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 2,500 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 40 full-time employees located at its Bradenton, Florida national headquarters. During its existence, 21st Century has obtained licensure and accreditation for over 2500 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, Founder

Rosina has been hailed as the pioneer of the home care consulting industry. A former CHAP accredited senior site surveyor; she received her BSN from Hunter College and an MS in community health administration from Long Island University. 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 possible analysis of data.

She has held many distinguished roles in healthcare including: Chairperson of the Public Policy Committee, member of the Legislative Analysis and Action Committee for the Home Care Association, first vice president of the Board of Directors of the Brooklyn Lung Association, member of the New York State Senate Health Committee, member of the Paraprofessional Taskforce and member of the Professional Affairs Policy Committee of the Greater New York Hospital Association.

Rosina was the 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.

Some of Rosina’s professional accomplishments include:

  • Pioneering New York’s Long-Term Home Health Care Program which became the model for new programs and remains the largest and most successful in the state.
  • Organizing the largest and most successful lifeline program in the country.
  • Negotiating the first fee-for-service nursing contract in the US which has increased the overall availability of nurses nationwide.
  • Founding a nationally recognized home care department whose budget grew to $20 million and 260,000 home visits under her leadership.
  • Providing leadership and expertise in the development of the Long-Term Home Health Care Program for the state of Hawaii.

Rosina McFadden is the founder of 21st Century Health Care Consultants and the company’s chief clinician and clinical servant leader.

John Dapello, CEO
John is a former executive at Reynolds and Reynolds (a Fortune 500 Company) and the president of Total Care Permanent Staffing Services (the industry’s most significant 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 is now a managing member of 21st Century Health Care Consultants and acts as its servant leader, president, and owner.

Steve Burnette, Chief Operational Officer

Steve Burnette has been with 21st Century since August 2017. He brings 31 years of experience in business consulting and general management for companies like Reynolds & Reynolds and the HAC group. At 21st Century, Steve is the national director of franchise development which is a new initiative for the company. He is also the director of sales for our ongoing consulting services improvement program which ensures the success of individual home care, home, and hospice agencies across the country.

Nicole Muskgrave, Operational Project Manager
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 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.


Becky Tolson, Clinical Director
Becky Tolson is a registered nurse who also holds a Bachelor’s Degree in Business Administration. Her extensive experience consists of both clinical and administrative aspects of home health care as well as providing operational assistance to 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.

As one of the clinical directors at 21st Century, she assists in the development and training of advanced coding and infusion in our boot camps. In addition, she makes onsite visits to clients for mock surveys for accreditation preparation. She has been involved in the formation of many new home health agencies’ policies and procedures and has implemented both digital and print marketing strategies including website development, agency brochures, and patient education newsletters.

Her accreditation knowledge expands both CHAP and ACHC. Her specialties and passions include OASIS and wound care.

Patricia Covone
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.

She has held management positions in both home health and legal consulting. She directed a team of legal nurses in the Philadelphia area to coordinate the completion of written medical chronologies with trial deadlines.

She worked as the supervisor of a home health agency, developing a self-scheduling program, teaching in-services to staff, acting 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 between our home healthcare consultants and our clients.

Melanie Ballinger, Field Nurse
Melanie Ballinger has been a registered nurse for over 40 years. She has been providing hospice nursing for 20+ years serving as director of nursing and charge nurse for an inpatient unit, admissions RN for home hospice, RN case manager, emergency on-call RN, administrator, and nurse educator.

She was an RN nurse educator for Chattahoochee Community College, and an RN and LPN instructor in pharmacology, anatomy, and physiology and medical terminology. She served as a clinical instructor for teams at the local hospitals for clinical rotations. She practiced oncology nursing for eight years, leading others in chemo certification, clinical management, and team building while helping patients and families make informed best choices about health care and end of life issues. She served as a cohort in the first successful team of clinical nurse managers in the first venture for a hospital with quality improvements, PIPs, and job sharing.

She served in leadership roles in emergency medicine for 10+ years, teaching new staff how to manage stressful situations around tragedy and sudden death. She taught code team appropriate responses to families during code situations and worked on a clinical nurse education team to ensure all ER staff was always up to date with the newest technologies and innovations.

Melanie currently works as a clinical director for 21st Century’s Hospice Consulting Program. She specializes in clinical symptom management and palliative care. She has a passion for teaching and implementing world-class customer service.

Customer Commitment

Carol Byrne, National Sales Manager
Carol Byrne 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 like 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 Byrne 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.

Patrick Fowler
Patrick Fowler 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 from New Jersey, 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.

Linda Michaelsen, Logistics Training Manager
Linda Michaelsen is a member of our quality commitment department and brings with her over 20 years of experience in customer service. Her high-energy positivity lends itself perfectly to her work facilitating teams that focus on customer satisfaction, employee productivity, and process change. Linda is dedicated to creating a winning experience for all of our clients.


Licensing Department

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

Casey Mahoney
Casey Mahoney has had over ten years of experience in the fields of 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 worked with several different specialty doctors for almost three 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 three young children that keep her busy. She is an account manager in our licensing and accreditation department and is entirely dedicated to the success of our clients.

Angela Eidson
Angela Eidson has had over 27 years of experience in the Eyecare Business. She is a former licensed optician who has worked with both optometrists and ophthalmologists. Angela is originally from Memphis, TN but moved to Bradenton, FL in 2015. She has joined the 21st Century family as an account manager for the licensing and accreditation department and is fully dedicated to seeing all our clients succeed.



Frances Alletto, Head of Publishing
Frances Alletto earned a Bachelor of Arts degree in Interdisciplinary Sciences and graduated Magna Cum Laude in 1981 from Stoney Brook University in New York. She has over 20 years of experience in accounting and customer service and 17 years as a geriatric case manager. She joined our team in 2008 and currently oversees the production of policies and procedures for our agencies, as well as all the print materials like logos, admission forms, patient information booklets, and more.



Shawn O’Conner, Marketing Director
Gary Cordeiro is responsible for all planning, development and execution for our company’s own internal marketing initiatives, including Facebook & Instagram Ad campaigns, Google Adwords, SEO, marketing automation strategy, landing page optimization, offer development and more.

Christine Dapello
Christine Dapello has over 20 years of experience in computer technology and web design. Her expertise in IT work, digital design, search engine optimization, and business development lends itself perfectly to her role at 21st Century Health Care Consultants. She joined us in July of 2008.