CRITERIA OF ACCEPTANCE FOR REFERRAL OF SERVICE

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Information Booklet

We thank you for your interest in Prestige Care Services. Our mission is to provide prestigious services to empower you to live an independent lifestyle so that you can embrace your highest quality of life. Our vision is to foster meaningful relationships through our belief that all people are valuable, having qualities worthy of respect and admiration. We strive to demonstrate our belief by recognizing every person has personal rights which shall not be violated. We, Prestige Care Services, are dedicated to promoting both the physical and the emotional wellbeing of our clients. Our contracted staff are carefully selected, screened, and trained to provide the highest quality of services. All aspects of each client s care are monitored by a registered nurse. Your happiness and safety are our priority. Prestige Care Services is an owned partnership with our Administrator, Kerrie Thacker and our Director of Nursing, Kim Parisi RN. Together we have prepared this booklet to assist you in becoming better acquainted with us and to help you understand the home health process. We provide short or long-term care by the hour as well as 24/7 and services can be medical or non-medical. We are not a Medicare or Medicaid provider, but most long-term care private insurance plans are accepted. When you have decided to choose Prestige Care Services as your provider of inhome care, a registered nurse will visit for a comprehensive assessment of needs. She will establish a plan of care with you. She will then go over the documentation we will require to initiate the services you have chosen. The following information will guide you in the different types of services available and the costs associated with them. If ever you have any additional questions or feedback, we welcome you to ask us without hesitation. We are here to meet your needs. Our office hours are Monday-Friday, 8 am-4 pm.

CRITERIA OF ACCEPTANCE FOR REFERRAL OF SERVICE Referral to this organization for provision for services can only be accepted under the direction of a physician, based upon the individual s health needs. We will guide you through this process and contact your physician for you. The service must be of the type that we provide and within the scope of the referred independent contractor. Companion and homemaker services may be provided by a client s request without direction from the physician. SERVICES INFORMATION This organization may make referrals for a combination of services in your home. The caregivers that we refer are independent contractors and not employees. 1099s are distributed to them and the IRS for tax purposes and caregivers are responsible for arranging their own taxes. The Agency for HealthCare Administration (AHCA) is the regulatory agency overseeing the nurse registry. Each independent contractor has passed a level II background screen with fingerprinting, has proof of certification or licensure in their scope, and has a physician signed health statement. We are responsible to ensure that each caregiver is competent in his/her scope of practice. Each caregiver has a comprehensive orientation, has demonstrated to the registry s Director of Nursing the level of skill needed to provide quality and safe care, and participates in continuing education. Our caregivers clock in and out using a GPS system on their smartphone or tablet or by telephony using the client s main phone ensuring your schedule is being maintained. AVAILABLE CONTRACTED SERVICES Skilled Nursing (RN or LPN) RN Care Management Services Personal Care Services (Home Health Aide or CNA) Homemaker Companion Services Services appropriate to the needs of the individual will be assessed, coordinated, and planned by a registered nurse under the direction of the attending physician except in the case of the homemaker companion service which does not follow the direction of a physician. All efforts will be made to accommodate requests within the state and federal rules and regulations and the constraints of third party payer source. SKILLED NURSING SERVICES Skilled nursing services are provided by a registered nurse or a licensed practical nurse under the orders and direction of a physician. The nurses communicate with your physician to monitor, report and update your medical plan. Services include assessment and evaluation of needs, performance of skilled procedures, education for the client and family/primary caregiver. Nursing care plan review visits are scheduled a minimum of every 60 days to oversee and update the CNA/HHA plan of care.

A registered nurse is on call 24/7. Requested skilled visits when a CNA/HHA is contracted to provide care is available for an additional cost. RN CASE MANAGEMENT SERVICES Case management service is an advanced skilled service performed by the registered nurse. The services performed are the comprehensive physical and history assessment, needs assessment, and plan of care. Medication review and management, education, chronic illness management, and doctor appointment attendance are also available, if indicated. The benefit is to have the nurse involved in all aspects of care in order to facilitate physician communication, client understanding, and communication with the client and designated family/primary care giver. Services are provided on a weekly basis at a set rate. Additional weekly visits may be performed by either an RN or LPN and are billed at the skilled nursing rate. PERSONAL CARE SERVICES (Home Health Aide or CNA) Personal care services are performed by the (CNA) Certified Nursing Assistant or the (HHA) Home Health Aide. Some, but not all, insurance companies will cover services. The primary function is to provide personal care. Personal care includes daily activities such as bathing, grooming, dressing, mobility assistance, etc. The CNA/HHA will follow the plan of care established by the registered nurse in agreement with the client. They report directly to the nurse who is responsible for oversight of the care plan. Tasks and responsibilities include: Documentation and submission of services provided to the nurse registry. Records are maintained by the nurse registry for AHCA review. Observation and reporting of appearance and behavioral changes. Perform other activities as taught and documented by the registered nurse within their scope of practice. Provide or assist with personal care including bathing in a tub, shower, chair side or bedside. Assist or provide oral care including denture care. Assist with dressing. Assist with ambulation and/or transfers. Assist with the use of devices such as wheelchair, walker or lift devices. Assist with prescribed range of motion exercises. Assist with colostomy bag change. Reinforcement of dressings. Assist with prescribed ice cap or collar. Perform simple urine tests for sugar, acetone, or albumin.

