Why He Needed to Reinvent His 30-Year Old Home Care Business (Bob Roth)

After two decades in the home care industry, Bob Roth found himself at a crossroads. Bob shares why he had to completely reimagine Cypress Home Care, from rebuilding operations post-Honor Care Network to transforming caregiver recruitment using machine learning and automation. He shares his candid take on today’s workforce challenges, the generational shifts shaping senior care, and why “home care is hard” but worth doing right. He opens up about the power of community partnerships, rewriting the narrative on aging, and the importance of self-care from his own lived experiences.

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min

Sep 23, 2025

Why He Needed to Reinvent His 30-Year Old Home Care Business (Bob Roth)

Miriam Allred (00:15)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. I am extremely excited to be here joining you from a studio in downtown Dallas. And I am joined by a friend and colleague and industry expert fan, incredible person that hopefully all of you know, Bob Roth. And again, we're joining you from downtown Dallas in studio. Bob, you have been on countless stages.

and conferences and webinars and podcasts and I've been thinking about our conversation and rather than your typical talk track, I want to have a more personal tone to the conversation today. I want to hear about your personal philosophies, your journey into home care, your your view on aging and retirement from your own perspective and from your own lived in experience. So let's at least start with your personal story getting into home care. The what, the when and the why of you starting Cypress and taking care of your own loved ones. And then we're going to kind of dial through your journey. But let's start with the beginning.

Bob Roth (01:19)
I appreciate that and I appreciate the opportunity and I want you to know how proud I am of you Miriam. I mean the Home Care Strategy Lab is a great medium for our industry and you and I have talked about this offline. We don't get an opportunity to really get a lot of information as operators. You know we want to at least learn best practices. We want to learn what's innovative and what's new. What you've created here is so beautiful.

We need more but you have really taken which you have your knowledge your six or seven years of doing podcasting and created this beautiful medium So thank you for doing this for all of us in home care and thank you for having me on the show So my journey was not very different from many people that got into the space mine started in 1985 January 2nd, know, it's interesting in 1985. There was no such thing as assisted living and in 1985, there was no such thing as these in-home supportive care companies, otherwise known as non-medical home care. They didn't really exist. So January 2nd, my mother had a massive heart attack, spent two months in the hospital, 18 days in a drug-induced coma, and came out a very different person. My younger brother, Jonathan, was in his freshman year at University of Miami, and he had to take a semester off to be home to help care for my mom. And we learned.

by trial and error. mean, we didn't have resources. And mom came out a very different person. And even though she went on to live almost 18 years later, her deficits were cumulative, and she was very limited in what she could do. And you know, she lost literally two thirds of her hard working heart, and only a third of it was working. So mom and dad actually moved from Baltimore, Maryland, that's where I'm originally from, to

Arizona Scott stars on and my brothers and I we visited there for almost eight years and we would go out there for Thanksgiving and other holidays and just really loved that experience and We also realized that you know mom, know her journey wasn't maybe at the end But it was getting close and we should all probably descend into Arizona and we did between 94 and 95 in 1994 my brothers and I we stood up a home care company to be able to care for other people's moms and dads

My brother Joe ran it for nearly 10 years and I came aboard in 2003. And my goal was to take a lot of what I learned in the consumer product goods world, because that's where I came from. I worked for the Quaker Oats Company. I was responsible for the Gatorade business in the Northeast. And I also worked for Dole Foods. So I came and landed in Arizona to be close to mom. I was doing some consulting. I worked for a frozen dessert company.

My brother Joe ran the business and in 2003 he decided to do something differently and I took over. So I brought a lot of the stuff that I learned from the consumer product goods world into Cypress. I rebranded it. We came up with very thoughtful messaging that kind of resonated with what we did. And then I brought a culture of innovation. And in 2005 we launched a caregiver training lab. And I believe we were the first.

