From Marine Insurance to Oregon Caregiving
Most people who run large home care agencies spent their careers in home care. David Pearlstein spent his building and selling companies across three completely unrelated industries - and then arrived at New Horizons In-Home Care ready to apply everything he'd learned.
Before caregivers and care coordination became his world, Pearlstein was deep in specialty commercial marine insurance. He built Tidal Solutions LLC in Charlotte, North Carolina - a managing general underwriter serving the North American specialty commercial marine market - and ran it as CEO from 2014 until February 2016, when he sold it to Venture Insurance Programs. He stayed on briefly as Executive Vice President after the acquisition, the kind of transition period that comes standard when you've built something someone else wants.
That wasn't his first exit. Earlier, Pearlstein had co-founded Bluestone Surety, a firm specializing in commercial and contract surety bonds. He built it to the point where American Safety Holdings - then a NYSE-listed company - wanted it. The deal got done. He walked away and looked for the next thing.
"A 30-year history of building and successfully selling organizations" is how his profile reads. That's not a boast - it's a pattern."
Between insurance ventures, Pearlstein also managed the sale and acquisition of properties in the Pacific Northwest through Pearlstein Properties. The region clearly made an impression: when the time came to make a career-defining move into healthcare, Oregon is where he landed.
New Horizons In-Home Care was already nearly four decades old when Pearlstein came aboard as CEO. Founded in 1985, it had become Oregon's largest in-home care agency - a full-service operation licensed by the state, with locations spanning Eugene, Salem, Medford, Roseburg, and beyond. The kind of organization that runs on institutional knowledge and trust built over generations of families. Pearlstein's job wasn't to invent it. It was to run it well and take it further.
Under his leadership, the company has maintained and sharpened the culture that makes large care organizations genuinely hard to run. New Horizons now employs more than 570 people. Glassdoor gives it a 4.3 out of 5 rating across 358 reviews - 27% above the healthcare industry average. Eighty-eight percent of employees say they'd recommend working there. In an industry defined by high turnover and difficult conditions, those numbers are unusual.
The company serves seniors, adults with disabilities, and medically fragile children - the last category a rare offering that most home care agencies avoid due to complexity. Services range from 24/7 companion care and personal care to medication management, transportation, meal preparation, and house cleaning. New Horizons has also expanded into remote patient monitoring and has healthcare partnership infrastructure that extends the agency's reach into telemedicine and rural care settings.
Pearlstein is based in Lafayette, California, while the company headquarters sits in Eugene, Oregon. He holds an educational background from UC Berkeley. His career arc - UC Berkeley, surety bonds, marine insurance, Pacific Northwest real estate, Oregon healthcare - doesn't follow a conventional script. It follows a single underlying logic: find something that matters, build it properly, and put the right people around it.
New Horizons has received Best of Home Care awards from Activated Insights across multiple Oregon locations - recognition granted both for care quality and for employer practices. The dual honor is harder to earn than either one alone. Organizations that score on care delivery often neglect worker conditions. Pearlstein's version of New Horizons earns both, which suggests the people-first culture he instilled isn't a tagline. It shows up in the data.