Operating Notes
Practical Guidance for Running Home-Based Care.
Source-conscious field guidance for the people responsible for referrals, schedules, documentation, revenue, workforce readiness, compliance and growth.
Library
All Operating Notes.
- 02
Revenue and Quality · October 16, 2026 · 6 min read
Medicare Advantage Home Health: Authorizations, Rates and Denials That Do Not Work Like Traditional Medicare
A Medicare Advantage patient has the same Medicare home health benefit with a different gatekeeper. The rules that bind that gatekeeper are more specific than most intake teams realize.
- 03
Growth and Engagement · October 15, 2026 · 6 min read
Section 504 Website Accessibility: The HHS Web Rule, Its New 2027 Deadline and What to Fix First
HHS pushed the Section 504 web deadline back a year, to May 11, 2027 for most agencies. That is time to fix the pages that matter, not a reason to stop.
- 04
Referral Operations · October 14, 2026 · 6 min read
Homebound Status: The Two Criteria Your Intake Notes Have to Prove
"She never leaves the house" is not homebound status. It is a sentence a reviewer will read as a conclusion with no evidence behind it.
- 05
Workforce and Compliance · October 13, 2026 · 6 min read
OIG Exclusion Checks: Why Monthly, Which Lists, and What to Keep as Proof
Screening at hire feels like enough until an aide hired two years ago turns up on the list. Monthly checks are cheap. Paying back every claim an excluded person touched is not.
- 06
Care and Clinical · October 12, 2026 · 6 min read
OASIS-E2 Changes Six Months In: The Items Still Producing Rework
OASIS-E2 looked like a small update, and on paper it was. Six months in, the rework clusters around a handful of items where old habits and old templates still win.
- 07
Revenue and Quality · October 11, 2026 · 7 min read
FY 2027 Hospice Payment Rates: What the 2.3% Update and the $36,174.75 Cap Mean for Your Census
The 2.3% headline is the least useful number in the FY 2027 hospice rule. What moves your budget is the corrected rate table, your wage index, your census mix and how close you already are to the cap.
- 08
Field Operations · October 10, 2026 · 7 min read
Flu Season Staffing: Size the Backup Pool Before the First Wave of Call-Offs
Every winter the same three people cover every open shift until one of them gets sick too. The backup pool is a number you can calculate in October, not a favor you call in during January.
- 09
Referral Operations · August 31, 2026 · 2 min read
Home Care Referral Management: From Intake to a Staffable Case
A referral is not ready for service merely because it reached the agency. It still needs ownership, complete information, a payment path and a staffing decision.
- 10
Field Operations · August 31, 2026 · 2 min read
Home Care Scheduling and Matching: What Availability Alone Misses
A person can be free at the correct time and still be the wrong match. Scheduling decides when; matching evaluates who.
- 11
Workforce and Compliance · August 31, 2026 · 3 min read
Home Care Compliance Software: What It Can and Cannot Decide
Automated compliance is an attractive phrase and a dangerous promise. The responsible model is source monitoring, traceable drafting and human review.
- 12
Field Operations · August 27, 2026 · 4 min read
The Admin Work EVV Creates
Nobody budgets for the job EVV creates. Verification is the easy half. The other half is the exception queue, and it lands on one person who was already busy.
- 13
Revenue and Quality · August 27, 2026 · 5 min read
Why Claims Get Denied, and Who Can Fix Each One
A denial code is not an accounting problem. It is a message about something that went wrong in intake, scheduling or documentation, sometimes weeks earlier, addressed to the person least able to fix it.
- 14
Revenue and Quality · August 27, 2026 · 5 min read
Three Care Lines, Three Systems, One Hidden Cost
The license fees are the small number. The expensive part is the work that exists only because two screens disagree, and it never appears on an invoice.
14 guides, updated as the work changes.
Founding Agencies
Bring the Workflow Behind the Search Query.
The strongest product questions begin with work an agency is already trying to make more reliable.