AHCA, CMS and accrediting organizations require the continuous tracking of certain information, such as educational hours, license expiration dates and insurance coverage, just to name a few. Home health agencies and nurse registries vary in their sophistication and mechanisms to avoid dropping the ball on these items. Expired materials represent one of the most widespread and easily avoided deficiencies. Here are some ideas:
Using software. Most agencies employ a software program to manage their patients. This system produces the Plan of Care and may even track staff visits and billing efforts. Most systems will also allow you to create a list of your personnel file requirements and track expiration dates. For example, you can probably enter dates for the driver’s license, auto insurance, CPR and professional license. The key is to be consistent and enter expiration dates for all required aspects of the personnel file.
The next step is to run a report from the software program on a regular basis. We suggest that you use a four-to six-week window of time, depending on the size of your agency. Example: in mid-April, run the report of items expiring in June. This gives you ample time to contact each staff member and request the updated information. As items are received, remember to key the new expiration date into your system. That way, when you run another report – say, two weeks before the end of May – you will only see the items that are not current. You can contact the staff members once again, with the explanation that they will be removed from active patient care if their materials are not current by end of May. Taking action will help you avoid being cited on an unannounced survey.
Using a manual system. Some agencies’ software programs cannot accommodate this task, or the managers don’t know how to properly use the system. While you obtain training and bring your system up to date, use a manual process to track expiration dates. A few suggestions follow, depending on your comfort level and computer skills.
- Use Outlook or another calendar program. Key document expiration dates using the same four-to-six-week system mentioned above. Example: Sally’s CPR expires on June 3rd. Enter a calendar reminder for May 1st and in the body of the reminder, list everyone’s materials that are expiring in June, and which require your follow-up. On May 1st, when you log into your Outlook, the reminder will pop up and you can begin contacting staff members. You can set another reminder two weeks before end of the month and depending on your staff load, can enter a final reminder on June 2nd so that you can remove Sally from patient care at the end of that day.
- Use Excel or other spreadsheet program. Some agencies enter all the aspects of the personnel file in an Excel spreadsheet, and use a column for expiration dates (Click Link). You can then sort the columns in date order, again, using the same four-to-six-week schedule mentioned above.
- Use an expanding file. Office supply stores have expanding files with the months of the year, and others with slots labeled 1 to 31, representing the days of the month. In a manual system, you would place a notation or a copy of the expiring document in the appropriate slot. Example: Sally’s expiring CPR would be filed either in the June tab (if you’re using the monthly tab format) or in the tab labeled with a 3 (if you’re using the daily format because it expires on the third day of the month).
- If using monthly slots, you will pull everything out that is in the June slot, again, in mid-April, and begin notifying the staff members. This needs to be a regular task performed on the first business day of the new month.
- If using 1-31 daily slots, the process is the same but with a twist: every day, pull out the information filed in that day’s slot. The challenge is that on the 3rd, you will pull out materials for January 3rd, March 3rd, April 3rd, etc. so you need to sift through and re-file the materials you don’t need at this time. The other key is that items will be filed on dates that fall on the weekend or on holidays. So on Monday, you will need to check the daily slots for Saturday and Sunday’s dates to make sure you don’t miss anything. This is a much more cumbersome process, so if possible, we suggest you use the computer to simplify your job.
No system will work without consistency so it’s important to set up the process and then make sure your employees are following it. Computerized systems lend themselves to auditing by the manager. Simply run a report yourself at any point in the process to make sure no expired items are unattended.
Final point: Tough love is needed to follow through on expiring documents. Your staff needs to know without any doubt that you will remove them from patient care if they don’t comply with your requests. It seldom happens more than once before employees get the message that you are not willing to risk your agency’s license or accreditation on their lack of compliance.