A Policies and Procedures Manual
Table of Contents
MASTER TABLE of CONTENTS
Section One: Organization & Administration
Mission, Vision & Values .
Legal Structure & Governing Body .
Organizational Structure .
Service Areas .
Operating/Service Hours .
Staffing & Staff Structure .
Roles & Responsibilities of Manager/Administrator .
Contracted Services .
Display of Home Care/Business License .
Certificates of Insurance .
Office Building’s Compliance with Regulations .
Promoting Agency Services .
Record Management .
Communication – Internal & External .
Compliance .
Compliance with Federal Deficit Reduction & False Claims .
Compliance with Agency Policies & Procedures .
Electronic Visit Verification .
Section Two: Scope of Services
Services Provided .
Personal Care Services . .
Homemaker Services . .
Companion/Sitter Services . .
Respite Services . .
Friendly Reassurance Services . .
Chore Services . .
Section Three: Service Delivery & Client Care
Service Delivery Process .
Provision of Information . .
Assessing Client Needs . .
Admission of Clients to Agency . .
Referral of Individuals Not Admitted to Agency . .
Re-Admission of Former Clients . .
Care Plan-Service Plan . .
Confirmation of Service Delivery . .
Service Agreement . .
Informed Consent to Receive/Refuse Services . .
On-Call Services . .
Client’s Consent for Referral & Release of Information . .
Monitoring & Follow-up . .
Advance Directives .
Death at Home .
In-home Orders .
Medication Management .
Change in Scheduled Care: Client Notification .
Discharge/Termination or Reduction of Client Services .
Discharge Planning . .
Discharge Summary . .
Transfer/Referral of Agency Clients .
Coordination of Client Transfer . .
Transfer Summary . .
Client/Consumer Protection .
Client/Consumer Rights .
Client/Consumer & Agency Responsibilities .
Matching Clients & Home Care Workers .
Supervision of Services .
Entering Clients’ Homes .
Failure of Clients to Answer Door .
Client Emergencies .
Weather Related Emergencies .
Unstable Health Conditions .
Client Service Certification .
Transporting Clients in Private Vehicles .
Managing Clients’ Finances/Property .
Assuming Legal Responsibility for Client .
Exploitation of Client’s Finances & Property .
Client Abuse .
Confidentiality & Privacy of Client Information .
Client Satisfaction Review .
Client Complaints… .
Documentation & Client Records .
Records Kept in Clients’ Homes . .
Safeguarding Client Records . .
Retention & Destruction of Client Records . .
Client Access to Information . .
Communicating with People with Disabilities .
Communicating with Clients with Limited English .
Restraint & Seclusion Measures .
Section Four: Human Resources
Recruiting, Hiring & Rostering .
Pre-Employment Background Checks .
Criminal Background & Sexual Offender Investigations .
Child Abuse Clearance .
Reporting Child Abuse . .
Provisional Hiring .
Adverse Actions .
Licensure, Certification & Registration .
Personnel Qualifications .
Job Descriptions .
Classification of Workers .
Training & Development .
Orientation . .
Personal Care Provider Training . .
Homemaker Training . .
Companion/Sitter Training . .
Annual Training . .
Staff Record of Training . .
Competency Evaluation of Direct Care Workers .
Probation .
Performance Appraisals .
Human Rights .
Civil Rights/Non-Discrimination .
Equal Opportunity .
Sexual Harassment .
Cultural Diversity .
Standards of Conduct & Work Ethics .
Conflict of Interest .
Solicitation and Distribution .
Gifts, Gratuities & Courtesies .
Employee Benefits & Compensation .
Employee Breaks .
Overtime .
Statutory Holidays .
Paid Leave .
Unpaid Leave .
Dress Code .
Employee Identification Badge .
Privately-Owned & Agency Vehicles .
Drugs & Alcohol Usage .
Secondary Employment .
Disciplinary Action .
Termination of Employment .
Employee Complaints & Grievances .
Personnel Records .
Protection of Personnel Records . .
Employee Medical Files .
Confidentiality & Non-Disclosure of Information .
Seniority and Promotion .
Media Inquiries .
Breast Feeding .
Agency Property .
Automation Systems . .
Social Media . .
Employee Personal Property .
Section Five: Health & Safety
General Health and Safety .
Employee Personal Safety .
Home Environment Safety .
Hazardous Household Materials . .
Oxygen Therapy . .
Violence & Threats of Violence .
Threats . .
