
1st Care at Home South Boston office. Courtesy of 1st Care at Home.
At 11 am, we hear a gentle “knock, knock.” This knock is right on time. We open the door and are greeted with a warm smile, a soft look of empathy, and compassion as our personal care professional arrives to aid in our family’s needs. Through this season of life, with unexpected changes and more of a need to care for loved ones, we knew support was necessary. Each day, we witnessed the care and expertise provided by a team of specialists that went above and beyond. Many people reading this article can attest to utilizing in-home services or desiring these services for family members. One organization within the Southern Virginia region that has continued to support multiple communities for decades is 1st Care at Home, known for their slogan, “Rooted in the Community.”
A Growing Lineage
I had the pleasure of connecting with Monica Mears, who is the director of business development at 1st Care at Home and who has served with the company for nine years. Before beginning our chat, Monica and I celebrated the fact that this year is their 40th anniversary of serving the community. During our conversation, she provided the history of this veteran-founded organization and its growth throughout the years.
In 1985, Mr. Al Burkholder launched the company after witnessing families who were experiencing disabilities and needed greater, specialized support at home. As a veteran, Al understood the importance of caring for those who experienced greater difficulties in life. In addition to building his passion, Al designed his business to be a legacy for his family.
In the 1980s, Al passed his business to his son Lee, who named the business Commonwealth Home Health. Just as his father did, Lee served in the military. Over time, Lee’s health declined as he battled cancer, and four years ago, he passed the business baton to his son Trey who is the current owner of 1st Care at Home.
Throughout Trey’s life, he watched his grandfather and father shape this organization. Many times, team members would see Trey performing small tasks around the company such as cutting grass and washing company cars – the details that contributed to growth and professionalism. Over time, he grew in business and studied accounting, human resources, and operations, ensuring that he would earn his stripes and continue the family legacy.

Our Unbeatable Team
Since its inception, 1st Care at Home has expanded from serving the South Boston community to Lynchburg, and now the South Hill community, providing support across 13 counties and partnering with multiple hospitals. During our conversation, Monica noted several times that it is their team that moves them forward. She stated, “Our clinicians are the best. They believe that and they are proud of the quality of care they provide to communities. As an organization, they look at the whole picture and the person.”
In addition to home health and personal care services, 1st Care at Home is pleased to have added hospice care two years ago. Home health services are available for families in need of skilled nursing care, home health aides, physical or occupational therapy, or speech language pathology. The company’s personal care services include assistance with personal hygiene, housekeeping, medication tracking, meal preparation, caregiver relief, and medical alert services. Lastly, through the hospice service, the organization can provide loved ones with bereavement care, emotional and/or spiritual support, pain management, and respite care. With each service, Monica explained, these “healthcare professionals turn homes into healing environments” – one of the most comforting attributes for families who need care.
The More You Know, The More We Can Help
When asked what she wanted the community to be aware of regarding 1st Care at Home, and what message she wanted to share with clients, she responded without hesitation that the organization is here to take care of its communities; that it exists to physically take care of residents but also strives to serve the community as a whole. Further, she explained that 1st Care at Home accepts most insurances to ensure it can accommodate as many patients as possible. Southern Virginia is an underserved community, and that is why the organization is here.
Monica said current clients should know that, “You have a choice in your healthcare. You can be an advocate for the best care you receive.” She added that potential clients should, “not be afraid to ask for help,” adding, “We have so many services that people are not aware of. Let us help you. Most of the time it is covered under your insurance policy.”
The team consists of over 200 employees who can serve over 400 clients across the three locations. This is a strong team and one with a deep foundation in the community. With anticipation for greater growth, the team at 1st Care at Home is focused on growing across Lynchburg and plans to release a few surprises to its communities in 2025.

Never Stop Helping
1st Care at Home has received a list of awards and recognitions. Monica said her most memorable recognition for the company was the Strategic Healthcare Programs (SHP) Award, because it directly reflects a standard of care. The company earned this acknowledgement by providing an extremely high level of care, she said. Along with this award, she said, she is proud of the word of mouth that the company receives in the community, and its excellent reputation.
One way the community can support 1st Care at Home and its dedicated team is by spreading the word about the care it offers, from pediatrics to geriatrics, depending on the need for care.
When asked about her favorite aspect of working at 1st Care at Home, Monica simply replied, “I love being able to see the fruits of our labor every day.”

425 Main Street
South Boston, Va. 24592
(434) 572-1312
[email protected]
www.1stCareAtHome.com