By Thomas A. Parmalee
When you meet Stuart Madow, marketing manager at Visiting Angels Lake Norman in Cornelius, North Carolina, you quickly sense two things: he’s a natural communicator, and he cares deeply about people.
Those qualities have served him well on the front lines of sports broadcasting and in his second career as a home care executive. Today, he works at a thriving franchise that serves Cornelius, Huntersville, Davidson, Mooresville, Statesville, Denver and surrounding communities.
Visiting Angels Lake Norman employs about 85 people, has several dozen clients and serves a geographic area with about 350,000 people. It’s poised for even more growth in the years ahead, he said.
For the past two years, Madow has played a critical role in the business owned by Scott and Tina Goins, who have proudly served seniors in the community for more than 14 years. In that short time, their agency has experienced a remarkable 47% growth — an achievement Madow attributes to the combination of strong community presence, digital savvy and a relentless focus on people.
Madow has known Scott and Tina for about 30 years, so when they asked him to join their team two years ago, it felt natural, he said. He served as general manager before transitioning to a marketing manager role.
“We were positioned to grow, but we needed some tweaks,” he said, noting that he’s emphasized connecting with key referrers and has focused on bolstering the agency’s search engine optimization, website and social media presence.
A Personal Journey into Home Care
Madow’s career began in the world of sports broadcasting, where he sharpened his public speaking, interviewing and storytelling skills.
“As a kid, I’d walk around the house holding a microphone pretending to interview sports heroes,” he recalled. In his 20s, he turned that passion into a career in radio, working in Cleveland’s competitive sports market.
But like many broadcasters, he faced a crossroads: relocate to a bigger media hub to advance — or shift careers. After moving to the Carolinas and running a bookstore with his first wife, he found himself at another inflection point when Amazon disrupted the independent bookseller world.
“I loved that business and could have done that forever,” he said – but he was also smart enough to see “the writing on the wall” that was being spraypainted everywhere in giant letters by Jeff Bezos.
That’s when Madow was introduced to senior care. A colleague recruited him into a marketing role with another home care franchise – Home Instead Senior Care – which he now competes against in his new role working for the Goins family.
Working in home care was appealing because he believed – rightly – that many of the skills he’d mastered in broadcasting, such as public speaking, could be applied to the field. He also knew he’d have the chance to make a difference in his local community, which appealed to him on several levels.
For instance, he knew about the challenges families seeking home care often face, as his mother was diagnosed with Alzheimer’s.
“If anything good came out of that, it’s that I truly understood what it feels like to stand in the shoes of a family caregiver,” he said. “I literally close my eyes and try to remember how overwhelming it was when I was looking for resources as a caregiver.”
The ordeal would provide a firm foundation on which to connect with clients and their families at a deep level.
The Role of Communication in Home Care
Madow believes his broadcasting background prepared him perfectly for senior care leadership.
“You can’t teach empathy or compassion — you either have it, or you don’t,” he explained. “But being able to communicate, to connect with adult children making decisions for their parents, is critical. Often it’s the daughter making that call, and she needs to trust that you understand her journey.”
Despite the rise of AI in the industry, Madow insists that nothing replaces one-on-one human connection. “AI may help with chatbots, pricing questions, and even safety monitoring,” he said, “but the decision to trust your agency with a loved one still comes down to a face-to-face conversation.”
Scaling a High-Performing Agency
Since joining Visiting Angels Lake Norman, Madow has leaned on both traditional networking and digital strategies to drive growth.
- Community Presence: He facilitates the area’s largest healthcare networking event, ensuring the agency remains visible and connected.
- Digital Marketing In-House: Rather than outsourcing SEO and social media to a national firm, Madow and the owners invested the time to learn it themselves. “A local touch matters. We know our market better than anyone,” he said.
He’s aware, however, that many companies pay someone to manage their social media and SEO efforts, which is what his agency was doing before he came on board.
“But I realized who we were using was not local – they did not know our market and what we were really involved with, so Tina and I took it over,” he said.
- Awards & Recognition: By actively engaging the community, Visiting Angels Lake Norman has earned multiple local awards from area newspapers. These aren’t vanity plaques you can buy — they’re voted on by local citizens. “That credibility matters,” he said.
For six out of the past seven years, his agency has won such local awards from the local newspaper that asks local citizens to vote for their favorite local home care agency, he said.
“That’s a big differentiator for us, plus we are dementia care experts,” he said.
Lessons for Other Home Care Leaders
Madow offers several best practices for agency owners:
1. Prioritize Marketing: “You can model operations, but marketing is an art. If you don’t invest heavily in sales and marketing, you won’t scale,” he said. “My personal opinion is that no home care agency can be successful if it does not understand sales and marketing.”
Unfortunately, too many firms ignore marketing at the expense of operations, which Madow said is a grave mistake. “Operations is much easier to model than marketing – you can set up best practices in operations whereas marketing is a much more subtle art, and you need a strategy to excel at it,” he said.
2. Focus on Referrals – and Measure Results: Too many agencies don’t track which marketing channels generate referrals. “Don’t just drop off cookies at referral partners — measure what works,” he advised.
While getting out in the community is critical, Madow noted that his biggest referral partner is Google.
Looking further, home health organizations, hospice, palliative care and even eldercare attorneys all generate referrals, he said.
