Home health care agencies (HHA) provide medical services to individuals recovering in their homes from chronic illnesses or post-acute conditions. Approximately 7.6 million people in the United States are served by HHAs each year. In order to ensure highest quality medical care, HHAs are regulated by the federal Center for Medicare and Medicaid Services (CMS), state departments of health, as well as local regulations and requirements. HHAs must comply with a long list of regulations in order to perform legally and continue to receive payments from Medicare and insurance companies.
Regulations governing HHAs cover all aspects of operation. These include, but are not limited to, ownership, licensure, submission of documents, personnel and staffing, policy and procedure manual, written agreements, reportable events, notices, pharmacy and supplies, nursing services, rehabilitation services, social work services, dietary counseling services, infection prevention and control, patient’s rights, and quality assurance. Below are highlighted some of the important requirements for patient acceptance, medical services and clinical records.
Patient Acceptance: For Medicare services, HHAs can only treat patients who meet the eligibility criteria as defined by CMS. The patients must be recovering from post-acute conditions following discharge from a hospital. A physician's order for home care must be available. A plan of care must be established by the clinician, and the patient’s progress must be routinely reviewed and recorded for quality and safety compliance.
Medical Services: Clinicians and health professionals employed by the HHA must have active, discipline-free licenses in the respective states. For example, nursing services can be provided by a registered nurse, or by a licensed practical nurse under the supervision of a registered nurse. Clinical supervision is a necessity to assure high standards of medical service. Moreover, health care personnel, who are selected for providing physical or occupational therapy, speech therapy, medical social services or health aide services, must comply with predefined CMS and state regulations.
Clinical Records: Maintaining documentations related to patient care is another key priority for HHAs. These records must be in accordance with accepted professional standards, and accurately document relevant information pertaining to the patient served. Medical records need to be retained for a defined amount of time from patient discharge. Furthermore, HHAs must handle all clinical records as privileged and confidential information.
A Step in the Right Direction: The efficient operation of a HHA depends on its capacity to deliver high quality care within the framework of regulations. In this regard, the development and implementation of highly sophisticated but convenient home health software can immensely benefit the way HHAs operate. These software products are designed to automate many aspects of the operation, which includes point of care, Medicare eligibility verification, medical billing, scheduling, OASIS analysis, human resources, in-service training videos, drug-drug/allergy interaction checks and remittance posting.
For example, HHAs can greatly benefit from the Electronic Visit Verification (EVV) feature of home health care software. This system allows the medical travelling aide to maintain compliance by recording their visit real-time at the point of care. Details, such as start and end times, and services provided, can be electronically documented through the EVV. For the medical personnel providing care, EVV cuts out the unnecessary time spent traveling back and forth from office and the efforts required to transcribe the medical visit.
Therefore, as home health care agencies look for ways to enhance their operational efficiency, home health software is the need of the time. Not only are these software products effective, convenient and cost-effective, they help the HHA maintain compliance with the myriad regulations for smooth and accurate operation.
