We are Helping You Choose Your Home Care Consultant Wisely

Choose a home care consultant that does it all. From guaranteeing your Home Care Agency startup, will successfully obtain a state home care license. To offering lifetime Home Care Agency consultation and home care training to your home care business. 21st Century Health Care Consultants is the only choice when choosing a Home Care consultant.


During its existence, 21st Century Health Care Consultants has successfully helped establish and helped obtain licensure and home care accreditation for more than 2,000 Home Health Care businesses. 21st Century Health Care Consultants have assisted clients in the establishment of such home care businesses in all states that do not require a certificate of need (meaning the state is not accepting new license applications).


We pride ourselves in our ability to complete state Home Care license applications quickly, without error as well as successfully preparing our clients for their home care license inspections. In our long history, we have never had a Home Care business fail to obtain its state license or home health care accreditation.


Today, 21st Century has more than 30 full-time employees located at its Bradenton, Florida national headquarters. During its existence, 21st Century has obtained licensure and accreditation for over 1500 health care organizations. We have assisted clients in the establishment of such Home Care Businesses in 43 of the 50 states.


Unlike most companies who offer diluted consulting in many different areas, we offer and pride ourselves on being the best in this one area of “Medicare, Medicaid and Private Duty Accreditation Preparation and Certification”.


Why have we been so successful helping all of our agencies obtain accreditation and certification?


The fact is that we are only focused on the Medicare/Medicaid accreditation and certification process. This allows us to provide the very best in education, training, and preparation for certification for home health care agencies.


21st Century Health Care Consultants Employees


Rosina McFadden, MS, BSN, is known as the pioneer in home care and a former CHAP Accreditation Senior Site Surveyor. Rosina received her BSN from Hunter College and received an MS in Community Health Administration from Long Island University. Rosina has had many great accomplishments, some of which she pioneered New York’s Long-Term Home Health Care Program which has become the model for new programs and remains the largest and most successful in the state.


She organized the largest and most successful Lifeline Program in the country. She negotiated first fee-for-service nursing contract in the USA which has provided increased availability of nurses. She founded a nationally recognized Home Care Department whose budget grew to $20 million and 260,000 visits under her leadership. Rosina provided leadership and expertise in the development of the Long-Term Home Health Care Program for the state of Hawaii. She was the First Vice President of the Home Care Association of New York State and developed procedures for recording and maintenance of records to provide improved accessibility, clarity, time efficiency and potential analysis of data.


She was the Chairperson of the Public Policy Committee, Legislative Analysis and Action Committee for the Home Care Association. She was First Vice President, Board of Directors of the Brooklyn Lung Association. She was a member of the New York State Senate Health Committee, Paraprofessional Task force and the Professional Affairs Policy Committee of the Greater New York Hospital Association. Recipient of the Ruth F. Wilson Award from the Home Care Association of New York State for outstanding contributions of statewide significance to the home care field and recipient of the New York State Legislature’s Nurse of Distinction, Nurse of the year Award. Rosina McFadden is presently the CEO of 21st Century Health Care Consultants Group and the company’s chief clinician and Clinical Servant Leader.


John Dapello is former executive at Reynolds and Reynolds (a Fortune 500 Company) and the President of Total Care Permanent Staffing Services (the industry’s largest international recruitment agency for nurses and permanent nurse place). With office locations in the Philippines, Dubai, Nigeria, and North America, John has been around home health care all his life and became a Managing Member of 21st Century Health Care Consultants and acts as 21st Century’s Servant Leader, President & Owner.


Rhonda Surgnier is a certified CHAP consultant and Registered Nurse of 38 years of extensive experience in Home Health Care including Medicare services, Private Duty services, Personal care services, Pediatrics, and Infusion therapy. Throughout her career, she has had many great accomplishments. Some of which are when she was a pediatric nurse manager.


She developed the first “sick” daycare unit in the state of Florida, a newborn care program and a maternal tocolytic therapy and fetal monitoring program for pre-term labor patients. She specializes in IV Therapy Services and has held positions that include Director of Nursing, General Manager of an Infusion pharmacy and Clinical Director for seven pharmacies.


Rhonda was an Administrator/Director of Nursing for a Medicare/Private Duty home care agency and has developed CEU programs, maintenance of Performance Improvement programs, staff teaching, PICC insertions, policies, and procedures. Her accreditation experiences include CHAP and ACHC. Rhonda also holds a certification in Case Management thru ANCC. Rhonda is an operations director at 21st Century Corporate office and their clinical Servant Leader.

Becky Tolson is a Registered Nurse serving as one of the Clinical Directors at 21st Century. Her extensive experience consists in both the clinical field and the administrative aspect of home health care as well as the operational assistance of a specialty pharmacy. She has practiced licensure in both Florida and Texas for Medicare and Private Duty Agencies. She is an active association member of HCAF, INS, and AHCC. She assists in the development and training of boot camps to include the advanced coding class as well as infusion boot camp. In addition, she makes onsite visits to clients for mock surveys for accreditation preparation. Her specialties and passions include OASIS and wound care. Her accreditation knowledge expands both CHAP and ACHC.


