How New Education Requirements Could Affect Home Health

May 7, 2018

By: Complia Health

Education has always been a key requirement for working in the health care field. Thanks to a series of new regulations, however, the standards for education in both administrative and direct patient care areas are becoming more stringent — and could have a significant impact on the home health care field.

Earlier this year, the updated CMS Conditions of Participation (CoPs) for home health care went into effect, and included new degree and experience stipulations for home health agency administrators. At the same time, New York passed a law requiring all nurses to earn a Bachelor of Science in Nursing within 10 years of earning their RN license in order to maintain their licensure. While these new regulations are in line with the Institute of Medicine recommendation for at least 80 percent of nurses with bachelor’s degrees by 2020 — and eventually have all nurses with a four-year degree — there are many who believe that implementing such requirements will only exacerbate the nursing shortage, especially in the realm of home health care.

HHA Education Requirements

Under the new CMS CoPs, home health care administrators are now required to hold a minimum of a bachelor’s degree, or be a licensed physician or registered nurse. This requirement does not apply to administrators who are already employed; however, as of this year, all administrators must meet the criteria even if they have already been an HHA administrator. In other words, if you are an administrator now, but do not have a bachelor’s degree, you cannot be hired to be an administrator of another agency, regardless of how many years of experience you have.

That being said, if you do have experience, that is in your favor. The new CoPs also stipulate that any administrators hired after the effective date must have experience in healthcare administration, with at least one year of experience in a supervisory experience in a home health or related health care program. This includes those who are RNs (including nurse practitioner and advanced practice nurses) and licensed physicians.

In terms of direct care providers, currently there are no standard regulations as far as education and experience for home health aides, but home health nurses must be licensed in all states. While many states have been considering legislation requiring nurses to hold a bachelor’s degree (and North Dakota actually had a law on the books until 2003) New York is the first state to put such a law into effect. The bill, AO1842-B/SO 6768 states that “in order to continue to maintain registration as a registered professional nurse in New York state, have attained a baccalaureate degree or higher in nursing within 10 years of initial licensure.” The law will officially go into effect in mid-2019, and all current RNs, as well as those enrolled in an RN program, are grandfathered in and not required to earn a BSN. RNs are being encouraged to earn an advanced degree though, since many hospitals will soon require the credential for hiring.

What Does This Mean for Home Health?

So, what do all of these changes to education requirements mean for home health care?

On the one hand, it’s difficult to argue that a better educated workforce is a bad thing. Home health nurses are often called upon to work with difficult cases and respond to emergency situations, and additional knowledge and preparation can improve outcomes. In fact, studies have shown that when nurses hold higher degrees, mortality rates in hospitals decline.

A workforce that is better prepared and has a better mastery of their profession will help improve care and outcomes. And on the administrative side, when administrators have experience in health care supervision and the skills gained through a bachelor’s degree, they are more likely to operate an efficient agency. After all, as the industry becomes more advanced via the implementation of home health care software and other initiatives, it only makes sense that staff become more advanced as well.

On the other hand, though, many industry experts fear that increasing educational requirements will have a detrimental effect on an industry that is already feeling the regulatory pinch. There is already a shortage of qualified home health workers, and adding a new educational requirement is likely to eliminate many otherwise qualified candidates from even applying for open positions. For example, in many regions, bilingual home health workers are in demand.

Many of the individuals filling these positions are not in a place where they can afford to return to school for a bachelor’s degree, meaning that not only are they limited in work opportunities, but patients may also suffer because they can’t access the care they need. Not to mention, more education generally equates to higher pay, something that many agencies simply aren’t in a position to provide.
As more states consider changes to nursing requirements, and the new CoPs take effect, there will be major changes to the home health care industry. It will be interesting to see how the changes play out in the long term, and how they affect the delivery of care. In the meantime, you can improve the efficiency and operations of your agency by checking out Complia Health’s home health case studies, and learning more about how they can help your agency reach its goals. Contact us today!

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