Becoming an Independent Home Health and Hospice Caregiver

Have you recently considered becoming a freelance hospice caregiver or nurse and you don’t know where to start? Are you wondering what types of certifications are required to become an independent home health and hospice caregiver? Are you looking to cut out the middleman and contract directly with your home health and hospice patients?

The Home Health and Hospice industry is ever-growing - especially with the baby boomers starting to retire and the increase of life-ending diseases and conditions.

• Home Health is medical care provided in a patient’s home. This can be provided by an array of medical professionals, including skilled nursing care, infusion therapy, physical therapy, speech therapy, and occupational therapy. Home health patients can come in many different shapes and sizes, whether it be a 55-year-old female with Parkinson's or a 78-year-old male who broke his hip and prefers to rehabilitate in the comfort of his home.

• Hospice, in this case, is in-home care designed to give support to those in the final phase of a terminal illness. The goal is to focus on comfort and quality of life, rather than a cure. Enabling patient comfortability and manage their pain, so they can live each day as fully as possible.

There are also in-patient hospice centers, however, for this article, we will only be referring to home-based hospice care.

Becoming a freelance home health and hospice caregiver comes with a lot of responsibility. Before you decide to go solo, make sure you are financially comfortable and are ready to work a lot more than you probably thought. When you work independently, you have to document more than the care provided to the patient. You also are the one holding yourself accountable - and have to maintain your own schedule. Before jumping into this big commitment, take some time to plan out the next steps to becoming an independent caregiver.

Document Your Business Plan

You need to start by formulating a business plan and putting it on paper. You need to prove yourself to hold the standards set by the government when it comes to taking care of home health and hospice patients. Consider the following:

• Prepare manuals on how you do everything. This is to cover yourself.
• Create a file of your policies and procedures, manuals, handbooks, forms, and other tools.
• Always remain HIPAA compliant and be able to access the policy whenever asked.
• Keep a process document of your workflow for each client or client-type. This will help with information gathering (and if you ever decide to expand into an agency, you will be prepared to take on new caregivers/).
• Document the number of hours put towards each task: caregiving, bookkeeping, submitting for Medicare reimbursement, documenting a patient’s status, scheduling, etc.
• Create a checklist of all of the certifications and licenses you need to have at all times, and keep them with the checklist.

Get You Certifications & Licensing

First, you will need to either become a single-member LLC to obtain a tax identifier for your business. You can use your social security number if you do not want to go through the process of incorporating yourself.

You will need to register with Medicare to obtain a National Provider Identifier (NPI). It is recommended you meet with a home health and hospice consultant to figure out your state-specific regulations and licensing rules.

Next, you will need to become Medicare accredited because a large portion of reimbursement comes through Medicare Parts A and B. This entails undergoing a three-day Medicare survey, where your policies and procedures, clinical practice, and record-keeping are evaluated (you basically go through an audit). You will need to re-certify every three years.

You can also choose to become accredited through the Community Health Accreditation Partner (CHAP) Standards of Excellence, Accreditation Commission for Health Care (ACHC), or the Joint Commission (JCO) instead of Medicare certified. These accrediting bodies hold agencies and independent caregivers to all Medicare Conditions of Participation, as well as beyond Medicare and Medicaid’s standards.

Track Everything

Make sure to track everything you do. From who your patients are and what they need, to the number of hours spent with each patient on a daily basis, and how much you can expect to be reimbursed for each patient by Medicare. There are software applications that can help you with this process. Consider investing in:

• Financial Tracker (RCM)
• Scheduling Application
• Health/Medical Record Software (EHR)

Be smart with what you buy. Just because the software is more expensive doesn’t mean it’s the right solution. The following Home Health and Hospice software should be considered:

• Brightree
• HEALTHCAREfirst
• MatrixCare Home Care
• Kinnser Agency Manager
• McKesson Homecare
• Casamba Home Health & Hospice
• HHAeXchange
• PointClickCare

Continue Your Education

It is extremely important to continue staying up-to-date with ICD-10 Readiness. You will either need to learn medical coding or use a third-party ICD coding partner. You need to make sure you document everything as accurately and timely as possible since cashflow and reimbursement rates depend on efficient and completed ICD medical coding.

Continued education has more to do than just knowing how to bill properly. If you are working for yourself, take as many opportunities to learn new skills or refresh existing ones, when you can. Being a dynamic and evolvable caregiver is extremely important.

Looking to Start as a Freelance Caregiver?

If you find yourself needing to find funding to get your personal business off the ground, First Union Lending is here to help.

We have nine different business loan types to choose from. This means that we’re uniquely qualified to help you find the perfect loan to open your small business.

Applying for a business loan doesn’t affect your credit. Better yet, your business loan may be approved as soon as the same day.

Applying for a business loan doesn't affect your credit. Better yet, your business loan may be approved as soon as the same day.

To discuss our business loans with one of our lending experts, click here or call 863-825-5626. We'll talk about our various business loans and help you find the right one for your medical practice.

Get started with the process now by learning more about our business loan types.