Start-Up & Operations Manual for Non-Medical Home Care
Table of Contents
Module 1 – Overview
Is There A Need for Home Care?
What Are The Goals of Home Care?
What Are The Advantages & Disadvantages Of Home Care?
What Types of Organizations Provide Home Care Services?
Non-Medical Home Care Agencies
Private Hire or Independent Providers
Client Responsibilities as an Employer
Pharmaceutical and Infusion Therapy Companies
Medical Equipment & Supply Companies
What Job Positions Perform Home Care Services?
Who Pays for Home Care Services
Social Services Block Grant Program
Commercial Health Insurance Companies
Health Insurance and Managed Care Organizations
Civilian Health & Medical Program of the Uniformed Services (CHAMPUS)
Health Maintenance Organization (HMO)
Automobile Insurance Companies
Disease/Condition Focused Organizations
Medicaid: Consumer Directed Services Program
Where Can Inquiries About Home Care Be Directed?
Module 2 – Preliminary Considerations
Mission, Vision and Value Statements
Example: Value and Belief Statement
Criteria for Effective Business Objectives
Example: Objectives Your Business Might Choose
Advantages and Disadvantages to Owning a Business
Keys and Obstacles to Successful Business Operations
Advantages and Disadvantages of Having a Home-Based Business
Sources of Additional Information on Home-Based Businesses
Services Delivered by the Franchise System
Obtaining Input from Experienced Franchisees
Advantages and Disadvantages of Buying Into a Franchise
Module 3 – Feasibility Study
Meaning & Objective of Feasibility Study
Conducting Test Market Research
Value and Format of a Test Market Survey
Things to Consider When Designing a Test Market Questionnaire
Things to Research When Evaluating the Market
Market Profile (Potential Clients)
Example: Estimating Your Share of the Market
Determine Price Structure for Home Care Services
Things to Consider When Pricing Home Care Services
Formula: Determining Total Costs
Formula: Determining the Cost per Hour to Deliver Service
Formula: Calculating the Amount to Charge for Service per Hour
Example: Determining How Much to Charge for Service per Hour
Determine Start-Up Expenses/Costs
Newspaper, Yellow Pages, Business Directories
Brochures, Stationery and Business Cards
Housekeeping Equipment/Supplies
Window Washing Equipment/Supplies
Yard & Garden Maintenance Equipment/Supplies
Personal Care Equipment/Supplies
Example: Setting-up a Spreadsheet for Projecting Start-Up Costs
Determine Operating Expenses/Costs
Example: Setting-up a Spreadsheet for Projecting Labor Expenses
Example: Setting-up a Spreadsheet for Projecting Operating Expenses
Formula: Forecasting/Projecting Service Revenues
Calculate the Break-Even Point
Determining Service Hours Required to Meet Expenses
Formula: Estimating the Break Even Point in Service Hours
Example: Estimating the Break Even Point in Service Hours for One Month
Determining Service Hours Required to Provide a Salary
Formula: Determining Service Hours Required to Provide a Salary
Determining Revenue Dollars Required to Meet Expenses
Formula: Determining Break-Even Point in Revenue Dollars
Example: Estimating Break-Even Point in Revenue Dollars for One Month
Example: Cash Flow Projection Chart
Analyze Feasibility Study and Make Decisions
Module 4 – The Business Plan
How a Business Plan Benefits You
Information Required in a Generic Business Plan
Description of the Home Care Industry
Description of Business Venture
Module 5 – Financing Your Business
Start-Up Capital and Operating Capital
Alternatives to Debt Financing
Funding Sources for Setting up Your Business
Small Business Administration Loan
American Corporate Giving Programs
Module 6 – Business Start-Up Requirements
Determine Professional Consultations Needed
Decide Which Business Structure/Form to Use
Limited and Limited Liability Partnership (LLP)
Limited Liability Company (LLC)
Choose, Search & File Your Business Name
Fictitious Business Name (FBN)
Choose Your Fictitious Business Name & Logo
Search Your Fictitious Business Name for Previous Registrations
Register Your Fictitious Business Name (FBN)
Limited Partnership, LLC, Corporation
Register Your Business with the State
Apply for An Employer Identification Number (EIN)
Open a Business Checking Account
