As a licensed agency providing care for seniors and the disabled in their homes, my agency has a lot of “masters.” Foremost among them are our clients. We respond to their needs in all that we do, and we answer to them for the quality of our services. That much is straightforward.
What is less obvious to most people is that we also answer to the NJ Division of Consumer Affairs (who grants us our license), the NJ Board of Nursing (who writes detailed best practices governing our standards and day-to-day practices), and an accrediting agency approved by the state to inspect and review every aspect of our business.
As of 2019, accreditation is now a requirement for any home care agency in the state, and the Division of Consumer Affairs has committed to shutting down those agencies who don’t comply.
Certification in New Jersey
New Jersey has some of the most stringent regulations in the nation governing the provision of care services to seniors in their homes.
On March 18, 2019, Governor Murphy signed and enacted Senate Bill Number 2773, which clarifies the definitions of Health Care Service Firms and Homemaker/Home Health Aides. The bill ensures that “all firms acting as health care agencies for our elderly, including the ones using the Internet to arrange and provide companies or health care services, are properly registered.”
While most other states do not require that an employee who provides personal care be certified or show proof of any training. In New Jersey, any aide who touches a client, whether it is to help them into a wheelchair or to give them a sponge bath, must be “certified.”
To receive certification, the aide must successfully complete a training course approved by the Board of Nursing. Once they have passed, they may call themselves a CHHA (a Certified Homemaker Home Health Aide.)
And that’s only the first step!
CHHAs must renew their licenses every two years, and the state will not grant that renewal unless the aide can prove that he or she is working under the supervision of a registered nurse. In other words, they must work for a licensed agency like ComForCare who employs RNs to assess patients, write detailed care plans, and supervise the home care aides.
Home Care Best Practices – It’s the Law!
Clients are sometimes surprised (and sometimes annoyed!) at how in-depth our initial assessments and bi-monthly reassessments are. It generally takes our nurses at least two hours in the home every 60 days to review and document according to state regulations and our accreditation standards. This thoroughness can seem excessive to clients, but the NJ best practices were written to safeguard the health and safety of home care clients.
Our nurses can (and do) catch problems that doctors and families are unaware of—everything from flagging fall risks in the home to addressing the potential for skin breakdown that can lead to life-threatening pressure ulcers. They connect clients who have balance and strength problems to physical therapy, catch medication errors such as duplicate prescriptions under different medication names, and flag cognitive decline that would indicate a need for more safety supervision.
In addition, the RNs are regularly supervising and evaluating our HHAs to make sure they adhere to nursing standards and understand what is required under the patient’s plan of care.
Over the past couple of decades, the home care industry was wide open to just about anyone who wanted to set up shop. Some agencies followed best practices in hiring and supervising aides, but others simply operated as “matchmakers,” much as current online registries operate.
When it comes to providing care for vulnerable seniors in private homes, choosing an accredited agency is the safest way of ensuring quality of care and accountability.