77 percent of seniors want to stay in their own homes as they age. Starting a private home healthcare business can be lucrative and not only meets a critical healthcare need but also contributes to the societal goal of improving the quality of life for seniors. “I love my career. I love visiting patients and building relationships with them and their social workers,” shares Sokolsky.

Getting started in this industry requires knowledge and preparation to navigate the complexities of the healthcare sector. “You need to know the industry, and it’s very important to be able to think outside of the box,” advises Sokolsky.

Keep reading to learn what she thinks everyone needs to know before starting their own private home care business.

Meet the Expert: Yelena Sokolsky, RN

Yelena Sokolsky

Yelena Sokolsky is a career registered nurse and entrepreneur who has positively impacted community members’ lives since 2006. Currently, she is the CEO, owner, and director of patient services at Galaxy Home Care, an NYC-based home care agency dedicated to providing exceptional care and support to patients in need.

In 2021, she took the leap and started Galaxy Home Care after gaining valuable experience as the director of patient services for a large, established home care company. While there, she oversaw the care of thousands of patients and caregivers, ensuring they received the highest quality of service. She has a bachelor of science in nursing and a bachelor of arts in psychology.

What To Know About the Business

As an experienced healthcare professional and entrepreneur, Sokolsky shares her top lessons and tips for anyone considering launching their own private home care business.


The home care industry can be complex and challenging, requiring a thorough understanding of federal and state regulations. “This is a business where we care for the elderly and provide services at home. We have a lot of entities that we report to, including the Department of Health, Department of Labor, Medicare, the Attorney General, and the Bureau of Consumer Protection. All these departments and entities regulate us to protect employers, employees, and patients,” shares Sokolsky.

Compliance is a crucial element in the home care industry. A private home care business must adhere to a myriad of rules and guidelines set forth by regulatory bodies to ensure quality care and patient safety. This includes compliance with health codes, labor laws, and privacy regulations such as the Health Insurance Portability and Accountability Act (HIPAA).

“To stay in compliance, all our providers are supervised by nurses and follow a plan of care created by the nurse. We also have visit verification so we know if the five hours a day an aide is supposed to be in a home, they are actually there. We have to ensure that the aide is there on time and works the full five hours to bill the insurance company and be reimbursed properly,” shares Sokolsky.

Home healthcare agencies must also be licensed by their state authority to provide care. Navigating all the rules can be daunting. “There are consulting companies and attorneys that can assist you,” says Sokolsky. “But this is a field where you also have to constantly be educating yourself and learning the rules.”

Quality Is Critical

As a provider of healthcare services, the quality of care delivered is paramount to the success of a private home care business. Training staff well is one of the best ways to ensure a high level of care. “Every aide we hire is being trained and retrained. We provide at least 12 hours of in-services a year,” notes Sokolsky.

Another way that Sokolsky ensures a high level of quality is by following up directly with patients and their families. “We always have nurses going out to patient’s homes to ensure they are getting the care they want from the aides. If there is a complaint, we follow up immediately. We also make monthly calls to families and patients to ensure that the care we provide exceeds expectations,” she says.

Over the years, Sokolsky has learned that the key to quality care is happy staff and a good patient and aide connection. “If your staff are unhappy, you won’t achieve good results. So, I strongly believe in a healthy working environment. And I also strongly believe there should be a match between the caregiver and the patient. Someone can be the best caregiver to a patient and a terrible caregiver to another. It doesn’t make them good or bad. It just means they need to work with the right patients.”

Staff Retention

With the high turnover rate in home healthcare, staff retention can be a challenge for private home care businesses. Sokolsky has found success by investing in her employees and ensuring they feel valued. “We offer competitive pay, and I believe in providing quality customer service not just to the patients but also to employees,” she says. “We also invest in training and make sure that every employee is treated with respect and every patient is treated with dignity.”

Unions are essential in staff retention in the private home care business. They provide employees with a sense of security and a platform to voice their concerns and needs. Unions advocate for employee rights, fair wages, and safe working conditions, all critical factors in job satisfaction. Sokolsky’s agency staff are unionized, which ensures they have all these additional benefits.

Leverage Technology

Technology applications can significantly enhance efficiency and effectiveness in a home care setting. From electronic health records to telehealth services and automated scheduling systems, technology can streamline processes, improve communication, and ensure accurate tracking of patient care.

“We use technology for electronic verification, record keeping, and calendaring on a patient side. On the employee side, we provide [digital] access to the payroll, benefits, and the schedule. We use electronic verification when they are working,” explains Sokolsky. “We’re always improving our technology and are open to any changes to increase the quality of care and our services.”

However, when working with the elderly, leveraging technology can be tricky. Many seniors may not be as tech-savvy as younger generations, which can pose challenges when implementing digital communication or care management systems. “It’s challenging because the majority of the patients are elderly, and it’s very difficult to introduce anything technology-related,” she notes.

Patient and Staff Safety

Safety must be a top priority for any private home care business. “Safety is our number one concern, but it has to be juggled between patients and employees. You need to have a perfect balance,” says Sokolsky. “I teach my staff that patient safety is number one, but at the same time, if they walk into a patient’s home and don’t feel safe, their life and safety become the number one priority. We have policies and procedures in place to keep everyone safe.”

To ensure safety, Sokolsky’s agency conducts thorough background checks on all employees and provides ongoing training on emergency procedures. They also have strict protocols for handling any potential hazards or risks that may arise while providing care. “Our top priority is to keep our patients and staff safe at all times,” she says.

Be Clear About The Services You Provide

A private home care business may offer various services, but it’s essential to be clear about those services and the expected outcomes for patients. This helps set realistic client expectations and ensures employees are well-equipped to provide the necessary care.

“It is essential that patients understand that home care is provided at the recommendation of a doctor and with a nursing recommendation and evaluation. Home health aides that come to a house are not butlers. They are healthcare professionals there to provide care. I’m very big on educating our patients on what aides can and cannot do,” advises Sokolsky.

She continues, “Mostly, we assist with daily routine complaints. We are not there to wash your windows, clean a chandelier, do the heavy-duty cleaning preparation for Passover, or paint the walls. We are here to help patients with tasks such as bathing, grooming, eating, and toileting.”

Kimmy Gustafson
Kimmy Gustafson

Kimmy Gustafson leverages her broad writing experience and passion for higher education to provide our readers with in-depth, quality content about the evolving landscape of business schools and the various pathways in business education. Her experience as a start-up CEO provides her with a unique perspective on the business world, and she has written for since 2019.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.

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