Obtain a State Seller’s Permit
Obtain a State Home Care Agency License
State Licensing Authority Links
Professional Liability Insurance/Errors and Omissions Insurance
Determine Hiring as Employee or Independent Contractor
When Individuals are Hired as Employees
Individuals Hired as Independent Contractors (ICs)
Strengthening Your Case for Independent Contractor Status
Complete Required Forms (obtain from government)
Set-Up Your Record Keeping System
Purpose of Accounts and Records
Components of an Effective Accounting System
Tips for Maintaining Good Records
Comply with Required Regulations
State Labor and Employment Laws
Occupational Health and Safety Administration (OSHA) Requirements
US Equal Employment Opportunity Laws
Determine Required Payroll Deductions
Federal Income Tax Withholding
Social Security and Medicare Taxes (FICA)
Federal Unemployment Taxes (FUTA)
State Income Tax Withholding and Registration
Workers’ Compensation Insurance
Consider Accreditation & Certification Options
Module 7 – Marketing
Difference between Marketing Plan and Business Plan
Guidelines for Marketing Plans
Developing a Competitive Advantage
Creating a Unique Selling Position (USP)
Creating a Good Mission Statement
Example: Mission Statement for a Home Care Business
Points to Consider When Web Building
Differences In Marketing Methods
Difference Between Marketing and Promotion
Difference Between Promotion and Advertising
Difference Between Advertising & Direct Marketing
Using Your Resources Prudently
Determining the Best Time to Advertise
Advertising in the Appropriate Places
Developing a Direct Marketing Strategy
Module 8 – Relationship Selling to Clients
Relationship Selling to Clients
How to Build and Maintain Relationships with Clients
Focus on Filling Your Clients’ Needs
Understand & Apply the Commitment/Sales Process
Module 9 – Home Care Service Menu
Overview of Non-Medical Home Care Services
Typical Non-Medical Home Care Services
Homemaker/Home Management Services
Intermittent Chore/Home Maintenance Services
Module 10 – Role of the Home Care Assistant
Work Duties/Tasks and Responsibilities
Duties/Tasks Companionship Does Not Include
How to be a Good Companion/Sitter
Work Duties/Tasks and Responsibilities
Duties/Tasks Homemaking Do Not Include
Work Duties/Tasks and Responsibilities
Duties/Tasks Personal Care Does Not Include
Live-In Duties/Tasks Do Not Include
Work Duties/Tasks and Responsibilities
Home Care Assistant Responsibilities
Occupational Health and Safety
Accountability, Judgment and Decision Making
Module 11 – Preparation Activities
Preparation Activities Flow Chart
Develop Your Service Standards
Develop Your Policies and Procedures
Purpose of Policies & Procedures
Essential Policies & Procedures
Choose those Services You Will Provide
Determine Your Staffing & Human Resources Needs
Organizational Chart for a Typical Home Care Business
Develop an Employment/Job Application Form
Steps in the Recruitment & Hiring Process
Define the Person and their Role in Your Agency
Home Care Assistant Competency Model
Attract Candidates to Your Agency
Example: Advertisement for Home Care Assistants
Assess Candidate’s Suitability for Role
Do’s and Do Not’s of Interviewing
Other Key Factors for Assessing Candidates
Select Candidates for Your Agency
Guidelines for Selecting Employees
Conducting Pre-Employment Screening
Orientation/Training New-Hire Employees
Conducting Effective Staff Orientations
Identifying & Documenting Orientation/Training
Criteria for Establishing Pay Rates
Types of Services Being Performed
Employee Qualifications and Experience
Create Employer/Employee Contracts/Agreements
Respect Privacy of Information
Obtain Forms for Client Records
Module 12 – Service Delivery Process
Initial Contact/Inquiry to Agency
Action # 1 : Request for Information
Action # 2 : Referral to Outside
Action # 3 : Request for Service
Steps for Implementing and Delivering Service
Step 1: Receive Request for Service
Step 2: Conduct In-Home Interview
Develop Care Plan/Service Plan
Confirmation of Service Delivery
Develop and Sign a Service Agreement
Obtain Consent to Release Information
Step 4: Deliver/Provide Services
Step 5 Maintain Client Records
Things to Know About Documentation
Responsibilities for Record Maintenance
