Your Next Move – "Going in the Opposite Direction of Everyone Else"

Podcast: Your Next Move (Inc. Magazine, Capital One Business)
Host: Ben Sherry (Staff Reporter)
Guest: Aisha Kwanu Tefera (Founder & CEO, Ultimate Care)
Date: November 18, 2025

Episode Overview

This episode features a candid, insightful conversation with Aisha Kwanu Tefera, founder and CEO of Ultimate Care (ranked #207 on the 2024 Inc. 5000 list), a fast-growing home health agency based in Virginia. Host Ben Sherry explores Aisha’s unconventional journey from hospital nursing leadership to entrepreneurship, her unique response to the pandemic, talent retention strategies, embracing AI, and her vision for the company's future. The central theme: achieving success by “going in the opposite direction” when everyone else retreats.

Key Discussion Points & Insights

Background and Company Origins

• Client Base & Location

  • Ultimate Care serves a wide range: from pediatrics to seniors and disabled clients (01:11).
  • Operates in the DMV area (D.C., Maryland, Virginia) (01:23).

• Founding Motivation

  • Aisha started Ultimate Care in March 2017, transitioning from Director of an Infusion Center at a hospital (01:30).
  • Gaps in communication and care delivery from existing home health agencies sparked her drive.
    • “I initially had no intention of starting a business... I was noticing gaps in care... There is no very clear, concise way of communication or providing the care that I expected from other home health agencies.” (02:00)

• Bootstrapping the Business

  • Self-funded, grew the company without outside investment (03:03).
  • The company now has 103 employees (03:09).

Lessons Learned & Personal Growth

• Resilience and Self-Discovery
  • “What I learned about myself is the deep, unlimited potential I had within me... to be resilient and persevere no matter what challenges come.” (03:24)
  • Emphasized tenacity and drive to succeed (04:04).

Navigating the Pandemic: Turning Crisis to Opportunity

• Contrarian Approach

  • While most agencies reduced services, Aisha’s team leaned in, filling care gaps during COVID-19.
  • “While everybody was backing out, we were backing in... stepping into the gaps, taking the clients that people were unwilling to take due to Covid... that actually exploded us.” (04:18)

• Risk Management and Impact

  • Developed strategies to minimize risk while maximizing client impact (04:50).
    • “If I don't do it, who do it?... I sat down, strategized, put all the resources that is in place, education wise to make sure that we minimize our risk, but then maximize helping the clients.”

Productivity and Operations

• Systems and Processes
  • “Systemizing everything that I do... I write everything down and when I write it down, I teach, you know, and I guide. So my SOPs are always written even up to where they go to the client's home.” (05:41, 05:46)
  • Care plans are highly individualized and detailed for consistency (06:29).

Talent Acquisition, Retention & Culture

• Retention Through Empathy
  • Aisha focuses on understanding and meeting employees’ needs, fostering an inclusive and respectful culture (07:06).
    • “I put myself in their shoes and I try to anticipate what their needs will be and developing a culture that is inclusive and very respectful. And they know that I am there for them as well as I'm there for the client.”
  • Heavy reliance on word-of-mouth for hiring — minimal recruitment needed (07:06).
  • Turnover is “very low,” better than the industry norm (08:23).

Transitioning from Nurse to Business Leader

• Learning Financial Acumen
  • The biggest learning curve: managing finances, billing, understanding company numbers (09:49).
    • “Financials. Knowing the numbers. Cause in the hospital what you do is you just provide a care... I was very unfamiliar with that part.”
  • Developed this competency through self-study: books, webinars, conferences (10:23).

Marketing Evolution and Use of Technology

• Word of Mouth to Digital Strategy

  • Grew primarily via referrals from stakeholders but now exploring TV, social media, and digital marketing for diversification (11:24).
  • Recognizes “concentration risk” from relying solely on stakeholder referrals (11:24).

• Adopting AI for Growth and Efficiency

  • Market Analysis:
    • Uses AI tools (ChatGPT, Meta AI, Gemini) for market and competitive analysis (13:00, 13:15).
  • Internal Processes:
    • AI-driven employee reminders, incorporating chatbots for client questions (13:20).
    • Experiments and staff-upskilling: Brought on a CTO to spearhead these initiatives (14:45).

Vision for the Future & Culture

• Scaling and Exit Strategy

  • Aisha sees Ultimate Care evolving into a comprehensive “home health system” providing a full spectrum of services (15:29).
  • Not interested in a traditional sale; instead, wants to transition to employee ownership as part of her exit (15:29, 16:42).
    • “I want an exit strategy where I get the employees to go public with it and get employees to become part owners of it.” (15:29)

• Leadership Philosophy

  • Practices “3 Fs” of leadership: Fair, Flexible, Firm (17:40).
    • “Accountability. I'll hold you accountable, but at the same time, I will show the care.”
  • Maintains strong personal relationships and an open-door policy (17:32).

Notable Quotes and Memorable Moments

• Discovering Inner Potential:

  • “I realized that I have a deep, unlimited potential that I can always pull out.” — Aisha Kwanu Tefera (03:24)

• Going Against the Grain:

  • “While everybody was backing out, we were backing in... that actually exploded us.” — (04:18)

• Leadership Philosophy:

  • “My three Fs of leadership is I'm fair, I'm flexible, and I'm firm.” — (17:40)

• Empowering Employees:

  • “It's not about the money, it's about the people.” — (17:37)
  • “I want an exit strategy where I get the employees to go public with it and get employees to become part owners.” — (15:29)

• AI for Small Business:

  • “So using AI to do a market analysis... We are using it to build into our processes, to streamline and automate a lot of reminders for the staff.” — (13:00, 13:20)

Timestamps for Key Segments

• [01:06 – 02:57] — Company overview, Aisha’s professional background, and why she started Ultimate Care
• [03:24] — Self-discovery and resilient leadership
• [04:18 – 05:28] — Pivoting during the pandemic: contrarian expansion and risk management
• [05:41 – 06:44] — Productivity strategies: process orientation and individualized care plans
• [07:06 – 08:23] — Talent acquisition and staff retention: culture and reputation
• [09:49 – 10:52] — The biggest lesson: learning financial management and business literacy
• [11:24 – 14:45] — Marketing shift, adoption of AI, and digital transformation
• [15:29 – 16:42] — Vision for future growth, scaling, and employee ownership as an exit plan
• [17:32 – 18:27] — Building a supportive culture and leadership approach

Conclusion

This episode provides a blueprint for entrepreneurial courage, especially in traditionally risk-averse fields like healthcare. Aisha Kwanu Tefera’s story is one of continuous learning, championing purposeful risk, and steadfast commitment to people—both clients and staff. Her approach to leadership, technology, and company culture makes Ultimate Care stand out as a model for sustainable, values-driven business growth.