Multi-Branch Home Health · Hospice · Home Care · Senior Living Platforms
Turn more referrals into admissions, and more authorized hours into staffed and billed care, in every branch.
Home-based care and senior living have the demand. What limits growth is the work between a referral and a paid claim: intake that waits on paperwork, authorizations that stall, caregivers who are hard to hire and harder to keep, and branches acquired onto different systems. We work with multi-branch operators and their sponsors to turn more referrals into admissions, staff more of the hours and visits already authorized, collect cleanly and integrate acquired agencies, with automation and AI built into the redesigned work and every result measured against your own baseline.
Health & Wellness · Care Platforms
The landscape
Demand is structural; the constraints are workforce, payer rules and integration.
Demand for care at home rests on a durable preference: AARP's 2024 survey found that 75% of adults aged 50 and older want to remain in their current homes as they age. The workforce case is the hard one. The Bureau of Labor Statistics projects employment of home health and personal care aides to grow 18% from 2025 to 2035, with about 760,500 openings each year, many of them replacing workers who leave the occupation. Every operator recruits from the same pool, which makes the speed and experience of recruiting, onboarding and scheduling a competitive advantage rather than an HR detail.
Payer rules now shape margin alongside rates. KFF reports that 55% of eligible Medicare beneficiaries were enrolled in Medicare Advantage in 2026, and that MA insurers received nearly 53 million prior authorization requests in 2024, denying 7.7% in full or in part. Only 11.5% of denials were appealed, and 80.7% of those appeals were partially or fully overturned. In traditional Medicare, CMS estimated a 1.3% aggregate decrease in home health payments for CY 2026. When authorizations gate admissions and so few denials are contested, intake discipline and denial follow-through become margin levers.
Senior living runs on a different curve with the same lesson. NIC MAP data put average senior housing occupancy at 89.9% in the second quarter of 2026, the 20th consecutive quarterly increase. With occupancy recovered, performance turns on move-in velocity, rate and labor cost. Across all of these businesses, platforms built by acquisition carry several EMRs, payroll systems and referral habits, branch by branch. That is where branch performance is hardest to see, and where redesigned workflows, with automation and AI handling the volume work, have the most room to improve it.
The market problem, in published numbers
75%
of US adults aged 50 and older wish to remain in their current homes as they age
760,500
openings projected each year, on average, for home health and personal care aides over 2025 to 2035, with employment projected to grow 18%
55%
of eligible Medicare beneficiaries (35.2 million of 64.2 million with Parts A and B) were enrolled in Medicare Advantage plans in 2026
Nearly 53M
prior authorization requests were submitted to Medicare Advantage insurers in 2024; 7.7% were denied in full or in part, just 11.5% of denials were appealed, and 80.7% of appeals were partially or fully overturned
1.3%
estimated aggregate decrease (about $220 million) in Medicare payments to home health agencies for CY 2026 versus CY 2025 under the final rule
89.9%
average US senior housing occupancy in the second quarter of 2026, the 20th consecutive quarter of increases (NIC MAP data)
Figures are third-party market benchmarks from the cited sources, not Ometz Partners client results. We share them so you can size the problem before we ever talk.
Where performance is lost
Referrals that never become admissions
Referrals wait on eligibility, authorization or staffing confirmation, and the discharge planner sends the next one to the agency that answered faster.
Authorized hours you cannot staff
Recruiting delays and early-tenure caregiver turnover leave authorized hours and visits unstaffed: revenue lost before it is ever billed.
Payer rules that shape margin
Medicare Advantage authorizations, Medicaid EVV requirements and Medicare billing timelines turn intake and billing into margin decisions.
Acquired branches that never fully integrate
Different EMRs, payroll systems and billing habits hide branch performance and slow cash after close.
The Home Health Platforms program
Programs built around how your business runs.
REVENUE
Referral-to-Admission Performance
More admissions from the referrals you already receive and the sources you already serve: faster intake, authorization handled at the front door, non-admits recovered, and liaisons focused on the sources that convert.
What we measure
- Referral-to-admission conversion rate
- Time from referral to start of care
- Authorization turnaround and denial rate by payer
- Admissions per liaison, or move-ins per community sales lead
01
Unified intake
Referrals captured from every channel into one queue: documents read and summarized, eligibility checked and missing items requested automatically, with the intake coordinator making the acceptance call.
02
Authorization at intake
Payer-specific authorization requirements checked at referral, submissions assembled, status tracked, and denials routed for appeal with the clinical record attached.
03
Referral source performance
Referrals, conversion, time to start of care and payer mix by source and liaison, so territory plans follow what converts. In senior living, the same discipline applies to inquiries, tours and move-ins by lead source.
