Going in the opposite direction of everyone else

Summary

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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

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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.

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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).

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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)

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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

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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.

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Transcript

[Capital One Announcer]

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[Sarah Lynch]

I'm Sarah lynch and you are listening to your Next Move audio edition produced by Inc. And Capital One Business. For this season, we gathered a bevy of conversations with entrepreneurs who made last year's Inc. 5000 list. They joined us in our your Next Move Booth at the Inc. 5000 to share lessons learned and anecdotes from building their businesses. In this episode, Inc. Staff reporter Ben Sherry spoke to Aisha Kwanu Tefera. She is the CEO and founder of the Virginia based Ultimate Care, a home health agency. The company is ranked 207 on the 2024 Inc. 5000 list. Ben started the conversation by asking Aisha about the company's clientele.

[Ben Sherry]

So who are the main clients that are getting these services? Seniors with disabilities.

[Aisha Kwanu Tefera]

So we have a wide range. We start from pediatrics all the way to seniors all the way to disabled clients. Yeah.

[Ben Sherry]

And where do you operate? Is it national or in a specific location?

[Aisha Kwanu Tefera]

Yes, we operate in the DMV area, which is Virginia D.C. area. Yes.

[Ben Sherry]

And when did you found the company?

[Aisha Kwanu Tefera]

I founded the company March of 2017.

[Ben Sherry]

And what were you doing before that? What was sort of your career trajectory to starting your own business?

[Aisha Kwanu Tefera]

I am a registered nurse, so I was working in the hospital as my last I was in the infusion center, the director of the infusion center.

[Ben Sherry]

And so what was it that got you to start thinking about starting your own business? And how did you get the original idea to go off and do this thing?

[Aisha Kwanu Tefera]

I initially had no intention of starting a business. I was comfortable where I was being the youngest patient care director. I knew there was a lot more opportunity for me in the hospital field, so I was comfortable. But I was noticing gaps in care where home health agencies, when we try to reach them for clients, you can get hold of them. There is no very clear, concise way of communication or providing the care that I expected from other home health agencies. So at a point on time, I'm a fast learner and like every five years I have to do something new in the healthcare industry. I'm like, oh, how about home care? Bring my expertise from the hospital and the leadership expertise I've learned and my skill set as a nurse I wanted to bring into the community.

[Ben Sherry]

Yeah. And so what was that process like of getting started? Have you raised any funds?

[Aisha Kwanu Tefera]

No I pretty much did everything by myself.

[Ben Sherry]

Oh, wow.

[Aisha Kwanu Tefera]

Yeah.

[Ben Sherry]

And where are you at now? How many employees do you have?

[Aisha Kwanu Tefera]

I have currently 103 employees.

[Ben Sherry]

103?

[Aisha Kwanu Tefera]

Yes.

[Ben Sherry]

Oh, wow. Congratulations.

[Aisha Kwanu Tefera]

Thank you.

[Ben Sherry]

And so what was the most surprising thing that you've learned about yourself and the business as you scaled over the last seven years?

[Aisha Kwanu Tefera]

I guess, yeah, it's been seven years. What I learned about myself is the deep, unlimited potential I had within me. Because as a nurse, you never get access to a business, how to, you know, manage or run the business. Even when you're in leadership, you know, it's limited. But when I started this, and pretty much from registration, everything, I started everything by myself and learning through the process and to be resilient and persevere no matter what challenges come, I learned through that. So I realized that I have a deep, unlimited potential that I can always pull out.

[Ben Sherry]

You have that drive.

[Aisha Kwanu Tefera]

Ah, the tenacious drive to make sure that what I'm doing is successful.

[Ben Sherry]

And so what have been some of those challenges that you faced along the way? I imagine that the pandemic was probably really tough. Right?

[Aisha Kwanu Tefera]

You know, although the pandemic was tough, it was actually our time of scaling up. Because while I can see that while everybody was backing out, we were backing in, you know, stepping into the gaps, taking the clients that people were unwilling to take due to Covid, we went forth and we just strived forward and that actually exploded us.

[Ben Sherry]

Yeah. Can you talk about having, like, the bravery to go in and go in the opposite direction of where everybody else is going and what that took?

[Aisha Kwanu Tefera]

So one of the principles in my life helped me a lot, which is, if I don't do it, who do it? So as people were struggling, everybody was running away because of fear, which I understand. I sat back and said, okay, what can I do to minimize my risk, but at the same time impact the life of those who need us now? And that's what we did. 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.

[Ben Sherry]

What's your key for staying productive and keeping yourself at the level of productivity that you want to be at without burning yourself out or needing to, like, take breaks. What's your, you know, way of, like, prioritizing yourself?

[Aisha Kwanu Tefera]

Systemizing everything that I do.

[Ben Sherry]

Systemizing and.

[Aisha Kwanu Tefera]

Putting down the processes. I'm a very deep, process detail oriented person. 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. One of the benefit for us is our advantage is that I am a nurse. So mostly when we start, I'll go start a case and. And then as an rn, outline how to really care for this client to maximize their recovery or sustain them. And so when I send nurses in, they have a very clear guidance how to provide the care.

