In the home health and hospice industry, there’s a dangerous practice that’s been quietly killing agencies for years: the belief that you can “get compliant when it counts.”
You know the pattern. Business gets busy. Patients need visits. Payroll needs to go out. Someone swears they’ll “get to the compliance stuff later.” Next thing you know, a year’s gone by, and you're prepping for a survey with the urgency of a five-alarm fire.
Here’s the uncomfortable truth: that mindset isn’t just risky — it’s unsustainable. At The Home Health Consultant, we believe the agencies that survive, and thrive, aren’t the ones who scramble before surveys. They’re the ones who commit to doing it right, every single day.
You may read that and think, ‘Yeah right, but my agency doesn’t have enough resources to do constant maintenance. We’re working to the wire as is.” This can be true, but we’re going to dive into why this practice of doing it right actually saves you time, money, and stress when implemented the right way.
In this article, we’ll show you why maintaining compliance is about more than passing surveys. It’s about building a business that’s actually built to last.
Why Catching Up on Compliance Before a Survey Doesn’t Work
Many small to mid-sized agencies don’t have the luxury of a dedicated compliance officer or full department heads for every task. For these agencies, compliance often becomes a back-burner chore. It’s understandable. You’re juggling a million priorities, and delivering the actual patient care always takes precedence.
But what’s actually happening behind the scenes? You’re teaching your team that compliance is something you only pay attention to when there’s a threat or an upcoming survey.
That’s exactly how major breakdowns, deficiencies, fines, and even shutdowns sneak in the door. You’re not “just catching up.” You’re building a habit of reaction — not prevention. And the toll isn’t just legal. It’s emotional.
Most agency owners aren’t neglecting compliance because they don’t care. They’re stressed, overwhelmed, and don’t know where to start. Over time, that weight builds — and it’s always there.
Is Being Survey-Ready the Same as Being Committed to Compliance?
You might be thinking: But wait, we already talked about Survey Readiness. Isn’t that the same thing as ‘doing compliance right’?
Not quite.
Survey Readiness is about being prepared when a surveyor walks through your doors. It’s a systems-focused approach that sets your agency up for consistency, transparency, and success. If you want to learn more about survey readiness, check out our article below.
Doing It Right, on the other hand, is a deeper mindset. It’s about:
- Rewiring your agency culture so compliance isn’t a scramble — it’s second nature
- Avoiding burnout from compliance procrastination
- Creating real operational maturity — even when you’re not a mega-agency
It’s like the difference between cleaning your house the night before guests come over… and living in a clean house every day. Only in this case, the “mess” can cost you your license.
Is Compliance Maintenance Really Necessary for Your Home Health or Hospice Agency?
You don’t need to “do it perfectly.” But you do need to do it consistently.
Think of compliance like brushing your teeth. You don’t skip a week and then brush 42 times the night before your dentist appointment. (And if you do… you know how that ends.)
In the same way, doing a few things every day or every week, 15 minutes here, an hour there, is not just easier than massive catch-up sessions. It’s more effective. More sustainable. Less soul-crushing.
It’s also the only way to protect yourself from catastrophic events:
- complaint surveys
- deficiencies
- lost revenue
- tanked star ratings
- immediate jeopardy
- shutdowns
You don’t build a solid agency by cramming compliance into Q4. You build it by showing up every day for the boring, necessary parts.
Core Compliance Habits of Thriving Home Health Agencies
Here’s a controversial truth most consultants won’t say: the skill of catching up is not the same as the skill of maintaining.
Yes, it takes grit to go from zero to survey-ready in two months. But it doesn’t make your agency stable. And it definitely doesn’t improve care. It just makes you good at cleaning up messes, not preventing them.
Here’s what ‘doing it right’ actually looks like in agencies that thrive, even those without huge teams:
- Monthly Chart Reviews
Don’t wait until the end of the month. Spot documentation gaps early by reviewing a sample of visits weekly — even just five charts at a time. - Annual Competency Checks
Make sure your staff can demonstrate they’re still qualified to do the work. It’s not just about compliance — it’s about patient safety and reducing liability. - Assigned Compliance Coordinator
Even if they wear multiple hats, someone should own compliance — not just “everyone and no one.” Ownership drives accountability. - Policy Updates Every 90 Days
Instead of one overwhelming annual policy review, split it up into quarterly sprints. Rotate through sections to keep it manageable and fresh. - Real-Time Tracking for Survey Readiness
Keep your logs, training records, and contracts updated as you go — not just when surveyors are on the way. Build a survey binder that’s always current. - Weekly or Monthly Internal Audit Touchpoints
Use a standing monthly meeting to review what went right, what went wrong, and what’s slipping through the cracks. Then actually fix it.
We get it, that’s a long and intimidating risk. But integrating these practices into your agency doesn’t have to mean you never have a spare moment. Doing it right isn’t about adding more work. It’s about spreading out the work in a way that protects your agency and your peace of mind.
Why Your Agency Needs to Stop Waiting for Emergencies
If this sounds like you — constantly stressed, always “meaning to” fix compliance later, dreading the next surprise survey — you’re not alone. But you do have a choice.
You can keep living in fire drill mode. Or you can build a company that doesn’t panic every time CMS sends an email.
We built our systems at The Home Health Consultant specifically for agencies like yours. The agencies that aren’t tiny anymore, but don’t have 15 department heads either. Whether you work with us or not, we urge you:
Start doing compliance right — now.
Because someday soon, “later” may be too late.
If you think implementing these practices may be a lot for you, but you still want to get started, explore how our administrative compliance program works to see if it’s right for your agency.
*This article was written in consultation with Mariam Treystman.
*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.
