How to Crack the Community Care Model Inside Independent Living (Rob Rister)

What if you could replace dozens of scattered hourly shifts with one scalable model inside an independent living community? In this episode, Rob Rister of HomeWell Care Services shares how he built his “Support On Site” program—turning caregiver shortages into retention wins, driving 45% margins, and embedding his agency in 10 communities across three states. He breaks down the numbers, the operations, and the technology (hello CINCH) that made it possible. Whether you’re frustrated with the limits of hourly care or curious about expanding into new markets, this is a blueprint for cracking the community care model.

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min

Sep 2, 2025

How to Crack the Community Care Model Inside Independent Living (Rob Rister)

Miriam Allred (00:00)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Alred. Today in the lab, I'm joined by Rob Rister the CEO of Home Well Care Services in Lexington, Kentucky. Rob, welcome to the show.

ROB RISTER (00:13)
Thanks for having me. It's a pleasure to be here. I'm looking forward to this.

Miriam Allred (00:17)
I have been as well. So let's just get right to it. Today we're going to unpack your business model. It's different than just traditional hourly care, companionship care that we talk a lot about in home care. And here's how I want to structure the conversation today. I want you to start with your aha moment and what led you to going all in on this business model.

And then I want you to walk through the details of the model, getting into the numbers and the technology and the operations behind this model. And then we'll wrap up with lessons that you've learned, maybe the hard way and advice that you have for home care owners that are interested in this model or considering expanding into different models. think this is an opportunity for them. So let's start at the beginning. When did you open your business?
And what was your initial vision for the business? And then what was the aha moment that led you down this path?

ROB RISTER (01:11)
Right. I'm going to hit on that. But before we start, want to, you know, we're going to talk a lot about me and what I'm doing and so forth during this conversation. But I want to start by acknowledging a lot of people that's helped me get to where we are today. First and foremost, most is my wife, Dr. Dolores Polito. We call her Dee. She's been a backbone of what we've been doing ever since we opened our doors in 2020.

I have a tremendous staff.

I've had some great people in my organization over the last five years. I have a great director of operations now, Sam Samantha Adkins. I have a great enrollment specialist who does recruiting, Marisha Griffin. ⁓ I have care managers, Nikki Leathers, Sierra Slaughter, and also Deborah Bueno is a director of operations in our southern office in Melbourne, Florida. Those ladies are a tremendous part of our organization and what we do and help me be able to do

what we're getting ready to talk about. And I want to make sure that they get acknowledged for that, especially my wife, because she makes sure everything is done the right way. ⁓ started, and I started in ⁓ August of 2020.

We opened our doors and it came right during COVID. And ⁓ I'd be remiss if I didn't mention Homewell because Homewell is my franchisor and we've been a part of Homewell for five years. when COVID hit in 2020, I remember them coming to me and saying, Rob, are you sure you want to do this? I'm like, well, yeah, when there's chaos, there's opportunity. And there's a lot of chaos at that time, if you remember.

So it took us six months to get the license and know COVID and we opened our doors in August of 2020 and You know, we're doing what you're supposed to be doing, you know through the home care franchise system and learning and training In about October. I'm like, there's got to be a better way. I need to expand I need to find something to grow our business

Because I had nothing to compare it to. Was this COVID related or was it not COVID related, right? I just knew that we needed to grow. So I was at a fall conference or something with Homewell, I'd heard about a man by the name of Michael Rowley, and I want to acknowledge his because he's been a big part of my story. And he was doing independent care in Phoenix, Arizona. And that intrigued me.

And I was like, yeah, I'm gonna find out about this. So call him up and I said, can I come out and shadow you for a couple of days? He said, yeah. So jumped on Allegiant with my son, Airlines, and we went to Phoenix, Arizona and spent two days with him. And he didn't have to do that. And I was very grateful. And as I was sitting there listening to him and how he's partnering with these independent living communities, and I was like, oh wow, I can do this.

Now I'm gonna bring it back to Kentucky and I'm gonna put my own spin on it. I talk about the Colonel Sanders putting my own secret, lavender herbs and spices. ⁓ So that's what I did. I brought it back and kind of cooked on it in my little office and worked and massaged a little bit.

From November to February I started making some calls and trying to get in to talk to building directors, general managers. Wanted to talk to them about bringing this unique program into their independent living facility. Because see that's what I had heard it in my training process through Homewell, facility, facility. So that's what I was using.

February happened in Kentucky in 2021 and it was a blizzard storm, know, bad weather. It shut down all business in Lexington for about a week and a half. We had no revenue for that week and a half, zero. As a small business owner, you're looking at this and like, my God, what am gonna do? There's gotta be a better way to this.

And then it started occurring to me, talking to Michael Rowley. Wait a minute. That's my aha moment. I can't get at that time, whatever clientele we had, 20, 25 clients maybe, right? I couldn't get 25, 30 caregivers to work. You know, couldn't do that. was logistically impossible. And I'm like, but you know what? I can get one or two caregivers to one building.

