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March 18, 2011

Home Care's Booming, and So Is Regulation (USA)

Home Care's Booming, and So Is Regulation
As services for seniors expand, entrepreneurs are preparing for more scrutiny from regulators
March 17, 2011

As the first baby boomers turn 65 this year, entrepreneurs see opportunity. The number of companies providing home health care or services such as assistance in dressing, bathing, and cooking increased by more than 50 percent in the past decade, U.S. Census Bureau data show. Now regulators are scrambling to catch up with the growing industry.
Home-care companies aren't regulated in about two dozen states, and just a handful require licenses for companies that provide nonmedical services. Today the industry faces a hodgepodge of inconsistent rules that advocates say puts vulnerable people at risk of financial exploitation or physical abuse. In states that require licensing, many operators ignore regulations because the costs of complying are high and the risk of getting caught is low, people in the industry say.
Advocates of home care say it is more compassionate and less expensive than nursing home care. More than 45,000 companies offered home health care or other aid in 2008, including 2,800 small outfits that pay franchisers for a brand name, training, and support, researcher Frandata estimates. They're targeting a $55 billion market that will surely grow as the number of Americans 65 and older increases by 79 percent in the next 20 years, to 72 million, according to Census projections.
A report by the Senate Special Committee on Aging notes that "addressing elder abuse in home-based care settings is becoming a growing concern." Much of the worry centers on how thoroughly companies vet workers before sending them into people's houses. The Senate report says that after seven states began requiring comprehensive background checks for caregivers in institutions and private homes, 4.3 percent of the 220,000 applicants were disqualified because of a history of serious crimes. Some 92 percent of nursing homes employ at least one worker with a criminal conviction, according to a Mar. 1 report by the U.S. Health & Human Services Dept. Not all crimes preclude workers from employment.

Abridged
SOURCE:      Business Week
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