[Ben Sherry]

So you're really developing a care plan personally for a lot of your clients.

[Aisha Kwanu Tefera]

Individual care plan which is detailed. So yes. And that really helps a lot because everyness that goes on, even when they don't know the client, they have a clear guidance how to provide a consistent care to the clients.

[Ben Sherry]

And how has it been finding people who are prepared to be doing this caregiving? I've talked to a lot of people, especially here at the conference who have said that in the caregiving space, it's difficult to find people who are ready to put up with all of the, you know, challenges that come with helping somebody that needs care. So how have you found identifying talent and bringing them into your organization?

[Aisha Kwanu Tefera]

I'm very good in retaining talents and how I do that is that first 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. So it's not a client or like clients first. How do you like customize or is right. That's not the principle we run by. We will hear both sides and then address it as needed. And to be honest, we don't do a lot of recruitment. Is our stuff that actually refer their friends police to us. So we don't put heavily in like doing maybe zipriculture Indeed or something like that. It is the word of mouth of our staff and mostly is. Oh, it's not. Mostly it is because of the way we treat them and how they like to be treated and you know, in the company. So out of all the one or three staff that we have, I can solely one person that I got through ZipRecorder.

[Ben Sherry]

Wow. And how's your turnover then? I imagine it's pretty low.

[Aisha Kwanu Tefera]

It's very low. Our turnover is very low in home health space. What happens is sometimes we lose a client and then you have stuff that doesn't have work. But with us it's very minimized. So our turnout rate is higher than the national level.

[Sarah Lynch]

When we come back. Ben asked Aisha about the biggest Lesson from her career jump. But first, a quick break.

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[Ben Sherry]

What was the biggest lesson that you had to learn when you went from being a nurse and running this section of the hospital to running a business and putting all of that together? Was there anything that you thought that you wouldn't need to know that you ended up having to do deep dives on or what were sort of the big blind spots that you had when you started that you kind of had to fill in over time?

[Aisha Kwanu Tefera]

Financials.

[Ben Sherry]

Financials.

[Aisha Kwanu Tefera]

Knowing the numbers. Cause in the hospital what you do is you just provide a care. They go home. You don't deal with no billing issues. You just do your part, provide a care document and go home. And then there is a department that handles that. So I was very unfamiliar with that part. So I really had to dive deep to learn how to bill, how to manage the financials of the company, you know.

[Ben Sherry]

So how did you do that learning?

[Aisha Kwanu Tefera]

I'm a self learner, so I dived a lot into learning. Reading books, webinars, listening to anybody that will talk about finances, how to know your statements, how to read them, what to do, you know, how to minimize your expenses. So I did learn a lot. I love attending conferences so I can learn from that from exped. So that's what I did and it really has brought me to this level.

[Ben Sherry]

That's great. And I'm hoping that the Inc 5000 is a good example of that.

[Aisha Kwanu Tefera]

Oh yes. Oh yes. That's why I keep coming. And the Inc 5000 is, I love the way it's structured. Right. You do have the learning part and you have the fun part, which every conference should be like that.

[Ben Sherry]

What has sort of your approach been to getting the word out about your services? When you're thinking about marketing, do you use social media? Do you use newsletters, tv? What's sort of the best way to reach the demographics you're looking to reach?

[Aisha Kwanu Tefera]

So starting this last Quarter is when I've been trying to start being innovative in marketing. Previously, my strategy has always been the stakeholders. So I recently noticed that I have a huge concentration risk because all my referrals are from stakeholders. Right. Because I do establish that credible, reputable service. So always this person will tell this person about me, they will call me, I'll start it, you know, But I want to use more marketing strategies like tv, social media. So we started. We already started posting a lot on social media, telling about who we are, and we do have data to back our credibility.

[Ben Sherry]

How did you go about developing a marketing plan as a business that had been mostly relying on word of mouth and referrals up to that point?

[Aisha Kwanu Tefera]

So recently is when I've been thinking about marketing outside the comfort zone that I know. But when I was in the hospital, I knew that it's always the stakeholders, the case managers, they are the ones, the referral source, they know. So I always want to partner with the hospital, partner with the doctor's office, partner with county. That has been my to go. But that has limitation. Right. So now you have to post out there in the social media. So one of the things is using AI industry. Yes.

[Ben Sherry]

How are you using AI?

[Aisha Kwanu Tefera]

Oh, I love AI.

[Ben Sherry]

Really?

[Aisha Kwanu Tefera]

Yes.

[Ben Sherry]

Okay. Okay, tell me about it.

[Aisha Kwanu Tefera]

So using AI to do a market analysis. Right. I'll prompt it. Tell me the market analysis or competitive analysis within this region or where we serve.

[Ben Sherry]

What AI are you using?

[Aisha Kwanu Tefera]

I've used ChatGPT and I've also used Meta AI.

