Keeping up with new home care regulations

With over 12,600 home care agencies servicing more than 5 million Medicare and Medicaid beneficiaries nationwide, it is important that there’s visibility into the services provided to ensure plan of care compliance. (source1) The 21st Century Cures Act, signed into law December 13, 2016, requires all Medicaid providers to use Electronic Visit Verification (EVV) for Personal and Home Health Care services. This mandate is a significant step in helping the home care industry become more efficient and transparent, while saving costs and improving patient care.

Like the 21st Century Cures Act, there are other rules and regulations being put into place to help the growth and success of the home care industry. It is important that we help the home care industry because the cost of care at a hospital or facility is so much higher than at home. For example, treatment cost for acute care hospital is around $3,250 per day, whereas home care cost is approximately $50.00 per day. (Source 2)

On January 13, 2017, Centers for Medicare & Medicaid Services (CMS) issued its final rule 3819-F outlining the Medicare and Medicaid Conditions of Participation (CoP) for home health agencies. There are now specific requirements that an agency must meet. (Source 3) The main purpose of these rules is to ensure the patient is receiving the highest quality of care from its home care agency.

The preferred shift towards home care will demand a larger workforce to help fulfill these services. With the potential increase in job opportunities, agencies need to be prepared for onboarding, training, and monitoring of new staff. Home Care Agencies are faced with several challenges in today’s market; however, having procedures in place can help overcome these obstacles and allow them to focus on the patients’ care.

Here are some key areas to focus on:

  • Communication: ongoing among the care coordinators, care takers, and the patient. Having a clearly defined plan of care in place that has been agreed upon and signed off by the physician, agency, and the patient.
  • Documentation and tracking: the care taker is responsible for documenting the services he/she has provided, and the agency is responsible for making sure those services were completed in accordance with the care plan.
  • Reimbursement: the agency must be diligent in submitting accurate and timely claims to the payer in order to get paid without denials or penalties.
  • Follow up: with the patient and other constituents in the care network once the services are completed to ensure the goals have been bet, and all parties are satisfied.

Running an agency can be difficult, especially if you do not have the right solutions in place to help manage your daily operations. By utilizing software, you can easily maintain your key operations, such as scheduling, documentation, compliance, electronic medical records, billing, payroll, and reporting. Choosing the right software company doesn’t have to be hard. There are many options available to you, but make sure you know exactly what you’re looking for, don’t be afraid to ask questions, view demonstrations to make sure it fits your needs, and compare services. Here at Sandata, we’ve been proving home care solutions to the industry for over 35 years. It’s our goal is to ensure our solutions deliver benefits to all the constituents in the home care industry, including Payers, Providers, and the Participants in the home.

Written by: Michelle Spinelli is the Sales Coordinator at Sandata Technologies, LLC

2016 in Retrospect – How Was Your Revenue and Cash Flow Performance?

Many of us step back at this time of year to reflect on how our organization performed, and to think about our goals for next year.  Hopefully, we have at this point at least made a pass at next year’s budget.  That exercise often uses the current year as a baseline, and then we jump off from there.  The question in our minds is naturally, did we do as well as we could?  How can we do better?

With the thin margins and ever-increasing costs in our business, revenue and cash flow are especially critical.    So let me ask you, is your revenue cycle performing at its optimum?  Are you getting paid as quickly and completely as you should?

In home care, speed and completeness of payment depends on how quickly caregivers report their time and then on your speed to get the claims out the door, correctly.

From an executive vantage point, you can’t determine if your processes are working correctly unless they’re being measured.  Just like in medical and automotive diagnostics, having key metrics is crucial.  When I think it through, I come up with 17 different metrics and studies that would provide the data needed to “swim upstream” through your revenue cycle from cash application and denial resolution, to intake, to identify and address any weak points.

There are two approaches you can take – a) identify an internal or external resource to pull all the data together, creating a really comprehensive look at your entire revenue cycle,  or b) concentrate on a few metrics, identify and address anything that needs attention, and expand from there.

