When you start a home care business on your own, two mistakes are easy to make: keeping your schedule in your head, and pricing like an odd-job freelancer instead of a business. Both feel harmless with two clients. Both turn into problems as soon as you grow.
Get the schedule out of your head
When I started, I did every visit myself, and it was easy to wing it. Then I hired my first part-time employee and realized I couldn’t run the business from memory anymore. Other people were depending on me for their schedules, their instructions, and their paychecks. That realization is why I built Nodal Care. Looking back, I wish I’d started organized on day one.
Even solo, relying on memory or text threads is risky. When you’re busy, it’s easy to forget a conversation. And if you forget a shift and leave a client waiting, that broken trust is very hard to win back.
- The bare minimum: put every shift into Google Calendar the moment you schedule it.
- Better: use scheduling software from the start. In Nodal Care I schedule shifts in 15-minute steps, and each assigned shift is emailed to the caregiver and added to their Google Calendar.
Keep families informed without extra emails
Family communication can eat your evenings. Nodal Care’s family portal has been the biggest time saver for me there. Caregivers write a short report after each shift, and the family sees the reports and photos I approve, no matter which employee wrote them. I don’t have to send a separate email or text. Families can also view the schedule, ask for schedule changes, upload documents, and message us in one place.
Billing lines without health details
At the end of each shift, Nodal’s AI turns the caregiver’s report into a short billing line and leaves out health details. I can edit any line before I approve it. At the end of the month I export the billing lines as a file and import it into Xero for invoicing.
Why leave health details off an invoice? Invoices travel. They get forwarded to accountants, bookkeepers, and bank trust officers. Nodal is built with HIPAA-level security safeguards, but once a billing summary leaves the app, the safest health detail is the one that was never on it.
Here’s a made-up example of the difference:
Caregiver’s shift report (visible to approved family members): “Helen felt dizzy this morning after starting a new blood pressure medication and was worried about a rash on her arm. Helped her find her insurance card, drove her to her dermatology appointment, took notes for her daughter, picked up a prescription cream at the pharmacy, and made her lunch.”
Billing line on the invoice: “Transportation and accompaniment to an appointment, pharmacy errand, and meal preparation.”
Pricing is part art, part math
You have to be able to sell your price, and your background matters. Being a retired police officer and former elder abuse investigator gave me a head start on trust, and I chose to price for the upper end of the private-pay market. That means some people who need help can’t afford me. It’s a hard trade-off, but it’s one that keeps my business sustainable.
Whatever you charge, remember that running the business takes many unpaid hours each week: scheduling, care coordination, family emails, bookkeeping, invoicing, and payroll. Your rate has to pay for those hours too.
My actual numbers
Here’s how one hour of a caregiver’s time breaks down for me:
- Billed to the client: $75 an hour
- Paid to the caregiver: $40 an hour, roughly twice the average caregiver wage in my area. It attracts exceptional people, and it covers their driving, so I don’t track employee mileage.
- Payroll taxes, insurance, software, and other overhead: about $20 an hour
- What’s left: about $15 an hour. That isn’t pure profit. It pays for the hours I spend managing employees, scheduling, coordinating care, and talking with families, none of which a client pays for directly.
Bill for the work that happens between visits
Some of that behind-the-scenes time is real work for a specific client, and I should be paid for it: care coordination, calls with doctors’ offices, paperwork, or an unusually long phone call with a talkative family member. I built this into Nodal Care’s to-do list. A to-do linked to a client can be marked billable, with the time recorded in 5-minute steps, and those items go into the monthly billing export alongside the visits. Clients see exactly what they’re paying for, and I’m not giving that time away.
Set your price from your real costs, including what you’d pay a great employee, even if you’re doing every visit yourself now. Then you won’t have to surprise clients with a big increase when you hire.
Minimums, drive time, and rounding
- One-hour minimum, both ways. Clients pay for at least an hour, and I pay my staff for at least an hour, however short the visit.
- Drive time for regular clients. For many regular clients, I include the caregiver’s drive time to and from their home in the bill. I see it as the fair cost of getting an exceptional caregiver.
- Rounding. Nodal can round worked time up for payroll and billing if you turn that setting on. I round up to the nearest 5 minutes.
Evenings, weekends, and holidays: your rules
At first you may want to take every shift anyone offers, for the income and the experience. Later, your priorities may change, and as the owner, that’s your call.
I didn’t mind evenings and weekends, but my wife felt I’d worked enough of them during my police career. So now I don’t work evenings or weekends myself, though my employees can if they want. I’ll occasionally work a holiday, and I tell clients up front that holidays are billed at double time.
Keep billing and errands simple
- One-off jobs: I collect a check before I leave.
- Regular clients: I invoice once a month for the month before, so September’s hours are billed in early October. Some families like to see the invoice alongside everything else, so I upload a copy to the document vault in Nodal Care for their convenience.
- Errand purchases: usually the client pays with their own money or card, and I help them at the checkout if needed. That’s the best practice. I do front money for regular clients when they don’t have cash on hand, with open eyes, and only when I know adding it to the monthly invoice won’t be a problem.
- Receipts: I photograph every receipt and upload it to the client’s file in Nodal Care’s document vault. The same photo goes into my accounting software and out with the emailed invoice, so there’s never a question about where money went.
When you start, set a price and a schedule that work for you today. You can adjust both as the business grows. In Part 4 I’ll share my most expensive early mistake, and what actually brought in clients.