Home health care is quickly becoming one of the fastest-growing occupations in the U.S as baby boomers begin to age. In fact, in 2012, around 3.5 million Americans receive home health care through Medicare—at a cost of $18.5 billion. This number could be even higher for those who self-pay. With this many aging individuals who need caregivers, there will be an increase in a concern for their safety.
Most states have provisions in place to keep the sick and elderly safe during in-home treatment. However, 10 states (Alabama, Connecticut, Georgia, Hawaii, Montana, New Jersey, North Dakota, South Dakota, West Virginia, and Wyoming) do not require any kind of criminal background checks. This is according to a recently released memo (PDF) from Medicare.
According to the Department of Health and Human Services Office of Inspector General, there are no federal law or regulation prohibiting home health agencies from hiring people convicted of crimes (rape, theft and assault to name a few). In addition, there is nothing stated about people who have a record of abuse and/or neglect.
Luckily, even in states that do not require home health-care agencies to perform background checks, Medicare still requires that prospective employees are vetted (investigated thoroughly in order to ensure that they are suitable for a job requiring secrecy, loyalty, or trustworthiness). Be cautious, however, because agencies that deal with families who pay directly are not always bound by these rules. In addition, Medicaid programs may also have a different rules set.
Not every conviction would justify barring an individual from working home health care – however, since the rules vary by state, it is important to check your state’s rules.
In the remaining states that have checks, home health agencies have safeguards that vary by state. Below are some state variations.
- California and Texas require only statewide background checks
- These checks do not pick up violations from other jurisdictions
- New York, Florida, and Illinois mandate FBI fingerprint background checks
- These include federal crimes and out-of-state offenses
Of the states that do not require background check laws, Connecticut, Georgia, Hawaii, and West Virginia are developing plans to require them.
Failing to require background checks for home health care workers stands as an example of the inconsistencies that exist in the background check rules (in different care-based industries) in the US. For example, all 50 states require criminal background checks before a prospective worker can be employed at a licensed childcare center.
Nevertheless, requiring background checks is only one piece of the puzzle to keeping people safe in long-term care systems. The most effective way to ensure patient safety would be to also allow nurses to check on home aides, state regulators to audit agencies’ work, and to provide an easy way for patients to lodge complaints.
While many people do not enjoy the idea of background checks—citing privacy concerns—they provide an invaluable service. For more information about background check policies (and software) please visit InnovativeBCS (http://www.innovativebcs.com).