If you opt for (b), I would pull together these six to start:

  • Revenue vs cash receipts vs cash applied by month for the past 12 months
  • Comparative aging trend by bucket for the past 6 months
  • Days Sales Outstanding by Payer
  • Dollars billed vs collected 120 days after billing
  • Unbilled (held) claims
  • Unverified hours (if using electronic visit verification)

Investigating anomalies in these figures will lead you to a myriad of opportunities for improvement in your revenue cycle.  Make changes, then run new figures.  Ensure that you’re getting updated figures reported to you regularly so your organization stays on track.  Then expand to new metrics.

If you’re an operationally focused person like I am, you have fun “pulling levers” and watching the results.  This is another opportunity to do that in an area of your organization that is as important as clinical quality and compliance.

If you have any questions, please feel free to reach out to me.  I’d also love to hear what you did and how it turned out.  Happy hunting!


phil  Written by: Phil Feldman, Vice President at Revenue Management Solutions, which provides revenue cycle outsourcing and support services to non-Medicare home health agencies.

The challenge of hiring and retaining home health caregivers

There is no doubt that having qualified, hardworking and dedicated employees is key to operating a successful business. Recruiting and maintaining staff in the home health care industry has been a real struggle, resulting in a high turnover rate. (Source 1) Interestingly, since last year the Home Health Care sector gained 64,700 jobs, representing a growth rate of 4.8%. (Source 2)

So you may ask yourself, why is it so difficult to hire and keep your staff when there is a high demand for home care positions? Well it’s just that: there are thousands of Home Care Agencies across the United States, so prospective employees will look for the agency that offers better incentives and tools for success.

Home Health Caregivers consist of both clinical and non-clinical workers, including aides and nurses. Caregivers can see multiple patients a day or week and not only do caregivers assist patients with their daily activities, but they also need to monitor and document the visit/interaction. Think about how challenging that can be for the caregiver, especially if they are manually documenting patient information on paper in the home. It is time consuming, can lead to errors, and takes time and attention away from the patient.

How can you make your agency more appealing to employees?  Here are some tips:

  • Offer tools that can help ease their documentation work load in order to allow more time to care for the patient
  • Take the time to match your caregivers and clients based on their needs and criteria
  • Follow up on a monthly basis with a survey or call that inquires a few basic questions on current processes and suggestions

Using a Home Care management software solution can help tie all your key operational processes together.  A solution such as Sandata’s Santrax® Agency Management can help with Scheduling, Documentation, Compliance Management, Electronic Medical Records, Billing Functions, Payroll, Reporting and Exporting in one easy to use system.

It incorporates Electronic Visit Verification™ (EVV™) that uses ANI technology to validate telephone calls to log in and log out, recording time and location in real-time.

Santrax® Point-of-Care (SPoC), powered by DeVero, works on any mobile device, enabling remote workforces to collect clinical and non-clinical data and access patient information at the point of care. In addition, it helps reduce clinical inconsistencies and documentation errors while improving communication, eliminating costs associated with paper forms and printed charts, and streamlines the process of assessment completion and submission.

If you’re interested in learning more about Sandata solutions, please contact us at 800-544-7263 or visit to schedule a free demo.

Written by: Michelle Spinelli is the Sales Effectiveness Coordinator at Sandata Technologies, LLC

Point-of-Care (PoC): Is it the right move for your agency?

The right move…what does that mean? Let’s explore some scenarios. Do your clinicians and field staff currently use paper forms and assessments as a means of documentation for patient visits? If so, are you struggling with documentation accuracy and timely submissions? If you answered yes, you might want to start looking for a solution that integrates with your current agency management software.

Home Care providers are implementing technology-based solutions to help increase the efficiency of those delivering care in the home setting and to ensure accurate and compliant data exchange of patient information. Improving patient outcomes and satisfaction is the primary goal for home care providers. By utilizing a PoC solution, clinicians have the tools they need to best assess the patient in the field quickly and easily.

This new technology is simply a different way of filling out the regular forms; it is easier and faster than spending hours filling out paper work and physically submitting them to the office. The clinicians will now have access to patient information in an organized electronic system.

Point of Care workflows are put in place to enhance the communication between all individuals in the patient process. Eliminating paper not only frees up more time for the clinician to focus on the patient, but it also allows for data to flow back to the billing and financial systems automatically. This improvement in the operational process can help prevent data entry errors and claim denials or takebacks.

