By Thomas A. Parmalee
The best things in life sometimes happen by accident.
Stephen Tweed, the CEO of Leading Home Care (a Tweed-Jeffries company), as well as the founder of the Home Care CEO Forum, can vouch for that.
While he’s never operated his own agency focusing strictly on home care, Tweed has served as a board member on three different not-for-profit agencies involved in home health and home care – with two of them also having a hospice division.
At one of those organizations, he was the senior vice president in charge of non-hospital operations and later served as interim CEO of its home health business.
He’s started four companies and sold three of them, building a business empire that revolves around home care in the process.
His journey, however, began by happenstance in 1982 when he was living in western Pennsylvania.
“My pastor called me one evening and said he’d just been elected to the board of directors of the local visiting nurse association, and he wanted to do some strategic planning … and could I help?”
As a good Christian always eager to assist others, Tweed’s answer was almost immediate: Of course he’d help.
“I was thinking it was a pro-bono engagement, but it ended up being a real company with money to pay my fee,” he said.
That pastor had come to the right person for guidance, as Tweed was already an established businessman, having started Tweed Corporation in 1979. Perhaps more important, Tweed had an intimate knowledge of home care, as his son, Jason, – who is disabled – was in a hospital bed receiving home health care when the pastor approached him.
“The pieces just came together,” said Tweed, who noted that more than 40 years later, he’s as passionate as ever about helping home care agency owners and CEOs boost business, serve more clients, employ more caregivers and lift up their communities.
He’s found home care professionals to be “amazing people and great businesspeople with a high level of compassion.”
In other words, his kind of people.
“My personal mission has been helping others find their way … not showing the way or guiding the way but helping others find their way,” he said.
But he would not have found the work as meaningful – and likely not have stayed in it for so long – if not for his son.
“As a family, we have experienced home care and understand the impact of home care,” he shared. “One of the things we have learned about home care is that while we have been able to help clients, home care is an even bigger benefit to families. It gives you peace of mind and comfort as a family member.”
His son, he’s happy to report “is surprisingly well.”
“At this point, he’s totally disabled physically … he’s able to use the fingers on his right hand to drive his electric wheelchair,” he said.
But his son, Jason, has achieved so much personally and professionally: He’s married and has twins – a boy and a girl – who are 23. He also owns his own business.
“He’s been able to adapt and learn and be independent, and a big part of that is his wife is amazing,” Tweed said.
Jason also receives about 55 hours per week of home care, which is another big reason he’s able to live such a fulfilling life, Tweed said.
He’s also a fighter.
“He has a rare neuromuscular disease called Werdnig Hoffmann Syndrome,” which is a severe form of spinal muscular atrophy, he said. “It was diagnosed when he was 1 year old, and the doctor told us he would probably live to be 3 or 4,” he said.
Jason just turned 55.
Another Happy Accident
Whether it was fate, destiny, or some cosmic force at work, Tweed also met his wife and business partner, Elizabeth Jeffries, by chance.
He saw her for the first time in 1990, when she was delivering a presentation at a National Speakers Association convention in Atlanta.
Little did he know at the time he’d be married to the confident woman who had captured his attention – and in only two short years.
Both were single at the time, and after watching her speech, he strode up to her to tell her how much he enjoyed her presentation.
He mentioned that he was working with a hospital in Louisville, where she was from … and could they get together in a couple weeks for lunch when he was in her area?
“I called her, and she had no recollection of who I was – but she reluctantly agreed to have a meal with me,” he said. “That led to another meal … and pretty quickly, we realized we were in a serious relationship. We got engaged, and ultimately I decided to move to Louisville.”
At that time, Tweed had owned another company engaged in consulting and research for home health care and hospice organizations in Pennsylvania, which was named Tweed Weber.
After about four years, Tweed and his wife decided they wanted to work together, so Tweed sold his portion of Tweed Weber to his partner, Al Weber. “He sold shares to our employees,” he said. “Al has since passed way, but the company is still operating in Reading, Pennsylvania, owned by our former employees.”
At that point the couple combined their speaking practices to form Tweed Jeffries, which became the parent company of two units: Leading Home Care and Executive Mastery. In 2012, they launched The Home Care CEO Forum as a division of Leading Home Care.
Going into business together was as big a step as getting married, and they were cognizant of the risks, Tweed said.
They kept in mind they were both speakers with strong personalities.
“We talked with a number of other couples in the speaking business to get their advice and wisdom,” he said. “Several of those couples have become lifelong friends.”
Ultimately, they combined their separate speaking businesses and began getting on stage together.
“We spoke together for a year or so, but we quickly realized that was not a viable business model because we were working twice as hard to put together the program for half the income – we could not get twice the fee,” Tweed said.
After starting the Home Care CEO Forum and setting up a separate office, the couple focused on operating separate practices, both under the Tweed Jeffries umbrella, Tweed said. About five years ago, they each started to lighten their work load to work a bit more closely together again, he said.
At Leading Home Care, Tweed and his son worked together for about 10 years before the younger Tweed, who was the company’s director of business development, started his own digital marketing and website design company, Mediastead, with Tweed Jeffries as one of his clients.
When Tweed’s son left, his daughter, Jill, began working with the business, providing executive support.