[Ben Sherry]

Okay.

[Aisha Kwanu Tefera]

Yeah. And we also use Gemini by Google. Okay. And right now we are building out things. We are using it to build into our processes, to streamline and automate a lot of reminders for the staff, you know, so it's helping, like questioning. So we build a bot into our website side where if you have questions, you ask the bot and the bot will provide the answers.

[Ben Sherry]

Has that been a popular feature, as you've seen it on your end with the website? Have people been responding to the chatbot?

[Aisha Kwanu Tefera]

People are very slow in this space when it comes to use of such technology. So the key is continuous education and helping them see how smoother it makes communication. So that's what we've been doing. So continuous education, because we just started like last summer, is when we started incorporating AI into our systems.

[Ben Sherry]

Right before you were just using it sort of for your own sort of research.

[Aisha Kwanu Tefera]

Research and information. And I realized that, oh, how can we implement this into our system to make it smarter?

[Ben Sherry]

Yeah. And have you had to like bring in Anybody or has it just been like you experimenting around with your own AI and figuring out use cases?

[Aisha Kwanu Tefera]

So I done some training on AI.

[Ben Sherry]

Okay.

[Aisha Kwanu Tefera]

And so I have a CTO currently. So I brought one of my staff had finished cybersecurity and stuff. I said, okay, well, so you are in that space of it, can we give you another title and train you more to do this stuff? And so he's been the one helping. So with the training, I've realized all the AIs forms of AIs out there that we can use. And so we are individually testing them out. But we haven't brought an aspect, we have learned from aspect how to use it.

[Ben Sherry]

So when you look to the future, what are you sort of hoping to accomplish with your company? Are you looking to continue growing? Are you looking to eventually sell? Are you?

[Aisha Kwanu Tefera]

Yeah, that's a big question. I know it's kind of like an exit strategy at the same time. What's your currently. So in the phase that we are in, I say we are in the like young adult phase of our company. And my strategy about that is to scale up and make it become a home health system, which means have more services and have like all inclusive service. Whatever you need, we are providing that. Right? Because home health is really range. You have home infusion, you have the just the personal care, you have the private duty nursing, you have the skilled nursing. Currently be doing almost all of it. So our focus is, okay, we're going to develop them separately, but under one umbrella. Our exit strategy is that I'm not willing to sell it. Okay. And the reason why is that it's very dear to me and at the same time, my employees are very important to me, right? So I want an exit strategy where I get the employees to go public with it and get employees to become part owners of it.

[Ben Sherry]

I mean, I love SPACs. Or not. Not. Not.

[Aisha Kwanu Tefera]

Yeah, SOPS.

[Ben Sherry]

Not SPACs. Exactly. SOPS. Yeah, exactly. SPACs are totally different acronyms. But you know, I love that though. Have your employees expressed interest in potentially doing that someday?

[Aisha Kwanu Tefera]

Only one person really expressed that interest a long time ago, but that person was a higher person. He's my CEO. But that time I wasn't ready. And as I learned more, I said, okay, let me start thinking about my exit strategy. And I want that to be an exit strategy whereby as we get to the prime, right? You know, the 12 stages of, oh, I don't want to get to the prime, I don't know what to do. So now I know that's my Asset strategy. Maintain a percentage of ownership and have percentage goes towards the employees. That too, they'll be invested.

[Ben Sherry]

How do you create such a great environment for your employees? Why do they love working for the company so much?

[Aisha Kwanu Tefera]

Because I love people and I show them that I care.

[Ben Sherry]

And how do you do that?

[Aisha Kwanu Tefera]

How do I do that?

[Ben Sherry]

What's. What's your love language?

[Aisha Kwanu Tefera]

So I always tell people I'm a very honest and straightforward person. My three Fs of leadership is I'm fair, I'm flexible, and I'm firm. Okay. So accountability. I'll hold you accountable, but at the same time, I will show the care. I'm the type. I'll reach out to you quick. I connect with them as a CEO and a founder. I. I have an open door policy. I know almost everybody in the company and have a relationship with each and one of them. So that makes them feel valued. And that's the most important thing to me. I always talk about it's not about the money, it's about the people.

[Ben Sherry]

I love that. And you're helping people every day, both in the company and your clients. So you must feel very satisfied and fulfilled.

[Aisha Kwanu Tefera]

I am. I am fulfilled just to see the ability to be able to help clients. Help and staff. I provide my staff with any resource to help them be successful.

[Ben Sherry]

All right, well, I think that's about all the time we have. So, Ayesha, thank you so much. I really appreciate you taking the time and chatting with me.

[Aisha Kwanu Tefera]

Thank you very much for having me.

[Sarah Lynch]

That's all for this episode of youf Next Move. Our producers are Blake Odom and Avery Miles. Editing and sound design by Nick Torres. Executive producer is Josh Christensen. If you haven't already, subscribe to your Next Move on Apple Podcasts, Spotify or wherever you listen, your Next Move is a production of Inc And Capital One Business.