Illinois Law Holds Providers, Hospitals Under Stricter Accountability

An Illinois law going into effect on January 1, 2018, will not only impact the home care industry, but also the hospital and health care groups they create relationships with.

Signed into law by Illinois Gov. Bruce Rauner on Aug. 21, SB 1676 mandates that hospitals or other health care agencies that receive state funding cannot refer a patient to an in-home care services provider unless they are licensed under the Illinois Home Health, Home Services and Home Nursing Agency Licensing Act.

Michael Melinger is a franchisee and owner of three Home Instead Senior Care in-home care franchise locations servicing the greater Chicagoland area.


In Melinger’s perspective, the impending law is twofold: It ensures that those competing in the in-home care space are providing licensed, regulated care, and that the historical long list of in-home care agencies distributed by hospital discharge planners is whittled down to only reputable agencies.

Flying under the radar

Melinger has been a franchisee of Home Instead Senior Care since 1994. The Omaha, Nebraska-based franchise company offers in-home care and has more than 1,100 franchise units across 14 different countries, including the U.S.


Since his break into the industry, Melinger has seen a number of franchisees and other independent for-profit entities enter into the in-home care arena.

“The influx of franchises and other independent for-profit entities has raised the bar, and competition has been a very good thing,” Melinger told Home Health Care News.

The problem arises, however, when many of these agencies circumvent regulations.

“When you have a growing industry—and particularly the fact that this industry is catering [to] a segment of the population that is vulnerable and can easily be taken advantage of … it has created the need for a lot of regulation,” Melinger said. “A problem arises if there are agencies out there that somehow fly under the radar and don’t bother to get licensed.”

Industry impact

While it can be costly to be a licensed, it ensures an even playing field for all agencies and compliance with state-imposed standards of operation, according to Melinger.

“[Being licensed] provides some minimum standards that all agencies must meet,” he said. “It makes sure that every agency has to do a criminal background check on their workers, and every agency has to make sure the worker is competent in certain areas before they send the worker into the home.”

All in all, the impending law will keep in-home care franchisees and agencies on their toes to make sure that they are not only complying with state regulations, but also those imposed by their parent companies.

“In order for me to be a franchisee with Home Instead, I have to be compliant with [numerous] standards, most of which are much more strict than the Illinois Department of Public Health standards,” he said. “I view [this impending law] as, ‘I need to be licensed and I will continue to be.’”

Further, the new law will ultimately purge lists provided by hospital discharge planners to patients of any non-reputable in-home care providers, Melinger explained.

“[The] list that [discharge planners] give out of caregiving agencies, these lists need to be purged,” he said. “When you call these agencies, some of them are out of business, some you’d get a disconnected number. Some don’t do home care like the list said. The list can be really confusing.”

In addition to evading licensure, some of agencies featured on these lists deal with misclassification of employees, which can pose another issue, according to Melinger.

“There are a lot of agencies out there that will get licensed by the Illinois Department of Public Health as a home services agency, and when they send a worker to your home, they’re not telling you that they’re really not withholding the taxes on that worker’s paycheck,” he said. “They’re really not bonding that worker or providing worker’s compensation insurance; they’re misclassifying that worker as an independent contractor and they’re sidestepping the Affordable Care Act responsibility, which is tremendous.”

In total, the impending law will hold both hospitals and in-home care agencies accountable.

“I think this makes an obligation on the hospital to make sure that the list is vetted,” Melinger said.

Written by Carlo Calma

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