Phony Emails, Unverified Products and Price Gouging: Red Flags for In-Home Care Providers Hunting for PPE

The COVID-19 public health emergency has forced in-home care providers to become increasingly more creative when it comes to procuring personal protective equipment (PPE) — and more diligent about avoiding scams along the way.

By now, it’s known that health care providers across the nation have been struggling with dwindling stockpiles of basic PPE. As the number of COVID-19 cases rises in the U.S., in-home care providers are hit especially hard by this shortage.

“In the home- and community-based setting, access to personal protective equipment is one of the biggest challenges that we have had to deal with from the onset of the COVID-19 crisis,” Jennifer Sheets, president and CEO of Caring Brands International and Interim HealthCare Inc., told Home Health Care News. “It continues to be the biggest challenge that we are seeing, as far as being able to pull patients out of the hospitals or divert them from the ER.”

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Interim is a Sunrise, Florida-based in-home care franchise with more than 300 locations across the U.S.

In the midst of the COVID-19 emergency, in-home providers have offered themselves as alternatives to hospital-based care, hoping to ease the burden on acute settings that may be experiencing over-capacity issues.

“Hospitals are under tremendous pressure right now,” Joanne Cunningham, executive director of Partnership for Quality Home Healthcare (PQHH), previously told HHCN. “They are experiencing and will continue to experience increased strain.”

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Securing PPE ensures that in-home providers will be better equipped to step up and fill this role.

“Once people are home, we have to be able to provide care on a consistent basis,” Sheets said. “If we have 10 gowns, and we run out of gown No. 10, we already have to be thinking about what’s next.”

For many providers, employing creative PPE solutions has been the key to keeping their heads above water. In lieu of the typical vendors, providers have been in contact with everything from construction-supply stores to tattoo parlors.

Other post-acute care providers have had to think outside of the box, too, exposing themselves to more risks than normal. Jewish Home Family — a New Jersey-based provider that offers skilled nursing, assisted living and other senior care services — has had to turn to a “parking lot guy.”

“He’s actually met with us in parking lots,” Jewish Home Family CEO Carol Silver-Elliott said Thursday during a virtual press conference hosted by LeadingAge. “We’ve been able to take a deep breath and wire money to bank accounts we’ve been told to wire money to, and the supplies thankfully have appeared — and have also been of good quality.”

On its end, Interim has been looking into using disposable raincoats to supplement the company’s supply of gowns, according to Sheets.

Strength in numbers

Regardless of the strategy, providers looking to secure new vendors amid the COVID-19 emergency have to be aware of the potential red flags, so as not to fall victim to scammers.

One way in-home providers have accomplished this is through strength in numbers. When looking for new vendors, the easiest way to vet a company is based on recommendations from industry peers.

For many in-home providers, this means leaning on state-based trade associations. In several states, these organizations have been the main resource for providers looking to access PPE.

“We are regularly in contact with our members about best practices, suggestions and assistance in gathering PPE,” Dean Chalios, president and CEO of the California Association for Health Services at Home (CAHSAH), told HHCN. “When an agency finds a good supplier, with whom they’ve had a good experience, they share this with us and we share that with the rest of our members.”

CAHSAH is a Sacramento, California-based nonprofit association that represents California’s home health, hospice and non-medical personal care providers.

State organizations are often the direct link between the government and private entities providers have to navigate, Barry S. Cargill, president and CEO of the Michigan HomeCare & Hospice Association, told HHCN.

“Our association is working closely with the Centers for Medicare & Medicaid Services (CMS) but also with our state Medicaid [program], as well as health insurance companies here in the state of Michigan,” Cargill said. “It’s important to have two-way communication.”

The Michigan HomeCare & Hospice Association is a state trade association for home-based care providers that represents 240 member organizations.

For a company that stretches across numerous states, such as Interim, one of the main strategies has been consolidating its efforts to secure PPE into a centralized location. Ordering on a national level, as opposed to by location, has helped the company when it comes to price and verification.

Interim has a very specific checklist that new vendors must meet in order to pass the company’s vetting process, according to Sheets.

“We have to make sure that the equipment meets the requirements and that the supplies will actually be shipped,” she said. “We place a [sample] order so that we can test the quality of both the shipping and the PPE.”

One issue that has cropped during the public health emergency is price gouging, according to Sheets.

“When we are finding these companies that are greatly elevating the price of PPE, we are following all of the recommendations to report the PPE — whether it’s unapproved or counterfeit — to the appropriate authorities,” she said.

Coming out of the woodwork

Shady, confusing or downright fraudulent PPE stories have become common in recent weeks.

At the beginning of May, for example, ProPublica reported on a $34.5 million deal the Department of Veterans Affairs made for 6 million N95 masks. The deal — which reportedly relied on “an underground of contractors and middlemen trying to make a buck” — never panned out.

At a time when many vendors will pop up, looking to get into business with in-home providers, it’s important to ask for a lot of information upfront, according to Sheets.

“[New vendors] seem to be coming out of the woodwork,” she said. “Upfront, we ask them, ‘Can you send us the certification? Can you send us pictures, dimensions, a link to where your models and serial numbers are referenced as meeting the requirement of the [National Institute for Occupational Safety and Health]-approved N-95 masks?”

One major red flag that providers should be on the lookout for is suspicious emails, where the vendor claims to be part of a known and trusted entity.

“We’ve gotten emails that say: ‘I work directly with the CDC, click here and place your order,’” Sheets said. “People have to be really careful and look at where the address is coming from. If they say they are from the CDC and the address of the sender is ‘fred@gmail.com,’ you know they’re not credible.”

Additionally, providers should not place a big order without connecting to someone within the organization with a credible company email address and phone number, according to Sheets.

“Make sure it’s a real company,” she said.

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