Becky also holds a Bachelor’s degree in Business Administration to include management and marketing. She has been involved in the formation of many home health agencies’ policies and procedures as well as marketing materials/strategies to include website development, agency brochures, and patient education newsletters.

Patricia Covone is a Registered Nurse of 42 years and a Legal Nurse Consultant. She has extensive clinical experience in Home Health Care, Critical Care, Medical Surgical Nursing, Post Anesthesia Care, Short Procedure Unit and Discharge Planning.


Some of her accomplishments include obtaining certification as a Legal Nurse Consultant, holding management positions in Home Health and legal consulting. Pat directed a team of legal nurses in the Philadelphia area and coordinated the completion of written medical chronologies with trial deadlines. As Supervisor of a home health agency, Pat also developed a self-scheduling program, taught in-services to staff, acted as a liaison between the hospital and home, and was a mentor to newly hired RNs.


Pat currently works as one of the Clinical Directors at 21st Century and is committed to fostering a communicative, trusting relationship with her clients.

Melanie Ballinger is a Registered Nurse for over 40 years. She has been providing Hospice Nursing for 20+ years serving as Director of Nursing, Charge Nurse, In-Patient Unit, Admissions RN for Home Hospice, RN Case Manager, Emergency on Call RN, Administrator, Nurse Educator.  Specializing in clinical symptom management and palliative care.  She has a passion for teaching and implementing great customer service. She was an RN Nurse Educator for Chattahoochee Community College, as RN and LPN instructor for Pharmacology, Anatomy, and Physiology, Medical Terminology.  Clinical instructor for clinical teams at the local hospitals for clinical rotations.  She has practiced Oncology Nursing for 8 years, leading others in Chemo Certification, Clinical Management, Team Building, helping patients and families make informed best choices about health care and end of life issues.  Served as a cohort in the first successful team of Clinical Nurse Managers in the first venture for a hospital with Quality Improvements, PIPs, with Job Sharing.


Leadership roles in Emergency Medicine for 10+ years, teaching new staff how to manage stressful situations with tragedy and sudden death, teaching code team appropriate responses to families during code situations, working on Clinical Nurse Education Team to ensure all ER staff is always up to date with newest technologies and innovations.


Melanie currently works as Clinical Directors at 21st Century’s Hospice Consulting program.

Nicole Muskgrave is a member of 21st Century Health Care Consultants “Clinical Department”.  She has more than 13 years of customer service experience with seven plus years being in the medical field. Her medical experience includes managing a private practice ENT office, transcription, coding, and billing. Nicole is a certified coder and biller with ENT Specialty experience. She is currently working on adding Home Health certification to her coding credentials.

Taylor Colby Anbari – Taylor is a member of the Clinical Department team. As a Licensed Practical Nurse with a degree in Bachelor of Science Healthcare Administration she has worked in the in the healthcare industry as a clinician and manager. With nearly 20 years experience in Private Duty Adult and Pediatric Home Care, Taylor is knowledgeable, supportive and understanding of our client needs.

Customer Commitment


Carol Byrne – For the last 10 years, Carol has worked with 21st Century Health Care Consultants as the Customer Commitment Director. She is generally the first contact clients make when they call the company and she guides them through the options available to them in their states. She likes to think of herself as an Ombudsman, always there for her clients to answer questions and provide guidance when needed. Along with her team, she has brought about a sustained growth in the company.


Carol was born in Brooklyn, New York and is a graduate of Hunter College with a degree in Psychology and Education. Her years of teaching and service to her community has brought about her love of people and her desire to help those realize their dreams and achieve their goals. Carol presently acts as 21st Century’s Servant Leader in the Quality Commitment Department.

Don Budd, As a member of the “Quality Commitment Department”, Don is the first point-of-contact for individuals wishing to begin the start-up process of owning a health care agency. He will assist you in identifying the “type of agency” that will best meet your needs as a business owner. He will educate you on the State regulations and requirements to ensure the successful launch of your agency.


As an individual, he has always had a passion for working with people from all walks of life around the world. Don has lived in India, the Philippines and various locations throughout the United States. Don is dedicated to helping clients fulfill their dreams while improving the health and well-being of the clients they serve in their communities.

Phebe Simmons is an out-going, hardworking professional who holds a Bachelor’s degree in Business Economics. She joined 21st Century Health Care Consultant following a relocation back to Florida after a 20 year journey in Northern California. Phebe brings a wide spectrum of experience and knowledge to the organization. She has over 14 years of management experience, 12 years of Corporate Business experience, and several years of business ownership experience. She is also a Certified Professional Coder through AAPC. Phebe understands the hurdles and challenges that goes along with stretching outside of comfort zones and not accepting anything less than the success of accomplishing what one sets out to do. The great Philosopher Aristotle once said: “Patience is bitter but its fruit is Sweet!”

