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Rochester Top 100: Firm adapts as industry undergoes changes

Rochester Business Journal
July 1, 2016

Significant changes in the state’s home care industry over the past few years have driven changes at Tender Loving Family Care Inc.

The provider of home care to clients in seven area counties was cramped and suffering growing pains in its former space. Tender Loving Family Care has moved its Brockport headquarters to a larger building.

Its new headquarters is just across the street from its former 1,500-square-foot location on West Avenue near UR Medicine’s Strong West freestanding emergency department, but it is 15,000 square feet larger. The company has some 130 employees.

The new location allowed the home care agency to add a small adult day care operation in Brockport similar to what it has in other areas. The Brockport adult day care added a new wrinkle: it also serves children, making the agency one of a few in the state to offer a multigenerational day care service.

“We decided to bring social adult day care to Brockport and decided to go all out by adding child care,” Chief Operating Officer Julie Westcott said. 

Most parents using the service for child care are Brockport residents, said Annika D’Andrea, founder and CEO of Tender Loving Family Care.

The home care agency’s day care fills a hole that was left when a child care service that had been run by Lakeside Health System closed after the financially ailing Brockport health system sold its West Avenue hospital building to the University of Rochester in 2013.

The multigenerational day care, begun this year, has been a big hit with parents and senior day care clients and has grown quickly, D’Andrea said.

“It’s still a smaller part of the business, but it’s growing. We were late getting started and yet it’s been full,” she said.

By the end of next year, she hopes to see the mixed-age day care service account for some 20 percent of the organization’s revenues.

Another change for Tender Loving Family Care: While third-party reimbursement used to account for a relatively small slice of its revenues, it is now an increasing revenue source for the agency.

Tender Loving Family Care relied on private pay clients for a larger slice of its revenues than most other home care services, D’Andrea told the Rochester Business Journal in a January 2015 interview.

Third-party insurance payers put strict limits on hours aides can spend with a given client, she explained. Serving private clients let aides and other care-givers spend more time with each client, an arrangement that made life easier for care-givers and improved continuity of care.

Some 18 months later, D’Andrea is aiming to increase Tender Loving Family Care’s managed long-term-care business from the relatively tiny share of total revenues it accounted for at the start of last year to 50 percent.

“It’s the direction things are going in. Managed long-term care is here to stay,” she said.

Driving the change in the agency’s case mix is New York’s ongoing reform of its Medicaid system. A key component of the reform, which the state kicked off in 2012, is a drive to move all of the state’s Medicaid program’s administration away from county social service departments to private managed care overseen by insurance companies.

Longer-term assignments fit in with her idea of how care should be delivered, D’Andrea told the Rochester Business Journal in January 2015. Tender Loving Care had been able to secure such assignments because clients were willing to pay privately for extra help.

Now care costs are going up, fewer are able to pay privately and with the state’s Medicaid reform, managed care insurers account for an increasing share of the long-term-care pie.

The shift to managed long-term care brings new management challenges.

“Insurance companies are a lot slower to pay,” Westcott said.

While private pay clients typically pay promptly, third-party payers take as long as 90 days to pay bills. Such delays make staying on top of the agency’s finances more of a headache.

Still, said Westcott, “We’d be behind the game if we didn’t move in that direction.”

Given the home care industry’s rapid evolution, “our focus for the next year is to stabilize the business,” D’Andrea said.

The Rochester Top 100 program is presented by the Greater Rochester Chamber of Commerce and KPMG LLP. Launched in 1987, it recognizes the fastest-growing private companies in Greater Rochester. The 2016 Rochester Top 100 event will be held Nov. 3. For more information, go to

Tender Loving Family
Care Inc.
Home health service provider
Year founded: 2007
Top executive: Annika D’Andrea, CEO
Current employment: 130
2015 ranking: 97
Headquarters: Brockport

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