Home Health & Hospice Week

Sloppy documentation can decimate your bottom line.

With the Supreme Court set to weigh in definitively on overtime pay for home health aides, it's a great time to review your agency's policies--or you could wind up learning some costly lessons.

Scrutiny is likely to continue to run high--regardless of what the nation's high court decides later this year, says Elizabeth Zink-Pearson of Pearson & Bernard in Covington, KY.

Use these tips to fine tune your staffing: 1. Know which staffers are covered by the companionship exemption. If you don't, the cost to your agency could soar.

Expensive error: The U.S. Department of Labor recently recovered $161,234 in overtime back wages after the Department's Wage and Hour Division determined a nurse staffing agency, StaffCo, incorrectly applied the companionship services exemption of the Fair Labor Standards Act to registered and licensed practical nurses, reports Jennifer Milligan, attorney with Gilliland Markette & Milligan in Indianapolis.

StaffCo provides registered nurses, licensed practical nurses and certified nursing assistants for nursing facilities and individuals who require in-home care. Some of the employees in question in the case provided skilled nursing care to individuals in their homes.

What went wrong: The companionship services exemption applies only to employees providing services for "the care, fellowship and protection of persons in their homes who because of advanced age or physical or mental infirmity cannot care for themselves," explains Milligan.

Tip: Employees whose duties require the training of a registered nurse or a licensed practical nurse do not qualify for the exemption.

2. Be careful what you ask employees to do--and when.

Another scary scenario: VITAS Hospice Services, a national hospice chain, agreed last spring to pay $13 million to settle a class action lawsuit alleging that it owed nurses, licensed clinical social workers and home health aides overtime compensation for work beyond eight hours a day, reports Milligan. Plaintiffs charged that in order to avoid overtime, employees allegedly were forced to check and return all voice mail messages before the start of the workday and to complete paperwork on their days off and weekends.

Such cases make similar lawsuits more likely, says Milligan.

Tip: To steer clear of trouble, review your em-ployee compensation system to see if it complies with federal and state wage and hour laws. 3. Be aware of how homemaking tasks affect the companionship exemption. The companionship exemption applies only to employees who provide primarily personal care services, as opposed to homemaking services, notes Zink-Pearson.

Most states have Medicaid waiver programs that piggyback onto Medicare/Medicaid to cover homemaking--and home health aides tend to provide both homemaking and personal care services.

"If an aide spends more than 20 percent of her time doing homemaking, she falls outside the exemption and must be paid overtime," says [...]