Home health care is a booming industry in the United States. The country's large aging population and increased average lifespan mean that more people than ever are receiving acute and long-term medical services. Many patients prefer to recuperate from surgeries and traumas at home when possible and would rather get home care than move to an assisted living facility or skilled nursing facility. The Center for Medicare and Medicaid Services requires all home health agencies have qualified administrators at the helm.
CMS regulations require that every home health agency to have a full-time administrator available by phone during all operating hours. Although an administrator can be at an agency's office to comply, it's not required. Administrators can leave and in theory go out in the field, go to meetings and even treat patients. The critical factor is that an administrator is immediately available by phone in case a clinician, patient or family member needs to speak with her. If an administrator leaves, home health agencies are allowed to operate no more than 30 days without a qualified replacement.
Registered nurses and physicians automatically qualify to be home health agency administrators under CMS regulations. Nurses must have at least one year of clinical experience before becoming home health administrators. CMS and most states prefer clinicians in administrator roles because they oversee health care workers who operate independently in the field. Nurses and physicians can provide clinical guidance and support to their employees as well as give knowledgeable advice and guidance to clients.
A person without clinical credentials who has at least one year experience managing in the health care field may also qualify to be a home health administrator. Human resource managers who have worked in medical facilities or organizations, as well as nursing home and hospital administrators are likely to meet the CMS standard. When a home health agency uses a nonclinician administrator, it must also have a nurse or physician to act as a clinical supervisor. Both administrator and clinical supervisors must be available by phone during business hours.
Federal Medicare regulations are critical to home health agencies because Medicare patients are usually the bulk of their business. Additionally, CMS guidelines typically set the standard for both state laws and private insurance standards of operations. However, states may also impose credential and licensing requirements on home health administrators. Washington and Texas, for example, require administrators to take an exam regarding laws, regulations and ethics irrespective of a prospective administrator's clinical background. Anyone considering a career as a home health administrator should check with her state department of health for additional requirements.