Client Rights Regarding Their Records
Step 7: Make Changes as Required
Case Study #1 : Applying the Service Delivery Process
Receive a Request for Service (Step 1)
Conduct In-Home Interview (Step 2 )
Develop a Care Plan/Service Plan
Example: Care Plan/Service Plan
Example: Consent to Release Information
Example: Confirmation of Service Delivery
Maintain Client Records (Step 5 )
Follow-Up and Monitor (Step 6 )
Make Changes as Required (Step 7 )
Case Study #2 : Completing Client Care Records
Example: Client Status Notations
Example: Client Medication Record
Example: Client Progress Report
Module 13 – Client Services
Guidelines for Effective Client Service
Traits Clients Want Home Care Personnel to Have
Interpersonal Relationships in Client Services
Home Care Assistant Character Traits
Personal Boundaries in Client Service
Home Care Agency Responsibilities
Personal Information and Privacy
Guidelines for Personal Information and Privacy Management
Guidelines for Disclosing Confidential Information
Ethical Guidelines for Home Care Assistants
Standards for Developing a Code of Ethics
Work Ethics for Home Care Assistants
Characteristics and Qualities of Good Work Ethics
Ethical Behavioral Patterns and Attitudes
Image and Self Care Responsibilities
Signs and Symptoms of Elder Abuse
Where to Report Suspected Elder Abuse
Module 14 – Day-to-Day Operations
Example – Home Care Assistant Work Schedule
Guidelines for Recording Client Information
Independent Contractor Agreements
Example: Employee Mileage Record
Example: Client Cash Transaction
Rates/Fees and Minimum Service Hours:
Computerized Accounting System
Example: Client Invoice: Individual
Example: Client Invoices: Master Log
Late Payment Notice – First Letter
Example: Late Payment Notice – First Letter
Late Payment Notice – Second Letter
Example: Late Payment Notice – Second Letter
Example: Client Service Schedule
Continuous Quality Improvement
Quality Improvement Evaluations
Confidential Information in Electronic Devices
Appendix “A” – Sample Business Plan
Appendix “B” – Forms
Care Plan/Service Plan (includes a Needs Assessment)
Client Cash Transactions
Client Flow Chart
Client Invoice: Individual – (MS Word)
Client Invoices: Master Log – (MS Word)
Client Medication Record
Client Progress Notes
Client Service Satisfaction Survey
Client Service Schedule
Client’s Consent: Referral & Release of Information
Confirmation of Service Delivery
Employee Confidentiality & Non-Disclosure Agreement
Employee Mileage Record
Employee Orientation Checklist
Employee Reference Check
Employee Time Sheet
Employer & Employee Agreement
Employment Interview
Field Supervision Review
Financial: Profit & Loss Statement – Excel Worksheet
Financial Projection Model – An All-in-One Excel Worksheet for projecting:
- Start-Up Funds
- Salaries & Wages
- Fixed Operating Expenses
- Projected Sales Forecast
- Projected Sales (Year 2)
- Cash Receipts Disbursements
- Income Statement
- Cash Flow Statement
- Balance Sheet
- Year End Summary
- Income Projection Statement (Year 2)
- Cash Flow Statement (Year 2)
- Balance Sheet (Year 2)
- Income Statement (Year 3)
- Cash Flow Statement (Year 3)
- Balance Sheet (Year 3)
- Financial Ratios (Years 1,2, & 3)
- Breakdown Analysis
- Amortization Schedules
- Financial Diagnostics
Home Safety Check List
Independent Contractor & Agency Agreement
Job Description – Home Care Assistant Model
Job Description – Home Care Companion
Job Description – Home Care Manager or Administrator
Job Description – Home Care Supervisor
Job Description – Homemaker
Job Description – Personal Care Attendant
Job Description – Live-In home Care Aide
Job Description – Registered Nurse
Job-Employment Application
Market Analysis for Home Care Business
Nursing Assessment
Personal Suitability Questionnaire
Personal Care Supplies Check List
Phone Numbers – Emergency
Pre-Employment Background Check Authorization
Rights & Responsibilities of Client & Agency
Service Agreement (Client & Agency)
Special Equipment Check List
Start-Up Work Plan Check List
Optional Forms
Assessment: General Needs
Assessment: Nursing
Assessment: Personal Care
Client Invoice: Individual MS – MS Word Manual Completion Version
Client Invoices: Master Log – MS Word Manual Completion Version