State Department of Health Lacks “Teeth” to Regulate Home Care Agencies

Home health care in New York is in crisis, according to an investigative Times Union article, due to a “patchwork system” of providers who often operate with less oversight—and fewer consequences—compared to the nursing home industry, many times leading to “lapses” in care that go unpunished.

What’s contributing to the so-called crisis is that the state department of health doesn’t have the resources available to regulate the growing number of home care agencies.

Part of the difficulty in managing home care agencies stems from a lack of resources at the state level, including a continued decline in the number of inspectors. Just as agencies subcontract some patient care duties to third parties, the Department of Health hires outside companies to help with oversight. They include IPro, a nonprofit organization focused on quality of care initiatives and headquartered just outside of New York City.

IPro senior director Alene Hockenstad warned that changes in New York’s home health care industry are only going to worsen existing problems in the coming years. In April, agencies began transferring patients into a managed care system. Rather than letting individuals choose their own agencies, the neediest patients will be assigned to HMOs, which may restrict their choice of provider or the number of visits allowed, Hockenstad said.

Researcher Sam Krinsky of the United Healthcare Workers East 1199 Union has noticed the same thing. Krinsky said the culture of home care differs vastly from that of nursing homes, which have received more attention in New York and elsewhere.

Statements of deficiencies issued to home care agencies by the Department of Health are “not something that we take seriously,” Krinsky said.

“In nursing homes, the inspections are a big deal. There are a lot more regulations they have to comply with … It’s just a much more robust system,” he said. “In home care, it’s more of a review of paperwork. It [Department of Health] doesn’t have any teeth.”

The home health care industry is booming in the state, says the article, as more than 1,300 agencies have become registered within the past 10 years. 

Read the full article at the Times Union

Written by Alyssa Gerace

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