Do you want to start a hospice and palliative care center? If YES, here is a complete guide to starting a hospice agency business with NO money and no experience plus a sample hospice and palliative care business plan template.
If you are naturally drawn towards taking care of people with life-terminating illnesses and other diseases, then you should consider starting a hospice and palliative care center. However, this is a very sensitive business to start up as a single mistake can have dire consequences for your patient and their families. This is also a business that shouldn’t be based primarily on profit.
The hospice and palliative care center business is a delicate business, you would need to network with hospitals and other businesses in the health sector so that they can refer patients to your center; but this does not however mean that you cannot source for your clients directly.
What Does It Take to Start a Hospice and Palliative Care Business?
If you intend to start this kind of business, you should know what licensing and certification requirements you would need. Asides licensing, you would need to know the minimum personnel that would be needed for your hospice and palliative care center depending on the scale of business you intend to run.
At the minimum, you would require a licensed therapist, psychiatrist, nurses and certified staff that would meet the staff-to-client ratio of the state you would be operating in. Another factor to consider when starting your hospice and palliative care center business is the location of the hospice and palliative care center.
Even though it isn’t compulsory that your hospice and palliative care center be residential; but most of the successful hospice and palliative care centers are those where patients can stay for a predetermined time and then leave. Your location should be one that will pass health and fire code before you start taking in patients so as not to run afoul of the existing law in the united states.
So, if you want to start your own private hospice and palliative care center, all you need do is to read this article and you will be well equipped.
You can start your hospice and palliative care center from a small town in the United States and if you are consistent and creative, it won’t be too long before your brand becomes a nationally recognized brand and you will be welcoming patients from all across the country.
Steps to Starting a Hospice and Palliative Care Business
1. Understand the Industry
Operators in the Hospice and Palliative Care Center Industry run programs that offer symptom relief and pain management for patients with life-terminating illnesses and diseases. Hospice care applies to establishments that administer care (in terms of comfort rather than cure) to patients with life-limiting illnesses or diseases.
Non – hospice palliative care is provided to individuals with serious, complex illnesses who may or may not be expected to recover fully; this sector is not part of the hospices and palliative care center industry.
If you a closer observer of happenings in the Hospice and Palliative Care Center industry, you will notice that prior to 2013, the industry grew rapidly for more than a decade, and this was due to the support and funding it got from government, an aging US population, rising healthcare costs and a general shift toward at-home end-of-life care.
The hospices and palliative care center industry continued growing straight through the economic downturn as relevant funding and the number of facilities offering hospice and palliative services increased. Though government funding for industry services has come under intense scrutiny in recent years, hospices and home healthcare organizations are aggressively lobbying Congress to reconsider or revoke these reductions.
The Hospice and Palliative Care Center Industry is indeed a very large industry and pretty much thriving in developed countries such as United States of America, Canada, United Kingdom, Germany, Australia and Italy et al.
Statistics has it that in the United States of America alone, there are about 5,055 licensed and registered hospices & palliative care centers scattered all across the United States responsible for employing about 503,023 employees and the industry rakes in a whooping sum of $36bn annually with an annual growth rate projected at 4.0 percent between 2012 and 2017.
No player in the industry can boast of having a lion share of the available market share in the industry. A recent report published by IBISWORLD shows that hospices are located throughout the United States, with a denser concentration in more populated states.
For example, 11.3 percent of hospice facilities are located in the nation’s most populated state, California. The report shows that the five states with the most hospice facilities (California, Texas, Ohio, New York and Florida) combine for 36.2 percent of establishments.
Hospices also are located in states with higher Medicare acceptance rates and reimbursement levels. The report further stated that in 2014, 79.3 percent of hospice patients paid for care using Medicare, according to the National Hospice and Palliative Care Organization.
Some of the factors that encourage entrepreneurs to start their own hospice and palliative care facility business could be that the business can easily get support from the government at all levels and the business is indeed a profitable venture despite the legislature governing the industry.
It is important to state that the hospice and palliative care facility business is indeed a growing business. Even though the business is not considered a Green business in the United States of America, one can comfortably say that the business is booming and open to potential entrepreneurs who are interested in the business.
