Contradictions in federal policies put elderly at risk of health care neglect.

Federal and state efforts to control hospital costs have increased the demand for home health services, especially services for the more acutely ill patient. At the same time, recent regulatory policies on Medicare eligibility and reimbursement are limiting the ability of home health agencies to respond. Examination of New Jersey home health data and case examples illustrate the increased demand, conflict with federal policy (as experienced in claim denials and loss of waiver of liability), and effect on patients and their families.