“If you understand hospice, you know that the client could be alive for just a week … or it could be six months,” he said. “And usually, if they need a hospice provider, they also need more help, such as home care.”
While many so-called experts suggest building relationships with case managers at hospitals to generate referrals, Madow hasn’t found that a worthwhile area to spend his time on. “Very few discharge directly to home care,” he said. “They are usually discharging to skilled nursing and home health facilities.”
How much time you spend visiting referral partners will depend on the maturity of your business, according to Madow.
“Face to face is always best, and if you are just starting in any market, you need to be out on the street,” he said. “But I am not a believer in simply dropping off candy or cookies. Tell them why your service will benefit them – and do it efficiently. They may love the Oreos you drop off every week, but that is not what gets you business.”
Once you earn referral partners, don’t take them for granted, which is something Madow says he’s learned the hard way. You must continue to nurture the relationship.
3. Recruit Full-Time: Staffing remains a challenge, so the agency employs a full-time recruitment coordinator. “You can’t treat recruiting as a side project — it requires daily attention,” he said.
4. Nurture Caregivers: With 85 caregivers on staff, Madow emphasizes constant communication and compassion. “Richard Branson said if you take care of employees, they’ll take care of clients. That’s our philosophy,” he said.
5. Build Real Relationships: While digital marketing is essential, Madow still believes in face-to-face networking. “Take referral sources for coffee or lunch,” he said. “Get them on neutral turf and get to know them personally. That’s where trust is built.”
6. Focus on Your Mix of Business: Most of the firm’s clients are private pay, Madow said.
“We are a Veterans Affairs approved provider – and we are constantly monitoring developments to stay updated on changes,” he said.
He noted that Medicare does not pay for home care, even though some people get confused and think their Medicare Advantage will cover such expenses. Those reimbursements, however, are reserved for home health.
Medicaid is a different story, but Madow noted that reimbursement levels need to be bolstered.
Fortunately, VA clients have higher reimbursement rates, which wasn’t always the case. That means there may be hope for Medicaid clients, as Madow noted the business would love to be in a position to serve more of them.
Getting Staffing Right
Staffing, however, remains the industry’s biggest challenge. “The demand will only increase. The question is, will we have enough caregivers to meet it?” he asked.
Getting the right people is a constant struggle, he said – noting that half the people his agency sets up interviews for do not show up, which has been happening since the outbreak of the COVID-19 pandemic.
“Fortunately, the industry as a whole has begun to pay caregivers a higher wage,” he said. “Before, they were saying that they could go to Walmart and make more money, but we are now becoming comparable to what they can make in that realm.”
At its core, home care remains “a people business,” which is why it’s critical to have an agency administrator like the one Visiting Angels Lake Norman has – Mary – who has loyally served the owners for many years.
“She is the foundation of everything we do, because she has working knowledge of everything,” Madow said, noting that an agency will not succeed if it does not hire the right people to manage day-to-day operations.
“You also need to hire people who have compassion and a customer service focused mindset.”
Given that most caregivers do not go into the office much and are remote employees, the challenges of promoting such a culture can be formidable, he admitted. “Staying in touch with them is vital,” he said, adding that his employees are encouraged to drop by the office anytime – even if it’s just to say hello.
Staffing missteps will always be made, which is part of being in business, Madow said. What is more important is to avoid pointing fingers when something goes wrong.
“Figure out what you can do to make things right for a client then go back and analyze the situation,” he said. “We must go back and analyze what caused the problem, and a lot of times, it goes back to miscommunication. When you make a mistake, own up to the mistake and tell the client what you are doing to remedy it, so that it won’t happen again.”
Sometimes, the problem may result in you firing a caregiver, but there are also times you must walk away from a client, he said.
“We never want to put our caregivers into a situation where they are unsafe,” Madow said. “It is rare, but we have had situations where we’ve had to say, ‘We cannot meet your needs.’”
Even if you connect with a family you can’t serve, however, it’s important to provide what help you can. “Every day, I get a call from someone who wants our help but cannot afford us, but I don’t say, ‘Sorry,’ and hang up,” he said. “I tell them about the resources there are in the community. There are not many, but they may help them, even if they cannot afford home care.”
The Future of Home Care
Looking ahead, Madow sees three key trends shaping the next decade:
- AI Integration: Technology will assist with fall detection, scheduling and even marketing — but won’t replace human caregivers.
- Consolidation: As demand rises with the aging population, only the largest and best-managed agencies will thrive.
- Client Preference for Home: With assisted living construction slowing, Madow notes that 80–90% of seniors still prefer to age at home. “Every study shows people live longer, healthier and happier at home,” he said.
At the heart of Visiting Angels Lake Norman’s success is a culture of compassion. Madow recalls a story of a caregiver who stayed by the bedside of a new hospice client estimated to have only 48 hours left. “She had just met him, but she held his hand and gave him peace in his final hours. That’s what this work is about,” he said.
For Madow, success isn’t just measured in growth percentages or market share. “When I’m at the end of my life and I look back, I want to know I made a difference by connecting people to the care they needed,” he said. “That’s why Scott and Tina started this business, and it’s why I’m here today.”
Overall, he thinks home care remains an exploding field that more people should consider entering, if they are doing it for the right reasons.
“You need to do your homework or hire people already in the industry,” he said. “That is kind of my go-to recommendation … you can’t just think you are going to flip a switch and be successful.”
