The home health (HH) and hospice (HSP) industry is complex, with its unique regulatory landscapes, compliance demands, and operational challenges. To navigate these intricacies, agencies often turn to consultants for support. Whether it’s preparing for surveys, filing applications, or resolving billing issues with Medicare, consultants can play a pivotal role in ensuring smooth operations.
However, not all consultants are created equal. If you are looking to hire a consultant, you’re likely already stressed about issues within your agency. Now you have another stressor: choosing the right consultant for your agency.
Mistakes made by an unqualified consultant can cost your agency time, money, and even its reputation. At The Home Health Consultant (THC), we have over 20 years of experience in the field. To help alleviate stress, we created a guide to help you choose the best fit for your agency, whether it’s us or not.
In this article, we’ll explore:
- why HH & HSP agencies seek consultants,
- the expertise you should prioritize,
- and the red flags to watch for when hiring one.
Why Home Health & Hospice Agencies Seek Consultants
For many HH and HSP agencies, hiring a consultant is not a luxury but a necessity. Regulatory compliance, for example, can feel overwhelming, especially when surveys are looming. Consultants help agencies identify and address gaps, ensuring they meet requirements.
Other scenarios also call for outside expertise. Ownership transitions or location changes often involve intricate paperwork that consultants can streamline. New agencies lean on consultants to guide them through licensing and application processes. Even established agencies may need help resolving complex Medicare billing issues or maintaining compliance standards.
Setting Clear Goals Before Hiring a Consultant
Clarity is key. Before hiring a consultant, define your goals. Are you looking for help with application filing, ongoing compliance management, or billing resolutions? Identifying your primary objective will ensure you find the right match.
To see an agency’s timeline and at what points they may consider seeking a consultant, you can find our article on the topic here.
The Consultant’s Role: Matching Home Health & Hospice Expertise to Your Needs
Consultants often specialize in distinct areas, such as:
- Enrollment services: Assisting with launching new agencies
- Administrative compliance: Ensuring adherence to regulations
- Billing: Navigating the complexities of Medicare billing
- Clinical documentation review: Improving medical documentation accuracy and compliance
- Mock surveys: Assisting with readiness for regulatory inspections.
The best consultant is the one whose expertise aligns with your agency’s specific goals. A great fit can lead to a seamless process, while a mismatch can result in frustration and unmet expectations.
6 Red Flags to Watch for When Hiring a Home Health or Hospice Consultant
Selecting the wrong consultant can have serious consequences. Look out for these warning signs:
1. Unnecessary Review of Passed Documentation: Beware of consultants who insist on reviewing files already approved during previous surveys or ADR rounds. This is a red flag unless preparing for a different regulatory purpose. This practice may indicate a lack of value-added expertise.
2. Excessive Use of Buzzwords: A consultant may frequently mention terms like "HIPAA." Without clear relevance, this might reflect shallow knowledge. While HIPAA is important, a truly skilled consultant knows when and how to focus on it.
3. Inconsistent Engagement: Is the consultant spending too much time in your office reviewing files in person? This might signal they lack scalable systems or a large client base. On the flip side, a consultant who relies solely on software may not offer the hands-on guidance your agency needs.
4. Lack of Continuity: If the consultant you initially hire is later replaced by an unrelated team, this could indicate the original person was simply a sales rep.
5. Questionable Pricing Models: Suspiciously low prices can suggest inexperience. Alternatively, excessively high fees may reflect unnecessary middleman markups. Look for consultants who charge within an industry-standard range for their level of expertise.
6. No Office Phone Number, Office, or Back Up Staff: If a consultant communicates only through their cell phone and doesn’t provide other office contact options, it’s a potential red flag. This approach might seem personal, but it could indicate they lack a larger team. Without proper support, both you and your agency may face inconsistent communication and project delays in the future.
These red flags are not always true for every consultant. There are always exceptions. You could have an incredibly knowledgeable consultant who is just starting out. But they may not have the resources to streamline their process yet.
This doesn’t make them a bad consultant, but it may make them a bad fit for your agency if you’re looking for constant communication and updates. Again, it all comes down to your agency’s goals.
By recognizing these red flags and comparing them with your agency’s primary objective, you can protect your agency from wasted resources and subpar outcomes.
Finding the Right Consultant for Your Agency
Choosing a consultant who matches your priorities requires thoughtful consideration. Start by clearly defining your agency’s needs. If you’re looking for hands-on support, a consultant offering only software may not be the best fit.
Here's a step-by-step guide to evaluating consultants:
- Visit their office: Does their setup suggest they have a professional and well-supported operation? An overly simple or one-person setup might indicate limited resources. This could lead to delays or inconsistent attention when they get busy or overwhelmed.
- Ask for references: Reliable consultants should provide references who can attest to their expertise.
- Assess their communication style: Do they explain their processes clearly? Do they have systems for tracking progress? An online portal?
- Gauge their trustworthiness: A great consultant admits when they don’t know something but is willing to research and provide accurate guidance.
- Evaluate their collaboration skills: Consultants should work harmoniously with your vendors or other consultants. Hostility toward industry peers can be a red flag.
By taking the time to evaluate consultants thoughtfully, you can ensure a partnership that aligns with your agency’s goals and values. The right consultant will meet your immediate needs and support your long-term success.
What to Know Before Contracting a Home Health or Hospice Consultant
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Your biggest takeaway from this article should be to make sure you know what your agency needs before hiring a consultant. Is your chart logging process unorganized due to a paper-only filing system? Then a software may be all you need. Are you confident in your agency’s ability to remain compliant, but nervous about a survey? In this case, last-minute survey prep may be the choice for you.
Are you constantly stressed about compliance and unsure how to take control or move your business forward? Then you may be a good fit for our administrative compliance program. To find the consultant with the least amount of red flags, it’s essential you understand what your agency needs first.
The best consultants don’t rely on improvisation. They bring structured, proven processes to maintain compliance, resolve billing issues, and support agency operations. Their expertise should build long-term efficiency and resilience into your agency’s systems.
Recognizing red flags and aligning your agency’s needs with a consultant’s expertise will help ensure a successful partnership. Take your time to evaluate candidates, ask the right questions, and invest in a consultant who will elevate your operations.
Next steps in your path to a compliant home health or hospice agency:
- Learn more about the best way to stay ready for surveys in our guide: ‘Survey Prep vs. Survey Readiness.’
- Discover the types of clients we work best with—read our article to see how our expert consulting can address your agency’s unique challenges.
By making thoughtful choices, your agency can secure compliance and achieve sustained excellence in patient care.
*This article was written in consultation with Mariam Treystman.
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