Inside a home care agency where we had a full-service training lab where we had two training centers and a training lab that had 18 pieces of assistive devices in there including a two life-size mannequins two hospital beds life-size and life-weight back mannequins and then Hoyer lifts and other ⁓ Other equipment that you would need that and that you would find in somebody's home

So we had that and we made national news on that in the industry. And in 2013, we created a dementia program. And that dementia program was really, really taken, you know, took by storm. Nationally, we got a lot of recognition and we were able to provide care in our community with people that had dementia, formalized dementia training. 2019, we took a leap of faith and we joined the Honor Care Network and for...

the listeners here today, mean, honored is the company that bought home instead. And they went through a number of iterations and one of them was partnership iterations. And we were one of the first partners and when we joined about 40 others joined after us. And it was an interesting experience. I learned a lot. ⁓ It didn't end exactly great for me. But at the same time, I took a lot of knowledge away from that experience. And basically what I did was reemerged in February of last year.

back out on my own and here we are. We're running full time, full speed ahead and as I shared with you prior to our show, we didn't have a whole lot of the stuff that we had in the past. We weren't beholden to the processes and the standards we were doing back in 2019 because we had shuttered those and we went all in with honor. Honor handled all our back office. So we had to reimagine and recreate that.

That's what we've done over the last 18 months and it's been a lot of fun.

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Miriam Allred (06:31)
Give us a little teaser about the last 18 months because like you said, you literally reemerged as a business a year and a half ago, but you've been at this for 30 years. And so to reemerge at that stage is such a unique undertaking in and of itself. So just give us a little teaser of what the last 18 months have encompassed.

Bob Roth (06:50)
It was more than 18 months because we kind of knew that we were coming near the end with Honor. So we actually started doing some research probably close to a year, maybe about nine months prior to coming off the Honor platform and really studying how people were recruiting, how people were handling inbound calls. Honor did a lot of that for us and we knew and the CEO from Honor talked about machine learning and

and artificial intelligence for years before it became mainstream like it did. And we knew that they were using a lot of that behind the scenes. know, one of the things that we discovered was we had this training lab and we had this training center and we would do two orientations at least a week. You know, the March before I went onto the HonorCare platform in July of 2019, we oriented, hired, and

put to work 32 caregivers. I mean, that was kind of what we did. But, you know, in the new world that we're in post-COVID was very difficult. So we tried a bunch of things out before we left the HonorCare platform. And one of the things we discovered was caregivers weren't coming to us anymore. They just didn't have the time and they didn't, you know, want to make that experience and to make that commitment. So we were trying to go to them.

And we played around with texting. We weren't using any automation. So we text them the day before. We text them an hour before. We still get about 20 % no call, no shows. And I was sending people out to go meet with them, whether it be at a Starbucks, whether it be a senior center or a library. And we still have 20 % that didn't make it. So we looked to solutions. We looked for collaborators. We knew we couldn't develop that internally. And we looked for others to help us do so.

And we found a couple to do that. And it was really it's been a great journey for us because I'm here and we're in Dallas right now and I'm at the, you know, home care ⁓ home health care news futures conference. And I'm on a panel and we're talking about some of the stuff that we're innovating on. And that's what I love. I love about this venue and certainly your podcast where we can share best practices.

And to really zero in on what we've done is the amount of time that would bring a caregiver into the funnel and back out working for Cypress could take as much as three weeks, sometimes more in the old paradigm that we were in back in 2019. And we know caregivers, 90 % or more, live paycheck to paycheck. And they need to get in and through that funnel with the least amount of friction as possible.

And we have collaborated with two partners to do so using machine learning, which is really fascinating. And the quality is really there. And we have machines doing redundant and repetitive tasks where humans don't have to. And the best part about it is our humans, meaning our HR personnel and our schedulers, get to be more relational and more personal and more intimate with our caregivers and get to know them.

You know, the only thing we have as agency owners is our caregivers. And you know, anytime I've ever heard an employee talk down about a caregiver, they definitely, you know, got written up. And if it continued, they were let go because the caregivers are the backbone of every company. And, you know, we're in this era right now where everybody's using electronic communications. They're using text messages or they're messaging through their enterprise software solutions.

we need to be talking to our caregivers. We need to have a conversation with them. We need to connect with them. We need to develop relationships with them. And what I'm seeing today, 18 months in, is my team is getting to know our caregivers because they have more time to be intentional and to be authentic and to be real. So here we are. We've come out of this. We have about 220 caregivers now that work for us.

We are still filling that pipeline like everybody else. Our retention rate is really high. The piece that I struggle with, and I think everyone struggles with, is how do you establish culture? How do you bring meaningful culture to this group, which is the most important part of any home care agency? How do you establish culture when it's a remote workforce? So that's something that I'm continuously trying to do.

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