In-home health care agencies are hired to help take care of your loved ones who stay at home. They even send nurses and aides to help them with everyday life. But our eight-month long hidden camera investigation exposes problems within one of those businesses serving Greater Cleveland. That business has now launched an internal investigation as a result of what we uncovered.

A Call for Help

"When you're up in age, you never know what's going to happen,” said 88-year-old Pauline Burt, of Westlake, who needed some assistance in her home.

“I got all my marbles, and I ain't lost them yet," she said with a smile.

RELATED: Following hidden camera investigation, state looking into issues with Westlake in-home care provider

Her grandson, Shane Rios, organized in-home care for Burt through Medicaid and hired Comfort Keepers, located in Westlake.

"All this work my grandson did for me to have somebody come in and help me do things so I wouldn't fall,” Burt explained.

"This is not only to help my grandmother, but it's also to offer respite to the families,” Rios said.

However, Rios said that, in a matter of months, the company failed to show up more than a dozen times. He was so incensed that he tracked and charted dates.

"We didn't receive a second individual to come in, you know, a back-up plan," Rios said while standing beside his dining room table filled with paperwork.

The family was also concerned about the quality of care when aides did show up.

“They would be more on their cell phones texting as opposed to taking care of the client," Rios said.

"[The aide] was always trying to find out a lot of information that was none of her business," Burt said.

“They have no professionalism, whatsoever," he added.

Our Findings

After learning about these complaints, News 5 starting digging into the company. We found out that an accreditation agency, Community Health Accreditation Partner (CHAP), wrote many citations about the company in 2017.

The agency cited problems with background checks, having enough employees to handle the caseloads and "systematic problems resulting in…the inability to ensure quality patient care in a safe environment."

The citations also include "no documentation of in-service education.” You can view the agency's documentation here.

We obtained an email from the accreditation agency that says Comfort Keepers in Westlake "indicated their desire to not continue with" correcting the problems, so it dropped the company.

Hidden Camera Investigation

We wanted to know how professional the company would be -- and whether it would be honest about its past problems -- when we sent producers to its office with hidden cameras asking questions about care.

Our producers requested to speak with a supervisor and were directed to the community relations manager, Kate, who said she had been with the company for eight years.

"Do you have problems with reliability?" our producer asked. "Have you had any complaints about your employees?”

“Actually, those people -- we pick those people out and put them with Medicaid clients,” Kate said of the aides. “To be honest, we have the aides for Medicaid and the aides for private.”

“What's the difference?” our producer asked.

“Private pay, I mean, that's coming out of people's pocket," Kate said. "And, you know, like my parents, like a lot of our clients they've worked hard all of their lives, and we just feel that they deserve the best care."

The Reaction

Rios was shocked after learning the same company he hired to help his grandmother, who was on Medicaid, said they give different care depending on how clients pay.

"The words I have for it are inappropriate for television," Rios said. "That's how disgusted I am. To be able to capture that on a hidden camera [is] an admission of my suspicions all along."

We sent another producer into the company on another date. The idea of different levels of care based on how clients pay was emphasized again.

"We have Medicaid clients and private," Kate said during the second visit. "They're separate, pretty much. We have aides that are straight up Medicaid."

“Now, what's the difference?” our producer asked.

“Um, they don't pay for their services," Kate replied. "You pay for your services…you're...priority and they get the better caregivers. We make sure of it. We have a certain group of caregivers that only do private pay."

Our hidden camera also captured this statement from Kate: “A lot of the Medicaid clients that are on it, they don't need it…'Oh, I'm depressed. I need somebody to clean my house.’”

We showed our hidden camera video to Gwendolyn Roberts Majette, an associate professor at Cleveland State University with an expertise in health care law.

"That is concerning because all patients should receive the same level of care," Roberts Majette said. "[The aides are] supposed to be competent when they're brought in. They're supposed to receive continuing education."

Roberts Majette also said at least 60 percent of people on Medicaid are working.

