For Home Health Agencies, Streamlined Documentation Is More Important Than Ever

During a public health emergency, documentation can feel burdensome for home health agencies. But it’s also more important than ever.

The COVID-19 crisis caught many providers by surprise. Yet those that had their ducks in a row on paperwork and technology best practices are far more likely to succeed operationally in the midst of the pandemic.

Jacksonville, Florida-based Forcura — a technology company aimed at helping providers with document management — knows this as well as anyone. Business has been booming for the company ever since coronavirus took grip of the nation.


The difference between the challenges of post-acute health care providers in February compared to April are stark, Forcura CEO Craig Mandeville told Home Health Care News.

“The best way I can define it is: In February, companies were thinking, ‘[Streamlined documentation] has a great return on investment, this is definitely something that we want,’” Mandeville said. “Now, the companies are thinking, ‘Oh my gosh, this is not a want. This is a need. How fast can you get this implemented?’”

Live video services have also been in high demand, Mandeville said. With the U.S. government implementing social distancing guidelines, providers with workers operating from home need a way to communicate with each other and patients in a HIPAA-compliant manner.


Those features, which Forcura itself offers, have helped many of its clients — including some of the largest home health providers in the country — weather the COVID-19 storm that arrived at the beginning of March.

But even before the pandemic hit, the Review Choice Demonstration (RCD) and the Patient-Driven Groupings Model (PDGM) had increased providers’ need to smooth out their documentation processes. For the time being, RCD has been suspended in the states where it had taken effect.

Meanwhile, PDGM — implemented on Jan. 1 — is still the payment system that providers across the country have to abide by.

“The Centers for Medicare & Medicaid Services (CMS) has relaxed the RCD rollout,” Mandeville said. “But with PDGM … and with requests for anticipated payments (RAPs) being phased out, I would say document integration needs to be at the forefront still, no matter what. Because at the end of the day, that’s how agencies are going to get paid.”

For agencies that are cash-strapped now that visits are down due to elective surgeries being postponed, the proper paperwork being submitted is vital to keeping their heads above water.

And if the arrival of PDGM didn’t serve as a wake up call to agencies on getting their paperwork in order in the first place, the COVID-19 chaos will.

“We saw a new demo that came in from a provider, and they wanted to see how fast we could get it implemented, because they were so heavily reliant on the tools and the devices that were all stood up in their clinical back office,” Mandeville said. “This industry — it’s technologically behind. One thing that we’ve done in our organization — and we are envisioning the same for this industry — is every single one of the tools that we use in our company, they’re cloud-based. So when we went remote, it was seamless.”

For many providers in the field, that transition to a more remote-heavy work environment hasn’t been as easy.

And if they weren’t ready for this surge, it behooves them to be ready for the next one.

The coronavirus, after all, is something that providers will need to manage for the indefinite future.

“I think a lot of agencies are going to do a lot of debriefing and strategy for if and when this happens again,” Mandeville said. “[They’ll need to consider], ‘What tools, what processes and what resources need to be in place for us to operate remotely at the drop of a hat?’ A big component of that is going to be technology adoption, and even more so, technology innovation. So I think this is also going to spur more innovation among the technology companies … which will help our industry customers operate more effectively in a remote and virtual care environment.”

Right now, home health providers are receiving new information on the fly and trying to manage the best they can in real time.

“I think it really hit everyone across the eyes with a two-by-four. No one would have ever predicted this would have happened.” Mandeville said. “But I think a lot of lessons will be learned from this.”

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