Your phones ring after hours. Sometimes it’s a worried patient, sometimes a hospital discharge planner with a new referral. If no one picks up, it’s not just a bad look. It could mean a missed patient need, a missed referral, or even a deficiency during survey.
As an owner or administrator, you know Medicare requires agencies to be available 24/7. But how do you prove it? That’s where call logs come in.
*This article was written in consultation with Mariam Treystman.
At The Home Health Consultant, we help Medicare-certified home health and hospice agencies stay survey-ready every day. We’ve seen firsthand how something as simple as keeping a call log can make or break agencies. In extreme cases, we’ve even seen it result in a shutdown.
In this article, we’ll explain what call logs are, how to use them, and why they matter for your operations and compliance.
What Exactly Are Call Logs in Home Health and Hospice?
Call logs are simple records that track whether your agency’s phones are answered during and after business hours. Think of them like a “secret shopper” test for your phones.
While call logs are not a direct Medicare Condition of Participation, accrediting bodies such as ACHC often require them. Even if your accreditor doesn’t require them, call logs are valuable compliance practice. They show surveyors you’re meeting CMS’s requirement that a clinician (or designee) is available 24/7.
When Do Agencies Need to Be Available by Phone?
24/7 access really means 24/7 access. Medicare-certified agencies are required to answer phones during business hours (usually 9–5) and have a system in place for after-hours coverage.
That means:
- Office staff should answer phones during the day.
- After hours, calls must route to a staff member on call or a third-party answering service that forwards urgent calls to a clinician.
This isn’t just about compliance or covering your bases. A missed midnight call might be a patient in crisis, or it might be a discharge planner who ends up calling another agency.
Who Should Be Responsible for Answering Agency Calls?
During office hours, the responsibility is usually clear: your front desk or admin staff. After hours, it’s a bit more complex. Agencies often rotate staff on call, or use an answering service that screens and forwards calls.
The key compliance point is this: a clinician, or the Director of Patient Care Services (DPCS) or their designee, must always be reachable.
How Should Agencies Perform Call Log Checks?
To keep an effective log, agencies should actually test their phone system both during and outside of office hours. Here’s how:
- Call the agency number at random times, including evenings, late nights, and early mornings.
- Call from different phone numbers (not the owner or manager’s cell, which office system or staff may recognize).
- Don’t announce when the test will happen. Otherwise staff may be on alert.
- Track whether the phone was answered live, how many rings it took, and if missed, how quickly the call was returned.
There’s no official requirement on how frequently you should be conducting these tests. At minimum, we at The Home Health Consultant typically recommend testing monthly. Weekly is even better, it creates a stronger paper trail and shows surveyors you’re consistent.
What Information Should Call Logs Include?
An effective call log should be simple but detailed enough to demonstrate compliance. It should capture:
- Date and time of the call
- Whether it was during business hours or after hours
- How long it took to answer
- Who answered or was supposed to be on call
- If missed, how long before a return call happened
- Notes on any patterns of missed calls
The goal is to show surveyors that your agency doesn’t just say it’s available 24/7, it can prove it.
What Should Agencies Do if Call Logs Show Problems?
Call logs aren’t just for survey binders, they’re a tool for catching problems early. If you see patterns of missed or delayed calls, take action:
- Talk to the staff responsible and reinforce expectations.
- Consider a Performance Improvement Plan (PIP) if responsiveness doesn’t improve.
- Evaluate whether your on-call system or answering service needs adjustments.
Corrective action is critical. Surveyors don’t just want to see records. Surveyors want to see that agencies use them to improve operations.
How Do Call Logs Impact Surveys and Compliance?
Surveyors, especially from ACHC, often ask to see call logs.
Here’s a key compliance nuance: if your policy says you’ll check call logs weekly, but you only do it monthly, you can actually get cited twice; once for not doing the task, and once for not following your own policy.
That’s why it’s best to pick a realistic frequency you can stick to, update your policies to reflect it, and then follow it consistently.
What’s the Bottom Line on Call Logs for Home Health and Hospice Agencies?
Call logs may seem like busywork, but they protect patients, prevent deficiencies, and ensure you never miss a referral.
They don’t have to be complicated. A simple Excel sheet can do the job, as long as it’s kept up consistently.
Start testing your phones at random times, document the results, and follow up on any problems you find. The more consistent your process, the stronger your compliance record will be.
Want to know what other compliance logs surveyors expect to see? Check out our article Compliance Logs Every Medicare-Certified Agency Should Keep by clicking below.
*Disclaimer: The content provided in this article is not intended to be, nor should it be construed as, legal, financial, or professional advice. No consultant-client relationship is established by engaging with this content. You should seek the advice of a qualified attorney, financial advisor, or other professional regarding any legal or business matters. The consultant assumes no liability for any actions taken based on the information provided.
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