Why Home Health is Going Virtual with Direct Care Staff Competency Training

Competency training for home health staff matters — but with in-home care professionals addressing so many urgent challenges in 2021, that training might not always be at the top of a home health organization’s priority list. Even when it is, executing it during the pandemic presents additional barriers.

It’s no wonder then that so many home health agencies are turning to virtual means to meet home health competency requirements for their direct care staff.

“Direct care staff competency in home health regularly becomes more of an administrative and burdensome task that lacks the focus and attention that it requires,” says Irina Gorovaya, home health consultant with Amity Healthcare Group, LLC. “This can frequently result in poor patient care outcomes and lack of confidence in clinicians. As a result, Amity Healthcare Group came up with an idea to decrease the burden by improving the competency process for home health providers.”


The idea: establish an in-person competency program in Amity’s local Colorado markets. That initiative resulted in inquiries for virtual options in light of the pandemic. Demand further increased in the ensuing months, leading the Amity team to develop a novel virtual skilled nursing competency program.

At this time, Amity is offering virtual skilled nursing competencies and will be launching virtual competencies for home health therapists (physical, occupational and speech) and social workers in the next six months[1] [IG2] . Here is a look at how Amity is helping agencies bring top training methods to direct care staff in a safe, virtual format.

Overview of competency requirements


Competency requirements are varied, coming from different agencies, including Centers for Medicare & Medicaid Services (CMS), and individual states. This can create further headaches for home-based care providers, so Amity combined all the requirements in one comprehensive, efficient and structured approach.

These include:

  • Medicare/CMS
  • Accreditation Commission for Health Care (ACHC): Each agency is required to design and implement a competency assessment program based on the care and service provided for all direct care personnel. Competencies are to be conducted initially, annually and prior to providing new tasks. Validation of skills is specific to each employee’s role and responsibilities. Competencies can be provided through clinical observation, skills lab review, knowledge-based tests and case studies.
  • Community Health Accreditation Partner (CHAP): Personnel who are providing patient care or services must demonstrate competency in the performance of their original duties.
  • State requirements: A range of requirements varying from state to state.

The 3 competency challenges for home health agencies

At the surface, competency might not seem like a particularly complicated task. But considering the range of competency requirements, the range of needs for patients within the home, particularly higher-acuity patients, and the technologies needed to serve those clients, this process can become complex in a hurry.

Amity views competency as possessing three fundamental challenges:

— Organizational challenges
— Clinician challenges
— Time management challenges

Organizational challenges can mean managing higher acuity patients, for which not everyone has experience. Clinician challenges include feeling prepared for all care delivery needs, including a more complex medical equipment, such as ventilators and wounds vacs.

“It’s always a challenging situation when you arrive at the patient’s home and find yourself facing a task that you have never done before,” Gorovaya says. “So it’s important for staff to feel prepared and confident.”

Lastly, there is the time management challenge of striking a balance between delivering patient care and managing administrative work and documentation.

Amity’s approach — including live demonstrations

When Amity transitioned its program from in-person to virtual, the company still wanted to maintain the same standard of service to providers. The program includes live instruction with clinical educators, with lessons in both theoretical information and hands-on, skills evaluation, and knowledge validation exam.

The program also mixes different teaching modes, with reading, lecture and video formats that focus on documentation, care planning, comprehensive assessments, patient education and patient care issues. The question arose, of course, as to how competency training would be completed virtually when some of it required the evaluation of the aforementioned hands-on skills.

“We solved this by creating a kit that gets mailed to the individual with all of the instructions and case scenarios to demonstrate certain skills,” Gorovaya says. “We were able to develop multiple skills that the clinician can do, and return the demonstration to the clinical instructor in a virtual manner.”

Upon completion of the Amity’s skilled nursing virtual competency, participants will be awarded continued education units. Participant’s employer will also receive a copy of the certificate, as well as the competency assessment and exam results, as evidence of compliance with the competency requirements until the next annual competency is due.

Final benefits

To Gorovaya, the difference between Amity’s virtual training and simply watching existing YouTube videos is Amity’s structured approach and support. Participants can develop and learn new skills under the guidance of an experienced clinical educator. In addition, participants also feel that their home health agency is investing in their continued growth and education.

“Here at Amity, we are trying to provide a simple, compliant, and structured way to meet home health competency requirements.”

To learn more about how your agency can access Amity virtual competency training, please visit www.amityhealthcaregroup.com.

Companies featured in this article: