Homecare Service under PA CHC Electronic Visit Verification (EVV) Policy

The 21st Century Cures Act, a federal law, requires all states to implement Electronic Visit Verification (EVV) for Medicaid-funded Personal Care Services (PCS). In Pennsylvania, EVV has been mandatory for PCS since January 1, 2020.

PA Department of Human Services uses an open EVV model, which means providers can either use the state's free EVV system or a different EVV system, as long as it meets federal requirements and sends data correctly to the state's EVV aggregator. The state works with companies like Gainwell Technologies and Sandata Technologies to run the system, which is connected to the PROMISe Medicaid billing system.

For homecare providers working with managed care programs like PA Community HealthChoices (CHC), the Managed Care Organizations (MCOs) use HHAeXchange to offer a free EVV and billing platform. This tool helps with tasks like client scheduling, service authorizations, communication, and EVV tracking. Homecare providers can either use HHAeXchange’s free tools or connect their own EVV system to HHAeXchange.

While PA DHS sets the rules and structure for how EVV works in the state, it doesn’t run the systems directly. Instead, third-party companies like Gainwell Technologies, Sandata Technologies, and HHAeXchange handle the technical parts of collecting and managing EVV data.

All homecare service documentation, including visit records and care notes, must fully comply with the Pennsylvania Community HealthChoices (CHC) Home and Community-Based Services (HCBS) Electronic Visit Verification (EVV) Policy.

This documentation is essential to verify that services are delivered as authorized, to the appropriate participant, at the correct location, and within the scheduled timeframe. Accurate and timely documentation supports service accountability, continuity of care, billing integrity, and program compliance.

Examples of Required Homecare Service Documentation Include:
 

• EVV Records
  Electronic visit verification entries must capture the required six data elements: the type of service delivered, name of the participant, name of the Direct Care Worker , the exact date and time the service started and ended, and the location of service delivery. These entries must be recorded in real-time via the approved EVV method (e.g., mobile app, telephony, or fixed device).
  
   

• Daily Care Notes or Progress Logs
  A brief but accurate narrative or checklist reflecting the services provided during the visit, client condition, any changes observed, and any support provided with activities of daily living (ADLs) or instrumental activities of daily living (IADLs).
  
   

• Medication Reminders or Non-Skilled Service Checklists
  When applicable, DCWs must document non-skilled tasks performed, such as medication reminders (not administration), hydration prompts, or other routine wellness checks, as outlined in the care plan.
  
   

• Behavioral Observations or Incident Reports
  Any unusual client behaviors, changes in physical or mental condition, or reportable events must be documented and submitted through the agency’s incident reporting procedure. Timely and accurate incident reporting is vital for client safety and regulatory compliance.
  
   

• Paper Backup Timesheets
  In the rare case that EVV is temporarily unavailable (e.g., system outage, phone malfunction), agencies may allow use of paper timesheets as a backup. These must be approved, completed in ink, signed by both the DCW and client (or authorized representative), and submitted according to agency policy. Backup use must be clearly documented and justified.
  
   

• Client Communication Logs or Service Confirmations
  Logs of significant communications with the client or their representative—such as service rescheduling, refusals of care, or confirmations of received services—may be required for quality assurance, documentation of client rights, or conflict resolution.