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Report: Palm Beach Explores Tighter In-Home Caregiver Rules

Palm Beach County officials are considering tightening rules for home health aides in response to a growing industry that is only loosely regulated by the state and federal government.

While such positions are often assumed by relatives, there are also home health agencies whose workers are hired to run errands, oversee medication and prepare meals for those who wish to stay in their homes as opposed to a nursing home facility.

Nurses and nursing assistants who work in licensed nursing home facilities must adhere to certain training requirements, the same standards are not always extended to those who provide in-home care. Many home health agencies do complete background checks, but it’s not a mandated requirement, and, as some officials point out, this can create problems when employees have prior convictions for crimes of theft and violence.

Many aides may be hired independently through word-of-mouth, meaning background checks might not occur at all.

But even background checks won’t necessarily ensure elder safety, particularly in light of the fact there is often little supervision. That opens the potential for abuse, neglect and mistreatment. State and federal regulators may only provide follow-ups once annually, and even then, they are not necessarily looking for signs of abuse and neglect. As a recent NPR report shows, those visits may only last up to 30 minutes, and typically, regulators are looking to see whether federal and state health care dollars are being spent appropriately. They are looking for changes in health care needs as opposed to a full analysis of the quality of care.

While there are some state-issued rules for home health care companies, there is no requirement that aides be licensed or certified to provide care, so long as what they are offering is not medical care.

The Home Care Association of Florida estimates roughly 150,000 people statewide receive some level of in-home care from aides, and that figure is growing. Palm Beach County is the third-largest in Florida, and nearly 20 percent of those are over the age of 65, according to the U.S. Census Bureau.

Personal preference and reduced costs to taxpayers are the driving forces behind the home health care shift. In California, for example, four times more elderly residents receive in-home care than live in nursing facilities. That figure is expected to grow exponentially in the coming years.

Home health agency insiders say most companies that operate ethically police themselves. However, they do encourage increased regulation among independent operators.

Our Palm Beach elder injury lawyers understand the need has been underscored by several recent incidents of elder abuse and theft. In one case, the sheriff’s office last year arrested a hired caregiver who reportedly stole more than $60,000 from a patient’s personal bank account. Three more were arrested in 2012 when it was discovered a 99-year-old woman had been swindled out of $400,000 over the course of four years.

Still, there is no clear sense of what the new regulations would include. The Palm Beach County Sheriff’s Office has teamed up with county attorneys to draft recommendations, upon which county commissioners are expected to vote sometime later this year. Some of the items being considered include standard licensing requirements, background checks and some degree of outside supervision.

Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights.

Additional Resources:

Palm Beach County considers tightening rules for in-home caregivers, Jan. 23, 2015, By Andy Reid, Sun-Sentinel

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Nursing Home Neglect Trial Follows Shell Company Sales, Jan. 27, 2015, Palm Beach Nursing Home Abuse Lawyer Blog

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