By Thomas A. Parmalee
Everyone’s journey to becoming a home care agency owner is different.
Ian Bongaardt, 45, the CEO and owner of Comfort Keepers of Delaware County, Montgomery County and Chester County, all in Pennsylvania, had not given the field much thought until his parents, Clark and Sallie Bongaardt, opened their first home care location in July 2002.
“They had an experience with my mom’s parents needing some support, which really wasn’t around at the time,” he explained. “And a couple of years later is when they began offering home care.”
As to why they chose to go with Comfort Keepers, he said, “Comfort Keepers was just starting out, and my parents truly believed in the purpose of caring for the elderly by providing them with the safety and security of staying in their homes, while bringing them joy. It was what they wanted for my maternal grandparents, and it’s still what we focus on daily today.”
For Bongaardt (pictured at right with team members in the picture at top), it was only natural to sign on as an employee a couple years later, lending his support to financial and information technology operations.
“I began to see the trend toward more care in the home … I saw the opportunity was there,” he said.
Several years ago, he became a minority owner and then became the sole owner of the business about three-and-a-half years ago, he said.
The business’s main location is in Ardmore, and it has two satellite offices – one in West Chester and the other in Ambler.
“Across our three counties, we typically serve 200 clients annually, providing over 200,000 hours of care,” Bongaardt said. “These numbers fluctuate with clients’ health needs, but the trend is clear: more older adults want to remain independent at home.”
One of the reasons Bongaardt initially gave home care serious thought was that it gave him much more flexibility than the typical 9-to-5 job, which enabled him to follow his passion of being a referee for professional soccer.
“There was a lot of travel involved,” he said. “Working in the family business gave me the flexibility to work half days, which was the main impetus for me getting into the family business.”
While he’s still involved with the Eastern Pennsylvania Soccer Association Referee Committee, he’s taken a step back.
“Now, I do just do instruction, assessments and mentoring of some up and comers, whereas for a few years, I ran the program for Eastern Pennsylvania,” he said.
Deciding to become an owner in the home care business was a gradual thing, he said. “My parents and I started to have some conversations … and I became a minority owner first – and then in 2021, my parents decided they wanted to exit,” he said.
With his wife also ready to do something else after a career in teaching, the time was ripe to take over the business.
“Now, I sometimes joke that I think I am unemployable,” he said, referring to the fact that he’s now been involved with home care for so long – this is all he knows.
Expansion
While his parents originally had only one location, today Bongaardt oversees three locations that operate “somewhat independently” in three different counties.
Delaware County has always been the anchor, as it was where the family started operating more than 20 years ago before adding West Chester and Ambler to their coverage area, giving them a stronger community presence – and allowing for more hiring events, client engagement, and participation in local programs.
“Office to office, they are about 45 minutes to an hour away from each other, and the whole area we cover is a solid 90 minutes or two hours from end to end,” he said.
While it would have been nice to operate out of one location to keep costs down, Bongaardt found that did not work in his market.
“Our industry is hyperlocal – we’ve seen that depending on the location of the office we are in,” he said.
For instance, his family had a location for 23 years in the same town and could not grow in adjacent areas, but once they moved their office to a place where more affluent people lived, they saw business markedly increase within six months, he said.
“There are nuances to each area,” he said.
The Right Mix of Business
When Bongaardt’s parents began a home care business, not many people knew what home care meant, he said.
“They grew fairly quickly from being mostly a Medicaid business, because when they started, no one knew they could privately pay for services,” he said. “Now, there is a greater awareness of what we do and how we do it – and with that awareness, we have become more embedded in the health care system as a whole.”
But with that comes increased regulation and the need for higher wages, he observed, which plays into why home care agencies must make some tough decisions about where they want business to originate.
Payment sources include private pay, long-term care insurance, Veterans Affairs, Medicaid and other third-party payors.
“We take a mix of all of that,” Bongaardt said.
At his agency, about 60% of business comes from “private pay,” with the rest being a mix of Medicaid, an agreement with an assisted living facility that drives about 10% of his business, a sliver from Veterans Affairs and other smaller programs, he said. This mix is something he tracks on a weekly basis, he said.
“Many owners are more entrenched in Medicaid, but that comes with more rules and regulations and lower reimbursement,” he said.
He added, “I have a competitor who relies on 100% Medicaid and another that is 100% private pay. Personally, I made the conscious decision to try to lower my business from Medicaid and to generate more from private pay, the VA and other sources.”
A big reason, he noted, is that the reimbursement rate from Medicaid is about 55% of what he can charge when compared with private pay. That has real consequences, as it slashes into his profit margin, which prevents him from paying people as well – and when that happens, the caliber of caregiver tends to go down, which is bad for families.
Moreover, with Medicare, there are sometimes other hoops to jump through, including the paperwork and administrative work you must do to be compensated, he said.
“As soon as I consciously turned back some Medicaid at beginning of the year, we started to even out our ratios,” he said. “We wanted to get closer to 25% instead of 35% of our business coming from Medicaid.”
The best strategy in terms of building the business has always been – and remains – having “boots on the ground,” he said.
“Our marketers and salespeople meet with referral sources on a regular basis,” he said, noting that he’s developed a caregiver program with West Chester University.
When someone is recruited in such a fashion, they tend to stay with the company longer, he said.
“We also use Indeed, which brings in volume but not necessarily the people who align with our culture and how we do things,” he said.
There really is no “silver bullet” to succeed in the home care business, he said.
“It’s about doing the right things day in and day out,” he said. “Salespeople and marketers need to meet their weekly key performance indicators. Client care coordinators must meet their numbers and be in the field, reinforcing the quality of our services and providing oversight. You need to do the right things over and over, instead of jumping from one flashy thing to the next thing. Focus on the basics.”
Asked about artificial intelligence, he said he’s been using it to create job advertisements for caregivers, as well as to create care plans in a timely fashion. “We can also strip out information related to the Health Insurance Portability and Accountability Act from a recorded call and come up with a care plan quicker,” he said.
Social media is another area of focus – although he’s found it drives awareness and engagement as opposed to bringing in employees or generating business.
As for joining the Comfort Keepers family as a franchisee, he gives the organization high marks.
“They have been great,” he said.
He noted that The Halifax Group, a private equity firm, purchased Comfort Keepers from Sodexo in late 2023, and since that time, the owners have begun transitioning away from corporate-owned locations to focus on a fully franchised model.
Now, most corporate locations have been refranchised, and the company has brought a renewed focus to prioritizing support for its franchisees, he said.
“The new owners have certainly changed the culture and morale of the system as a whole,” he said. “They are really emphasizing speed and growth and providing tools to keep driving up market share.”
Asked about his long-term vision for his business, Bongaardt said it weighs on his mind – but he has time to figure it out.
“My kids are in high school and middle school, so they are a little young,” he said. “But my wife and I do have active conversations as to what the next phase or exit strategy or structure is … can we put the infrastructure in place to ride to the long term and have a decent work-life balance, or should we build it to sell?”
In home care, “There are a lot of very big highs and very low lows,” he said. “That goes along with entrepreneurship as a whole, but this is an industry where you can do a ton of good and change the lives of a lot of people.”