2. Conduct Market Research and Feasibility Studies
- Demographics and Psychographics
The demographic and psychographic composition of those who need the services of a hospice and palliative care center business is restricted to those who are down with life-terminating illnesses and diseases and they can fall under any age group.
So, if you are looking towards defining the demographics of your hospice and palliative care center business, then you should make it far reaching to people who are down with life-terminating illnesses and diseases in and around the location where your facility is located.
3. Decide What Niche to Concentrate On
Most hospice and palliative care center businesses tend to operate general services that a standard hospice and palliative care center provider is expected to offer, that is why it seems that there are no niche areas in the industry. But on the other hand, some hospice and palliative care centers may decide to major in some key areas such as;
- Providing continuous home care
- Providing general inpatient care
- Providing routine home care
- Providing inpatient respite care
- Providing hospice and palliative care
Level of Competition in the Industry
No matter the line of business you decide to pitch your tent, you are still going to compete with others who are into the same line of business and the hospice and palliative care center business is not an exemption.
The level of competition in the hospice and palliative care center industry to some extent depends largely on the location of the business, your niche area of operation and of course the capacity of your hospice and palliative care facility.
If you can successfully create a unique niche for your hospice and palliative care center business, you are likely going to experience little or no competition.
For instance, if you are the only hospice and palliative care center business in your location that is into providing inpatient respite care or providing continuous home care, you can successfully monopolize the market for a long time before you start having competitions.
It is important to also state that the competition in the hospice and palliative care center business is not restricted to that line of business, as you will be competing against all players in the hospices and palliative care center industry.
4. Know the Major Competitors in the Industry
It is important to point out the fact that in every industry, there are always brands that perform better or are better regarded by customers and the general public than others.
Some of these brands are those that have been in the industry for a long time, while others are best known for how they conduct their business and the results they have achieved over the years. These are some of the leading hospice and palliative care centers in the United States of America and in the globe;
- Top Care Hospice Inc
- Intrepid USA Healthcare Services
- Ocls Intrepid USA
- MSA | Medical Services of America Home Health & Hospice
- Center To Advance Palliative Care
- Center for Hospice Care
- Caring Connections
- The National Hospice and Palliative Care Organization
- Compassion and Choices
- Hospice Foundation of America
- Zen Hospices Care Center
Economic Analysis
When starting a hospice and palliative care center business, you just have to get your costing cum economic analysis right if your intention of building the business is to generate profit, grow the business and perhaps expand the business and start competing at the national level.
When conducting costing and economic analysis for your hospice and palliative care center business, you just have to critically examine these key factors; place, pricing and promotion. As a matter of fact, you would have to continue to review these key factors at regular intervals while running your hospice and palliative care center business.
As a hospice and palliative care center business owner, you just have to have a proper grasp of your competitive landscape if indeed you want to maximize profit and be in the frontline of the industry.
It is important to note that renting, overhead and medication cost are some of the important factors contributing to the overall cost of running a hospice and palliative care center business and should be considered as a major factor when carrying out your costing and economic analysis.
5. Decide Whether to Buy a Franchise or Start from Scratch
If you are looking towards starting a hospice and palliative care center business, you would have to start from the very scratch because you can hardly get the franchise of a hospice and palliative care center business to buy. It is a business that is open to all and sundry.
Besides starting a hospice and palliative care center business from the scratch is less stressful when compared to other similar businesses.
With a hospice and palliative care center business, you should just try as much as possible to secure a good residential facility inside a residential estate and then leverage on every marketing tool within your disposal especially the internet to market your hospice and palliative care center.
Please note that most of the big and successful hospice and palliative care centers around started from the scratch and they were able to build a solid business brand. It takes dedication, hard work and determination to achieve business success.
6. Know the Possible Threats and Challenges You Will Face
If you decide to open your own hospice and palliative care center today, one of the major challenges you are likely going to face is the presence of well – established hospice and palliative care centers and of course other players in the Home Health Care Providers industry in your target market location.
