Divine Home Care TABLE OF CONTENTS

1 Divine home care TABLE OF CONTENTS A comprehensive listing of the policies and procedures in numeric order can be referenced under the Crosswalk tabbed section of this manual. SECTION C: CLIENT care Abuse Prevention Plan C-560 Admission Policy C-120 Advance Beneficiary of Non-Coverage Notice C-123A Advance Directive Policy C-430 Advance Directive Procedure C-435 Adverse Medication Reaction C-730 Anticoagulant Therapy C-715 care Plans C-660 Client Admission Process C-140 Client and/or Family Responsibilities C-390 Client Discharge Process C-500 Client/Family Education C-400 Client/Family Complaint/Grievance Policy C-381 Client Identification C-210 Client Information Required for Medication Management

2 C-704 Client Privacy Rights C-382 Client Reassessment/Update of Comprehensive Assessment (SCIC) C-155 Client Requests for Restrictions on Use and Disclosure of PHI C-388 Client Security and Privacy C-900 Client Transfer C-840 Clinical Documentation C-680 Clinical Record Confidentiality C-880 Clinical Records/Medical Record Retention C-870 Clinical Record Removal C-420 Clinical Supervision C-300 Code of Ethics C-510 Communication with Limited-English-Proficient Persons C-860 Communication with Sensory-Impaired Clients C-850 Comprehensive Client Assessment C-145 Consent for Use and Disclosure of Protected Health

3 Information C-386 Consent for Filming or Recording C-610 Controlled Substances C-740 Coordination of Client Services C-360 County Medical Examiner Notification of Impending C-480 Death of home Health care Client Delegation of nursing Tasks C-350 Discharge Summary C-820 Discontinuation of Life-Sustaining Treatment C-490 Documentation of Changes to the Medical Records C-873 Electronic Signature C-872 Emergency care C-655 End of Life care C-440 Ethics Committee C-530 Extended Hours of Service C-280 Face to Face Encounter C-590 Divine home care TABLE OF CONTENTS Fall Prevention Program C-146 First Dose Medication Therapy C-750 Flow Sheets C-710 Handling of Clients Finances and Property C-895 Hand Off Communication C-365 home care Bill of Rights C-380 home Health Change of care Notice C-123 home Health Aide care Plan C-751 home Health Aide Medication Administration Procedure C-760 home Health Aide Services C-220 home Health Aide Supervision C-340 home Health Aide: Assignment C-780 home Health Aide.

4 Documentation C-800 Identifying and Reporting Abuse/Neglect/Exploitation of Clients C-540 Investigational Medications C-620 Licensed Practical Nurse Supervision C-320 Medical Social Services C-260 Medical Supervision C-645 Medicare Qualifying Criteria for Beneficiary Reimbursement C-122 Medication Administration C-708 Medication Administration by home Health Aides C-755 Medication Administration Error C-720 Medication Labels C-707 Medication Management C-705 Medication Orders C-706 Medication Profile C-700 Medication Reconciliation C-709 Medication Set Up Policy C-701 Notice of Privacy Practices C-384 Notice of Medicare Non-Coverage C-124 Obtaining and Renewing DNR/DNI Orders C-460 Pain Assessment and Management C-148 Physician Orders C-635 Physician Summary C-650 Plan of care C-580 Provision for 24-Hour RN Availability C-180 Release and Disclosure of Information C-125 Reporting of Critical Values C-370 Restraints C-625 Section 504 Grievance Procedures C-422 Service Agreement C-160 Services on Hold C-630 Services Provided C-100

5 skilled nursing Services C-200 Standards of Practice C-110 Supervision of Staff C-315 Therapy Services C-240 Voluntary Informed Consent C-600 C-100 Divine home care SERVICES PROVIDED Agency will provide intermittent, part-time or extended hours of skilled nursing and home health aide services to clients in their places of residence. The intermittent or part-time services shall be provided on a visiting basis. Agency will also provide Physical Therapy, Speech Therapy, Occupational Therapy, and Medical Social Services on a visiting basis to clients in their places of residence.

6 At least one (1) of the qualifying services will be provided directly through agency employees. The second qualifying service and additional services may be provided under arrangements with another agency or organization. If, for medical or safety reasons, a service to be provided must be completed at the scheduled time, and the Agency is unable, for any reason, to keep the scheduled appointment, arrangements will be made to complete the service through a contract with another provider or through other reasonable means. Services shall be available seven (7) days a week, twenty-four (24) hours per day.

7 On-call nurses will carry pagers/cell phones for contact in the event of an emergency and will be available supplied twenty-four hours per day, seven days a week. Services will be coordinated by the Registered Nurse/Therapist managing the care . This will include implementing, revising, and updating the Plan of care ; physician conferencing; scheduling of visits; supervision of health team members; and conferencing with health team members to plan and evaluate client care . All services not furnished directly, are monitored and controlled by the parent agency.

8 Appropriate administrative records shall be maintained for each Branch. The qualifications and competence of the individual(s) providing service are appropriate to client needs and the required services and comply with applicable laws and regulations. The Agency will provide services to clients in the following county service area: Crow Wing, Morrison, Stearns, Pope, Stevens, Grant, Traverse, Big Stone, Swift, Chippewa, Kandiyohi, Meeker, Wright, McLeod, Renville, Redwood, Yellow Medicine, Lincoln, Lyon, Murray. Agency maintains business hours Monday through Friday, 9:00 to 5:00 , except during holidays or as authorized by the Administrator.

9 C-100 Divine home care Statement of home care Services Comprehensive home care Provider Comprehensive home care Provider Name: Divine home care , Inc. Below is a list of all services that may be provided with a Comprehensive home care License. Each service that is offered by this provider is indicated by a check next to the service. Advanced Practice Nurse Services Registered Nurse Services Licensed Practical Nurse Services Physical Therapy Services Occupational Therapy Services Speech Language Pathologist Services Respiratory Therapy Services Social Worker Services Services by a Dietitian or Nutritionist Medication Management Services Delegated tasks to unlicensed personnel Hands-on assistance with transfers and mobility Providing eating assistance for clients with complicating eating problems ()

10 Difficulty swallowing, recurrent lung aspirations, or requiring the use of a tube, parenteral or intravenous instruments) Complex or Specialty Healthcare Services Assistance with dressing, self-feeding, oral hygiene, hair care , grooming, toileting, and bathing Providing standby assistance within arm s reach for safety while performing daily activities Providing verbal or visual reminders to take regularly scheduled medication (includes bringing clients previously set-up medication, medication in original containers, or liquid or food to accompany the medication)