Some things you should keep in mind when looking for a Point-of-care solution:

  1. Find a solution that is easy to use for field and office staff
  2. The solution should include industry-standard forms and the ability to customize forms
  3. The solution should include the ability to report on any field on any form
  4. The solution should include the ability to upload images and videos to the patients’ charts
  5. The ability to access the solution from any device connected to the Internet
  6. Electronic signatures for Physicians, Staff and Clients
  7. HIPAA compliance and a certified, secured data solution

The rollout and training process should be seamless and not interrupt the delivery of care. Your PoC solution is simply replacing the paper assessments with an electronic version that will flow back to your billing and financial systems. All your clinician will need is a device with Internet to access the patient information. No paper, no pens, no old charts to refer back to, it’s all available via the Internet!

Written by: Michelle Spinelli is the Sales Effectiveness Coordinator at Sandata Technologies, LLC

Family Caregiving: Challenging, yet Gratifying

There are several forms of caregiving ranging from formal to informal. If you are caring for a parent, child, or sibling who is sick or disabled, you are still providing caregiving services. Many family members do not consider themselves as caretakers when they are helping a loved one. The position can be short term or long term, but either way, the demand for care can become overwhelming and stressful for the caregiver.

According to the Family Caregiver Alliance, about 44 million Americans provide 37 billion hours of unpaid “informal” care each year for adult family members and friends with chronic illnesses or conditions that prevent them from handling daily activities. 75% of caregiving support in the United States is provided particularly by women.

Informal caregiving has an effect on our economy. Just in 2013 alone, the economic value of unpaid informal caregiving was estimated at $470 billion. Source 1 When caretakers are helping family, they typically cut back on work hours, use personal or vacation days, or leave their jobs completely. This can cause financial strains due to lost wages, loss of health insurance, and possibly even loss of social security benefits. When caregivers suffer, they can have a difficult time dealing with the stress and accountability.

On the flip side, it is rewarding to share quality time with a loved one and to assist them in the daily activities they can no longer perform themselves. These activities may include bathing, managing medications or preparing meals. You never want to give up when one is in need; however there are other options to ease the stress on informal caregivers.

Helpful tips on managing caregiver responsibility:

  1. Understand the patient’s condition; use all your resources to learn as much as you can about the disease at all its stages. Speak with the physician to make sure you understand the care plan and what to expect if it progresses. Being proactive can help you manage and prepare.
  2. Encourage the patient to stay strong and mindful, they should not become completely dependent on you. Make sure they understand their current condition and the importance of following the plan of care.
  3. Know your limits, you are only human, you can’t do everything on your own. As much as you would like to be there all the time, it is probably not possible. You need to make sure you are taking care of yourself. If you’re not in the right state of mind or health, it will become a disservice to the patient.
  4. Seek help from others. It’s ok to ask for help, you can reach out to other family members or seek professional care. Homecare agencies have trained staff that can help provide services in the patient’s home. Depending on the kind of services (medical or non-medical), the appropriate staff will be assigned.

Family caregivers should to make the best of their situation. Unfortunately it’s not easy, but you are not alone. Family caregiving is becoming very common. With the 65+ age group expected to double to 70 million people by 2030, family caregivers increasingly provide care for aging parents, siblings, and friends, most of whom have one or more chronic conditions and who wish to remain in their own homes and communities as they age. Source 2 Check out home care agencies near your loved one, set an appointment and see if it’s the right fit for you and your family.

Source 1:

Source 2:

Written by: Michelle Spinelli is the Sales Effectiveness Coordinator at Sandata Technologies, LLC


The rapid growth in Home Care triggers the need for innovative technology

In the United States, the healthcare market is growing rapidly due to two primary reasons: the increasing number of individuals 65 and older and the ability to live with a chronic illness longer. Therefore, there is an increased need for long term care. Home care is the preferred method for a number of reasons. The patient can remain comfortable in his or her own home. Moreover, the average daily cost to deliver home care services is $48, whereas a skilled nursing facility is $400, and a hospital is $1,835. Source1

Technology plays a big role in the home healthcare industry. Advanced tools are available to help improve efficiencies and keep costs down. The homecare network consists of 3 major constituents:

Participants: The participant is the patient and, arguably the most important constituent of the homecare network, since the participant is the individual receiving the care.

