I am 75 years old. I can get around, reasonably, in my apartment with the aid of a rollator. Away…read morefrom home I use a power wheelchair. I travel by a pre-order ADA wheelchair van services. I have a Medicare Advantage Ins. coverage for medical insurance. With my current plan I have received help from various PCA (Personal Care Attendant) organizations for approximately 14 years. For various reasons, not only have the companies that are set up by my insurance changed frequently but the PCAs change frequently, within these agencies. Currently I have coverage from a business called Soto Home Care, out of Holyoke, MA. It has been the worst operating business of it's kind that I have been involved with. It is poorly managed and pretty far away from operating 'as a professional business, nevermind as a home care facility for handicapped and elderly' that Ihave had. I understand there is a shortageof people willing to do this work and I understand that since there are other agencies that pay more than Soto Home Care, it's even harder for them to keep enough staff to have full coverage all of the time. But, in the last 2 years, the issue of coverage 100% of the time is a constant problem. And the personnel who you depend on never seem to have mastered their skills in particular positions in over the 2 years...I don't think the owner/boss has a policy and procedure manual(s) for any position in this business. If he does then nobody fallows it!! Too many mistakes in scheduling and in notifying clients of changes or problems, etc. The PCAs are allowed to request time off in less than 24 hours before they are going to be out. They offer 24 hours a day service 7 days a week, including all holidays. A PCA can request any day(s), holidays included, and nothing is denied. Many times the PCA just doesn't show up, and when I call to find out why, and not only don't get an answer, I don't get an apology, an offer to find other coverage, or even a promise to find out why that PCA hasn't shown up...etc. This happened again today. So, I called, the person couldn't answered my questions and I had to ask her to find out if the coverage was due to an emergency or whatever, and pleaded with her to get back to me, whether or not the PCA, already 20 min. late, was going to make it in soon or not. That was @ 9:50am this morning. It's now 11:14am, and I've heard nothing. . I've had enough.