Executive summary of the 2024 post-acute care audit survival guide

The 2024 post-acute care audit survival guide is designed to help home health and post-acute care leaders confidently navigate the complex world of payroll, wage, and hour compliance. Blending expert insight with a playful rock-and-roll theme, the guide walks agencies through common audit pitfalls and offers practical steps to ensure accuracy, compliance, and peace of mind when regulators come calling.

Command the payroll compliance spotlight

Payroll compliance in post-acute care is no easy act. Between tax reporting, Social Security verification, and labor law obligations, the regulatory landscape can feel chaotic. The guide kicks off by setting the stage for success, explaining that preparation – not panic – is the key to surviving an audit.

Don’t miss a beat with W-2s

When filing annual W-2 forms, accuracy is everything. Even small mismatches between an employee’s name and Social Security number can cause wages to land in the SSA’s “suspense account,” leaving caregivers without proper credit for their earnings. The guide recommends verifying employee data early and often, using tools like the Social Security Number Verification Service to prevent issues before they surface.

Keep your data in tune

An EDCOR letter from the SSA is often an early warning sign of deeper data inconsistencies. While not an audit in itself, it can lead to costly fines from the IRS if left unresolved. The guide emphasizes proactive verification, consistent data audits, and communication with employees to resolve mismatches – all while avoiding disciplinary actions that could trigger compliance risks.

Caregivers are employees – but are they in your band?

Misclassification remains one of the most common audit findings. The Department of Labor applies special rules for in-home service workers, particularly in consumer-directed care settings. Agencies must carefully distinguish between serving as fiscal intermediaries and acting as employers. Using the patient’s tax ID and filing Schedule R can help avoid joint-employment liabilities and clarify compliance responsibilities.

Harmonize with caregiver companionship

The guide dives into one of the most misunderstood areas of home care law – the “companionship services exemption.” It explains how patients may qualify for this exemption under very limited conditions, such as when caregivers spend less than 20 percent of their time on personal care and perform no medical or household tasks for others. Agencies, however, are not exempt and must always meet minimum wage and overtime requirements.

Rock around the clock

Wage-and-hour miscalculations are an auditor’s favorite find. Complex schedules, multiple clients, and retroactive time submissions make it easy for agencies to miscalculate overtime. The guide provides clear examples of how errors occur and advises using automated payroll systems that correctly allocate regular and overtime hours. Transparency in pay stubs and access to detailed wage data are also essential for compliance and trust.

Why this matters

In an environment where audits are increasing and regulations are tightening, post-acute care agencies can’t afford to improvise. From accurate W-2 filings to overtime calculations, every detail matters. The post-acute care audit survival guide equips leaders to prevent compliance breakdowns, reduce financial penalties, and maintain harmony between payroll accuracy, caregiver satisfaction, and legal peace of mind.

The takeaway is simple – by keeping your payroll systems, records, and processes in tune, you’ll hit every compliance note with confidence.