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NewsDay Tuesday: The Effect of Home Healthcare Regulations on Home Care Agencies

Author: Allen Wilson

Recent healthcare regulations have affected home care agencies, particularly with regard to ensuring the confidentiality of patient records and payment levels of home care workers. Now more than ever, agencies have to make sure they comply with the latest rules while keeping their companies viable and meeting the needs of their in-need-of-care clients. Safeguarding that vision means that agencies are most likely going to have to embrace all that the modern world of healthcare provisions have to offer, including features such as mobile health devices, electronic medical records and affiliated software.

HIPAA Compliance

In September 2013, all home healthcare agencies had to comply with new Health Insurance Portability and Accountability Act (HIPAA) provisions[i]. This means that agencies have to strictly protect patients’ health information, not only within their own records but in the sharing of information with business associates such as contractors and subcontractors, which includes home health aides and other individuals contracted by agencies. If contracts are terminated, protected health information (PHI) needs to be destroyed, and audits checking on HIPAA compliance can be carried out regularly by the Office for Civil Rights (OCR)[ii].

In addition, the Health Information Technology for Economic and Clinical Health Act (HITECH) covers the use of electronic equipment for the recording and storing of PHI. These electronic medical records (EMR) are subject to various rules and regulations, ensuring their security. Mobile health, or mHealth, is an up-and-coming method of recording information during visits to patients’ homes by healthcare agency staff.

It’s not easy to keep up with all the new healthcare regulations without adding extra staff on the payroll and increasing administrative paperwork to an alarming degree. Home healthcare software, such as that supplied by Axxess, enables home care agencies to easily be HITECH and HIPAA compliant, and the data is securely stored in cloud-based centers that agencies can access at any time and from any location with secure messaging facilities.

Wage Regulations

September 2013 also saw the approval by the White House of new federal regulations regarding minimum wages and overtime protections for home health workers, including those employed by home care agencies.[iii] The rule will be effective Jan. 1, 2015, and will, according to the US Department of Labor, affect nearly two million direct care workers. This figure will continue to grow as the baby boomer population (born between mid-1946 and mid-1964) ages. An AARP paper shows that while the caregiver support ratio in 2010 was seven potential caregivers for every person in the over 80 age group, this ratio would be 4:1 by 2030, when the majority of baby boomers hit the 80-year-old mark.[iv]

Home care agencies need to make sure that they keep their operations economically viable, and this means improving patient outcomes, increasing revenue and decreasing costs. Inefficient methods of care compromise patient safety and satisfaction, and home care software is one of the best ways of ensuring that caregivers are able to focus on what they do best – care for patients. Agencies that use Axxess software give their staff the ability to access patient education and medication guides, formulate graphs that track patient progress and pick up inconsistencies in clinical documentation. In addition, Axxess software facilitates efficient billing processes and decreases administrative costs with streamlined and effective procedures.

State Rules

More and more US states are putting rules in place regarding the operations of home care agencies. For example, both California and Texas require agencies not only to be licensed but also to perform background checks on all staff, provide continuing education and training, and apply for and receive accreditation from the Community Health Accreditation Program (CHAP), Joint Commission and Accreditation Commission for Health Care (ACHA).[v] Home healthcare software programs help home care agencies meet these requirements as all documentation is accurately recorded and easily accessible.

Embracing Change

Home healthcare is in the midst of revolutionary change due to an increase in the numbers of people needing home care, changes in federal and state healthcare regulations, and the availability of electronic devices and software that may be used to facilitate and improve services. Home care agencies, in order to keep up to date with issues such as HIPAA compliance, minimum wage regulations and other rules, need to look for ways to remain viable.


[i] National Association for Home Care and Hospice, HIPAA Compliance Reminder.

[ii] US Department of Health & Human Services, Office for Civil Rights.

[iii] US Department of Labor, Minimum wage, overtime protections extended to direct care workers by US Labor Department.

[iv] AARP Public Policy Institute, The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers.

[v] Texas Department of Aging and Disabilities Services, How to become a licensed HCSSA provider.

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