I worked for a federal home health program. 45 branch offices around the country.
DC had the most inept staff, the most clients banned from the office for violence, the only office with security and metal detectors, the most clients tagged with no home visits, the highest number of complaints alleging racism(staff and clients), the longest intake process for simple things " da fuck is surname??,aint no one know what the fuck is on your white ass papers", the most fraud cases and the last place in America to adopt Internet based time keeping (5 years after the rest of the country) due to technical illiteracy. We also had to revise program materials that were typically written for an 8th grade reading level down to a third grade level and that really didn't help.
The program? allowing senior citizens and disabled people to hire their own home health caregivers at no cost to the client. We had so much staff turnover on that account that all communication was assigned to my 7 person work group in our corporate headquarters, because general customer service would leave in tears and the branch office was too stupid to keep up with basic compliance rules.