People often ask me why I am choosing to work on AI for home healthcare from the technology side rather than continuing to run an agency. The simple answer is that it’s hard to see the structural problems when you’re buried inside them. This experience will only make me a stronger operator or leader should I return to the frontlines.
Let me explain with an example.
When I opened and ran a home care branch in Charlotte, North Carolina, I started noticing a pattern. Our Client Services Managers (CSMs) who handled PDN caseloads handled recruiting along with everything else they were responsible for. Over time, I realized something interesting. The CSMs who consistently hired one nurse per week were the ones driving the growth of the office.
Each CSM typically managed about 2,000 hours of care. If they averaged one new nurse per week, that same caseload would produce double-digit growth year over year. The branch would grow, we’d split the caseload, grow again, split again, and eventually open another office.
I carried that rule for PDN with me through every leadership role I held because the math kept working. But the reason it worked had less to do with recruiting than most people realize. The real reason was attrition.
In home care, we routinely lose 30% or more of nurses every year, and many leave in the first 90 days. So, hiring one nurse per week wasn’t really a recruiting strategy. It was simply the pace required to out-hire the loss.
Over the years I had CSMs and directors challenge me on that rule, and I was always glad they did. They would say, “Melinda, if I could retain more nurses, I wouldn’t need to hire one per week.” My response was always the same. Great! Show me how you do that so we can teach others.
Because if someone (or all of us) could consistently improve retention, the hiring goal wouldn’t go away. We would just grow even faster.
As an operator, I didn’t spend much time analyzing why that rule worked. We were too busy keeping the system moving. Years later, even as a CEO, I was still using the same math to drive growth targets across large, decentralized organizations.
Eventually I began looking for technology that could help our CSMs manage larger caseloads and hire and support nurses more effectively so we could improve retention. That’s when I met Kunal Sarda , who was approaching the same problem from the technology side. He wasn’t trying to solve a single workflow issue in home care. He was trying to solve the coordination problem underneath it.
That conversation changed the way I thought about the entire system.
What I realized is that the math behind “one nurse per week” was really exposing something deeper about our operating model. We weren’t actually designed to retain nurses early in their journey. We had built systems that allowed us to replace them quickly when they left. Because we had to.
Think about the experience many nurses have in their first 90 days. They accept the job because they want meaningful work and flexibility. But once they join the organization, the system often slows them down. Onboarding and credentialing take longer than expected. Communication becomes inconsistent after the offer. They wait too long to get matched to the right case. Schedules don’t quite align with what they expected. The right cases aren't available in the right territories. The list goes on.
By the time everything lines up, the nurse has already moved on. Not because she didn’t want to work in home care, but because the system didn’t get her to success fast enough.
That’s when I began to see what Arya was actually building, and how I could help.
Arya wasn’t another point solution trying to improve one step in the workflow. It wasn’t just recruiting software or a scheduling tool. It was a redesign of the recruit-to-retain operating model for home care nurses.
Arya agents coordinate the lifecycle of the nurse: engaging candidates early, guiding them through credentialing and onboarding, helping ensure they are ready for work quickly, matching them to the right cases faster, and supporting communication once they begin caring for patients.
Instead of optimizing a single moment in the workflow, Arya helps the system move nurses from candidate to confident caregiver more quickly and consistently. It puts the nurse in the driver seat to control their destiny - choose the days and hours, location, and client they want to work with, and reduce the burden of administrative coordination.
And that’s when the math begins to change.
If nurses reach their first successful case faster, retention improves. When retention improves, the hiring engine that once existed simply to replace attrition becomes the engine that actually unlocks growth.
That’s why I chose to work on the technology side to help make our industry better. For decades, home care companies built systems designed to compensate for early nurse loss. Now we have the opportunity to build an operating model designed to help nurses succeed from the start. When that happens, the entire math of the industry changes. And most importantly, the nurse wins.