The only way to avoid this challenge is to create your own market; concentrate on those who are down with life-threatening sickness and diseases in your immediate community.
Some other threats and challenges that you are likely going to face when you open your hospice and palliative care center are mature markets, bad economy (economy downturn), stiff competition, volatile costs, and rising medical care prices.
So also, unfavorable government policies, seasonal fluctuations, demographic/social factors, downturn in the economy which is likely going to affect consumer spending and of course emergence of new competitors within the same location where yours is located.
There is hardly anything you can do as regards these threats and challenges other than to be optimistic that things will continue to work for your good.
7. Choose the Most Suitable Legal Entity (LLC, C Corp, S Corp)
When considering opening a hospice and palliative care center, the legal entity you choose will go a long way to determine how big the business can grow; some hospice and palliative care centers design their business and services for the community market, while others for national market via franchising and branching out.
You have the option choosing a general partnership, limited liability company, or a sole proprietorship for a hospice and palliative care center. Ordinarily, sole proprietorship should have been the ideal business structure for a small – scale hospice and palliative care center business especially if you are just starting out with a moderate start – up capital.
But if your intention is to grow the business and operate all across the United States of America, then choosing sole proprietorship is not an option for you. Limited Liability Company, LLC or even general partnership will cut it for you.
For example, Setting up an LLC protects you from personal liability. If anything goes wrong in the business, it is only the money that you invested into the limited liability company that will be at risk. Limited liability companies are simpler and more flexible to operate and you don’t need a board of directors, shareholders meetings and other managerial formalities.
These are some of the factors you should consider before choosing a legal entity for your hospice and palliative care center business; limitation of personal liability, ease of transferability, admission of new owners, investors’ expectation and of course taxes.
If you take your time to critically study the various legal entities to use for your hospice and palliative care center business, you will agree that limited liability company is most suitable. You can start this type of business as limited liability company (LLC) and in future convert it to a ‘C’ corporation or an ‘S’ corporation especially when you have the plans of going public.
Upgrading to a ‘C’ corporation or ‘S’ corporation will give you the opportunity to grow your hospice and palliative care center business so as to compete with major players in the industry; you will be able to generate capital from venture capital firms, you will enjoy separate tax structure, and you can easily transfer ownership of the company; you will enjoy flexibility in ownership and in your management structures.
8. Choose a Catchy Business Name from the ideas Below
Normally, when it comes to choosing a name for your business, you should be creative because whatever name you choose for your business will go a long way to create a perception of what the business represents. It is the norm for people to follow the trend in the industry they intend operating from when naming their business.
If you are considering starting your own hospice and palliative care center business, here are some catchy names that you can choose from;
- Happy Ending® Hospice & Palliative Care Center, LLC
- Sweet Rest™ Hospice & Palliative Care Center, Inc.
- Life Line® Hospice & Palliative Care Center, Inc.
- Caring Hands® Hospice & Palliative Care Center
- Trans – World® Hospice & Palliative Care Center
- Aisle of Mercy ® Hospice & Palliative Care Facility
- Peaceful Tides® Hospice & Palliative Care Center
- Warm Embrace® Hospice & Palliative Care Center, Inc.
- Smiling People® Hospice & Palliative Care Center
- Red Bed® Hospice & Palliative Care Center, Inc.
9. Discuss With an Agent to Know the Best Insurance Policies for You
In the United States and in most countries of the world, you can’t operate a business without having some of the basic insurance policy covers that are required by the industry you want to operate from. Thus, it is imperative to create a budget for insurance policy cover and perhaps consult an insurance broker to guide you in choosing the best and most appropriate insurance policies for your hospice and palliative care center business.
Here are some of the basic insurance policy covers that you should consider purchasing if you want to start your own hospice and palliative care center business in the United States of America;
- General insurance
- Health insurance
- Liability insurance
- Risk Insurance
- Workers Compensation
- Building/Property insurance
- Overhead expense disability insurance
- Business owner’s policy group insurance
- Payment protection insurance
10. Protect your Intellectual Property With Trademark, Copyrights, Patents
If you are considering starting your own hospice and palliative care center business, usually you may not have any need to file for intellectual property protection/trademark. This is so because the nature of the business makes it possible for you to successfully run it without having any cause to challenge anybody in court for illegally making use of your company’s intellectual properties.
