If Rosemary Francisco (left) retired 10 years ago, no one would have begrudged her the right. After all, in 1992 she was 52 years old and had toiled long, hard hours for more than 20 years in the HME industry. Living and working in the Little Rock, Ark, area, she had built a good reputation by earning the respect of customers, coworkers, and competitors alike, while serving at both national and small independent HME companies.

If that was not enough to justify retirement, or at least a slower pace, consider that Francisco also had managed to raise three children as a single mom along the way. But after 2 decades in the field, holding down just about every imaginable job responsibility over the years, Francisco believed there was still one position she would like to try: owner.

It is not news that women have made major inroads in almost every segment of the corporate world. In the medical care profession, the fact that a woman happens to run the company is commonplace. However, few men or women strike out on their own at the age of 52 without the support of a spouse. However, that is exactly what Rosemary Francisco did in 1992—gathering all her courage and resources to found Diamond Medical Equipment & Supply in Little Rock.

Independence Day
“I had worked for several companies, and they all eventually sold out, and I went along as part of the acquisition,” Francisco says. “I found myself in my 50s and I did not want to be looking for a job when it happened again. When you work for someone else, you always feel that way. I do not know if that is a good reason or not, but that is why I did it.”

She put together a business plan with a former coworker who was a certified public accountant and wanted to invest in her company. (The CPA cashed out in 1996.) “I felt like I knew enough about the business with 20-something years under my belt that I could give it a try,” Francisco says. “I had a good referral base.”

As for the inherent risk in any new business venture, Francisco acknowledges her endeavor was far from a sure bet. But independence, she says, actually made her braver.

“I was unmarried and all my children were adults with their own lives, so I felt that if it did fail, the only person I would be hurting was myself.” Her daughter, Cindy Bishop, who is now the general manager at Diamond Medical, measures the risk a bit more bluntly: “All she had to lose was her home.”

Indeed, Francisco mortgaged her home, which she owned outright, to get the cash to open a tiny office in downtown Little Rock. With her experience in HME sales, Francisco had developed many contacts who had stuck with her as she moved from one company to another, following one acquisition after another. The contacts turned out to be her ace in the hole, because Diamond Medical had little else going for it back in 1992.

“I was not much competition to the competition,” Francisco says with a laugh. “I opened the doors with a card table and a dial-up phone, and that’s no joke. It was just me, another woman, and a part-time delivery man.”

Ten Years Later
In the HME world, where customer trust can be the only differentiation between two companies with similar inventories, Francisco’s many contacts proved to be good enough. As implausible as it might seem, Diamond Medical not only survived in the 1990s, it thrived.

Rosemary Francisco (right) and her children Cindy Bishop and John Scott run the business.

In the 10 years since setting up shop on a card table, Diamond Medical has grown each year, according to Francisco. The company now employs 19 people, including four service technicians and three respiratory therapists as well as in-house billing and customer service staff. And it is a family affair with two of Francisco’s children playing active roles. In addition to Bishop, who joined in 1996 to handle day-to-day operations, Francisco’s son John Scott came on board 2 years ago to work in sales and delivery.

Covering a 75-mile territory, Diamond has contracts with several local hospices, and provides a full line of HME and respiratory services. In the past year, Diamond has added power wheelchairs and liquid oxygen to its offerings, enjoying immediate success.

Faced with a crowded location and growing client base, Diamond opened a second small office near headquarters last year. It plans to merge the entire operation under one roof this summer when it moves into a 9,000-sq-ft facility.

HME consolidation efforts in the market have helped Diamond Medical’s cause, Francisco says. “Every time that an owner-operated local company sells, the [acquiring company] has big turnover,” she says. “I hired three people recently from a large company. They did not want to be there and they seem happy here. When people call here, they know they are going to talk to Cindy or me or someone else who has been here for years. It is not a receptionist taking the order and then you hope the equipment will get delivered in the next 2 or 3 days.”

That combination of personalization and reliability, Francisco says, has earned the confidence not only of patients but physicians, which, in turn, boosts Diamond’s strong referral business.

“She does not realize what an accomplishment all this is,” Bishop says of her mother. “It is all about a strong work ethic and treating people fairly. Hospital equipment is hospital equipment unless you are putting out junk. The only thing different is the service. She is real honest and well respected.”

She also has experienced minimal downtime in 30 years—none of them any busier than the past 10 years spent dealing with the challenges that come with being owner.

“I will be 63 years old in July,” Francisco says. “I have never regretted one day going into business for myself, but as we go on, we are making changes in the ways that the business can handle me getting out. I do not think I will ever get out completely. I would like to get to where I do not come in every day, but I do not know what I would do [without some role in the business].”

When she finally does slow down, many in the Little Rock community—the customers who depend on her; the caregivers who work with her; even competitors—will miss her dedication. Some of the Diamond Medical employees even call her “mom”—and not just her son and daughter. But none of them will deny that Rosemary Francisco has earned a vacation.

Aaron R. Smith is a contributing writer for Dealer/Provider.