Reflections on Two Businesses During the Pandemic

On this week’s episode of the PNC podcast, I provide a brief overview of the impact of the Coronavirus pandemic on two of the businesses I'm involved in: my urgent care business and my wife's home services agency.

On the positive side, both businesses have remained open, which highlights one of the benefits of owning a healthcare-related business. The need for services is very consistent, especially for essential services like those provided by hospitals, emergency rooms, urgent care centers, hospices, home health providers, nursing homes, and ambulance services. Even in-home nonmedical care must continue for frail seniors, especially.

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Challenging Environment

During the initial stages of the pandemic, public health experts told us to avoid coming into contact with infected persons. After all, there was no treatment, and no way to test. So, the patients were advised to remain at home if they felt they had a COVID-19 infection, unless they were very ill. In that case, they were advised to go to the emergency department for evaluation.

This, of course, led to reduced patient volumes in our clinic. And we considered closing one of our two clinics because of the reduced volumes.

However, we soon found access to testing through one of the large national laboratories. And we decided to take a completely different approach to the problem.

Shifting Gears

Once the testing became available, we decided to dedicate one clinic to evaluating patients with potential COVID-19 infections.

The other clinic could then focus solely on evaluating patients with no infectious symptoms. Such patients included those needing drug screens, work physicals, and injury and non-respiratory illness care. Those patients were very low risk for infecting staff. In the low-risk clinic, we also spend significant time contacting patients with lab results for the testing done at the “respiratory” clinic.

In that second clinic, we set up a tent in the parking lot, and perform brief histories and physicals and lab tests. Our staff work in full personal protective equipment, outside the clinic, with patients still in their cars.

Effects on the Home Helpers Franchise

The primary challenges facing Kay's in-home care business during the pandemic relate to the constant fear of a caregiver or a client becoming ill. In fact, the week before I recorded this episode, one of her clients became ill, was hospitalized, and found to be COVID-19 positive.

Since this client had been cared for by three or four of her caregivers, they needed to remain in quarantine at home for 14 days. This led to cascading issues with insufficient numbers of caregivers in an environment in which recruiting new caregivers is very difficult.

There is also the constant fear that a caregiver will be infected at home, and infect clients. This means that they must be especially diligent in wearing appropriate personal protective equipment (PPE).

Finding PPE in a Pandemic

And to compound matters for both businesses, the availability personal protective equipment is often not readily available. We have been able to make due in the urgent care clinics by aggressively locating and purchasing PPE. However, the situation for Kay's business ultimately required her caregivers to use home-made face masks. Luckily, Kay has sufficient supplies of gloves during this pandemic so far.

Finding Help

Kay has already applied for the Economic Injury Disaster Loan, which provides a $10,000 “advance” that will not have to be repaid.

My urgent care business has applied to the Paycheck Protection Program. It is helpful that we have a relationship with an SBA lender, because we previously accessed SBA loans to fund our start-up. 

Summary

Ultimately, both businesses remain open and in fairly stable financial condition. Both will likely see a decline in revenues over the short term. But they will survive and, I believe, later will thrive.

This experience reinforces several lessons. First, small business owners are often called upon to make difficult decisions with little information. And they must respond quickly to external threats. 

Second, keeping retained earnings as an emergency fund is a very wise practice.

Let me close by telling the apocryphal story that triggered me to post today's episode.

Some of Kay's caregivers work with clients in assisted living and nursing home facilities. The facilities where her caregivers were caring for clients invoked a policy that all caregivers wear protective face masks, even if neither party was ill, as a precaution during the pandemic. However, the facilities are unable to provide the personal protective equipment for them to wear while on duty.

So, Kay and I scrambled to make home-made face masks that the caregivers could wear when visiting their clients in those facilities. Kay also provides them to her other employees working in clients' homes. 

Ironically, the home-made face masks came in handy, because our daughter, a social worker, who works at a large academic medical center, also needed to bring her own personal protective equipment to wear in non-patient contact areas.

What a world we live in!

Thanks for listening.

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