The Complete Home Health Agency Compliance Checklist

The healthcare industry must follow many regulations to protect patients and promote ethical behavior, and the consequences of non-compliance are costly. Completing regular home health agency compliance checklists and compliance audits prevents unnecessary business disruption. 

The Importance of Compliance in Home Health Agencies 

Compliance with regulations is mandatory and can make the difference between operating and shuttering your business. Non-compliance is a significant risk to patient safety and leaves your agency vulnerable to legal action, financial losses, reputation damage, and license revocation.

A robust compliance program prevents unethical and illegal activities and provides clear expectations, standards, and consequences for staff. It also ensures health providers and care workers deliver efficient, consistent, and quality health care. The result is greater transparency and trust, cost savings, and risk reduction.

Essential Components of a Home Health Compliance Program 

An effective home health compliance program focuses on health regulations, patient well-being, and health services outcomes. The foundational component is a set of written guidelines that provide a roadmap for ethical and sound decision-making. These include a code of conduct, policies, procedures, and response and disciplinary protocols.

The next element is education, training, and active monitoring. Staff must understand common home health compliance issues and how to prevent them from occurring. However, communication is also essential. 

Healthcare providers, staff, patients, families, and other care agencies need a point of contact for reporting concerns. An open-door policy is essential to ensure staff feel heard and promotes transparency and ethics in the workplace. 

Finally, health technology solutions are essential in monitoring a high volume of documentation and interactions. Audit logs provide a detailed activity trail of compliance across medical care, privacy, and reporting, including: 

  • Record updates
  • File access
  • Physician orders
  • Patient care 

How to Navigate Regulatory Requirements

The first step to navigating regulations is understanding your requirements. Then, implement daily practices, software, and other tools to streamline your compliance. 

Medicare and Medicaid Compliance Regulations

Medicare and Medicaid have strict patient eligibility requirements and regulations for home health agencies. Home care services must be medically necessary, ordered, and certified by a physician. 

These orders must include detailed health plans outlining the frequency and type of services needed. The supervising physician reviews these plans periodically, and the agency must incorporate them into the patient’s permanent record. 

Health technology solutions and referral management software provide a central location to manage patient intake and attach patient documents to electronic health records. Automatically track physician orders and ensure you collect the necessary signatures and certifications before care begins.  

HIPAA Compliance for Patient Privacy

The HIPAA privacy rule stipulates that healthcare providers and clinics must protect all identifying health information from unauthorized access or disclosure. These include patient health history, type of health care, demographic data on health forms, and payment history.

Agencies and providers can disclose patient information without consent when required for healthcare operations, treatment, and payment, or public benefit activities, research, or public healthcare operations. In all other cases, agencies must protect data and obtain consent from the individual before disclosure. 

In the current digital landscape, that means using systems, devices, and software with data encryption, HIPAA-compliant electronic forms, user access control, and audit logs. Health software with native secure messaging is best for communicating with peers in the health clinic or field. 

Health workers should avoid discussing patient information via text or email and share only via HIPAA-compliant apps. Additionally, vigilance with mobile devices is essential to prevent unauthorized access. 

OASIS Assessment Compliance for Quality Reporting

The Outcome and Assessment Information Set (OASIS) is data home health agencies must collect and report on all adult Medicare patients, except those receiving maternity care or housekeeping services only. These data track patient outcomes, demonstrating your agency’s care quality and performance.

Physicians must complete a comprehensive patient assessment every 60 days, within 48 hours of returning home after a hospital admission lasting more than 24 hours, and at discharge from home health care. Care agencies that don’t report OASIS data will receive a costly 2% payment decrease.

Health software with reporting and document management functions simplifies the reporting process. Collect and manage essential assessment data and automatically attach them to records for easy submission.

Stay Compliant With a Powerful Document Management Software

WorldView is an all-in-one document hub designed for home health agencies. Securely share and store critical documents with physician order tracking, referral management, automated document processing, and mobile solutions. 

Gain visibility into outstanding orders and referrals, automatically process and update records, and streamline team communication with HIPAA-compliant messaging. WorldView’s solutions increase efficiency, making administrative and regulatory tasks easier for staff. Spend less time on data entry and more time with patients. Learn more

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