‘Certification mill’ for bogus health aides

It is any family’s worst nightmare - entrusting your frail, elderly loved one to an agency-provided caregiver, only to find out that the aide is not qualified - or worse, not even licensed.
Attorney General Andrew Cuomo recently garnered indictments for the owners of two “certification mills” that provided false credentials to hundreds of home health aides. The operations were part of a widespread and elaborate scheme to defraud Medicaid of millions of dollars, according to Cuomo.
The On Time Home Care Agency, based in Jamaica and run by Laurette Escarment, 60, gave hundreds of home health care aides fraudulent documents between 2003 and November of last year.
Brooklyn-based Smalls Training and Counseling School, operated by Registered Nurse Mary Smalls, 75, of Laurelton, issued false certifications for two years, between 2003 and 2005.
“The audacity displayed by the operators of these false certification mills is matched only by the severity of the damage they’ve done to the Medicaid system and the risk they’ve imposed on the patients who count on home health care,” said Cuomo. “We count on these schools to ensure that the aides sent into patients’ homes are well-trained and qualified.”
The attorney general said that Escarment and Smalls would provide - for a fee of approximately $300 to $400 - certificates of completion for state-required home health aide training courses.
According to the investigation, Smalls even went so far as to furnish “students” with the correct answers to the licensure exam, keeping the exams on file as purported proof the students had completed training.
Armed with the false credentials provided by Escarment and Smalls, aides would gain employment with licensed home care service agencies, causing Medicaid to be billed for services they provided. However, since these were by unlicensed practitioners, the services were not eligible for payments.
Medicaid requires home health aides be able to administer medication and provide services such as catheter, colostomy and wound care to successfully complete a training program licensed by the Department of Health or the State Education Department. All such aides must receive a minimum of 75 hours of training, including 16 hours of supervised practical training conducted by a registered nurse, and must pass an examination.
Many of the aides possessing certifications from Smalls and On Time had received no such training, and as a result, Medicaid was billed for services provided by unqualified aides, and patients were given care by untrained attendants.
Escarment pleaded guilty to grand larceny in the third degree. She faces a maximum penalty of seven years in prison at sentencing.
Smalls pleaded guilty to grand larceny in the fourth degree and faces a maximum penalty of four years in prison. She is due to be sentenced on September 15.
As a result of the ongoing investigation, Cuomo released the names of 14 New York home health care aides, two registered nurses and a Medicaid recipient variously convicted of practicing with false credentials, billing for services they did not provide or receive, and Medicaid was billed for 24-hour - and in at least one case - 36-hour workdays.
The cases continue to mount as the investigation expands, and more arrests are expected, said Cuomo.
“A solution exists to the problems with home health aide training certificate verification,” said Christine L. Johnston, Executive Vice President of the New York State Association of Health Care Providers, Inc. (HCP). “[The] establishment of a centralized state registry of certified home health and personal care aides, which has long been advocated by HCP.”
“This registry would ensure that only trained and certified workers are placed in the field,” she continued. “Without this solution it will continue to be extremely difficult for agencies to access accurate information on aide certification to better protect public interests.”
Cuomo is urging New Yorkers to report cases of suspected fraud to the AG’s Medicaid Fraud Hotline, at 1-866-NYS-FIGHT (697-2444).