The AHCA update session at last month’s Annual Conference brought about a lot of discussion and some confusion by members related to home care agencies contracting with outside entities to provide home care therapy services. There are three critical elements you need to consider and all three revolve around Health Service Pools (HCSP):
1. First and foremost, you must determine how is the outside entity which you wish to contract with licensed in the state of Florida?
2. If the business entity is licensed as a health service pool, then your home care agency must already have clinicians (i.e. therapists) on staff who are direct employees.
3. The therapists that the HCSP sends to you can only be utilized to supplement your direct staff and they can only do so for a temporary period of time.
There are three other types of entities that a home care agency could contract therapy services from. Review the AHCA FAQ 13.3 and please note that the two requirements above apply only to HCSPs not the three other entities.
AHCA has assured us this is not a new requirement, merely a clarification due to recent survey findings that showed home health agencies to be in violation of statute. According to AHCA survey findings, many agencies were running afoul of this by not having therapists on staff and just contracting with the HCSPs to provide therapy services for an indefinite period of time. This resulted in both the HHA and the HCSP being cited because the service pool therapists were being used as more than “temporary”.
AHCA provided HCAF with two survey examples where HHAs and/or HCSPs were found to be in violation of the statutes.
The first survey cited the health care service pool for “P104 – Operating Beyond Scope”. The health care service pool violated their licensing as such due to the following:
They are only allowed to provide temporary help and in this survey it was found they were providing help on an ongoing basis.
They are to act simply as a middle man (almost like nurse registries) where they assign an employee to a facility (or agency) and then the home health agency takes over from there. The home health agency is responsible for supervising and assigning patients to the HCSP staff member (in this case the HCSP was receiving a faxed referral from a HHA and they were assigning a patient to their appropriate staff member).
The HHA needs to also have their own staff and use the HCSP to supplement on a temporary basis (e.g., one of their therapists goes on maternity leave for 4 months and they hire an employee of the HCSP to fill in for those 4 months). In this survey, the arrangement was not a temporary set up, but the HCSP staff person did note that there were other staff of the HHA present at meetings.
Once assigned to an agency, the therapist essentially becomes a temporary staff member of that agency and they identify themselves as employees of the HHA rather than the HCSP when talking with patients. In this survey, the staff member interviewed stated they were not doing this and would identify that they were employees of the HCSP and that the HHA contracted with them to help with therapy staffing.
In a nutshell, this is much like any other temporary staffing company situation. When a construction company hires an employee of a temp agency to temporarily fill in as an office assistant, that person acts as