MARGIN
Caregiver Capacity & Visit Delivery
Staff more of the hours and visits you are already authorized to deliver: a faster recruiting funnel, fewer early-tenure exits, and schedules that close gaps before they become missed visits.
What we measure
- Applicant-to-first-shift conversion and time to hire
- Early-tenure caregiver turnover
- Authorized hours staffed (fill rate)
- Missed and late visit rate
- Visits delivered against the plan of care
01
Recruiting funnel
Applicants answered within minutes by text, screened against criteria your HR leadership and counsel approve, booked for interviews and moved through credentialing and onboarding with reminders. Recruiters handle the conversations that need judgment.
02
Retention early warning
Signals such as declined shifts, long travel between visits and early schedule changes flagged to branch managers, so they can act before a caregiver leaves.
03
Schedule fill and visit oversight
Open shifts matched to qualified caregivers nearby and offered automatically; EVV exceptions and late visits surfaced to the scheduler as they happen.
VALUE CAPTURE
Agency Acquisition & Revenue Cycle Integration
Acquired branches onto one EMR, one revenue cycle and one reporting layer, with referral sources and caregivers retained through the transition and cash protected at conversion.
What we measure
- Unbilled revenue and billing holds by branch
- Days in AR
- Referral volume retained after close
- Caregiver retention through conversion
01
Integration plan and tracker
A standard integration sequence covering payer enrollment, EMR and payroll conversion, policies and branding, tracked weekly against the deal model. Licensure and change-of-ownership filings run with your regulatory counsel.
02
Revenue cycle standardization
Pre-billing audits, NOA and authorization tracking, billing holds and denial queues worked to one standard across branches, so cash does not dip at conversion.
03
Retention through transition
Communication plans for referral sources and caregivers, with weekly tracking of referral volume and caregiver retention at each acquired branch.
The diagnosis
What we look for in your branch.
A Performance Diagnostic measures these in your own systems first, so every later result is judged against the same baseline.
Referral volume by source and payer, acceptance rate, and the reasons behind non-admits
Time from referral to start of care, and where it waits: eligibility, authorization, staffing or paperwork
Authorization turnaround and denial rate by payer, and how many denials are appealed and won
Caregiver applicant-to-first-shift conversion, time to hire and early-tenure turnover by branch
Authorized hours staffed versus authorized hours available, and missed or late visit rates
Visits delivered against the plan of care, and clinician productivity against your visit standards
Billing holds, unbilled revenue, NOA and NOE timeliness, and days in AR by branch
Senior living: inquiry response time, tour-to-move-in conversion, and move-ins versus move-outs by community
How an engagement runs
01
Performance Diagnostic, 2 to 4 weeks
Fixed fee. We baseline the referral-to-cash chain branch by branch from your EMR, intake, scheduling, payroll and billing data: conversion, time to start of care, staffing fill, authorization and denial patterns, billing holds. You receive three priced improvement plays with margin and cash estimates, and a 90-day plan your leadership team and sponsor can hold us to.
02
First 90 days: Prove it in a set of branches
The first play goes live in a set of branches, for example unified referral intake with authorization tracking, or the caregiver recruiting funnel, with weekly reporting against the baseline.
03
From the second quarter: Scale and integrate
Proven plays roll out across branches on one reporting layer, and the integration playbook for acquired agencies is written from what worked, so each new branch reaches platform standards faster.
Home Health Platforms FAQ
Around the care, not in it. Intake paperwork, authorization tracking, recruiting follow-up, shift fill, billing holds and reporting are where coordinators and managers lose their day. Clinical assessment, OASIS, the plan of care and visit decisions stay with your clinicians, and we make no clinical recommendations.
Yes. Where our work touches protected health information, we sign a BAA and scope PHI handling during the diagnostic: what is accessed, where it is stored, which downstream vendors are involved, and what stays human-only.
Home health and hospice operators commonly run platforms such as Homecare Homebase (HCHB), WellSky or Axxess, and home care operators add scheduling, EVV and payroll systems. We assess integration options for each (API, middleware or structured exports) during the diagnostic and price only what is confirmed.
The method is the same; the programs differ, because each line has different economics: Medicare and Medicare Advantage reimbursement in home health, per diem rates and cap management in hospice, hourly private-pay and Medicaid in home care, occupancy and rate in senior living. The diagnostic baselines each line separately and ranks plays by margin and cash impact across the platform.
On documented consent. Outbound texts and calls run with consent records, opt-out handling and the disclosure rules your compliance team sets, and recruiting screens use criteria your HR leadership and counsel approve. We do not give legal advice; we build to the rules you confirm.
Next step
Start with a Performance Diagnostic.
The Performance Diagnostic runs for two to four weeks at a fixed fee and ends with a baseline, three priced improvement plays and a 90-day plan. The findings are yours whether or not we continue.