Assaults . .
Weapons . .
Bomb Threats . .
Hostage Situations . .
Suicide Situations . .
Emergency Preparedness .
Fire . .
Earthquake . .
Hurricane . .
Tornado . .
Tsunami . .
Power Outages . .
Chemical Spills . .
Infection Control .
Tuberculosis Control . .
Blood-borne Diseases .
Exposure Control Plan for Blood-borne Diseases . .
Reporting & Recording Exposure
to Blood-borne Diseases . .
Universal Precautions .
Personal Protective Equipment . .
PPE – Gloves . .
PPE – Gowns & Aprons . .
PPE – Masks & Protective Goggles . .
Hand Washing . .
Sharp Objects . .
Handling & Transporting Specimens . .
Laundry . .
Blood & Body Substance Spills . .
Household Wastes . .
Aseptic Techniques .
Care & Handling of Equipment .
Care of Urinary Catheters .
Hygienic Measures in the Home .
Food Safety .
Infectious/Communicable Diseases in the Community .
Employees with Infectious/Communicable Diseases .
Clients with Infectious/Communicable Diseases .
Smoking .
Pregnant Employees .
Immunizations .
Incident Reporting .
Section Six: Financial Management
Financial Management System .
Service Rates & Fees .
Cash Disbursements .
Cash Receipts .
Billings & Receivables .
Payroll .
Bank Reconciliations .
Section Seven: Quality & Risk Management
Continuous Quality Improvement .
Continuous Risk Management .
Annual & Quarterly Quality Improvement Evaluations .
Red Flag Rule .
Securing Electronic Devices & Confidential Data .
Section Eight: Forms (Listed Alphabetically):
Advance Directives Information Sheet – CAD
Advance Directives Information Sheet – U.S.
Adverse Action Disclosure
Adverse Action: Pre-Action Disclosure
Assessment: General Needs
Assessment: Nursing
Assessment: Personal Care
Bomb Threat Check List
Care Aide Notations re Client Care
Care Plan/Service Plan
Client Care Flow Sheet
Client Complaint
Client’s Consent for Referral & Release of Information
Client/Consumer Rights
Client/Consumer and Agency Responsibilities
Client Satisfaction Survey: Direct Care Services
Client Satisfaction Survey: Implemented Services
Client Service Certification Record
Communicating with Clients Who Have Disabilities
Competency Test for Care Aides (Written Questions)
Competency Test for Care Aides (Answers & Composition)
Competency Test for Care Aides (Practical Skills)
Compliancy Agreement – Policies & Procedures
Confidentiality/Non-Disclosure of Information Statement
Conflict of Interest Statement
Consent for Child Abuse Clearance Check
Consent to Release Child Abuse Clearance Report
Coordination of Client Transfer Checklist
Decline Influenza Vaccination
Discharge/Transfer: Client Notification
Discharge Summary
Employee Complaint/Grievance
Employee Compliancy Agreement: Policies & Procedures
Emergency Preparedness Plan
Employee Orientation Check List
Employee Performance Appraisal
Employee Time Sheet
Employment Application for Home Care Workers
Employer & Employee Agreement
Employment Candidate Interview
Financial Expenditures on Client’s Behalf
Field Supervision Review
Home Safety Checklist
Incident Report – General
Incident Report – Medications
Incident Report – Post Exposure to Blood-borne Diseases
Incident Report – Post Exposure to Tuberculosis
Incident Reporting Log
Identity Theft Prevention Program & Addendums
Independent Contractor & Agency Agreement
Job Description — Home Care Aide
Job Description — Home Care Companion
Job Description — Live-In Home Care Aide
Job Description — Home Care Manager/Administrator
Job Description — Home Care Personal Care Attendant
Job Description — Home Care Supervisor
Job Description — Home Care Registered Nurse
Medication Administration Record
Mission, Vision & Value Statement
Notification of Direct Care Worker Status – Agency Employee
Notification of Direct Care Worker Status – Non-Agency Worker
On-Call Inquiry Log
Organizational Chart
Personal or Private Vehicle Usage Mileage Record
Pre-employment Background Check
Reduction of Services: Client Notification
Reference Checks
Request or Decline a Hepatitis B Vaccine
Service Agreement
Service Information Handout for Clients/Consumers
Staff Record of Training & In-services
Standards of Conduct
Transfer Summary
Transportation Liability Waiver
Section Nine: Index
All policies, procedures & forms are listed categorically & alphabetically