Doctor Caring for senior patient
How companies’ response to the COVID-19 pandemic can shape their futures
by Ryan Iwamoto

COVID-19 has changed the business of care forever. Certainly, the pandemic has been devastating to many industries, companies and the thousands of individuals who lost jobs due to layoffs. Many of the businesses around me have shuttered their doors for good due to the lockdown and corresponding economic impact. We have learned a lot about business through this pandemic, and these lessons will carry on long after the crisis has passed.

In-home care has a unique ability to provide real value to patients, loved ones and the broader health care continuum. Companies that demonstrated bold thinking and quick action during the pandemic have created positive changes to the health care system that alleviated stress on hospitals and frontline workers, creating a lasting impact for our industry’s top priority—customer comfort and satisfaction.

Clarity Over Certainty

When the pandemic hit, a critical challenge presented itself on how to care for one of the most vulnerable populations—seniors. Skilled nursing facilities that became superspreader sites were making headlines and people were scared to let caregivers into their homes. Some homecare businesses lost as much as 20% of their business in the first month of the pandemic. Hospitals were canceling elective surgeries, which further impacted bottom lines as the post-surgery patient population was no longer in need of services.

The entire industry was deeply concerned because caregiving was at a crossroads regarding how to help patients in desperate need of care; revenue dips left many struggling to keep their doors open and be a part of the conversation. For those whose entire mission was to care for the vulnerable, the pandemic’s many unknowns and the search for operational clarity were crushing. Clients, caregivers and staff were fearful of contracting the disease, and business executives were very concerned about their teams’ safety and business liability.

It would have been easy to take the path of least resistance and risk and say “There is no way we are taking on any COVID-19 patients!”

But as cases started surging and hospitals and skilled nursing facilities struggled to provide care, the industry just couldn’t stand by knowing that we could make a difference in caring for COVID-19-positive patients that did not need an acute level of care. At times like this, it is important to remember that clarity can be more important than certainty.

Especially in the early days of the pandemic, there were new guidelines and regulations on best practices for COVID-19 patients. The industry didn’t have all the answers, but needed to make a decision about providing care. Homecare businesses that offer personal caregivers were uniquely suited to make a positive difference in people’s lives at a time when the whole nation—and the world—was suffering.

People, Preparation & Partnerships

Many homecare businesses have showcased innovation and developed additional services to support those in need. For instance, in the first six months of the pandemic (between March 9 and September 9), more than 2,600 of our caregivers at 24 Hour Home Care provided 817,698 hours of in-home care. Of those hours, more than 21,600 were in the service of COVID-19-positive (or symptomatic) clients.

And yet, among these employees and clients, there was almost no cross-contamination between caregiver and patient. Less than 0.1% of caregivers reported a COVID-19 diagnosis from patient care and less than 0.06% of clients reported COVID-19 exposure due to their caregiving experience in the home setting. And 100% of the patients the company worked with recovered from COVID-19. This is because in-home care reduces the number of touchpoints (e.g., nurses, cleaning staff, food preparers, therapists, etc.), creating a safer environment for all.

Obviously, these statistics aren’t possible without exceptional caregivers. And the numbers don’t reflect many crucial intangibles: the feelings of safety, comfort and reassurance provided to patients who felt so much better being cared for at home.

This success is a testament to people, but also to preparation. Companies need to take every possible step to protect their communities. In the beginning, there was a tremendous amount of work needed to keep up with information from the many health authorities. Company safety programs needed to be put in place that addressed safety equipment, safety training and safety protocols to focus on living with this disease for the foreseeable future. 24 Hour Home Care invested over half a million dollars in personal protective equipment (PPE) to give clients and caregivers complimentary PPE for added protection and peace of mind both now and moving forward in this new normal.

COVID-19 also created unique opportunities to collaborate with companies that could help care for our community in ways beyond homecare. From food delivery to COVID-19 testing, there is a spirit of cooperation and collaboration that has resulted from this crisis and made us all stronger together. Caregiver companies have been able to extend their services and offerings through a partnership with experts, resources and services beyond the normal core services.

The Way Forward

Obviously, not every company can respond so literally to a pandemic or other crisis. But a crisis of any kind allows leaders to make bold moves. Indecisiveness breeds panic and unrest, and a strong team is essential to work through a crisis. Businesses that pivoted to remote operations within days have also improved their operational efficiencies and flexibility.

This was a very challenging year for the industry, but there are exciting tailwinds for homecare. Home is the safest place to be—now more than ever.

This realization has led to conversations with hospitals and insurance companies who are looking to partner with homecare companies to provide programs and benefits that will allow even more patients to recover safely at home.

In 2019, for the first time, Medicare Advantage plans were allowed to include homecare as a supplemental benefit. The pandemic has increased homecare’s value. The industry has realized the dramatic impact it can make by allowing seniors to age in the safest environment possible—their homes.

I hope other in-home care business owners can make decisive action plans and tap into insights from their peers to overcome this crisis. With every challenge faced in life and business, there is an opportunity. You just have to find it.



Ryan Iwamoto is president and co-founder of 24 Hour Home Care, a privately owned non-medical homecare companies in the country. Iwamoto is responsible for the company’s senior care operations, strategy, business development and innovation.