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 4000 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 4000 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

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


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.

Clinical Team

Becky Tolson

RN, BS, COS-C 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.

Roberta Edson

Clinical Administrative Assistant

Roberta Edson has over 25 years of Office Management in Nursing Education. Previous to joining 21st Century, she worked for a private catholic college supporting both the Online Nursing and Traditional Nursing degree programs. She has worked closely with nursing administration, faculty and students, assisting them through all processes required to meet their goals, some of which are; earning a nursing degree, attaining accreditation, passing their RN exam, arranging for NP Clinical Sites, managing the office. Roberta is a native of Maine and moved to Bradenton, FL in the spring of 2018. She then joined 21st Century Health Care Consultants and is presently the Clinical Administrative Assistant dedicated to supporting the Clinical Director, Assistant Director and the Clinical Managers. She is dedicated to serving the needs of all our clients.In her spare time, she is with her husband here in Florida, and her family camping in Maine camping and enjoying the Florida beaches.

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.

Debra Kelly


Debra Kelly (Debbie) is a Registered Nurse who also holds a Bachelor’s Degree in Health Services Administration with dual sub-specialties of Compliance and Security. In her decades long career, she has held numerous consulting, training, management and leadership roles in hospital, home health and hospice agencies. After many years working in high risk obstetrics, she worked as a field RN, admission nurse, mentor/trainer, team lead and senior staff nurse (nursing supervisor) for one of the first and largest home health and hospice agencies in the country. In these roles she gained experience in patient care, documentation, relationship building, teamwork, leadership and management. Debbie then worked as a Joint Commission accreditation and EMR clinical compliance specialist for a medical software supplier with hundreds of home health and hospice customers all over the US. She was the point of contact and support for those agencies as they went through their state, initial accreditation and re-accreditation surveys. The part of her job that she enjoyed most was teaching home health agency owners, IT managers, physicians and nurses how to be successful. The home health and hospice software that she helped to develop, implement and support was subsequently sold to a multi-national electronic medical record provider operating in three countries and servicing ever three million patients daily. She next worked on a small team with a large budget (six million) to design and implement a telemedicine kidney disease management program. In this role she wrote staffing models, strategic plans, nursing care plans, coding specifications, policies and procedures, patient teaching materials and staff training curriculum. All of the materials were subsequently approved for state and Medicare use. She also hired, taught and trained the clinical team and launched the clinical components of the program. As a Clinical Manager for 21st Century, Debbie is committed to providing clients with the knowledge, tools and support that they need to achieve their dreams. She is always mindful of the privilege to participate in and to be entrusted with those dreams.

Sandy James

RN BSN, Clinical Manager

Sandy is a Registered Nurse with over 25 years’ nursing experience. Sandy’s background in nursing is Medical-Surgical, Oncology, Open-Heart recovery, Home Health, Private Duty and Hospice. Her nursing specialties includes Oncology and Hospice. She has earned certifications in Oncology and Hospice specialties. She has extensive experience in providing Hospice nursing in Hospital, Home, ALF and Hospice House settings, Medicare Home Health and Private Duty Home Health. Further, Sandy has served as an Infusion Therapy instructor in both Clinic and Hospice Home Health settings and has presented in-services on Pain Management to Long Term Care Facilities as related to Hospice patients. Sandy currently works as one of the Clinical Managers at 21st Century and has a passion for teaching, customer service and takes great pride and pleasure in the success of 21st Century’s clients.

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 has 17+ years in staff development and currently leads the licensing team of eight national account managers. Kim’s vast knowledge and experience in state licensing requirements, medicare certification  and accreditation requirements for home care, home health care, and hospice is unprecedented. Under Kim’s leadership at 21st Century Healthcare Consultants, , the team of account managers have successfully licensed nearly three thousand agencies nationally. Prior to Kim joining the 21st Century Healthcare Consultants team she spent seven years as a Supervisor at Liberty Mutual Insurance Company in the No Fault department (Catastrophic Unit).

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.

Kalli Seger

Kalli Seger is a Licensing Manger with the 21st Century team. Her experience in customer service and management spans over 13 years. Her favorite aspects of her job are helping clients achieve their dreams and making them laugh with her witty personality. Kalli enjoys crafting, billiards, singing karaoke, and taking her young daughter to theme parks.

Lisa Van Overmeiren

Lisa Van Overmeiren has had over 17 years in the Drug Retail Business from store level to corporate office. She also has experience in a hospital setting as Financial Counselor for 10 years. Lisa is originally from Chicago, Illinois but moved to Bradenton, Florida in 2016. Lisa joined the 21st Century Team in early 2017. She is an account manager in our licensing and accreditation department and is dedicated to the success of our clients.

Jaymee Stephens

Jaymee Stephens is the newest Licensing Account Manager to join the 21st Century Health Care Consultants team. She was born in New Orleans but raised in Bradenton, Fl and is a proud mother to her miniature poodle Cocoa. A product of the illustrious Tuskegee University, Jaymee has worked with organizations across a wide range of industries from Management and Marketing to Bioethics and Telecommunications. Standing firm on her faith is her secret to success. No matter which hat she chooses to wear, her goal is always simple; To empower individuals to differentiate themselves and drive results through perseverance and innovation.

Policy & Procedures Writers

Gail Castanho

Gail holds a bachelor’s degree in Secondary Education, with a concentration in English/Rhetoric, and a master’s degree in English literature, with her efforts focused on early 20th century American and Post-colonial literature. Gail was involved in the teaching of writing for twenty years, at the college and high school levels, instructing students in proper grammar, structure, and elements of writing, academically and professionally, as well as poetry and creative fiction writing. Additionally, Gail operates a business writing firm, Have the Last Word Writing Services, where she creates documents for businesses and private individuals, including resumes, professional profiles (LinkedIn, etc.), and professional correspondence. Primarily, Gail’s endeavors fall heavily on the editing side of writing, through coaching, tutoring, and manuscript revising. The company’s founder is also a fiction writer, continuing to write under the genre, family saga, examining life as it pertains to characters, loosely based on familial connections.


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.


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.


Megan Steele

Megan was born and raised in Charlotte N.C and moved to Florida in 2005 in search of a better life for myself and my children. I am a mother of four amazing children and one grandchild. I have been an Administrative Assistant /Receptionist over 8 years it’s my passion. I enjoy dancing, painting, reading, traveling, helping others, and most importantly spending time with my family. I became a part of 21st Century Healthcare Consultants in March 2019. I am proud to be a part of an amazing team.

Jackie Valentino

Jackie V has 20 years of experience in customer service and has spent the last 10 years working in the medical field. She has an Associate’s degree in Medical assisting, and is CPR certified. She works prn at an acute care hospital on the weekends as a unit clerk. She also has some experience as a personal caregiver/companion. Jackie joined us about 8 months ago and is part of the reception team at 21st Century. She feels blessed to be a part of this dedicated organization and respects the hard work and commitment applied by all to help clients obtain their goal.