At her home healthcare agency in the District, Venus Ray quizzes 65 job applicants assembled before her: Can they cook? Do they know the right way to wash their hands? Can they safely transfer patients into wheelchairs? If they give wrong answers, speak English poorly or -- God forbid -- forget to turn off their cellphones, she asks them to leave. By the end of the session, Ray has dismissed 42 of the applicants, almost two-thirds, even though she's in dire need of employees. The demand for workers by Ray's company mirrors national trends and is fueled in part by stepped-up efforts to keep seniors and the disabled out of nursing homes. The growth is likely to pick up in coming years as the new federal health law tries to reduce hospital readmissions and expands programs such as Money Follows the Person, which encourages Medicaid recipients to receive care at home. But experts warn that a shortage of qualified labor is looming. Workers often lack the training and support needed to properly care for patients, and poor working conditions lead to high turnover, experts say.