As an entrepreneur, it is important to understand home health care laws and regulations in order to ensure your business is compliant. In this article, we cover common laws and regulations that impact private duty home health care agencies.
Importance of Following Home Health Care Laws and Regulations
It’s important to follow home health care laws and regulations to protect both patients and home health care agencies. By following these laws, home health care agencies can avoid costly penalties and ensure they are providing the best possible care for their patients.
Your goal is always to ensure your clients trust your agency with proper care. After all, patients who receive home health care services have a right to expect that the agency providing their care is following all applicable laws and regulations.
Let’s dive in.
Private Duty Home Health Care Agency Licensing
Most states require home health care agencies to be licensed in order to operate. The licensing process varies from state to state, but generally includes submitting an application, paying a fee, and passing a background check.
Typical licensing requirements are as follows:
- Agencies must have a designated administrator who is responsible for the overall operation of the agency
- The owner of the agency must pass a criminal background check and be fingerprinted
- The owner of the agency must submit all documentation with a fee
- The owner or administrator must have a tuberculosis test and complete yearly training
- Agencies must maintain liability insurance
- Agencies must undergo an administrative review (wait times are 4 to 6 months in some states)
- In some states, home health care agencies may also be required to have a surety bond
- In some states, the state board will make unannounced on-site visits to inspect the premises
- In some states, the agency owner may apply for a “Waiver for Medicaid” during the application phase.
The home health care company must obtain the proper licensing and permits and so do the staff members. For example, home health aides must have a certification in most states.
Safety Guidelines for Home Health Care Agencies
All home health care agencies must follow safety guidelines set forth by the Centers for Medicare and Medicaid Services (CMS). These guidelines protect both patients and home health care staff. Agencies must follow safety guidelines set forth by state and federal law. These guidelines cover a range of topics, including infection control, fire safety, and disaster preparedness.
Some states also require home health care agencies to complete regular safety inspections.
OSHA also sets down guidelines for staff. For example, they must take regular breaks from work. Furthermore, home health care agencies must provide their staff with the proper Personal Protective Equipment (PPE).
Staffing and Payment Regulations
Private duty home health care agencies must follow state and federal regulations regarding staffing levels and pay rates. For example, the Fair Labor Standards Act (FLSA) sets minimum wage and overtime pay standards. In general, home health care workers must be paid at least the minimum wage for all hours worked.
In addition, home health care agencies must follow state laws regarding employee classification. In some states, home health care workers must be classified as employees, while in others they may be classified as independent contractors.
Finally, home health care agencies must comply with wage garnishment laws. This means that they cannot withhold wages from employees to pay for debts or other obligations.
Medicare and Medicaid Services Provider
If your home health care agency provides care to Medicare or Medicaid patients, you must meet additional regulations. For example, you must be accredited by an approved organization. In addition, you must have a written policy and procedure manual that meets the standards of Medicare.
You must also follow Medicare’s guidelines for billing and claims. For example, you can only bill for services that are medically necessary and homebound patients must receive care from a licensed professional.
Private duty home health care agencies must follow a variety of state and federal laws and regulations. These laws and regulations protect both patients and home health care staff. By following these laws and regulations, home health care agencies can avoid costly penalties and ensure they are providing the best possible care for their patients.