But on the other hand, if you just want to protect your company’s logo and other documents or software that are unique to you or even operation concepts, then you can go ahead to file for intellectual property protection. If you want to register your trademark, you are expected to begin the process by filing an application with the USPTO.
11. Get the Necessary Professional Certification
If you intend to start a hospice and palliative care center in the United States of America, you are encouraged to pursue professional certifications; it will go a long way to show your commitment towards the business. Certification validates your competency and shows that you are highly skilled, committed to your career and up-to-date in the business.
Besides it is almost impossible to run a hospice and palliative care center business in the United States without the proper professional certifications. In most countries of the world, running any medical related practice without a license is illegal.
In most jurisdictions, individuals found to be providing medical, nursing or other professional services without the appropriate certification or license may face sanctions including even criminal charges leading to prison. These are some of the certifications you can work towards achieving if you want to run your own hospice and palliative care center;
- Advanced Certified Hospice and Palliative Social Worker (ACHP-SW)
- Registered nurse and Licensed practical nurse Certificate
- The Hospice and Palliative Nurses Association (HPNA) Certification
- Caregiver Certification
- Membership – American Academy of Hospice and Palliative Medicine (AAHPM)
- Membership – American Board of Hospice and Palliative Medicine (ABHPM)
- QAPI Certified Professional (QCP)
12. Get the Necessary Legal Documents You Need to Operate
The essence of having the necessary documentation in place before launching a business in the United States of America cannot be overemphasized. It is a fact that you cannot successfully run any business in the United States without the proper documentations.
If you do, it won’t be too long before the long hands of the law catch up with you. These are some of the basic legal documents that you are expected to have in place if you want to legally run your own hospice and palliative care center in the United States of America;
- Business and liability insurance
- Federal Tax Payer’s ID
- State Permit
- Certificate of Incorporation
- Business License
- Business Plan
- Health inspection Certificate
- Copy of license for the service support facility and/or a recent inspection report
- Non – disclosure Agreement
- Employment Agreement (offer letters)
- Employee’s Handbook
- Operating Agreement for LLCs
- Insurance Policy
- Online Terms of Use (if you have a website)
- Online Privacy Policy Document (basically for online payment portal)
- Company Bylaws
- Memorandum of Understanding (MoU)
- Building License
- Franchise or Trademark License (optional)
13. Raise the Needed Startup Capital
Starting a standard and well – equipped hospice and palliative care center business is capital intensive especially even if you choose to launch the business on a small scale and you only have a handful of full – time employees on your payroll.
Leasing of a standard facility that can accommodate your residents and staff members and of course the purchase of medical equipment are part of what will consume a large chunk of your start – up capital, so even if you choose to start the business on a small scale, you will still have to go and source for fund to finance the business.
When it comes to financing a business, one of the first things and perhaps the major factors that you should consider is to write a good business plan. If you have a good and workable business plan document in place, you may not have to labor yourself before convincing your bank, investors and your friends to invest in your business.
Here are some of the options you can explore when sourcing for start – up capital for your hospice and palliative care center business;
- Raising money from personal savings and sale of personal stocks and properties
- Raising money from investors and business partners
- Sell of shares to interested investors
- Applying for Loan from your Bank
- Pitching your business idea and applying for business grants and seed funding from government, donor organizations and angel investors
- Source for soft loans from your family members and your friends
14. Choose a Suitable Location for your Business
Starting a hospice and palliative care center business comes with its own fair share of challenges; it is a business that cannot be started in any location. As a matter of fact, you will need approval from the local council and other regulating authorities in the city you intend opening your hospice and palliative care center business.
It cannot be overemphasized that the location you chose to start your business is key to the success of the business, hence entrepreneurs are willing to rent or lease a facility in a visible location.
If you make the mistake of renting or leasing a facility for your hospice and palliative care center business in a not too visible or hidden location simply because it is cheap, then you must be prepared to spend more in promoting the business.
