Just days after we uncovered problems with a local in-home care agency, two state agencies, as well as a key non-profit that plays a major role in referring people to that business, are looking into the care the elderly receive.
This comes after a 5 On Your Side hidden camera investigation captured a manager at Comfort Keepers in Westlake describing the different treatment of clients based on how they pay.
On two different occasions, our hidden camera video showed a community relations manager, Kate, telling potential clients the company gives poorer-performing aides to Medicaid clients and better aides to private payers.
"Do you have problems with reliability? Problems with...have you had any complaints about your employees?” asked our producer, who visited the Comfort Keepers office in Westlake.
“Actually...those people...we pick those people out and put them with Medicaid clients,” Kate said. She also said she has been with the company for eight years.
The Ohio Department of Medicaid as well as the Department of Aging sent us separate statements with the same wording.
The state of Ohio is committed to providing quality, medically necessary services to individuals enrolled in the Medicaid program. At all times the health and safety of our program participants is our priority. We are currently looking into this matter to ensure the people we serve are receiving the best possible care.
Just a day after our story aired, the Western Reserve Area Agency on Aging told News 5 it is looking into whether or not clients were mistreated.
The non-profit agency monitors businesses that give Medicaid care and refers Medicaid clients to businesses. They play a major role in referring clients to Comfort Keepers in Westlake.
They were shocked when they saw our hidden camera video.
"Well, first of all, that's disappointing," said Doug Beach, the non-profit's CEO. "That's a tough video to watch."
"She needs to understand that this is a caring business,” Beach said of the manager's statements captured on our hidden camera video.
Shelia Dessau, senior director of clinical programs with the non-profit, said there were checks on Comfort Keepers in Westlake.
"But you didn't know the attitude here that's on the video?” we asked.
“No, we didn't," Dessau said. "So, we need to...knowing this information now we need to do more education with our providers."
Our investigation also found Community Health Accreditation Partner (CHAP) wrote numerous citations against Comfort Keepers in Westlake less than a year ago.
When asked about past problems, the manager at Comfort Keepers in Westlake did not bring up the issues we uncovered.
"Is there anything that maybe has happened in the past that we should know about and would just be good to know?” our producer asked.
“No,” the manager said.
“Whether it be with nurse’s aides or...” we asked.
“Not here that I know of. No, nothing much,” Kate said.
We asked Beach what he thought of her not acknowledging those citations.
“I think that's unfortunate," Beach said. "I think this whole thing is unfortunate."
He also said he did not know about the citations.
“The fact that not all of the information is always shared with everybody is a little bit of a concern," Beach said.
Beach said he has further concerns that our video appeared to show a belief from the manager that private pay clients have worked hard all of their lives so they should get the best care.
“Private pay, I mean, that's coming out of people's pocket," Kate said. "And, you know, like my parents, like a lot of our clients they've worked hard all of their lives, and we just feel that they deserve the best care."
"The implication that people who end up on Medicaid didn't work hard during their life is a very difficult thing to say," Beach said. "I don't know how she knows that."
During our investigation, the Ohio Department of Medicaid told us Medicaid payments were terminated for Comfort Keepers in Westlake on Jan. 22. But it still qualifies for programs called Passport and MyCare, which are paid for by Medicaid.
"Comfort Keepers [in Westlake] may have lost their license on the Medicaid side, but they have it on the Passport side,” Beach said. “And because they have it on the Passport side, they can still serve those clients either in MyCare or Passport."
There are many levels, agencies and programs when it comes to payments. A business can be deficient or can volunteer to be "terminated" for Medicaid payments, but still get your tax money in other ways.
"One of the things, though, that the state's pushing is the idea of going to a one waiver….one Medicaid waiver," Beach said. “And if they did that, then it would all be together and a lot of the bureaucratic snafus that you're suggesting would go away."
Beach told us the best way to head off problems is to make sure your case worker knows about whatever issue is happening. He said you can also reach out to the state’s Ombudsman program for help intervening.
The corporate side of Comfort Keepers told us it has launched its own internal investigation into the Westlake franchise.
The owners of the Westlake Comfort Keepers said they have never been sanctioned by Medicaid.
After supervisors at Comfort Keepers in Westlake would not speak in-person, News 5 followed up with them via phone and email. On Feb. 23, we received the following statement from the company via email from principals Paul Burke and Mark Shee:
Comfort Keepers-Westlake would like to thank you for your interest in our business operations. Our Westlake office has had the privilege to service Cleveland and the western suburban senior market by providing non-medical in home personal care, companion care and transportation services since 2005.
Currently our office services both private pay and Medicaid clients, as our directive is that we accept all payer sources (private, long term care insurance and Medicaid) and all clients are entitled to receive the same quality of care. At no time does Comfort Keepers allow its franchisees to differentiate the quality of care or the quality of caregiver provided to private pay or Medicaid clients.
The State of Ohio is a non-licensure state as it applies to non-medical Home Care. However, our Medicaid contract stipulates the following when providing services to a Medicaid client:
- All caregivers meet the qualification of State Tested Nurses Aide (STNA) or Home Health Aide or equivalent.
- All caregivers are subject to six-point background check and fingerprinting.
- All caregivers are required to have annual skills testing and complete 8 hours of continuing education annually.
- All caregivers are to be supervised by a licensed Registered Nurse (RN).
- Provider shall employ a Registered Nurse to provide initial assessment and re-assessments every 62 days.
- Provider shall employ a Registered Nurse to oversee caregiver staff and perform caregiver assessments.
- Provider shall meet required documentation and record keeping protocols.
- All personal care, companion care and homemaking services provided are authorized and under the direction of a Medicaid Case/ care Managers who specifically assigns the total hours of weekly service and all activities of daily living that need to be completed.
For the past eight years, our office has been subject to an annual structural compliance review (audit) and has never been sanctioned by Medicaid for failure to meet any requirement.
Medicaid clients receive highly skilled and trained caregivers and the care provided is under the direction of a registered nurse, as well as the client's case and care managers. At no time is the quality of care substandard to the care provided to private pay clients.
News 5 followed up again with the company with specific questions about the manager who made statements regarding different levels of care depending on how clients pay.
We then received this statement from Saudia Gajadhar, U.S. director of marketing and communications, CK Franchising Inc., parent company and franchisor of Comfort Keepers, promising to launch an internal investigation.
For twenty years, Comfort Keepers has provided quality in-home care to all our clients allowing individuals to live independently in their homes and enjoy a quality of life that cannot be duplicated elsewhere.
Recently, allegations were levied against an independently owned and operated franchisee and its employee suggesting inconsistent caregiver quality based on a client’s ability to pay. Comfort Keepers has clear standards for the appropriate hiring and training of caregivers to ensure we provide the best care possible to all of those we serve. Care for all clients is held to the same high level of quality standards, focused on providing professional, compassionate assistance that meets our organization’s highest standards.
We learned about this from WEWS reporting and will be launching an internal investigation to ensure that this franchisee is complying with our standards of care.
We also received an additional statement from Burke:
Thank you for bringing this matter to our attention. We have addressed the issue with our employees to make sure that they share accurate and factual information with all potential clients and not share their opinions.
Comfort Keepers -Westlake would like to share the following additional information regarding this matter.
1. Ms. Christian is employed as a community liaison and only handles private client in-take, private client marketing and community/industry networking events. She is not involved in providing services to Medicaid clients.
2. Caregiver assignment is handled by our client care coordinator/scheduler and nurse. Ms. Christian is not involved in caregiver assignment to any of our clients.
3. All Medicaid Service recipients have the right to choose their caregivers and their provider and may change caregivers and /or providers at any time.