Driven to care

Over 30 years in the business, Rosa K. Barksdale has ably traversed the changing landscape of home care services in New York.

“It”™s all difficult,” she said at her company”™s Fifth Avenue office in Pelham.

Yet she”™s a survivor in a crowded field of care providers in Westchester and the Bronx. She has seen the state Department of Health become more rigorous in its licensing and regulatory oversight of agencies such as Barksdale Home Care Services Corp., the business the 72-year-old CEO opened on a shoestring budget in Pelham in 1982. She has seen a vast increase in the number of competing home care agencies, prompting the state health department to declare a moratorium on new licenses that was lifted in November. A licensing moratorium still is in effect in New York for long-term home-health care programs that provide care for patients with long-term needs who opt to stay out of nursing homes.

A tough market to crack

In the highly competitive and regulated home care market, “Some businesses cannot withstand it,” said Kellye Davis, Barksdale”™s daughter and the agency”™s vice president of marketing. “Recently I know of three agencies that have closed or moved to other boroughs. Westchester is a tough market. It”™s a place where you have to grow. You just can”™t come in and crack it.”

“I got in at the right time,” said Barksdale, whose agency has grown from a two-person enterprise ”“ Barksdale in the field and one office worker ”“ to 250 full-time and part-time employees. “I had this intuition that I had to move now or never.”

“When Rosa started,” said her daughter, “there wasn”™t the proliferation that there is now” of competition in the home care field.

Startup costs have risen sharply too for home care entrepreneurs. Davis said her mother would need at least $1 million to open a licensed agency today. Barksdale said most owners who now go into the business take on partners and investors. Barksdale did it largely on her own.

“It sort of came upon me accidentally,” she said of her career at the head of a home health agency that serves a range of clients, from infants to the elderly and from low-income Medicaid recipients to affluent private-paying clients.

”˜A knack for caregiving”™

Trained as a registered nurse, Barksdale in her mid-30s was feeling “a little frustrated” in her job when she enrolled at the College of New Rochelle to better provide for her family as a divorced mother of two children. After graduating, she was hired as a public school teacher in the South Bronx.

“I was so happy. I was settled in a position,” she said. That ended in a round of teacher layoffs.

Barksdale took a sales representative job in the hospital products division of Abbott Laboratories, where in two years she increased annual revenue in her sales territory from $800,000 to $8 million. She later sold medical equipment for Gould Statham.

Remarried and wanting to work closer to her New Rochelle home and reduce her business travel, Barksdale took a position with a local home care agency. “At that point I really got a taste of it,” she said. “I was very, very good with clients and with the workers as well. It just seemed like I had a knack for caregiving.

“I thought I”™d like to venture on my own, but I didn”™t have the startup money.” She took a day job as a private-duty nurse while struggling to find her first client. “I was so driven. I just went blindly. I had nothing to lose.”

Barksdale rented a third-floor office at 1 Wolfs Lane in the Pelham Post Office. “My husband put the sign on the door for me,” she said. “I picked up furniture from the Salvation Army.” At a neighborhood liquor store, she found an employee eager to help operate her new office and willing to start at minimum wage.

An aging client base

Barksdale”™s company now focuses on custodial and skilled home care for which it trains aides in a state-certified program in the Pelham building that Barksdale bought about 20 years ago. About one-fourth of the agency”™s clients are 16 and younger, Barksdale said.

Davis said the company is moving into niche services for bathing care, hospice care and companion care. “Those are the areas that are really growing right now,” she said. The bathing and companion care are private-pay services that bolster the agency”™s cash flow.

Unlike many of her industry colleagues, Barksdale was not alarmed by the cuts in Medicaid funding for home care agencies and community-based programs recently proposed by a Medicaid Redesign Team appointed by Gov. Andrew Cuomo.

“They can only cut so much for home care,” she said. “We”™ve got the baby boomers out here and people living longer.” Home care is a less expensive alternative to nursing homes and institutional care for those clients, she said.

“There”™s always going to be money for home care,” she said.