WEST PALM BEACH, Fla. - Trish Armand is done.
"Do I trust it? No, no not at all," she told the Contact 5 Investigators.
Her son, Mikey, moves with a rare cell disease called Mucolipidosis type 2. Six-year-old Mikey probably won't make it to 10.
"No, no," said a teary eyed Armand. "So I just enjoy every day with him," she said.
For years, Medicaid funded home health aides have helped Armand provide Mikey with round the clock care and for years, mom has complained.
"I feel like they're hiring the bodies just to meet company quotas," she said.
A few months ago, Trish captured cell phone video of a new home health aide sleeping on the job.
"I hear him yelling mommy, I'm like what's going on? I come out of the shower and I go into his room and he's in the crib. So I come down the stairway and I look and there was this aide, stretched out on the couch with her cell phone in the hand- sleeping."
After three attempts to wake the aide, Trish took action.
"I literally had to shake her to say wake up and she woke up- deer in headlights look, drool coming out of her mouth. She was in such a sleep and she looked at me and said what time should I be here tomorrow? I just said you need to call your agency. That was the last I ever saw her.
The aide was fired.
But for Trish, the scene was nothing new.
"I had another aide who fell asleep on the couch," she said.
A photo captured by Trish, shows another aide sleeping on the couch while Mikey was awake on the carpet a few feet away.
"It's really just a paycheck, that's what I have found in the quality of people who are coming to take care of my son," said Trish.
From basic household chores to skilled nursing care, home health aides are, often, taxpayer funded and designed to help consumers, but state inspection reports reveal that doesn't always happen. In fact, over the past five years, nearly 90 percent of home health agencies have been flagged by the state for a range of problems.
Issues include minor administrative problems to quality of patient care concerns, like ignoring doctor's orders and lying about patient visits.
One Boca Raton agency was cited 90 times in one day. The agency has since changed ownership.
The problems are nothing new to Mark Ardis who is a quadriplegic and is dependent on home health aides just to get out of bed in the morning.
"I've been through 25 aids in the past 9 months," he told the Contact 5 Investigators.
He requires a lot but says, he doesn't always get it.
"No one is holding them accountable to training a skill set of an aide to come and take of a person like myself," he said.
Ardis isn't alone. Since 2007, of the 250 home health agencies in Palm Beach County and along the Treasure Coast, more than half were cited for personnel issues.
One even hired a Certified Nursing Assistant with a criminal past.
"Should these places be inspected more frequently because clearly, there are issues in this industry," asked Contact 5 Investigator, Katie LaGrone.
"Yes, there are issues," responded Molly McKinstry of the Agency for Healthcare Administration. McKinstry oversees state field inspectors who are out inspecting the nearly 2,500 licensed home health agencies across the state.
Unless there's a complaint filed, home health agencies can go three years without being looked at. McKinstry says, agencies with problems will be inspected more frequently.
But home health agencies are far from the state's only priority. In fact, the same inspectors who review home health agencies are also inspecting state hospitals, nursing homes and assisted living facilities. There are currently 270 state inspectors who inspect more than 30,000 patient care operation centers.
"That's a lot of places to inspect,"
Debra Alexander owns Comfort Keepers in Boynton Beach.
It's among the 12 percent of area home health agencies not cited for problems in the past 5 years.
Alexander doesn't believe more state oversight is a must.
"It couldn't hurt but to be honest if someone doesn't follow the rules, they're not going to follow them," she said.
Leaving patients like Mikey Armand and Mark Ardis in the hands of who decides to care and who doesn't.
"it's just not worth it. it's not worth the risk and it's not worth my peace of mind," said Trish Armand.
Since 2008, all new home health agencies must be accredited in order to obtain a Florida license to operate.
The accreditation requirement helps provide additional oversight.
The Agency for Healthcare Administration is working towards more frequent inspections.
Experts suggest before you choose the right home health agency for your loved one:
- Make sure you visit the agency
- Ask for references
- Make sure you review state inspection reports
The Agency for Healthcare Administration encourages consumers concerned about their care to file complaints. You
can do that by calling AHCA's Complaint Hotline (888) 419-3456. You can also submit concerns through the website. Complaints are prioritized depending on the alleged harm or possible harm to patients and are investigated on an unannounced basis by field office surveyors.
Florida law requires that anyone that suspects that abuse, neglect and exploitation of children and vulnerable adults, including those receiving services from home health agencies) be reported to the Florida Abuse Hotline operated by the Department of Children and Families, (800) 962-2873 or online. Investigators will investigate and arrange for immediate action when needed to protect the patient. Calls of abuse concerning children by others than their caregiver are transferred to local law enforcement in the community where the child lives.
Investigative Producer Lynn Walsh contributed to this story.