“When I sold the Home Care CEO Forum, she left with the business and was there for a year before starting her own LLC, with the objective of providing back-office support to speakers,” he said. Her company, Tweed Scott Speaker Services, is thriving, he said.
“Part of that came out of her experience at the National Speakers Association, attending the youth program and being involved with lots of speakers,” he said.
Making it Work as a Family
Tweed and Jeffries’ two-fold approach has worked wonders, with Elizabeth focusing on coaching physician leaders in academic medicine, and Tweed providing strategic advisory services to owners and CEOs of home care companies in the top 10% of the industry.
When they started the Home Care CEO Forum in 2013, they were looking to duplicate the success of mastermind groups they saw in action as members of the National Speakers Association.
Ultimately, Tweed — with help from his son and wife — grew the business so that it encompassed five mastermind groups with 55 companies that met regularly to share ideas, solve problems and support each other.
Groups were organized by size and revenue. “One of our principles was no one could compete with someone else in the group,” Tweed said. “That way, everyone was very open to share ideas and data.” While numerous franchisees lobbied to join the organization, members chose to limit membership to independent home care operators, he said.
They sold the business in January 2023 to Jensen Jones, a former member, who now serves as CEO.
“Now, my work is focused on serving on boards of directors of home care companies and/or companies that support the industry,” Tweed said. “I also provide strategic advisory services to CEOs and I continue to do industry research,” which includes collaborating on an annual future of homecare study sponsored by AxisCare.
He still relishes speaking, although he’s no longer on the road 125 days a year, which was the case when he met his wife.
“I’m not actively promoting speaking, but I do about 10 to 12 engagements per year, mostly for previous clients,” he said. Over the years, he’s spoken to almost all the top 20 home care franchises, he said.
“I’m being much more selective in the engagements I accept,” he said. “I still enjoy it. I love being there – it’s the getting there that is the hassle.”
Although he’s sold the Home Care CEO Forum, it’s clear that Tweed has no plans of retiring.
“When I got to what many consider normal retirement age, I knew I was not going to retire, but I began to think about an exit strategy,” he said, noting that in the speaking business, that is a bit of a novelty as you typically wind down, stop speaking, “turn out the lights and lock the door.”
But it became apparent that several potential buyers wanted to keep the Home Care CEO Forum going – the problem was most of them wanted him to continue to run it after selling it.
“I knew I would work even harder after selling it,” he said, which made him realize he needed to find the right buyer “to make the economics work.”
At age 76 and with 2025 speeding by, he’s committed to “rewiring” his work, he said.
He’s always open to working with new clients, he said, noting that he specializes in serving owners and CEOs of home care companies that are in the top 10% — with more than $3.5 million in annual revenue. It’s imperative that they’re serious about growing their business and implementing strategies to prepare for the future.
“The second type of client I work with is CEOs of companies that serve the home care industry that want a strategic adviser or a board member who can hep them understand the industry and devise a strategy to further penetrate it,” he said.
Lessons Learned
Working at the intersection of health care, home health and home care has given Tweed an insider’s perspective of what works and what doesn’t when it comes to caring for seniors and others who need a high level of care.
“For the most part, home health serves a different population that needs skilled care that is mostly covered by Medicare, Medicaid and insurance,” he observed. “Some home health agencies have a private pay business that may compete with home care companies.”
But for the most part, companies that try to do both – home health and home care – don’t do particularly well, he said.
“There are lots of reasons for that, namely that they really are totally different businesses,” he said. “When people ask me, I discourage them from trying to do both.” The ones who do both well tend to operate them as separate companies, he said.
With that said, home health and hospice often align, and he notes that he’s served on boards representing organizations that do both. It’s critical for those serving seniors to realize there really are five distinct businesses – hospitals, hospice, home health, home care and home medical equipment, he said.
Over the years, he’s reaped tremendous rewards from being a member of the National Speakers Association – and it goes beyond being how he met his wife.
“I had joined the association on the advice of a friend, and I went to the national meeting and realized it was a totally different experience from other associations I had been a part of … you had about 2,500 members who in essence competed with each other, and yet they come together and share ideas to support one another,” he said.
Tweed went on to serve as president of the association in 2003 and has also spent time as chairman of the board of trustees of the NSA Foundation, which provides grants to members who are affected by a short-term crisis, often a natural disaster, illness or injury – as well as providing scholarships to members.
He remains active with the association, delivering presentations and attending conferences. His grandchildren are in the association’s youth leadership program, he said.
“The association is a core part of who we are because of the people we have met through it from all around the world,” he said.
Through all the ups and downs of Tweed’s career, faith has remained at the core of who he is and how he lives life.
A member of an evangelical church in Kentucky – Southeast Christian Church – he’s active with its pre-marriage ministry and is providing support to the planting of a new church in Naples, Florida, called The Gathering … a Christian Church, where he has a second home.
He credits the Lord with being the driving force for how he carries himself and conducts his practice.
“As a result of being comfortable sharing my faith from the platform and in conversations, we have learned that home care is represented by a very large number of people who are very active in their faith,” he said. “That has enabled us to have that in common and support one another – all kinds of positive things have come out of home care owners sharing their faith.”
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