The 21st Century Cures Act is a federal law requiring the use of Electronic Visit Verification (EVV) for all Medicaid-funded Personal Care Services (PCS) (by January 1, 2020) and for all home healthcare services (by January 1, 2023) that require an in-home visit by a provider, or risk loss of federal Medicaid matching dollars (Centers for Medicare and Medicaid Services [CMS], 2019). The EVV requirement was created to help verify that home care services were actually provided. It can be achieved in a variety of manners: mobile applications with Global Positioning System (GPS) capabilities, telephony, fixed devices, and biometric recognition (CMS, 2018). Home care providers also frequently use a mobile device, such as a cellular telephone, tablet or laptop, to capture the patient's signature as verification of the home visit. These mobile devices are potential reservoirs of pathogenic organisms that may be transferred to the patient when capturing their signature.

Figure. No caption available.

When making home visits during mock surveys, common breaches in infection prevention and control practices I have observed are listed in Table 1, as well as an explanation of how these breaches place patients at risk for infection and potentially subsequent patients receiving a home visit (if the mobile device is not cleaned and disinfected after use and hand hygiene performed). It is important that staff break the chain of infection, and manage mobile devices in a manner that prevents skin and/or mobile device contamination.

Table 1. Common Breaches When Capturing the Patient's Signature at the Point of Care

REFERENCES