Wall Street Journal Examines Calls For Regulation Of Home Health Care Industry To Prevent Abuses By Caregivers As Industry Grows

Main Category: Caregivers / Homecare
Also Included In: Public Health
Article Date: 16 Jul 2008 - 9:00 PST

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The Wall Street Journal on Tuesday examined calls to increase oversight of the expanding home care industry in light of a "growing number of cases of abuse, neglect or fraud in which home caregivers take advantage of the frail and the ill."

The trend toward home health care is seen as a way of keeping elderly U.S. residents "happier and healthier" than at a nursing home and at a lower cost. On average, it costs Medicaid $6,000 annually per person for home care, compared with $20,000 annually per person for nursing home care.

As a result, certified nursing assistants -- who are generally licensed and regulated -- and aides hired to provide nonmedical assistance are the second- and third-fastest growing occupations in the U.S. There are 1.6 million people who work as in-home aides. According to the Journal, the majority of abuse cases involve aides hired to provide nonmedical assistance, which does not require additional training. In at least 22 states, nonmedical aides do not need to be licensed or pass a criminal background check to be hired.

Even in states where a background check is required, "applicants with criminal records can slip through the cracks, some research has found," according to the Journal. Researchers at Michigan State University participating in a CMS pilot program screened 214,167 people who held or sought jobs working with elderly people, including home care, between April 2006 and November 2007 and found that 5,462 had criminal histories that should have disqualified them from employment. According to Lori Post, a Michigan State University professor who led the study, such disqualifying histories could go unnoticed because personnel registries are not centralized or because states do not always have, or seek, access to police, federal or each others' records.

The article profiles Priscilla Stovall and Bruce Hammer, two people who were abused by in-home aides (Shishkin, Wall Street Journal, 7/15).

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