YOUNGSTOWN, Ohio – As you walk down the hallway in the offices of Mirkin & Associates, you’ll find a picture hanging at the end, a silent but enduring symbol of the company’s deep family roots.
The portrait is of William Mirkin, who founded the used car lot that operated in the same Mahoning Avenue building in Youngstown where the family now runs Comfort Keepers and Comfort Care-a-Van.
Next to the picture is a safe that has been in the family for generations, a tangible reminder of the family’s longstanding commitment to the business world.
“My grandfather built this building in the 1940s. It was an indoor used car lot and my family has been here every day since,” says Dave Mirkin, owner of Mirkin & Associates.
Along with his wife, Carol, and their son, Adam, Dave oversees the nonmedical in-home care services the company provides through Comfort Keepers. His cousin Harvey is also involved in the family-run business.
Dave’s journey into the health care industry began in 2001 after spending years working in the family’s greeting card business. “I was working with my father, he recalls. “But I wanted something different.”
After researching various opportunities, he discovered Comfort Keepers, a franchise specializing in nonmedical, in-home care for seniors and older adults.
“I did a lot of research,” Dave says. “My wife, Carol, was a registered nurse and had worked in a nursing home. So she had experience in the industry. We thought it was a good industry to be in, especially in Youngstown, where the population is aging.”
By March 2002, they had opened their Comfort Keepers franchise, offering companion care, homemaking services, respite care and private duty nursing to clients in Mahoning and Trumbull counties.
“We grew very quickly,” Dave says. “There was a need in the area for this type of service. There was some competition – but not a lot.”
The rapid growth of the company, Dave notes, was driven by his father’s business philosophy: “relationships, relationships, relationships.”
Over the years, the company expanded its services, including Medicaid and veterans care, which now forms a significant portion of its business.
Relying on government programs, however, came with its own set of challenges. “Government work became less and less profitable over the years,” Dave explains.
Adam Mirkin, Dave’s son, handles most of the Medicaid and veterans reimbursements, which he says saw about a 40% increase at the beginning of 2024.
“It made a huge difference,” Dave says. “I was about ready to drop the government work because it just wasn’t profitable anymore.”
Before that, the company faced rising wages and shrinking margins, especially in the wake of the Covid-19 pandemic.
“Covid was a big turning point for our industry,” Dave says.
At its peak, Mirkin & Associates employed more than 300 caregivers. That number has dropped to around 150. “We have half the staff we had pre-Covid,” Carol says.
One reason for the decline is that many people were no longer interested in providing caregiving work. Meanwhile, industries like fast food and retail were offering wages that in-home care providers, like Comfort Keepers, struggled to match.
Even with the increased Medicaid reimbursement rates, finding qualified caregivers remains a challenge.
“If I’m paying the same as, let’s say, a fast-food place, mine is the much more difficult job,” Dave explains. “The desire to work in this field is way down and it’s nationwide.”
To combat the labor shortage, Mirkin & Associates turned to creative solutions. During the pandemic, it launched a program allowing friends and family members of seniors to become certified caregivers, providing them with the training and qualifications needed to care for their loved ones and receive reimbursement for their services.
“We’ll hire a loved one or a friend, get them trained, and pay them as our employee to take care of their loved one,” Dave says. “A lot of these loved ones are already taking care of family members anyway. So they may as well get paid.”
Carol highlights the success of the program, noting that about 75 of its caregivers are family members or friends of clients.
“Half the time, they’re living with them anyhow. They were already taking care of their loved ones. So it’s been really good and we’re really trying to push that now,” she says.
In 2017, the Mirkins expanded their business with the launch of Comfort Care-a-Van, a transportation service for seniors.
The service, which began with Carol’s personal car, has grown to a fleet of 24 vehicles, serving Trumbull and Mahoning counties.
“It was a natural tie-in to what we did,” Dave says. “For the first couple of months, we didn’t even have a vehicle here.”
Comfort Care-A-Van provides wheelchair-accessible transportation and other nonmedical rides for seniors.
The service is supported by senior levies in Trumbull and Mahoning counties.
The Trumbull County levy allows residents over 60 to receive unlimited rides to medical appointments and one nonmedical ride per week.
“If you want to have dinner with a friend, we’ll take you and bring you back. It’s a great program,” Dave says.
Comfort Care-a-Van, through Provide A Ride, also contracts with United Healthcare and CareSource, transporting patients on as many as 100 trips per day, Dave says.
“We’re the largest provider in the area for Provide A Ride,” Dave says, adding that the next five years look promising as long as Medicaid rates remain competitive.
For the Mirkin family, the business is not just about financial success. It’s about trust, relationships and community impact.
“I don’t know that I could ever trust someone as much as I trust Carol,” Dave says. “If she says she’s going to do something, I know she’s going to do it.”
For Carol, working with family has been a rewarding experience.
“We never thought it would be like this, making a difference in the community,” she says. “We love what we do.”
Their son, Adam, who returned to work with the family last October, prefers the transparency of a family business to that of a corporate job.
“You know what you’re doing and what you’re doing it for,” he says.
As for Dave, who once played hide-and-seek in the building as a child, working with family is second nature.
“I grew up in a family business. That’s the way people did things and I still enjoy it,” he says, with Adam jokingly adding, “He’s really good at hide-and-seek.”
Pictured at top: Dave Mirkin, owner of Mirkin & Associates, stands outside the family business with his wife, Carol.