Company's Response

With hidden camera video and documents in hand, we visited Comfort Keepers in Westlake Feb. 21 to give them an opportunity to respond. We tried to ask Kate about her statements concerning different treatment based on the way clients pay. However, Kate closed the door on us and did not respond.

"It just makes me feel like this system is broken,” Rios said. A broken system for people like his grandmother, Pauline Burt, who wanted help so she didn't fall in her home.

"You gotta be able to trust them, too,” she said of the aides.

After supervisors at Comfort Keepers in Westlake would not speak in-person, News 5 followed up with them via phone and email. On Feb. 23, we received the following statement from the company via email from principals Paul Burke and Mark Shee:

Comfort Keepers-Westlake would like to thank you for your interest in our business operations. Our Westlake office has had the privilege to service Cleveland and the western suburban senior market by providing non-medical in home personal care, companion care and transportation services since 2005. Currently our office services both private pay and Medicaid clients, as our directive is that we accept all payer sources (private, long term care insurance and Medicaid) and all clients are entitled to receive the same quality of care. At no time does Comfort Keepers allow its franchisees to differentiate the quality of care or the quality of caregiver provided to private pay or Medicaid clients. The State of Ohio is a non-licensure state as it applies to non-medical Home Care. However, our Medicaid contract stipulates the following when providing services to a Medicaid client: All caregivers meet the qualification of State Tested Nurses Aide (STNA) or Home Health Aide or equivalent.

All caregivers are subject to six-point background check and fingerprinting.

All caregivers are required to have annual skills testing and complete 8 hours of continuing education annually.

All caregivers are to be supervised by a licensed Registered Nurse (RN).

Provider shall employ a Registered Nurse to provide initial assessment and re-assessments every 62 days.

Provider shall employ a Registered Nurse to oversee caregiver staff and perform caregiver assessments .

Provider shall meet required documentation and record keeping prot ocols .

All personal care, companion care and homemaking services provided are authorized and under the direction of a Medicaid Case/ care Managers who specifically assigns the total hours of weekly service and all activities of daily living that need to be completed. For the past eight years our office has been subject to an annual structural compliance review (audit) and has never been sanctioned by Medicaid for failure to meet any requirement. Medicaid clients receive highly skilled and trained caregivers and the care provided is under the direction of a registered nurse, as well as the client's case and care managers. At no time is the quality of care substandard to the care provided to private pay clients.

News 5 followed up again with the company with specific questions about the manager who made statements regarding different levels of care depending on how clients pay.

We then received this statement from Saudia Gajadhar, U.S. director of marketing and communications, CK Franchising Inc., parent company and franchisor of Comfort Keepers, promising to launch an internal investigation.

For twenty years, Comfort Keepers has provided quality in-home care to all our clients allowing individuals to live independently in their homes and enjoy a quality of life that cannot be duplicated elsewhere. Recently, allegations were levied against an independently owned and operated franchisee and its employee suggesting inconsistent caregiver quality based on a client’s ability to pay. Comfort Keepers has clear standards for the appropriate hiring and training of caregivers to ensure we provide the best care possible to all of those we serve. Care for all clients is held to the same high level of quality standards, focused on providing professional, compassionate assistance that meets our organization’s highest standards. We learned about this from WEWS reporting and will be launching an internal investigation to ensure that this franchisee is complying with our standards of care.

We also received an additional statement from Burke:

Thank you for bringing this matter to our attention. We have addressed the issue with our employees to make sure that they share accurate and factual information with all potential clients and not share their opinions. Comfort Keepers -Westlake would like to share the following additional information regarding this matter. Ms. Christian is employed as a community liaison and only handles private client in-take, private client marketing and community/industry networking events. She is not involved in providing services to Medicaid clients. Caregiver assignment is handled by our client care coordinator/scheduler and nurse. Ms. Christian is not involved in caregiver assignment to any of our clients. All Medicaid Service recipients have the right to choose their caregivers and their provider and may change caregivers and /or providers at any time.

Looking Ahead

On Tuesday, 5 On Your Side Investigators will bring you reaction to our hidden camera investigation from the regional agency that refers Medicaid clients to the company.