Our agency is built around one mission: helping people live safely and comfortably in their own homes. But like every agency, we learned quickly that a good day of care depends on far more than the caregiver in the home. Behind the scenes, we are managing referrals, authorizations, scheduling, visit documentation, Electronic Visit Verification, billing, and a long list of compliance requirements, and nearly all of it runs through technology.
For a long time, we treated IT as something to deal with only when it broke. When we finally decided to bring on a dedicated IT partner, we assumed the hard part was behind us. It wasn’t. Our first choice was a capable, well-reviewed general IT firm, and they were not a bad company. They were simply the wrong company for home care. We also came to realize we didn’t just want someone to keep the lights on; we wanted a partner who could help us work smarter, especially as AI started reshaping the administrative side of our business. Here is what we wish we’d known before we signed.
Lesson #1: HIPAA Risk Belongs to Us, Not Just Them
What It Is
Protected health information moves constantly between mobile devices, our scheduling and EVV systems, computers, and email. As the agency, we are accountable for protecting it, and a breach lands on our reputation and our regulators first.
What We Learned the Hard Way
– We assumed the IT company simply “handled security.” In reality, the compliance obligation stays with the agency, and the partner’s job is to help us meet it.
– No one had clearly defined who does what if a breach actually occurs.
What We’d Look For Now
We’d ask exactly which security controls are included versus billed separately, including endpoint protection, multi-factor authentication, email security, encrypted backups, and proactive monitoring.
Then we’d ask the uncomfortable question directly: if we have a breach, what specifically do you do, and what is still on us? A strong partner answers without hesitation. A weak one improvises.
Lesson #2: Field Support Beats Office Support
What It Is
Our staff doesn’t sit at desks. Caregivers work in clients’ homes, on mobile devices, and often outside normal business hours. Support has to meet them where they actually work.
What We Learned the Hard Way
– Our first partner’s support model assumed an office full of workstations. A caregiver who can’t clock in through the EVV app at the start of a 7 a.m. shift did not fit that model.
– “Next business day” response times sounded reasonable on paper and proved unworkable in practice.
– Device and connectivity issues in the field had no clear path to fast resolution.
What We’d Look For Now
We’d look hard at the support model, not just the monthly price. We’d ask about realistic response times, after-hours coverage, and whether the firm has genuine experience supporting a mobile, distributed workforce.
Most importantly, we’d get those service-level commitments in writing. A friendly assurance during the sales process is not the same as a contractual response time, and the gap between them shows up at the worst possible moments.
Lesson #3: Integrations Make or Break the Day
What It Is
Intake, scheduling, EVV, billing, and payroll all need to communicate with one another. When they do, a visit flows cleanly from referral to verified, billable service. When they don’t, staff re-key the same information and small errors multiply.
What We Learned the Hard Way
– We had several systems that technically worked but didn’t talk to each other, and our partner treated each one as a separate island.
– Those integration gaps created hours of duplicate manual work every week.
– No one was looking at the whole workflow, only at individual support tickets.
What We’d Look For Now
We’d ask candidates how they think about our systems as one connected environment rather than a list of programs to keep online. A partner who understands home care will ask about our scheduling and EVV setup before we even raise it, because they know that’s where the friction usually lives.
We’d pay close attention to whether a firm is curious about how our work actually flows. The ones who are tend to prevent problems instead of just closing tickets after the fact.
Lesson #4: A Forward-Looking Partner Should Be Fluent in AI
What It Is
AI is rapidly changing the administrative side of home care, from after-hours call handling and scheduling support to documentation review and routine data entry. We don’t expect our IT partner to build AI from scratch, but we do expect them to help us adopt it responsibly and put it to work where it actually helps.
What We Learned the Hard Way
– Our previous provider had no point of view on AI at all.
– Hours of repetitive administrative work, including data entry, scheduling adjustments, and document sorting, went unautomated simply because no one on the technical side knew what was possible.
What We’d Look For Now
We’d ask candidates directly how they are helping other clients implement AI today, whether that’s intelligent call handling, scheduling support, document and data automation, or the secure use of AI tools that respect HIPAA. A partner who engages seriously with that question is thinking about our future. One who waves it off is thinking about our last decade.
We’d also want a partner who treats AI carefully rather than recklessly, someone who can help us capture the efficiency gains without putting protected health information at risk. The goal isn’t AI for its own sake. It’s freeing our team from busywork so they can spend more time on the people we serve.
Lesson #5: Onboarding and Offboarding Are Compliance Issues
What It Is
Home care sees real turnover. Every new caregiver needs accounts, devices, and access provisioned quickly, and every departing one needs that access fully and promptly removed.
What We Learned the Hard Way
– New hires sat idle for days waiting on accounts and devices, because there was no standardized process.
– Offboarding was inconsistent, and we later found former employees who still had access to systems they should never have retained.
– Each gap was a quiet security and compliance risk we hadn’t priced into the relationship.
What We’d Look For Now
We’d ask how a firm handles provisioning and deprovisioning, and whether it’s a documented, repeatable process or something improvised each time someone is hired or leaves.
For an agency that recruits and loses staff regularly, getting this right is one of the highest-leverage things an IT partner can do. It protects our clients’ information, supports our compliance posture, and lets new caregivers start contributing on day one.
Choosing an IT Partner Is a Strategic Decision
If we could start over, we would not choose an IT partner the way we chose our first one, on general reputation and price alone. We would choose based on how well a firm understands home care specifically: EVV, caregiver coordination, HIPAA accountability, the daily reality of running an agency across multiple counties, and increasingly, whether they can help us put AI to work.
Technology is no longer a back-office afterthought for agencies like ours. It touches nearly every step between a referral and a verified, billable visit, and it shapes how productive our caregivers can be in the field. The right partner makes that infrastructure feel invisible and actively looks for ways to make us more efficient. The wrong one becomes one more obstacle standing between us and the care we exist to provide.
We learned these lessons the slower, more expensive way. We’re sharing them in the hope that the next agency owner reading this can skip a few of the mistakes we made, and ask better questions before they sign.
About the Author
Stephen Matoesian is a Managing Partner of Heart of Humanity, a dual licensed agency that offers a full continuum of in-home services, including skilled nursing, therapy, and disease management, as well as non-medical support such as personal care, companionship, respite care and daily living assistance. Since 1997, Heart of Humanity has supported thousands of individuals and families across Northern California, with a specialized focus on serving individuals with developmental disabilities, while also providing care for older adults.
