TABLE OF CONTENTS ORGANIZATION AND ADMINISTRATION 1 PERSONNEL AND CONTRACTORS 24

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1 i TABLE OF CONTENTS ORGANIZATION AND ADMINISTRATION 1 Mission Statement... 2 Policy and Procedure Development and Implementation... 3 Governing Body... 5 Professional Advisory Committee*... 8 PAC and Governing Body Member Orientation Organizational Structure Organizational Chart Compliance/Whistleblower Policy Conflict of Interest Public Disclosure Legal Requirements Closure/Transfer of Ownership PERSONNEL AND CONTRACTORS 24 Equal Employment and Affirmative Action Criminal History, Disclosure, and Background Inquiries Personnel Selection Personnel Requirements Personnel File Content and Management Orientation to Home Care Agency Continuing Education Home Care Agency Resource Materials Performance Evaluations Supervision of Basic Personal Care Assistants Supervision of Homemakers Corrective Action Employee Grievances and Complaints Smoke Free Workplace Drug and Alcohol-Free Workplace Drug Testing... 58

2 ii Intimidation, Discrimination, and Harassment Ethical Issues Conditions of Employment Job Description: Administrator Job Description: Office Manager Job Description: Quality Coordinator/Compliance Officer Job Description: Service Supervisor Job Description: Basic Personal Care Assistant Job Description: Homemaker Job Description: Scheduler/Client Care Coordinator CLIENT SERVICES POLICIES AND PROCEDURES 88 Scope and Availability of Agency Services Client Rights and Responsibilities Advance Directives Informed Consent Admission and Assessment Plan of Care On-Call Services Basic Personal Care Assistant Services Homemaker Services Contracted Services Coordination of Services Medication Assistance Client/Caregiver Education Communicating With Clients Behavior Management Client Transfer and/or Discharge Client Expiration at Home CLIENT RECORDS/INFORMATION MANAGEMENT 131 Information Management Plan Record Retention And Disposal Notice of Privacy Practices HIPAA Compliance for PHI*

3 iii Release and Disclosure of Client Health Information Client Requests for Restrictions on Use/Disclosure of PHI Client Privacy and Security Client Service Record: Non-Skilled PERFORMANCE IMPROVEMENT 157 Performance Improvement Program Performance Improvement Initiatives Performance Improvement Program Monitoring Client Record Review Annual Program Evaluation Client Satisfaction Survey Client/Family Complaints and Grievances Risk Management Mandatory Reporting of Abuse and Neglect Client/Employee Incident Reporting Client Self-Administered Medication Errors Adverse Events INFECTION CONTROL 196 Tuberculosis Exposure Control Hepatitis B Prevention/Vaccination Infection Control/Exposure Plan Universal Precautions Employee Exposure to Bloodborne Pathogens Hazardous Waste Disposal Reportable Diseases SAFETY 222 Safety Management Workplace Safety Safe Medical Devices Act/Medical Device Tracking Personnel Safety Pets In The Home Food Handling

4 iv Fall Prevention Violence in the Workplace Emergency Care Emergency/Disaster Preparedness and Procedures Staff and Client Home Safety Home Environment and Safety Assessment OSHA 300/300A/301 Logs Employee Protective Equipment FINANCIAL POLICIES 252 Financial Management Fee Setting and Collections Liability Insurance Budget Preparation Strategic Plan Financial Monitoring Chart of Accounts Claims Submission and Denied Claims Processes Billing Audits and Annual Financial Review Accounts Receivable and Accounts Payable Transportation Reimbursement Payroll Compensation and Benefits Petty Cash Inventory/Fixed Assets RESOURCE TOOLKIT 277 Compliance Plan Education Elements Samples of Suspected Home Health Care Compliance Violations Developing a Client Bill Of Rights Sample: Individual Statement Regarding Conflict of Interest Sample: Continuous Service Personnel Orientation Sample: Complaint Form Sample: Employee Complaint Form Sample: Home Care Quality Grid OSHA Injury and Illness Recordkeeping and Reporting

5 v Application information and forms 291 Administrative Organization Organizational Structure Criminal Record Statement Criminal Record Exemption Transfer Request Criminal Record Clearance Submission Criminal Background Clearance Transfer request Request for Live Scan Services Guidelines for Community Care Licensing HomeCare Aide Registry Application Registration Intent Form Instructions for Completion of the Medi-Cal Provider Agreement Medi-Cal Provider Agreement