DOL plans to let agencies use the companionship and live-in exemptions again. In states whose own law requires overtime for home care workers, nothing changes. How to check yours.
State program integrity units, Medicaid Fraud Control Units, MCOs and federal contractors all audit home care claims. The findings that cost agencies most, and a prep checklist.
Provider tax limits from October 2027, state-directed payment caps from 2028 and new rate transparency rules will move Medicaid home care rates. Where to look in your state.
From January 1, 2027, many Medicaid adults 19 to 64 must show 80 hours a month of work. Paid caregiving counts. Exemptions, proof and a free hours letter template.
A living page of every state minimum wage, home care wage floor and Medicaid personal care rate change taking effect around January 1, 2027, updated monthly, with the notice deadline for private-pay rate letters.
What the One Big Beautiful Bill Act's Medicaid provisions mean for home care agencies and their caregivers: six-month eligibility redeterminations, community engagement (work) requirements that affect direct care workers who are themselves on Medicaid, and the retroactive coverage limit from January 1, 2027. With a client redetermination checklist and a caregiver guidance sheet.
Fifteen states raise their minimum wage on January 1, 2027, from Montana's $11.20 to Washington's $17.73, and New York raises its home care aide minimum. The new rates, and what each increase does to your bill rate.
From January 1, 2027, New York home care aides must be paid at least $20.00 an hour in New York City, Long Island and Westchester and $19.00 in the rest of the state, even though the general minimum wage doesn't change.
CMS-2442-F gives providers six years to put 80% of Medicaid HCBS payments into worker compensation. Here's what changes now versus what changes in 2030.
In most states, yes. Caregivers must report suspected abuse, neglect or exploitation of older or dependent adults to Adult Protective Services. What to report, how fast, and what agencies should train.
Caregivers at licensed California Home Care Organizations must register with CDSS: $35 for two years, Live Scan, TB test, 5 hours of training before client contact and 5 hours a year.
Non-medical caregivers can remind, and in many states assist, but administering medication needs a nurse or nurse delegation. Four states' rules and how to write your policy.
Most states require a criminal check before client contact, many fingerprint-based through the FBI. Five states' rules, FCRA steps, exclusion lists and rechecks.
Track every caregiver credential with an expiry date, alert at 60 and 30 days, and block assignments when something lapses. Surveyors check the visit date.
There is no federal training rule for non-medical caregivers. States set hours from 5 to 75. Six states compared, with sources, plus what to document for a survey.
Most licensing states require TB screening before a caregiver's first visit. CDC dropped routine annual tests in 2019; states still set their own intervals.
Yes. Since January 1, 2015, agencies cannot use the companionship or live-in exemptions, so every caregiver gets time-and-a-half after 40 hours. Who is covered, what counts, and the 2025 proposal to change it.
In most states, yes. How the license depends on the services you offer, what six states actually require, what applications ask for, and how to check your state.
A HIPAA checklist for home care agencies: risk analysis, policies, training, access, devices, BAAs, breach response, six-year records, with the rule for each.
HIPAA applies if you send electronic claims, not because of the care you give. How to tell if you're a covered entity, what it requires, and what to do either way.
Since 2015, home care agencies must pay caregivers overtime after 40 hours in a workweek. How the rule works, what counts as hours worked, and which states add daily overtime.
Most licensing states require written home care policies. The 16 sections to include, what Texas, Washington and Pennsylvania require, and how to review them.
Payroll 3 years, time records 2, HIPAA documentation 6, tax records 4, and client and Medicaid records 6 to 10 years by state. One schedule covers them all.
Surveyors check client files, caregiver files, visit records, incident logs and policies against your state's rules. Audit a sample of files, fix gaps, and make records fast to pull.
When an agency can exclude sleep and meal time from a live-in or 24-hour shift, what the written agreement must say, and what happens when sleep is interrupted.
Step-by-step math for the Medicaid HCBS 80/20 rule at 42 CFR 441.302(k): what counts as compensation, what is excluded, a worked example, and what to do if you are below 80%.
Hours for every client you assign a caregiver add up in one workweek. Over 40 is overtime at a weighted-average rate. How to calculate it and when a private family's hours count.
No federal paid sick leave law, but many states require it for hourly caregivers. Typical accrual is 1 hour per 30 worked with a 40 to 56 hour cap. State table inside.
AI can draft caregiver visit notes under HIPAA if the vendor signs a business associate agreement, you limit what goes in, and the caregiver reviews and signs every note.
Most states do not require a surety bond for a home care license. Where one is required, by licensing or Medicaid, the amounts run from $5,000 to $50,000 and up.
A risk list, clients ranked by how long they can go without a visit, contact trees, staffing when roads close, and remote access to schedules, records and payroll.
Every recurring deadline in one place: payroll tax filings, W-2s, OSHA posting, license and credential renewals, exclusion checks and record retention.
California, Alaska, Nevada and Colorado require overtime after a set number of hours in a day. What each rule says, with sources, and what it does to 10-, 12- and 24-hour shifts.