Home care agencies must ensure their caregivers meet all regional, state, and federal regulatory guidelines. However, with caregivers working in client homes throughout a large area and not coming into the office daily, keeping up with caregiver compliance issues can seem nearly impossible.
If you are struggling with caregiver compliance issues, you aren’t alone. Many home care owners are in the same boat. We’ve compiled the most common caregiver compliance issues we see across the industry, as well as how exceptional agencies are leveraging technology to solve these problems for good.
Why Compliance Matters
Caregiver compliance matters for all home care agencies, and for a variety of reasons. Without proper compliance, agencies risk:
- Decreased revenue from CMS reimbursement
- Accruing fines from state and federal regulatory boards
- Decreased reputation throughout the local community, leading to fewer professional referrals and fewer clients
- Increased strain on caregivers who are currently in compliance, leading to compassion fatigue and retention issues
- Paying more money for expiration, renewal, or late fees
While caregiver compliance regulations vary from state to state, the majority of home care agencies operating across America are bound by some type of regulatory standards. Maintaining compliance ensures your agency receives insurance and CMS reimbursement, as well as securing your position as a leader in your area.
Issue #1: No System for Managing Certification Expirations
Home care agencies employ caregivers touting a variety of certifications and licenses, each with a different expiration or renewal date. While caregivers and nurses should be responsible for renewing their own certifications, it is common for busy professionals to forget when their certification is almost expired. Beyond professional certifications and licenses, caregivers also need to have updated physicals, vaccines, and TB tests in order to remain in compliance and able to safely give care to clients.
Some home care agencies try to manage expirations and renewals by tracking them in HR files or an analog calendar system. This tactic can be effective, but it requires a manager with an eye for detail and the time to inform caregivers that their renewal date is arriving in the next few months. When you add in the complications that arrive with new employees starting weekly and using a PRN pool, agency leaders simply find it too difficult to manage everyone’s certification requirements and renewals.
Technology can play a part in solving the certification and license issues. Try upgrading your HR files and using a digital calendar system to automate the process. It will take some time to load in renewal dates into your calendar’s timeline, but once entered, you can receive notifications when it is time to remind your caregivers to bring in their updated information.
Issue #2: No Consistent Training Plan or Documentation
Ongoing training is a hallmark of most caregiver regulations, and most agencies struggle to find a way to gather employees for required training throughout the year. Since caregivers and nurses are not in the home care office consistently, like hospital or skilled care counterparts, it makes it difficult to find a time when the whole team can get together to learn more about a specific training topic.
Most home care agencies end up scrambling to schedule training towards the end of the calendar year in order to stay compliant. Unfortunately, this time of year is especially busy for caregivers and clients, making it even more difficult to get every staff member to attend educational opportunities.
Exceptional home care agencies are choosing to use online training solutions to ensure their caregivers are staying compliant, as well as making sure everyone gets the same reliable information from a trusted source. Your agency can use online training as well, either by offering a learning platform for caregivers to use individually or by watching training in larger groups during your monthly staff meetings. Choose to work with a platform that is easy to use and that offers tests at the end of each module so that caregivers can demonstrate understanding.
Issue #3: High Turnover Leads to Confusion
Caregivers need to maintain their professional certifications, medical check-ups, and training in order to remain compliant. With most home care agencies struggling with high caregiver turnover rates, it is no surprise that this revolving door of caregivers can make tracking compliance especially difficult. When you factor in a large PRN pool or part-time staff members who pick up fewer than one shift per week, things get even more complicated.
While you might not be able to fight high turnover rates, your agency can find digital solutions to make managing a large pool of employees easier. Try upgrading HR files to digital versions that make finding and tracking certifications, checkups, and training easier. Shifting to digital can also give leaders the opportunity to check compliance from anywhere, not just from the office HR filing cabinet.
Issue #4: Poor Inter-Agency Communication
Perhaps the biggest culprit for caregiver non-compliance is poor communication between caregivers and the office staff. Whether it is to remind a caregiver to update their TB test next month or for a caregiver to bring in a copy of their renewed certificate, effective communication is critical.
Even the most veteran home care agencies can struggle with communication, especially if there are not policies and procedures outlining the process. Language barriers can also cause communication issues, further complicating the situation.
To manage this difficult issue, many home care agencies are moving communication to specialized apps, as most caregivers and office staff have some type of smartphone. These apps make communication much easier for everyone, especially since caregivers are often working when office staff are not. Apps offer real-time communication via text, email, or voicemail while still meeting HIPAA confidentiality and privacy guidelines. Most apps also allow document uploading and transfers, making it easy for caregivers to send along renewed certificates or testing confirmation directly to the office with a few button taps on their phone.
Issue #5: No Streamlined Documentation
Finally, caregiver compliance isn’t just about certificates, licenses, TB tests, and training. It’s also about making sure documentation accurately reflects the care happening inside the client home. Most home care agencies find caregiver documentation is either not timely, not accurate, or not reflective enough of what is happening during a shift.
Inaccurate or incomplete documentation can lead to more than just noncompliance. It can also lead to:
- Decreased reimbursement rates through insurance companies or CMS
- Poor or compromised patient care because caregivers cannot (or do not) access an updated care plan
- Inability for office leaders to effectively schedule care or communicate with family members
Technology can step in here as well, making documentation easy via an app. Today’s caregiver apps are easy to use, and the office staff can update a care plan or instruction quickly and in real-time. Further, apps are a secured place to store care plans, documentation, and other confidential information about current patients.
Next Steps for Your Agency
Compliance is not something home care agencies can simply ignore, no matter how overwhelming it may seem. Your agency’s journey to compliance begins with a thorough, comprehensive, and honest audit of your employee and patient files. While auditing, begin with your employee files and check for:
- Updated certifications or licenses (numbers or copies)
- Current vaccine and TB test results
- Current health check-up
- Training log for past 12 months (compare to your state’s list of required yearly topics)
- Dementia specific training completion certificate (if required by your state)
Next, audit your patient files. Look for:
- Updated care plans
- Current assessments
- Daily documentation for care tasks
- Thorough emergency and incident reports
Once you are able to see how your agency is doing in terms of your state and federal regulations, it is time to begin setting up the practices and technology that will be the foundation of your compliance plan moving forward.
If you are searching for a technology solution that will make compliance much easier, start by investigating comprehensive platforms. You can find a platform that will streamline communication, compliance, and documentation for your entire agency. As you research potential platforms, make sure it includes an easy to use app that caregivers and leaders can download. Not only are apps convenient, they lend themselves quite well to a home care workforce that is spread throughout a neighborhood or town. Make sure you find an app that is easy to use and that makes client documentation easy to update.
Finally, consider choosing a platform for your agency that doesn’t just stop with documentation or communication. For example, Medflyt, a comprehensive home care management platform, offers compliance tools in addition to dozens of other features related to online training, caregiver staffing, remote onboarding, and RN documentation.
Technology offers home care agencies an effective solution for managing the daily responsibilities of compliance. Don’t miss out on the chance to give your agency an easier way to stay within state and federal guidelines.
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