You need to check yourself Virginia and DMAS.  The threatening has gotten so bad that you would think caregivers are doctors that need malpractice insurance except for one thing: very low incomes.  You are chasing away people doing the hardest jobs with the lowest pay.  The jobs no one wants.  How?  By admonishing them on a regular basis with EVV and all the entails.  There is a caregiver crisis in the US.  These are the people that WILL care for YOU one day.  They cannot afford malpractice insurance and WILL LEAVE THE FIELD.  Where is the workforce pool you plan on pulling from Virginia?  The institutions where the expense is very large due to THEIR insurance costs and overhead?!  Give me a break.  Check yourselves!