Audits aren’t new, but the intensity, frequency, and consequences have changed.
Recent analyses indicate a growing trend among states to enhance oversight of Medicaid Home and Community-Based Services (HCBS) providers, including the implementation of more frequent audits and increased enforcement of Electronic Visit Verification (EVV) requirements and caregiver training compliance.
According to a 2025 report by HHAeXchange, the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) may intensify audits to ensure continued compliance with EVV mandates. States like New York and Ohio have conducted audits highlighting the growing emphasis on adherence to EVV requirements.
Furthermore, a 2024 audit by the Ohio Department of Medicaid revealed that EVV was utilized for only 44% of provider-paid personal care services (PCS) and home health care services (HHCS) claims in 2022, indicating a need for increased enforcement and oversight.
These developments underscore the heightened focus on compliance and the necessity for HCBS providers to adopt robust systems and practices to meet evolving regulatory expectations.
What’s driving this uptick?
Failing an audit can mean:
Many agencies still manage compliance with a blend of:
This creates what compliance experts call a “fractured audit trail.”
And that’s exactly what auditors look for: inconsistent documentation, training gaps, and hard-to-trace timelines.
Many home care agencies continue to rely on spreadsheets or paper-based training records, leading to challenges in retrieving complete documentation during audits.
What a Modern Compliance Culture Looks Like
Shifting from reactive compliance to proactive readiness requires more than a system. It requires a mindset.
Here’s what defines a modern compliance culture:
1. Real-Time Recordkeeping
Instead of pulling reports the night before an audit, data is continuously updated and accessible. Audit prep becomes an output, not a project.
Ask yourself: “If an auditor walked in today, how quickly could we provide every required training certificate?”
2. Centralized Data, Not Siloed Spreadsheets
All caregiver records — from onboarding to annual compliance records and annual CE’s — live in one digital environment, accessible by those who need it (and protected from those who don’t).
This eliminates “he said/she said” disputes and supports consistent internal standards.
3. Automated Alerts and Expiration Tracking
Credentialing, TB tests, training renewals — all automatically flagged before expiration, not after.
Proactive agencies build buffers into their compliance calendar, so deadlines are never a fire drill.
4. Multilingual, Mobile-Accessible Training
For agencies with high caregiver diversity and turnover, training systems must be accessible in multiple languages and via mobile devices — not just desktops in the back office.
Mobile-first training platforms enhance accessibility and flexibility, making it easier for caregivers with multiple jobs or irregular hours to complete their training.
The ROI of Being Audit-Ready Every Day
Shifting to a proactive compliance model delivers value across several measurable dimensions. Agencies that move from reactive, paper-based compliance to integrated, digital solutions are better able to:
By routinely monitoring these metrics, agencies can quantify the benefits of their compliance strategy—demonstrating improvements in efficiency, regulatory outcomes, and staff satisfaction (HHAeXchange, 2025).
Almost every Nevvon customer who switches to centralized compliance tracking and automated reporting sees a significant improvement in audit preparation time. In some cases, agencies have reduced audit prep from weeks to just minutes with the click of a button, while also enhancing documentation accuracy and consistency.
How to Start the Shift: Strategic Steps for Compliance Leaders
In the coming Medicaid environment, audit preparation isn’t a quarterly sprint — it’s a continuous discipline.
Agencies that build systems and cultures around daily compliance will:
As scrutiny grows, trust becomes the currency of survival. And trust is built on precision, not paperwork.