The District’s health finance agency says caregivers must be “consistently available” as advocates cite staffing shortages and limited enforcement.
WASHINGTON — A paraplegic D.C. resident says he filmed overnight caregivers sleeping in his apartment and filed complaints for years, prompting advocates and local officials to revisit how the city monitors Medicaid-funded home health services delivered behind closed doors.
Damon Brooks, injured 13 years ago, receives services through the Elderly and Persons with Physical Disabilities program. He says his daytime nurse is steady, but the overnight shift has been unreliable, with aides he filmed sleeping when they should reposition him and manage scheduled catheter care. The Department of Health Care Finance, which oversees the program, said aides are required to be available and follow each beneficiary’s plan of care. The Long-Term Care Ombudsman’s office and Legal Aid D.C. say the case highlights chronic gaps: too few aides for hard shifts, complaints that languish and a lack of consequences that leave residents without dependable care.
Brooks said he installed visible cameras, gathered hours of video and emailed images to nursing agencies and city officials. He told reporters he has worked with more than 40 nurses through a single agency. “Sometimes I’ve been left sitting in wet chucks,” he said, adding that recent weeks included no-shows that forced his mother to step in. Asked whether he would be safe in an overnight emergency, he said, “Truthfully, I don’t know.” Brooks said he continues to receive solid daytime care while seeking a stable overnight team.
At a D.C. Council discussion on long-term care, Senior Attorney Holly Eaton of the ombudsman’s office said some clients reported aides arriving for midnight–8 a.m. shifts with “blankets, pillows and hair rollers.” Mark Miller of the same office said sleeping on duty amounts to taking public dollars without providing care, calling it “potential fraud” and neglect. The health finance agency reiterated expectations for consistent, safe service. Reporters said agencies linked to Brooks’ care did not respond to questions. An inspection record from 2023 involving a former agency cited a sleeping complaint; the agency reported verbally warning staff and retraining them on a no-sleeping policy.
Legal Aid D.C. has told lawmakers the home-health workforce is shrinking, with the number of licensed home health aides in the city falling by more than 1,700 between August 2023 and January 2024. Advocates say the drop has meant missed hours and uncovered nights, especially when one day’s schedule requires a full 8-hour shift plus a shorter add-on that is hard to staff. They argue that some agencies avoid assigning workers to clients who closely monitor care or who insist aides follow instructions, creating friction that leads to turnover and gaps in coverage.
Oversight responsibility rests with the Department of Health Care Finance, which licenses providers, sets rules for plans of care and can sanction agencies. The ombudsman’s office fields complaints, helps residents seek fair hearings and refers serious allegations for enforcement. Advocates want stronger use of penalties and more incentives for nights and weekends, including higher pay differentials and travel-time reimbursements. Workforce proposals before the council would raise pay for direct care workers and streamline licensing across the region to increase the pool of eligible aides for D.C. cases.
Brooks said he will continue pressing for answers while focusing on work and rehab. “I’m really worried about others,” he said. As of Thursday, District officials had not announced disciplinary actions tied to his case. Lawmakers are expected to review home care complaint handling and staffing trends in a follow-up session later this winter, with updates on enforcement steps and any proposed regulatory changes.
Author note: Last updated December 19, 2025.