Massachusetts seniors may be at risk due to the lack of government oversight in the home-care industry, according to an excellent article by the New England Center for Investigative Reporting published on masslive.com. The article highlights the peculiar fact that despite all its progressive credentials, Massachusetts is among a handful of states that do not license or regulate the private-pay, home-care industry (full article here).
Private-pay, home-care agencies are privately run businesses that do not work under either a federal or state contract, and are not reimbursed by Medicare and Medicaid. Such agencies may provide basic assistance to seniors living at home such as companionship, housekeeping and cooking, and are paid out of pocket by the seniors or their families.
Home-health agencies that are reimbursed by Medicare and Medicaid, are governed by federal regulation and are subject to state oversight. However, these account for roughly only a third of the estimated 400 home-care agencies doing business in Massachusetts, according to the article. Private-pay home care agencies that are not regulated have no state requirements for training or bonding.
Surprisingly, no single Massachusetts agency is tracking either the total number of complaints involving private-pay home care workers or the type of complaints. And private home-care workers are generally only required to submit to a Massachusetts criminal background check, not a federal check.
This report is disturbing because it indicates that we are not doing enough to protect those in the Massachusetts community who are already most vulnerable to abuse and neglect. While there are certainly many well regarded home-care agencies in the Bay State, seniors and their families must be very discerning when contemplating a new hire.
Here is a list of important questions to ask when trying to choose a private-pay home care agency:How long has the agency provided home services?How does the agency recruit, screen, and train its workers?Is the agency bonded? Does it have dishonesty or malpractice insurance?Will the agency provide references from people who have used its services?Does the agency assign supervisors to oversee the quality of care patients receive in their homes? If so, how often do these supervisors make visits? Who can the patient and family members call with complaints?If you are dissatisfied with the caregiver, will the agency send someone else? And if so, how soon?Can the agency provide a written plan of care that explains the service to be performed, the days it will provide care, and fees to be charged? Are there any extra charges for holidays, travel or supervision?What happens if the caregiver calls in sick? Will the agency send someone else? Is there an emergency number to call?Will the agency always send the same caregiver? Although most families prefer the same caregiver, problems may occur when the personal relationship between caregiver and patient becomes too close. A new caregiver may help spot irregularities.
Sources: National Association for Home Care and Hospice, the Home Care Alliance of Massachusetts and the Massachusetts Council for Home Care Aide Services