Most importantly, before choosing a location for your hospice and palliative care center business, ensure that you first conduct a thorough feasibility studies and market survey. The possibility of you coming across similar business that just closed shop in the location you want to open yours can’t be ruled out.
These are some of the key factors that you should consider before choosing a location for your hospice and palliative care center business;
- The demography of the location
- The demand for the services of hospice and palliative care centers and other homecare related businesses in the location
- The purchasing power of the residents of the location
- Accessibility of the location
- The number of hospice and palliative care centers and homecare related services businesses in the location
- The local laws and regulations in the community
- Traffic, parking and security
15. Hire Employees for your Technical and Manpower Needs
When it comes to starting a standard hospice and palliative care center, you will need stethoscopes, blood pressure cuffs, oxygen tanks, first aid kits and other related equipment that will aid you in carrying out your job. It is important to state that these equipment can be purchased as fairly used if you are operating on a low budget.
In setting up a small office for your hospice and palliative care center, you will also need computer, printer, home healthcare software, telephones, pager, photocopier, scanner, fax machine, first aid kit, gloves and uniform.
When it comes to choosing between renting and leasing a facility for your hospice and palliative care center business, the size of the facility you want to own, and your entire budget for the business should influence your choice. Besides, you will need a facility that is in a serene environment, a facility that is big enough to accommodate the number of residents and staff members working for you.
As regards the number of employees that you are expected to kick start the business with, you would need to consider your finance before making the decision.
Averagely, when it comes to starting a standard hospice and palliative care center business on a large scale, you would need the services of the following professionals; Chief Operating Officer (you can occupy this position), Marketing and Sales Executive (Business Developer), Accountant, Nurses Aide/Caregivers, Medication Management Counselors, Hospice and Palliative Care Administrator (Human Resources and Admin Manager), Customer Services Executive/Front Desk Officer, Security Guards and Cleaners.
Over and above, you would need a minimum of 10 to 15 key staff members to effectively run a medium scale but standard hospice and palliative care center.
The Service Delivery Process of the Business
The service delivery as it relates to hospice and palliative care center to a large extent depends on the organization and what they stand to achieve.
Basically, a hospice and palliative care center business sources for clients, once they are able to win the clients over based on the services they intend offering and the facility available, they will both agree on the terms and conditions as required by the nature of the job they are to execute.
For example, if it is to help someone who is down with life-terminating illnesses and diseases for a period of time, they will ensure that they carry out all that is agreed upon.
It is important to state that a hospice and palliative care center business may decide to improvise or adopt any business process and structure that will guarantee them efficiency and flexibility; the above stated hospice and palliative care center business process is not cast on stone.
16. Write a Marketing Plan Packed With ideas & Strategies
The fact that the entry barrier for starting a small scale hospice and palliative care center business is low means that there is bound to be more players in the industry no matter the location you choose to start yours. In essence, you must come up with creativity and innovations if you must carve out a market for yourself within the available market in your community, city, state or country.
So, when you are drafting your marketing plans and strategies for your hospice and palliative care center, make sure that you create a compelling personal and company profile. Aside from your qualifications and experience, it is important to clearly state in practical terms what you have been able to achieve in time past as it relates to your line of business.
This will help boost your chances in the market place when marketing your services. Here are some of the platforms you can utilize to market your hospice and palliative care center;
- Introduce your business by sending introductory letters alongside your brochure to households, hospitals, religious organizations, clubs/organizations, campuses and NGOs et al who have or work with people with life-terminating illnesses and diseases in and around the location where your facility is located
- Open your hospice and palliative care center with a party so as to capture the attention of residents who are your first targets
- Advertise your services in community based newspapers, local TV and radio stations
- List your business and products on yellow pages ads (local directories)
- Leverage on the internet to promote your hospice and palliative care center
- Engage in direct marketing and sales
- Encourage the use of Word of mouth marketing (referrals)
- Leverage on the internet to promote your business
- Join local chambers of commerce and industries around you with the main aim of networking and marketing your services; you are likely going to get referrals from such networks
- Engage the services of marketing executives and business developers to carry out direct marketing for you
17. Work Out a Reasonable Pricing for your Services & Products
One key factor that will help you offer your services at the right price is to ensure that you cut operational cost to the barest minimum, and channel your efforts towards marketing and promoting your brand name. Aside from the fact that this strategy will help you save cost, it will also help you get the right pricing for your products.
