Why Home Care Agencies Need a Safety PlanWhen someone hires an agency to supply a caregiver for their senior parent or other loved one, they expect to be provided with a trained, responsible, and experienced professional. After all, this is a big decision and a big expense for a family, and they want the best care for their loved ones. So they assume that by going through a professional agency, they’re getting a safe, responsible, trustworthy caregiver.
Sadly, that’s too often not the case.
In fact, using a home care agency to find a caregiver can give families a false sense of security about the skills, background, and experience of the caregiver they’re hiring to take care of their loved one.
That’s the finding of a 2011 research project conducted by the Feinberg School of Medicine at Northwestern University in Chicago, and published in the January 2012 edition of the Journal of the American Geriatrics Society.
Key Takeaways
- Families often assume that hiring a caregiver through an agency means the caregiver has been thoroughly vetted, but that isn’t always the case.
- A Northwestern University study of 180 home care companies found uneven screening: only 55% ran federal background checks and about a third conducted drug tests.
- If an agency hires someone with a criminal record who later harms a patient, the agency can be held liable.
- Three practices set agencies apart while managing risk: criminal background checks, drug screening, and pre-employment assessments.
- Screening has to follow the law too, so background checks and drug tests should be run in line with federal and state rules.
- Documenting your hiring process and telling prospective families about it turns risk management into a competitive advantage.
In the study, researchers interviewed 180 home care companies in five states and questioned them about their recruiting, screening, and hiring practices.
What they found was disturbing:
- Many home care agencies hired people who randomly responded to Craigslist ads, and some routinely lied to their clients about the skills, experience, and training their caregivers had.
- Only 55 percent of agencies performed federal background checks, and only about a third conducted drug tests.
- Over half (58.5 percent) relied on applicants’ own assessments of their skills, rarely asking the applicants to provide any proof to back up their claims.
- Once caregivers were in patients’ homes, only about 30 percent of agencies sent supervisors into homes at least once a month to evaluate the quality of care.
It’s a dark underside of the caregiver industry, with serious risks for patients and the families that hire caregivers. Imagine just a few of the possible scenarios…
- A negligent caregiver could neglect or endanger patients by failing to feed or exercise them properly
- A patient suffering from dementia could be vulnerable to abuse by an untrained caregiver
- A drug abuser could be hired without a drug test and gain access to an elderly patient’s prescriptions
- An unscrupulous caregiver with a criminal record could exploit a patient’s personal and financial data
As you already know, the potential risks are almost limitless. That’s why your screening and hiring practices are mission-critical.
As a quality agency, with a robust and proactive screening and hiring procedure, you have an important competitive advantage. Carefully document your efforts and tout the importance of this extra care when meeting with prospective patients and their families. In our experience, agencies that keep a standard hiring checklist and a signed file for every caregiver are in a much stronger position when a family raises a concern, because the record shows what was checked and when.
Below are three ways to set your agency apart while also managing risk:
- Criminal background checks. If you hire someone with a criminal record who later harms a patient, you’ll be held liable. Unfortunately, some applicants lie on applications, so it’s imperative to run a thorough background check on all applicants. The same principle applies to licensed staff, as the fake-diploma scheme covered in our post on Operation Nightingale shows.
- Drug screening. You have a responsibility to protect your clients, patients, other employees, and your business from anyone who might cause harm or damage your reputation due to drug use, and the patients you serve deserve a caregiver who is physically and mentally sharp.
- Pre-employment assessments. To make sure a caregiver is ready and fit for the job, consider conducting pre-employment assessments such as personality evaluations, talent assessments, physical exams, sample job tasks, English proficiency exams, and tests that assess attitudes, behavior, cognitive abilities, job skill aptitude, workplace motivations, and other factors.
Make Sure Your Screening Process Is Legal, Too
Screening that protects patients can create legal exposure of its own if it isn’t done correctly. Background checks run through a third-party provider are generally subject to the federal Fair Credit Reporting Act, which requires disclosure and written consent from the applicant. Many states and cities also have fair-chance hiring laws that limit when and how criminal history can be considered, and some states restrict pre-employment testing for cannabis. Requirements differ by location and by the type of care provided, so agencies should review their process with HR or legal counsel.
Smart hiring is your first line of defense against inexperienced, unscrupulous, and even dangerous caregivers, and it’s the first crucial step toward keeping your patients safe and your business reputation intact.
Build a Hiring Process That Protects Your Agency
Smart hiring is your first line of defense, and the right insurance is the safety net behind it. Heffernan Insurance Brokers is actively involved with industry groups across the nation, and we understand what you need to keep providing your clients the care they deserve. Learn more about our home care liability insurance, our programs for senior living communities and allied health centers, or read about why home care agencies need a safety plan. For a broader look at day-to-day exposures, see our post on four common exposures facing care providers.