And they can take care of 25, 30 clients in that building. And at that moment, I'm like, I'm done with this individual. I'm gonna focus and change my business model. And that's what I did. And then I started aggressively going and talking to these general managers, executive directors in the Lexington area. And finally, I was talking to a guy and he said, listen man, he said, we're a community. We're not a facility.

And I didn't understand that. He explained it to me. know, people live here don't want to think that they live in a facility. And that was like another aha moment. I'm like, my God.

So I changed my language and the way I approached the general managers and executive directors. And now the doors just started opening up for me. People would listen to what I was saying. So I was finally able to get into one community. And that's what started it right there. The ball started rolling. ⁓ It was all because of bad weather, you know, and that's what happened. And that's how we started the model. ⁓ And that was in 2021.

And then of course we start that model and there's always bumps and you know as you're starting a new business so we're tweaking it every day, every day. We end up picking up another community so now we're at two communities and this is probably I don't know 2023 maybe and I'm having a document problem.

A major document problem because what we were doing is that we were charting the task that the caregivers was completing. You know, the clients buy packages from us of care. We go in, we do this care, but we also have to document it. So it was starting to mount up. And that's where if you have that picture for a sense, I'd like for you to share this because this is what this looked like.

For one community by the way, that document that you're looking at, it's about a three foot and a half tall stack of papers that I had a problem with of our caregivers documenting what they were doing for the clients. So I was trying to find a way to get rid of that because my wife's big into digitizing everything. So out of it, you're

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Miriam Allred (07:58)
Let me just vocalize what we've got on the screen for those that are listening to it just via audio. There is a mound of paper on Rob's desk that's probably three feet tall. And so what you're explaining is you had to rely on paper to facilitate the documentation in these facilities because, know, WellSky didn't have the capabilities. So just want to illustrate that mound of paper on the screen, because that's going to be a big part of this story is you bringing in technology and processes that allowed you to stream like this which will help you scale.

ROB RISTER (08:26)
At the time, we were working with two communities, learning the program, honing it, and so forth. And then out of the blue, a guy by the name of Tim Murray called me at my office. Because I was making calls trying to find document manager. And then he calls my office, and he starts talking to me about his program and what this software program he's got called CINCH And I'm like, OK, let me look at that.

So when he showed that to me, he showed that to him and his wife, Gina, I was like, my God. It literally, at that moment in time, I knew instantly this is the answer to my problem. Instantly. And I knew it was going to take my trajectory to my business. It was going to grow it.

⁓ So I enrolled and talked to Tim and Gina, his wife, and his IT person or assistant, Micah, at CINCH. And man, I'm gonna tell you, of course I'm 58 and I've met a lot of people in my lifetime, but these are three quality people that run this program called CINCH.

And they walk through this with me to show me how this could help my business and improve it. And every day I got off a meeting with them, I got more excited because I know what's This is what's going to take me to a different level. So I partnered with CINCH, ⁓ I think at the end or beginning of 2023. And what that allowed me to do is, like you said, come into the digital age.

And we'll talk more as we go about the caregivers and how they use this CINCH app and so forth. But that was the story of how we started. We started with two little communities and then I was having this problem and then I found a solution with CINCH and now the doors just started flooding open.

Miriam Allred (10:23)
And now if I'm not mistaken, you're up to about 10 communities and anticipating more and you're in multiple states. So we'll get to kind of where you're at today and how you're streamlining and scaling this. I want to unpack a lot of what you shared though. I want to go back to you getting into the first community, you said you had maybe 25 to 30 clients. So you were doing the hourly kind of traditional home care model. This is a completely different model. And I want you to explain just some of those key differences that you learned maybe the hard way early on from the caregivers, from the scheduling. You kind of talked about the documentation, but you were in home care mode and now you're going to community mode.

What are some of the key differences that you had to learn very quickly getting into that first community?

ROB RISTER (11:13)
Scheduling, number one. ⁓ You're not scheduling for individual clients in a community.

You're literally scheduling that community. You're not scheduling individual clients. Which, if you have 20 individual clients, you have 20 different care plans, you have 20 different schedules, times and things that they need help, you have to have at least 20, maybe 40 different caregivers to staff those clients. It's just a completely different animal. ⁓ The other thing too is that you have more issues that way as well.

You know, when you're dealing with 20 clients to 200 clients, whatever that number may be, your issues are multiplied. But in a community care setting, it's more concentrated. I had more control, and I do have more control of my business under the community care model than I ever did individual care. ⁓ As far as...

The way the caregivers, for us, it's very difficult with the caregivers calling off work and things of that nature. It's home care. I don't care, and I can speak to this because I have businesses in three states. It's the same everywhere, whether it's in Indiana, Kentucky, or here in Florida, it's the same issues. So you have those issues with individual clientele. Those issues are minimized when you have community care. The caregivers love, and we'll get to some more things that they love, but they love the thought of going to one spot.

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