In the fragmented world of in-home care—where rules are complex and coverage is uneven—1st Choice Home Care is changing the game. Founded by RN Alycia Stroud, whose sixteen-year career spanned front-line nursing, private insurance marketing, and multi-state case management leadership, the company grew from her firsthand insight into the system’s blind spots.
When Alycia left her role overseeing thousands of nurses and case managers, she didn’t slow down—she jumped into action. Using her deep understanding of contracts and reimbursement, she secured agreements with private insurers, Medicare, Medicaid, hospitals, and four VA programs, creating a lifeline for clients who would otherwise have nowhere to turn.
Today, 1st Choice’s passion lies in America’s rural care deserts. Rather than chasing volume in crowded markets, Alycia and her team cultivate relationships with Departments of Human Services, primary care physicians, and local advocates—one referral at a time—to map regions lacking home-care support. Every dollar beyond sustainable wages is reinvested into expanding services, closing gaps, and educating families on available resources. The result is a community-driven agency where clinical expertise and relentless advocacy deliver care exactly where—and when—it’s needed.
“I knew there was more I could do,” Stroud says. “So much of what patients need isn’t just about medical treatment—it’s about understanding the systems, the paperwork, the programs they don’t even know exist.” That insight became the company’s foundation.
1st Choice Home Care continues to serve all of Arkansas with ADL assistance, Medicaid navigation, and tailored care plans, with a commitment to educate, advocate, and push through red tape for every person they serve.
Hands-On, Community-Driven Approach
At the heart of the company’s model is a deep respect for the individual. Rather than relying on standardized care plans, 1st Choice builds each client’s support system from the ground up, factoring in everything from the number of pets in the home to how a client likes their bed made. This level of personalization is rare, but Stroud sees it as non-negotiable.
That personalization isn’t only about comfort—it’s about creating a care environment where nothing is left to chance. The company’s electronic visit verification (EVV) system allows caregivers to track and report real-time updates on clients’ needs. This creates a living document of sorts—a portrait of the client’s lifestyle and preferences that ensures seamless care, even if caregivers change.
The company’s hands-on, community-driven approach has proven especially valuable in rural areas where care is hard to come by. In some regions, 1st Choice is the only provider willing to set up operations. Rather than shy away from logistical challenges, the team leans in. They visit underserved towns, meet with primary care physicians, and educate providers about what services are available. Often, these efforts reveal that even healthcare professionals are unaware of all the options.
Seeing the Full Person Behind Each Case
Stroud and her team bring binders filled with information to meetings, determined to close the knowledge gap that so often keeps patients from getting the help they need. Once an area’s need is established, 1st Choice works quickly to become a recognized community provider through the state’s Department of Human Services. That designation gives the company a critical edge in helping families navigate applications, portals, and other barriers to care.
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So much of what patients need isn’t just about medical treatment—it’s about understanding the systems, the paperwork, the programs they don’t even know exist
The company has taken on clients in unimaginably difficult situations—individuals living without insurance or basic support. One such case involved a paraplegic man who had no Medicaid coverage and was relying entirely on friends for food and daily care. 1st Choice stepped in, helped him qualify for Medicaid, and found the appropriate program to provide the long-term care he needed. It didn’t stop there. From cleaning the house to making sure meals were provided, the team stayed involved, offering 24/7 on-call support for emergencies.
These stories aren’t rare—they’re part of the company’s everyday work. In a space where providers often focus narrowly on what is billable, 1st Choice has instead made it a priority to see the full person behind each case.
Relentless Commitment to Doing the Right Thing
The commitment also extends to its staff. Many of Stroud’s team members have been with her for years, drawn in by the company’s mission and culture of compassion. Stroud is known for valuing heart and drive over credentials. While education and certifications matter, what she really looks for is that extra spark of empathy—the kind of caregiver who sees the job as a calling, not just a paycheck.
She invests in those people, giving them leadership roles and opportunities to train others. The company’s internal culture reflects the same values it brings to client care: kindness, flexibility, and a relentless commitment to doing the right thing.
Stroud’s background in contracts and policy has also been a powerful asset. Over the years, she has established multiple agreements with Medicare, Medicaid, private insurers, and even four different VA programs—opening doors that would otherwise be closed to many clients. These contracts make it possible for the company to serve veterans, spouses, and even children who qualify under lesser-known benefits.
“There’s just so much people don’t know,” says Stroud. “And it breaks my heart when I meet families who say, ‘If I had known these six months ago, maybe Mom wouldn’t be in a nursing home.’ That’s what keeps us pushing every day.”
Reliability. Compassion. Results.
As the company continues to grow, its future lies in expanding both geographically and programmatically. 1st Choice is actively pursuing licenses in additional counties and is looking at how to extend services into mental health care—an urgent need in Arkansas, which ranks among the highest in the nation for mental disability per capita. With limited providers currently in the space, Stroud sees an opportunity to make a meaningful impact.
The expansion is being handled carefully and deliberately. For Stroud, success isn’t measured by numbers, but by presence—by making sure no person in Arkansas is too far from the care they deserve. Whether that means investing in transportation, hiring additional caregivers in hard-to-reach towns, or working through layers of regulatory paperwork, she’s all in.
And the results are measurable. Word-of-mouth referrals have become the company’s strongest marketing tool. Families who once struggled to find reliable care are now telling their friends, their neighbors, and their doctors. Community by community, 1st Choice is becoming synonymous with reliability, compassion, and results.
Perhaps what makes the company’s impact so profound is that it refuses to treat healthcare like a transaction. For the team at 1st Choice, it’s a relationship—one built on trust, time, and the simple belief that everyone deserves to be cared for with dignity.
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