Patrick Fowler – Patrick brings to the 21st Century team nearly 30 years of management experience in sales and marketing. Beginning his career in market research with National Geographic Society and a leading public service advertising agency, he served in senior management positions in public transportation at two of the largest transportation systems in North America. Originally a “Jersey boy,” he relocated to Florida to follow the sun and direct the marketing activities for the fourth largest AAA club in the United States. He took some time away from the corporate world to pursue a long-time avocation, serving as a teaching chef in a cooking school. He joined the sales team at 21st century to fulfill his passion for assisting other people to pursue their entrepreneurial dreams.

Duane Welch – Experienced Sales Positions with a demonstrated history of working in the building materials industry, Health Industry, and IT Consulting. Skilled in Negotiation, Business Planning, Operations Management, Microsoft Office, CRM Solutions, and working work Architects, Contractors, and Installers. Strong sales professional with a Bachelor of Arts focused in Computer Science from Rollins College.

Sherry Forbus

Licensing Department


Amanda Mahoney – Amanda is also one of our managers in Licensing and and Accreditation Department, and loves working with her team. She was born and raised in the Bradenton, Florida area. She came to us with about 10 years of customer service experience, and as a Pharmacy Technician. In her free time, she owns and operates a photography business, loves spending time with family, and her pet chihuahua, Lola.

Kim Cavanaugh is originally from Philadelphia, PA. Kim moved to the Bradenton/Sarasota area about 7 years ago. Kim currently works in the Licensing and Accreditation department with an amazing team. Kim loves her role as an account manager. In her spare time she enjoys spending time with her two daughters.

Brit Johnson is a member of our Licensing and Accreditation team.  She came to us with over 10 years of customer service experience.  She has worked in a variety of industries that has given her an expanse of knowledge and once in a lifetime experience.  From learning how to cook the perfect funnel cake for the fair goers in the state of Iowa- to racing BMW’s at the BMW Test Track in Spartanburg, South Carolina, Brit’s past experiences have yielded a professional, adaptable and friendly lady.


She now works for 21st Century Health Care consultants her 10+ years of customer service (and that bachelor’s degree too) taught Brit to treat our clients like friends rather than serve customers.  Brit loves her team at 21st Century- They’re wonderful people and the fact that she gets to see them every day makes getting out of bed in the morning, not such a grueling task. We all work very hard to ensure all of the 21st Century clients succeed in every way possible.  In her spare time, Brit enjoys playing games (board, cards, video, lawn and party games)  spending time with her friends and family, traveling and meeting new people.

Casey Mahoney – Casey has had over 10 years of experience in the healthcare field including home health, memory care, and Ophthalmology. She has worked closely with Alzheimer’s and dementia patients in several memory care units and assisted living facilities. She was most recently certified as an Ophthalmic Technician. She worked with several different Specialty Doctors for almost 3 years doing insurance, Optical coherence tomography, Fundus photography, post-operative care, and routine eye exams. Casey was born and raised here in Bradenton, FL and has 3 young children that keep her very busy. She has joined the 21st Century family as an Account Manager with the Licensing and Accreditation Department and is fully dedicated to the success of our clients.

Angela Eidson – Angela has had over 27 years of experience in the Eyecare Business.  She is a former License Optician.  Has work with both Optometrist and Ophthalmologist.  Angela is from Memphis, TN and moved to Brandenton, FL in 2015. She has joined the 21st Century family as an Account Manager with the Licensing and Accreditation Department and is fully dedicated to the success of our clients.

Strategics & Planning

Linda Michaelsen is a member of 21st Century Health Care Consultants “Quality Commitment Department” and brings with her over 20 years of experience in Customer Service. Linda is a high-energy level person who has facilitated many teams on process change focus on improving customer satisfaction and employee productivity. She believes in a win/win experience for the customer and the company. Linda is the Logistics Training Manager for the Boot Camp Training programs at 21st Century Health Consultants. Linda transferred from Rochester, NY to Bradenton, Florida 18 years ago with her husband.

Human Resources

Jean Marie –


Frances Alletto – In 2008 Fran joined the 21st Century Health Care Consultants team and currently is the head of the publishing department, oversees the processing and production of the Policies and Procedures for our Agencies. Our publishing department works diligently to assure that the policies and procedures are formatted and customized to meet the specifics related to your Agency.


She earned a Bachelor of Arts degree in Interdisciplinary Sciences and graduated Magna Cum Laude in 1981 from Stoney Brook University in New York. Her studies afforded her the opportunity to work for Catholic Charities as a Geriatric Case Manager for 17 years. She managed a caseload of seventy-two clients which entailed making home visits, doing initial assessments and putting various entitlements in place.


Close communication with our clinical department assures that your policies have the latest updated State and Accrediting Body regulations. The Agency’s demographics, personnel, logos etc. are all incorporated in the policies. In addition, our Publishing Department customizes your Patient Information Booklet, Admission Forms, and Advance Directives.

IT & Internet Services

Christine Dapello is the lead for 21st Century Health Care Consultants IT and Internet department.  Her expertise is in the area, IT work, Website design, Search Engine Optimization/Business Development. She started working at 21st Century Health Care Consultants in July 2008. She has over twenty years combined experience in Computers and Web Design.