How do you stay compliant with EVV regulations in home health care?

Let’s be honest, home health care is complicated. And staying compliant with ever-changing rules doesn’t make it any easier. But there’s one thing you can’t ignore: Electronic Visit Verification, or EVV.

This is not just another tech requirement. As most home health professionals know by now, it’s a federally mandated system that helps verify when and where home care services happen, making sure that caregivers show up, services are actually delivered, and Medicaid dollars are used the right way.

Think of it as a digital proof-of-care system. It tracks visit details like time, date, location, and who provided the service. For agencies, it’s a safeguard. For caregivers, it offers clarity. And for patients, it’s about peace of mind.

So, if you’re running a home health agency, or work in one, understanding how EVV works in your state isn’t optional anymore. It’s essential.

Understanding EVV

EVV systems electronically capture six key data points during a home healthcare visit (first laid out by the 21st Century Cures Act):​

1. Type of service performed
2. Individual receiving the service
3. Date of the service​
4. Location of service delivery​
5. Individual providing the service
6. Time the service begins and ends
   

These data points help confirm that the right care is provided to the right patient at the right time and place.​

State Implementation Status

As of January 1, 2024, states have reported their compliance status with EVV requirements for home health care services. The statuses are categorized as follows:

• Compliant: The state has fully implemented an EVV system.​
• Non-Compliant: The state has not fully implemented an EVV system.​
• Not Applicable (N/A): The state or territory does not provide Medicaid-funded home health care services.​
  

Below is a table summarizing each state’s EVV compliance status:

Source: Medicaid.gov – EVV Compliance Status for Home Health Care Services by State or Territory

Implications for Home Health Agencies

For home health agencies, understanding your state’s EVV compliance status is crucial. Operating in a compliant state means adhering to the established EVV protocols to ensure Medicaid reimbursement. In non-compliant states, agencies should stay informed about ongoing developments and prepare for eventual implementation to avoid disruptions.

Challenges in EVV Implementation

Implementing EVV isn’t just about checking a compliance box. It involves real operational changes, and not all agencies are prepared for the shift.

Here are some of the most common challenges you might face:

1. Staff Resistance

Some caregivers feel EVV is intrusive. They worry about being constantly tracked, or fear that new systems could disrupt workflows or create more paperwork.

To address this:

• Be transparent. Let staff know EVV protects them by tracking hours accurately.
• Frame EVV as a safeguard, not surveillance.
• Offer clear training and support.

2. Technical Limitations

Not every caregiver has the same level of tech fluency. Some work in rural areas with spotty internet. Others may have older devices or run into app bugs.

Solutions include:

• Choosing systems with offline modes.
• Offering mobile-friendly platforms.
• Providing 24/7 support and quick video tutorials.

3. Budget Constraints

Software, hardware, and training all cost money — and not every agency has spare funds.

You can ease this by:

• Exploring state-approved vendor options that are subsidized.
• Applying for grants (some states offer these for small providers).
• Using EVV systems that bundle services and avoid nickel-and-diming.

Best Practices for Agencies

So how can your agency adapt and turn compliance into an advantage? Here’s a simple checklist to help.

Know Your State’s Requirements!

Each state has different timelines, systems, and certification processes. Check your state’s Medicaid EVV page regularly. Bookmark it.

Pick the Right Vendor

Ask:

• Does this EVV vendor meet our state’s requirements?
• Do they offer real support?
• Is there offline capability?
• Do they provide caregiver training tools?

Train Your Staff — Early and Often

Don’t make EVV a last-minute scramble. Include regular sessions that walk through:

• Common troubleshooting
• Data privacy and protections
• How to use the app or device

Ohio providers saw a 40% drop in EVV-related errors after offering quarterly training. That’s significant.

Perform Routine Audits

 – Check your EVV records against timesheets, billing, and care notes.
 – You’ll catch mistakes early and avoid claim denials.
 – In Michigan, one agency reduced their denial rate by 60% with monthly EVV audits.

Communicate with Caregivers

Make EVV part of a broader trust-building effort. Explain what’s tracked (and what’s not). Let them know their time and effort are protected, not micromanaged. Agencies that build trust see higher EVV adoption and less pushback.

Why EVV Is More Than a Rule, It’s an Opportunity

Yes, EVV is mandatory. But it also offers real benefits for agencies that embrace it:

• Reduced Fraud
  CMS estimates EVV could prevent over 30% of fraudulent claims. That’s money saved and credibility earned.

• More Accurate Records
  No more guesswork or manual entries. Everything is tracked in real-time.

• Stronger Payroll Protections
  With clear hours logged, your caregivers are paid accurately, and disputes are easier to resolve.

• Better Data for Planning
  The more accurate your visit logs, the better your scheduling and coverage decisions.

What’s Next?

If your agency is already compliant, stay sharp. States continue to update EVV guidelines, sometimes with very little notice.

If your agency is in a transitioning or non-compliant state, now is the time to prepare. Choose a vendor, develop a training plan, and talk to your Medicaid office for guidance.

If you’re not sure where your state stands, scroll back to the state-by-state chart and get a quick answer.

The Takeaway

EVV isn’t just a mandate, it’s a tool. It protects your business, your caregivers, and the patients you serve. The transition to new technology, including home health software with built-in EVV may take effort and even investment, but with the right plan and the right mindset, it is worth it.

Notable References.

https://www.dhcs.ca.gov/provgovpart/Pages/EVV.aspx?

https://www.dds.ca.gov/services/evv/

https://www.dhcs.ca.gov/provgovpart/Pages/EVV.aspx

https://www.medicaid.gov/medicaid/home-community-based-services/guidance/electronic-visit-verification/evv-compliance-status-for-home-health-care-services-state-or-territory/index.html

Other helpful blogs:

1. Choosing EVV Software
2. Caregiver training – six key practices to get nurses off to a good start
3. Home Health Marketing Strategies
4. Financial Management in home health agencies
5. Homecare Agency Services Expansion

Author’s Note: Views, information, and guidance in this resource are intended for information only. We are not rendering legal, financial, accounting, medical, or other professional advice. Alora disclaims any liability to any third party and cannot make any guarantee related to the content.