A Caring Heart Home Health

11/10/17

A Caring Heart, LLC takes pride in offering a variety of Home Health Care options for families in need of Service. The subject of the complaint is part of one of the services offered by the agency; Missouri Medicaid’s Consumer Directed Services (CDS) Program. A Caring Heart, LLC is a Vendor for the State of Missouri’s CDS program. The CDS model is somewhat unique in that the client or “Consumer” is the Employer, and the agency or “Vendor” is the Fiscal Intermediary (see attached) as well as handles all administrative functions associated with the Service. The CDS model requires the “Consumer” meet specific eligibility criteria so they are able to act as employer by directing his or her own care and hire caregivers who meet the guidelines defined by the State. The Vendor is therefore not the employer and as such does not take on “employer” liability. The State of Missouri does not authorize the “Vendor” agency to be the employer.

Each client assigned to our agency through the CDS program is welcomed with a personal face to face visit in their home. Either I, or a member of my management team visits the client’s home, explains the program, and has the client/consumer sign documents indicating they understand and agree to the terms and guidelines of the CDS program(see attached signed document). I want to stress that A Caring Heart, LLC offers other forms of In Home Health Care, such as Private Pay and Veterans Aid & Attendance Pension. The care attendants for those services are actual employees of the Agency, and would therefore fall under General Liability of the Agency.

In the case of Ms., she directed her caregiver/employee to remove a crockpot from the kitchen counter and place it on a glass top wooden table in her living room, plug it in and turn it on. The caregiver did exactly as directed immediately prior to her shift ending. The caregiver clocked out from her shift at 1:10pm on 9/15/17. According to Ms. she noticed the glass broken the next morning 9/16/17. In looking at the photo (see attached) of the broken glass, it appears to be a heat related glass break, and not a break caused by caregiver negligence. I also spoke with the caregiver and she indicated the glass was not broken when she ended her shift, nor did she damage the glass in anyway when she moved the crockpot from the kitchen to the glass table. Ms.’s decision to use a crockpot to slow cook a meal over several hours on a glass surface is likely what caused the break.

My goal was to understand exactly what happened so that I could appropriately respond to Ms.. I reminded Ms. of the terms of the CDS program, and informed her that A Caring Heart, LLC could not honor her request to file an insurance claim to replace her table. To require such would mean the “Vendor” would have to take on accountability for something they have no authority over, since "care" authority in the CDS program lies with the “Consumer”. Additionally, the unintended consequence of honoring such a request would mean that "Vendor" Agency’s General Liability insurance would be vulnerable to losses beyond the control or management of the "Vendor" Agency, and set a bad precedent. As owner of A Caring Heart, LLC, I take pride in the quality service provided to all clients or consumers, and am sorry Ms. doesn’t understand the specific terms of the CDS business relationship.

Best Regards,
***
Owner/Director

Side Note (please do not place the following names in my response to this complaint): The care attendant Ms. referenced in the complaint was ***, however, the care attendant who worked the shift referenced in the complaint is ***. Ms. had a Care attendant named ***, but she did not work the day of the crock pot incident.