Ai3: Educated Design
In 1998, Scott Dunlap reached a crossroads: he’d been tagge...
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Brandon Howes had been a nurse for two years when, in 2007, his father-in-law sold a business he had grown from the ground up to more than 100 employees. "I wanted that for my family," he says. So, that same year, at just 28 years old, he started Methuen-based Comfort Home Care (CHC), a home health care business.
There was a lot of competition in the field, but Howes envisioned a niche of his own: serving people with complex medical issues or mental illness, who other nursing agencies refuse. "As soon as we began taking these patients, we started growing," he relates. "Now, that kind of patient makes up the majority of our business, and we continue to grow because of them."
The overall goal regarding the patient population CHC serves, Howes says, is to "keep them safe in their homes and decrease their chances of being re-hospitalized." One of the first patients he accepted—a man who had been living in a state hospital for years—stands as an illustration. "He was confined to a wheelchair, had bipolar disorder and out-of-control diabetes, and had several wounds all over his body infected with Methicillin-resistant Staphylococcus aureus (MRSA), often called the 'super-bug,' due to its resistance to antibiotics," he says. "With our help, he was able to move to his own apartment, his wounds and infections healed, and he has not been hospitalized in four years."
A privately held company that now has three offices, CHC has used its philosophy to triple its profits and expand its staff from five to more than 100 since 2009, while serving more than 800 patients across Massachusetts. Its revenue growth from 2009-10 was 400 percent, 100 percent from 2010-11, and is on track for 50 percent growth this year. Howes attributes this remarkable expansion to two key factors: "We offer a service and serve a population that many agencies shy away from, and we've built our reputation on giving them top-notch care," he asserts.
As far as people growth goes, Howes has been able to expand his infrastructure organically and tap his network for help. "All of my supervisors have been promoted from within. And my director of nursing, who was a previous supervisor of mine that I convinced to come here, has a knack for spotting talented employees that show leadership qualities while in a regular staff role," he says. That foundation has helped Howes hire several nursing managers, a therapy manager, and a quality control manager, all of whom work closely with the RNs, LPNs, PTs, and OTs.
Howes's Salem Five credit line has also played a part in CHC's growth. "In 2009, Massachusetts Medicaid stopped reimbursement for nearly two months at the end of their fiscal year," he explains. "We could continue to bill, but had to wait until the beginning of the next fiscal year for payment. I had to carry about six to eight weeks' worth of payroll for the entire company, so without our credit line, I would have been out of business."
In 2012, CHC's payroll is more than triple the amount it was in 2009, and Howes stresses that "it's even more important now to have a bank that recognizes the need for a line of credit and how much cash flow fluctuates for a company. There were other banks who didn't believe in me and my vision for the company, and they no longer benefit from our business. Salem Five saw something in a young business owner, and it has been a mutually beneficial relationship ever since."