Free Home Health Aide (HHA) Time Log & ADL Timesheet

The EVV Mandate: Why a Paper HHA Timesheet is Your Backup

Under the federal 21st Century Cures Act, all Medicaid-funded personal care services must use Electronic Visit Verification (EVV). This means caregivers must use a smartphone app to log their GPS location, time-in, and time-out.

"Technology fails. EVV apps crash, rural homes lose cell service, and phones die. When the app fails, a physical paper timesheet signed by the patient is the only legal way to prove you worked and ensure you get paid."

A smartphone displaying an EVV app crash error message, sitting next to a neatly filled out paper Home Health Aide timesheet with a pen. — When the agency EVV app crashes, a paper log with the patient's signature protects your paycheck.

Documenting for Medicaid: ADLs vs. IADLs

If you work for an agency, you know that Medicaid audits are incredibly strict. You cannot simply write "helped patient" on your time log. You must specify whether you performed ADLs (Activities of Daily Living) or IADLs (Instrumental Activities of Daily Living). Mixing these up can lead to rejected claims.

A clean corporate infographic showing the difference between Activities of Daily Living (ADLs) like bathing and eating, versus Instrumental Activities of Daily Living (IADLs) like housekeeping and shopping. — Accurately separating ADLs (basic survival tasks) from IADLs (independent living tasks) on your timesheet is critical for passing Medicaid audits.

**Caregiver Duties: ADL vs IADL Classification**
ADLs (Basic Survival Tasks)	IADLs (Independent Living Tasks)
Bathing, showering, and grooming	Housekeeping and laundry
Toileting and incontinence care	Meal preparation and grocery shopping
Feeding (putting food in mouth)	Managing medications and pills
Transferring (bed to wheelchair)	Transportation or running errands

Live-In Caregivers and the 5-Hour Sleep Rule

Wage theft is rampant among 24-hour live-in aides. By default, many agencies deduct 8 hours for sleep time and 3 hours for meals, only paying for 13 hours of work. However, the U.S. Department of Labor (DOL) has a strict rule: If your sleep is interrupted by the patient to the point where you do not get at least 5 continuous hours of sleep, you must be paid for the entire 24-hour period.

If you log multiple nighttime interruptions on your timesheet above, you should use an overtime calculator to ensure your agency pays you 1.5x your regular rate for those extra hours. When translating short 15-minute nighttime tasks into payroll numbers, use a decimal hours converter to maintain accuracy on your timesheet.

Frequently Asked Questions

1. Why do I need a paper log if my agency uses an EVV app?

Electronic Visit Verification (EVV) systems are mandated for Medicaid-funded care, but apps frequently crash or lose GPS signal in rural areas. A paper HHA time log with the patient's physical signature serves as a legal backup to ensure you still get paid.

2. What is the difference between ADLs and IADLs on a timesheet?

ADLs (Activities of Daily Living) involve basic personal care like bathing, feeding, and dressing. IADLs (Instrumental Activities) involve secondary tasks like light housekeeping, grocery shopping, or meal prep. Many Medicaid programs require these to be categorized separately for billing.

3. Do live-in caregivers get paid for sleep time?

Under DOL rules, if a 24-hour live-in caregiver does not get at least 5 hours of uninterrupted sleep due to patient interruptions, the employer must pay them for the entire 24-hour shift, not just the 13 or 14 hours usually billed.

4. Does commute time between patients count as paid hours?

Yes. If you are an agency employee traveling directly from one patient's home to another patient's home in the middle of the workday, that travel time must be compensated under the Fair Labor Standards Act (FLSA).

Home Health Aide (HHA) Time Log

Patient Visit Timesheet