You can also try as much as possible to work with independent contractors and marketers; it will help you save cost of paying sales and marketing executives.
So also, if you are able to secure business partnership with hospitals and medical insurance companies as it relates to getting referrals, then you will be able to get the right pricing and of course maximize profits from your hospice and palliative care center business.
As regards medication, toiletries, cooking ingredients and other supplies that you need to effectively run your hospice and palliative care center, you need to ensure that you purchase your items directly from the manufacturers or from wholesale distributors in pretty large quantities.
The truth is that the higher the quantity of items you purchase directly from the manufacturers or wholesale distributors, the cheaper you tend to get them.
18. Develop Iron-clad Competitive Strategies to Help You Win
The hospice and palliative care centers industry is a competitive industry, and you must come up with a unique and highly creative strategy to be able to outsmart your competitors in the industry. Part of what you need to do in order to stay competitive in the industry is to continue to create easier and cheaper ways of taking care of your patients/clients and also make your facility highly secured and conducive.
In other to stay competitive in this industry, you must ensure that your rooms are always comfortable and always ensure that you pay attention to details when carrying out your job. The truth is that if there are fluctuations in the services you provide, customers can choose to shift allegiance and settle for other options available.
19. Brainstorm Possible Ways to Retain Clients & Customers
When it comes to business, no matter the industry that you choose to pitch your tent in, one of the easiest ways to increase customer retention and perhaps attract new customers is to produce results and satisfy your customers always.
If your customers are satisfied with your products and services delivery, they can hardly source for alternative service providers or products.
One of the strategies that you would need to employ in order to generate repeated sales from your customers and also retain them is to ensure that your facility is always homely and secured, always ensure that you pay attention to details when carrying out your job, and your customer services does not fluctuate.
The truth is that if the services and customer service fluctuate, you are likely going to struggle to get your customers coming back; people usually go for products or services that are of good quality. Ensure that you offer your customers incentives if you want to retain them and of course continue to generate repeated sales from them and also to attract new customers.
Part of what you need to do to achieve this is to track progress, results or outputs with the aim of improving on them quickly as the case demands. When it comes to managing your customers and building a loyal clientele base, you should purchase a customized CRM software. With a customized CRM system, you can easily stay in touch with your clients.
20. Develop Strategies to Boost Brand Awareness and Create a Corporate Identity
If your intention of starting a hospice and palliative care center business is to grow the business beyond the city where you are going to be operating from to become a national and international brand by opening chains of hospice and palliative care facilities and franchising, then you must be ready to spend money on promotion and advertisement of your brand.
No matter the industry you belong to, the truth is that the market is dynamic and it requires consistent brand awareness and brand boosting cum promotion to continue to appeal to your target market. Here are the platforms you can leverage on to boost your brand awareness and create corporate identity for your hospice and palliative care center business;
- Place adverts on both print (newspapers and health magazines) and electronic media platforms
- Sponsor relevant community based events/programs
- Leverage on the internet and social media platforms like Instagram, Facebook, Twitter, YouTube, Google + et al to promote your services
- Install your billboards in strategic locations all around your city or state
- Distribute your fliers and handbills in target areas
- Contact households, hospitals, religious organizations, clubs/organizations, campuses and NGOs et al that have or work with people who are down with life-terminating illnesses and diseases in and around the location where your facility is located informing them of the services you offer
- List your hospice and palliative care center in local directories / yellow pages
- Advertise your hospice and palliative care center in your official website and employ strategies that will help you pull traffic to the site
- Position our Flexi Banners at strategic positions in the location where your hospice and palliative care facility is located
- Ensure that all your staff members wear your branded shirts and all your vehicles and vans are well branded with your company logo et al.