Arsen Ustayev, Founder & CEO, CareChoice

In an interview with Invest:, Arsen Ustayev, founder and CEO of CareChoice, discussed how shifting demographics, policy changes, and client expectations are accelerating the move toward home-based care. Drawing on his journey as an immigrant entrepreneur who built, sold, and then rebuilt a large senior-care platform, he outlined a national expansion strategy grounded in operational discipline, technology, and community partnerships. “Our priorities come down to three things: deliver excellent care so people can age at home, take good care of the caregivers who make that possible, and keep innovating so we can bring this model to more communities across the country,” he said.

What changes across the healthcare and caregiving landscape over the past year have most influenced how you lead CareChoice and set your priorities?

One of the most important trends is that more of our clients want to hire the caregiver of their choice. That is exactly why we are called CareChoice. A typical example is an elderly woman living alone who needs help at home. In the past, a stranger from an agency would show up at her door. Today, many clients tell us they would rather hire a daughter, a friend, or someone they already know and trust.

When that happens, everything changes. It is much easier and less embarrassing for someone’s mother to be bathed or helped with personal care by her own daughter than by a stranger she has never met. There is built-in trust and comfort. At the same time, we are creating jobs for people who might be struggling to find work. We can train them, give them the tools and resources they need, and help them become professional caregivers for the people they already love.

Caregiving is something most of us do naturally anyway. When a parent gets sick, children step in whether they have formal training or not. We are simply expanding on that instinct. We provide additional training, structure, and support so that family members or friends can do the job safely, get paid for it, and turn it into a real career with benefits.

How are demographic shifts, economic pressures, and policy changes reshaping the home care industry, and what challenges and opportunities do you see?

One of the biggest challenges is funding. The rates we are reimbursed by insurance companies have barely changed over the past 10 years, while the cost of living keeps rising. We want to pay caregivers more, offer strong health insurance, retirement plans, dental coverage, paid time off, and sick time. All of that creates a significant overhead burden, and shrinking margins make it harder to run a high-quality business.

Pennsylvania faces an additional issue. Reimbursement rates here are roughly 20–30% lower than in neighboring states like New Jersey, New York, and Ohio. That puts companies like ours at a disadvantage and makes it more challenging to sustain a strong caregiver workforce. Through state associations, we have been pushing for rate increases so we can continue to invest in our teams and maintain quality care.

Workforce supply is another major pressure point. After COVID, it became harder to find nurses and caregivers. Even with the option to hire friends and family, not everyone has a daughter, son, or neighbor who can take on that role. In those cases, we still need to recruit, train, and place caregivers, and that is not easy in this environment. We are offering sign-on bonuses and constantly looking for creative ways to bring people into the field, because there is no shortage of clients who need help.

We are leaning into technology to respond to these pressures. We have moved to electronic onboarding so caregivers no longer have to come into the office to complete stacks of paperwork. Training and orientations are increasingly remote and digital, which speeds things up. We are also implementing AI for after-hours call answering so our staff can go home at the end of the day and spend time with their families, while clients still receive support around the clock. These tools help us stay resilient and efficient despite the economic and workforce challenges.

As you expand into new markets, how do you navigate different regulatory environments and workforce conditions without compromising your core model?

Everything starts with the core operations in the Philadelphia area. I have a strong team here that functions like a well-oiled machine. They manage the day-to-day business with minimal input from me, which is crucial. This core operation is what feeds everything else we do, so it has to be well-managed and stable.

For expansion, I rely on targeted research. I hired a consultant whose job is to study other states and identify where the laws and programs are favorable for the services we offer. Not every state is a good fit, but we have selected places like Ohio, Texas, Georgia, and New York because they have programs that align with our model and allow us to provide the level of care we want.

When we enter a new market, we keep the local footprint lean. For example, when we opened in Detroit, we hired a minimal operations team on the ground. Most of the back-office support comes from our corporate headquarters. That approach keeps expenses low while the business is still developing, and it allows us to maintain consistent standards across locations.

How does Philadelphia’s ecosystem support your work in home care and aging in place, particularly around workforce development and innovation?

Philadelphia is a diverse city, and that is a big advantage for our industry. There are many immigrants and minority communities here, and a large share of women in those communities work in home healthcare. That gives us access to a pool of people who are naturally inclined and motivated to do this kind of work.

We do a lot of outreach in the community, and we focus heavily on making caregiving into a real career, not just a temporary job. We offer a 401(k) with a company match to help employees build long-term retirement savings. We provide paid time off so that if someone needs to stay home for a week, they know they will still have income. We also offer comprehensive health and dental insurance.

Those benefits, combined with the mission of the work, help us attract and retain people who want to stay in the field. Philadelphia is a large city with a significant population that needs care, so there is plenty of demand. I am proud to serve this region and build a workforce that reflects the community.

Looking ahead, what are your top priorities to ensure that CareChoice continues to grow over the next three to five years?

First, we need to make sure operations remain strong. We need to be able to service the business we already have, keep clients and families happy, and maintain a high standard of care. Reputation matters. In today’s world, people look at online reviews before they choose a provider. It is always easier for someone who is upset to leave a negative review than for a satisfied client to leave a positive one, so we work hard to ensure that the experience we deliver earns trust and positive word of mouth.

Second, we plan to keep growing, and that requires continuous investment in marketing. We are pursuing unique, out-of-the-box marketing strategies, including commercials that look different from what others in the industry are doing. Some people might question that approach, but we do not want to look like everyone else. Being distinctive works for us, and we intend to keep leaning into that.

Third, we are going to continue expanding geographically while strengthening our technology infrastructure. We believe home care is the future of care, and we want to be present in more markets, providing the same choose-your-own-caregiver model on a larger scale. At the same time, we will keep investing in tools and technology that streamline the business, from documentation and note-taking to electronic visit verification and other digital solutions.

Our priorities come down to three things: deliver excellent care so people can age at home, take good care of the caregivers who make that possible, and keep innovating so we can bring this model to more communities across the country.