These same issues do not exist in the hospital setting. The Competitive Environment. Unlike a hospital which requires bricks and mortar to exist, in most states new home agencies can be formed very easily to provide significant and quickly responding competition for the hospital-based home health agency. While a hospital my be able to take several months to make a program or service decision, if its home health agency cannot react more quickly, competing agencies will have already gained the competitive advantage in new market niches. Different Laws Apply.
Different laws can apply to a home health agency than to a hospital.
A common example is that state laws may require criminal history checks of home care employees but not of hospital employees. Furthermore, even when the same law does apply to the hospital and the home health agency, the way it applies or what it will require often is different. For example, OSHA requirements concerning the bloodborne pathogen standard requires different responses in a hospital than in a home health agency. Policies developed for the hospital may very simply not work in the home care setting. The fact that a home health agency and a hospital are significantly different and that hospitals have failed to recognize those differences has resulted in a number of ramifications for hospital-based home care.