Nearly all monitoring mechanisms used by home care programs focus on the structure or process of service delivery. Although few programs have developed approaches to monitor service outcomes, one method reported to monitor subjective outcomes is client satisfaction surveys. Efforts to monitor objective service outcomes are even less common. Only three programs reported objective criteria to monitor service outcomes. Enforcement in home care .
Enforcement is the act of carrying out sanctions for failure to comply with standards.
These are the most frequently cited economic penalties. Other economic penalties include reassigning clients to competing providers, withholding client referrals, and limiting the services of a provider. Use of these mechanisms is influenced by service provider availability. Programs located in areas with only one or two home care agencies are restricted in the number of economic penalties they can employ without adversely affecting service delivery. Imposing criminal penalties including imprisonment and fines.