June 18, 2020

COVID's impact on home care: Notable trends and lasting implications

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During these unprecedented times, it’s more important than ever for home care agencies to work together to share updates and best practices on how they're reacting to this crisis. Recently, Home Care Pulse, HCAOA, and ClearCare surveyed thousands of agencies across the country on their opinions and experiences dealing with COVID-19. We compiled key findings and trends across all three surveys and added some insights from Honor and our Honor Care Network agency Partners.

Key Findings

Unsurprisingly, acquiring PPE is the top challenge for agency owners—and agency owners feel this is one of the biggest obstacles to providing safer care in the home. Caregiver supply, a traditional challenge for agencies, has quickly transformed but continues to be a struggle. As unemployment rates rise, most agencies have seen an increase in caregiver applicants. But this increase is offset by new challenges in staffing caregivers due to illness or concerns about getting sick. According to Home Care Pulse, 56% of agencies report having caregivers decline to take shifts. Plus, government-funded unemployment benefits have increased amid COVID-19 which can make recruiting more challenging.

While agency owners face many near-term challenges, they are generally optimistic about the future. As awareness of the novel coronavirus and the risk of COVID-19 surged early on, virtually all agencies experienced a slight revenue decline due to family members not wanting caregivers in their home. Even with these declines, many expect long-term demand for home care services to grow. In fact, some agencies are already seeing a bump in business. According to Home Care Pulse, 25% of survey respondents say they’ve experienced an increase in demand due to people moving out of nursing homes and other facilities.

With market uncertainty and increased investment in safety initiatives, many agency owners are concerned about cash flow. Most agencies are aware of government support initiatives like the Paycheck Protection Program and tax credits for sick and family leave, though many have not been able to take advantage of them.


How Agencies are Rapidly Adapting Their Operations to the New Reality

The survey results reveal three trends brought on by COVID that could have a lasting impact on the future of home care:

  1. Most agencies say they wouldn’t provide care for a client diagnosed with COVID-19.
  2. Many agencies are expanding their service lines to better support clients.
  3. Many agencies are transitioning to virtual caregiver onboarding.

Caring for Clients Diagnosed with COVID-19

The majority of HCAOA survey respondents reported that they currently are not willing to care for a client diagnosed with COVID-19. Yet demand for COVID care among vulnerable older populations will remain for the foreseeable future. It’s up to your agency to decide whether or not you’re able to care for clients diagnosed with COVID-19—but as you make the decision, here are some questions to consider.


  • Is it the right client? Is this an existing client or a new one? Are you providing companionship care or are you providing essential support with activities of daily living?
  • Is the caregiver comfortable? Talk to your team of caregivers who would provide care. Are they properly trained and up-to-date on your agency’s COVID protocols? Are they willing to forgo visits with other non-COVID clients while they care for a client diagnosed with COVID?
  • Do you have the necessary equipment and training in place? Sufficient PPE stock is essential to providing care to any clients with flu-like symptoms. Do you have infection control protocols in place? Have you updated your emergency plans? Are you providing specialized COVID training for your caregivers?

Asking these questions may help you better prepare, assess risk, and evaluate whether or not to provide COVID care on a case-by-case basis.

Expanding Service Lines

Many agencies in the Clearcare survey reported that they’re expanding their services to provide more comprehensive support to clients during social distancing. We’ve also seen many examples of Honor Care Network Partners expanding their support to clients—and becoming a resource for their entire community by connecting older adults with the products and services they need.


  • Affordable Home Care in Detroit, Michigan is offering free grocery delivery to older adults in their community. They also posted lawn banners throughout the region thanking caregivers for their essential services and heroic work during a pandemic.
  • Agility Health in San Mateo, California is delivering groceries to clients. 
  • Bridgewater Senior Home Care in Cleveland, Ohio is dropping off gift baskets with puzzles, games, and other activities for residents in local assisted living facilities.
  • Connections In-Home Care in Phoenix, Arizona holds virtual pet therapy sessions with their two dogs for nursing home residents. They also performed a virtual concert for hundreds of older adults in the local Jewish community. 
  • Keepsake Companions in San Diego, California is cooking family-style, gourmet meals to share with clients and members of the community.
  • 4Ever Young Living in Irvine, California is checking in on clients—even those who have paused care—to ask how they’re doing, inform them about tele-health services, and deliver food or supplies to their homes if needed. 

Offering additional services and resources can provide real value to your vulnerable clients during this crisis—and differentiate your agency from competitors in your community.

Transitioning to Virtual Onboarding

According to Home Care Pulse, roughly 70% of home care agencies have introduced virtual caregiver onboarding tools. If you’re among the minority of agencies that haven’t, now is the time to invest in virtual programs. It can help your caregivers feel safer in the short term—and provide you with more flexibility in the long term.

We hope these resources are helpful to you and your agency. COVID’s impact may last for years to come—but we hope this crisis can also unite us and drive positive change in the home care industry. Take good care.

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