Electronic Visit Verification (EVV) management is one of the most important elements of a home care agency’s operations. EVV touches every aspect of your business. While client care should be an agency’s number one priority, managing EVV should be number two.

Caregiver using the Rosemark Caregiver App for EVV Management
EVV Management should be a top priority for all home care agencies.

EVV helps agencies:

  • Make sure billing is accurate.
  • Ensure payroll is correct
  • With caregiver management and oversight
  • Stay compliant with state and federal regulations

From reviewing EVV events in a timely manner to making sure staff are properly trained on EVV tools, we’ve compiled a list of best practices for home care agencies that use EVV.

Review EVV Often

The single most important thing to keep in mind when it comes to EVV management and best practices is that EVV should be checked frequently. In a perfect world, caregivers will always clock in and out on time and an agency will never need to make any manual adjustments. But that’s just not reality.

Checking EVV should be at best an hourly task and at minimum a daily one. If agency administrators and schedulers wait too long to review EVV events, they will eventually have to dig themselves out from under a mountain of EVV that needs to be linked to the shift it belongs to.

Using EVV to Correct Shifts

When it comes to EVV management, home care agencies also need to document everything so they can adjust shifts to more accurately reflect what actually happened. The further you get away from an event, the more difficult it will be to remember why something did not happen the way it was supposed to.

Not only will it be more difficult to keep things up to date, but it will also make it more difficult to track down problems and address them in a timely fashion. The further away you get from these issues, the more difficult they will be to resolve.

For example, if a caregiver was 15 minutes late and they were 500 feet from a client’s home, by definition that caregiver is late and not on location.

But context is important. If you saw that at the moment it happened, you would call the caregiver and ask what’s going on. The caregiver might respond that they were late because Mrs. Smith never leaves her house. She was looking out the window when the caregiver arrived and said she wanted to go to the park. So the caregiver might have prioritized client care, i.e. getting Mrs. Smith out of the house and walking her to the park across the street before sitting on a bench and taking the time to clock in.

In situations like these, context is everything. If an agency waits a week after the shift to reach out to the caregiver, it’s possible that the caregiver won’t remember why they clocked in late and not on location.

Caregiver Management

Timely EVV management also helps agencies deal with bad caregiver behavior. If a caregiver is consistently clocking in and out from an unacceptable distance range, that’s something supervisors need to address sooner rather than later. If you’re not properly managing EVV on a regular basis, it makes it more difficult to find problems, address them quickly, and deal with potentially big issues with your caregivers and their inability to provide the care they were supposed to.

Timely review of EVV ensures that schedulers and administrators are aware of what’s going on in their business. It’s not that you don’t trust your caregivers. It’s not that there’s some problem you’re trying to find. In fact, it’s the opposite.

By reviewing EVV frequently, agencies are making sure caregivers are where they’re supposed to be when they’re supposed to be there. EVV helps agencies not have to worry about non-compliance.

Payor Source Doesn’t Matter When It Comes to Best Practices

Being aware of EVV and staying up to date on it as frequently and consistently as possible is the best practice for all agencies, whether they bill private pay or the Veterans Administration. When billing Medicaid, correct EVV is mandatory because it affects agency billing.

Train Office Staff on EVV Tools

Many agencies roll out new EVV tools to caregivers without realizing their office staff also need to be trained on EVV. Caregivers will likely call the office the first time they have a question or are confused about clocking in.

You have to know the product in order to diagnose the problem. If office staff don’t have the same training on EVV, they will have a difficult time providing help.

With more than 10,000 caregivers using EVV apps on any given day, software vendors cannot provide support to individual caregivers. Thus, it’s crucial that office staff are properly trained on the caregiver app so they can provide local support should issues arise.

We recommend home care agencies that are implementing EVV start off by practicing. Here are some tips:

  1. Set up a testing client
  2. Perform in-person clock in and clock out tests with your caregivers and office staff to make sure everyone at the agency fully understands how to use the caregiver app
  3. Use caregiver onboarding and in-service training as in-person opportunities to train and retrain on EVV
  4. Troubleshoot problems during training rather than starting from scratch on your go-live date. In most cases, any issues that arise are minor and office staff can provide coaching and one-on-one support to find a solution.
  5. Office staff should use the software to clock in and out daily for their shifts so they can have informed conversations with caregivers as necessary
  6. Make sure to have GPS location enabled so EVV functions correctly. If GPS location is disabled, caregivers will not be able to clock in and out for their shifts.
  7. Take an active role in understanding, training, and maintaining EVV

Be Prepared for Challenges

Implementing EVV will cause the most challenges with an agency’s caregivers. It’s a guaranteed friction point because it’s new and requires change.

EVV is designed to make sure caregivers confirm that they’re doing what they’ve been assigned to do and are on location at the correct time. This will likely be the main issue caregivers have about using EVV.

It’s important to help them understand that EVV is mandatory for the agency to be compliant with state and federal regulations. By helping them understand the importance and necessity of EVV, it can help defuse any issues before they arise.

Agency staff should be prepared to troubleshoot issues effectively. Asking the right questions will help you get a comprehensive view of the problem and find a solution more quickly. Consider asking these questions:

  • What did you experience?
  • What were you trying to do when the problem occurred?
  • Was there an error message?
  • Did you take a screenshot when it happened?

If you cannot help your caregiver with their EVV issue, providing the answers to those questions your software company will help with a more speedy resolution.

TIP: Screenshots of error messages are extremely helpful so the software provider can get a comprehensive view of what the problem might be.

Caregivers Need to Prioritize EVV

If you get buy-in from your caregivers, the EVV process will go much more smoothly. It will be like night and day.

That’s why it’s important for agency owners and administrators to do their best to explain how EVV works, that it is not an invasion of privacy, and that it’s a mandatory requirement by the state.

If your state regulations require clock ins and outs for any kind of accreditation, there is no option for them to say, “No, I won’t do this.”

In addition, your agency should want to track time worked for a variety of reasons, not just for state compliance. You need the data provided by your software to help you run your business more efficiently, run reports, and assess key performance indicators (KPIs).

If you have a caregiver who does not want to download the caregiver app onto their phone, let them know they have the option to use Telephony. It’s more time-consuming and the app is much easier to use, but if the caregiver absolutely refuses to use the app, your home care agency can always use Telephony as a back up.

There is no excuse for your caregivers not to be clocking in and out of their shift on time since they have both the caregiver app and Telephony as EVV options.

Generate Excitement Around EVV

If your agency touts the benefits of EVV to your caregivers, it will help them understand the need for using the tool and help them embrace it more fully. You can even generate excitement when you explain that paper timesheets are going away, and you’re providing a new, faster, user-friendly tool for them to use.

One of the biggest misunderstandings surrounding EVV is that it tracks caregivers wherever they go. That is simply not true. The app only takes a snapshot of the user’s location at clock in and again at clock out. The app is not built to track time in between those two events.

In fact, if it were monitoring the user’s location the entire time they were on their shift, their phone battery would drain quickly and cause problems. It would also cause a huge data management problem for the software vendor who doesn’t need to store all that data.

So in a purely technical sense, it’s almost impossible to track a caregiver 100% of the time, and software partners like Rosemark do not do that. We only take snapshots of where you were when you were clocking in and clocking out.

To Close

EVV is becoming the standard across all payor sources, including private pay. So if you have a caregiver who simply refuses to work for your agency because you require it, they will likely have a difficult time finding any agency to hire them that does not use EVV.

Rather than present EVV as a mandatory tool, get your office staff and caregivers excited about using new technology that was specifically designed to make their lives easier.