Providers: The provider is the healthcare professional or homecare agency who delivers services to participants. These services can be delivered in multiple settings, such as the patient’s home, a nursing home, a rehabilitation facility and a hospital. Providers can be chosen based on a number of factors, such as the type of care required and reputation.

Payers: The payer is the entity responsible for paying the providers to deliver services. Payers can be Public third-party payers such as Medicare, Medicaid, and the Veterans Administration, Private third-party payers such as health insurance companies and managed care plans as well as the Patient and family (out of pocket). Source 2

So, you may ask, how can technology help these constituents? The global health technologies market will grow from $3.4 billion in 2014 to $13.7 billion by 2020, according to Tractica’s latest report “Home Health Technologies.” The number of consumers taking advantage of these tools will increase more than five-fold, from 14.3 million in 2014 to 78.5 million by 2020. Source 3

There are numerous technological tools available for all of the constituents in the homecare network, such as monitoring devices, mobile health applications, and agency management software which can include the following features: scheduling, billing, payroll, and electronic time and attendance solutions. These tools enable the provider to track visits and help to ensure the proper plan of care is being delivered. Electronic time sheets reduce internal staff labor of having to track, collect, verify and enter data manually, which increases productivity. The payers can gain better visibility over operations to ensure the services are being delivered as authorized.

Technology alone can’t change the industry, but it can certainly help increase connectivity and collaboration. It is Sandata’s mission to help maximize the value of every in-home encounter, maximize the efficiency of home-care providers, and integrate payers and providers to improve care delivery.

Written by: Michelle Spinelli is the Sales Effectiveness Coordinator at Sandata Technologies, LLC

Payroll: Integrated solutions for end-to-end automation

Everyone wants to get paid, right? Right! So how can companies guarantee that its employees get paid on time and for the correct amount of time? Well, it takes both the company and employee to ensure accurate and timely payments. Employees need to do due diligence and submit time sheets on time and without any errors to ensure a smooth and quick process. On the flip side, the payroll department needs to make sure they give themselves enough time to collect, verify and input information into the payroll system. What is enough time? Well that depends on how many people are helping with the process, how many employees on the payroll, and how user-friendly the payroll system is.

Well, I don’t know about you, but I think that’s a long process and I would think there is an easier way to process payroll. And guess what, there is! Now a days’, technology has made it easy to streamline the payroll process by integrating your current payroll system with other systems, such as time and attendance and scheduling, via the web.

Helpful tips:

  • Evaluate your current process, figure out what is working and what needs to be changed. Determine how long it takes your staff to process payroll. When do time sheets need to be submitted? How are they being submitted? Are they being submitted on time? Are they accurate? Are they legible? Is your process easy or time consuming?
  • Avoid the manual process! Is payroll still being done by hand or in excel? Are papers being mailed in, faxed in, emailed, or walked into the office? Where is all this paper being stored? What happens if you lose the paper time sheet? What if you enter in the wrong information?

Top 5 Benefits of utilizing one electronic system for end-to-end automation:

  1. Increase productivity for quicker reimbursements: electronic time sheets reduce internal staff labor of having to track, collect, verify and enter data manually
  2. Easier audit process: access to reports, analytical data and ability to create data extracts
  3. Protect your agency from the risk of fraud, payment denials and penalties: validate visits in real-time and receive alerts for late and missed visits
  4. Remain compliant and up to date on Federal and State labor regulations
  5. Reduce the amount of checks: employees have options with direct deposit and debit cards

An integrated and cost effective solution for managing time and attendance and payroll is important in streamlining business processes. Just about everything we do is done on a computer, tablet, or phone, wouldn’t you agree? So it would only make sense that payroll is too. I’m excited to announce that Sandata now offers a payroll module, powered by PayPro Corporation that can help agencies increase financial compliance through end to end automation.  Check out our website for upcoming webinars on Paperless Visit Verification with Integrated Payroll.


Michelle Spinelli is the Sales Effectiveness Coordinator at Sandata Technologies, LLC