Measures intake and output. Foley catheter care, maintenance, and drainage. Vital signs including Temperature, blood pressure, pulse, respirations, weight. Measures and prepares special diets. Assistance with meal preparation to meet nutritional needs. Maintains clean and safe environment including laundry and dishes for the client. CNA/HHA Restrictions: Changing sterile dressings. Irrigating body cavities such as giving an enema. Irrigating a colostomy or wound. Performing gastric irrigation or enteral feeding. Catheterizing a patient. Administering medications. Applying heat by any method. Caring for a tracheotomy tube. Cutting toenails. HOMEMAKER/COMPANION SERVICES Homemaker/Companion service does not provide personal care or provide any medication assistance. The focus of care is to assist with all functions that are within a normal homemaking role and to provide companionship. Homemaking services include light housekeeping, shopping, meal planning and preparation, etc. Companion services include conversation, activities and recreation, outings, etc. Homemakers and companions are responsible for following the plan of care established by the registered nurse, documenting all services and submitting records to the nurse registry. Their care does not require physician orders or oversight. Tasks and responsibilities include: Reports unusual incidents or obvious changes in condition to the nurse. Companionship and escort services for activities, outings or appointments. Light housekeeping tasks such as meal preparation and laundry for the client. Maintains clean and safe environment. Casual cosmetic and hair assistance, filing and polishing nails. Holding hand or arm when walking. Companion/homemaker restrictions: Assistance with medications Personal care of any kind Cutting finger or toenails

Any care outside of services listed. MEDICATION ASSISTANCE Medication administration is a skilled nursing service. A client must be able to self-administer his/her own medications or have assistance from a family member/primary caregiver. In some circumstances, under the guidelines and restrictions set forth by the Agency of Healthcare Administration, a CNA/HHA may provide assistance with self-administration of medications. Must have Florida mandated training requirement Assist only with previously dispensed medication (ongoing). Assist only with regularly scheduled medications. Must be in the original container with a pharmacy label Patient must be medically stable Must have written a request and consent to assist from client or legal designee. Must have a nurse review and document medications for assistance to ensure compliance with state statutes. Medication assistance includes: Assistance with scheduled and over-the-counter oral, topical, ophthalmic, otic, nasal, solutions, suspensions, sprays, and inhalers. Taking medication from proper container and bringing it to the patient. In the presence of the client, reading the label, opening container removing prescribed dose and closing the container. Placing oral dosage in the client s hand or other container and helping to lift the client s hand to his/her mouth. Applying topical medications. Returning medication containers to proper storage area. Keeping a record of when client has been assisted with medications. Medication assistance does NOT include: Assisting with PRN, as needed, medications unless there are specific parameters. Any medication time, dose, method, or reason requires judgement or discretion. Medications given into a body cavity including nebulizer or injections, rectal, urethral, or vaginal preparations. Mixing, compounding, converting, calculating dosages except to measure liquids, crush or breaking a scored tablet. The preparation of syringes for injection or any injectable medications. Irrigation or debriding agents used in skin or wound care. Does not administer medications only able to provide assistance

Hours worked on the following holidays are invoiced and paid at a rate of time and a half. The executive offices are closed during these observances. Holiday rate will be charged from Midnight to Midnight on the day of each holiday. Services do not have to be received on weekends and holidays if a client chooses not to have care those days. New Year s Day Birthday of Dr. Martin Luther King, Jr Easter Sunday Memorial Day Independence Day Labor Day Veteran s Day Thanksgiving Day Christmas Eve Christmas Day New Year s Eve For purposes of the executive offices closing only, if the actual holiday falls on Saturday, the preceding Friday is observed as a holiday. When a holiday falls on Sunday, the following Monday is observed as a holiday and the office will be closed. BILLING The client or representative agrees to pay a deposit equal to four (4) weeks of service as agreed upon during intake and prior to the initiation of services. We will send an invoice on a monthly basis on the first of each month with payment to be rendered upon receipt. All invoices not paid by the tenth of each month forfeits the agreement that is signed upon intake and services will no longer be provided. All outstanding balances existing at the time of the cancellation or forfeiture of the agreement are then applied to the deposit. Any remaining deposit monies are returned to client or client s representative at the time of the cancellation or forfeiture. DISCRIMINATION POLICY Prestige Care Services, LLC complies with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Regulations of the U.S. Department of

Health and Human Services issued pursuant to the Acts, Title 45 Code of Federal Regulations Part 80, 84, and 91 and the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 in that its activities are characterized by the absence of separation or discrimination by race, sex, national origin in any activity carried on, in, by, or for the organization affecting the care and treatment of patients. Prestige Care Services, LLC does not exclude, deny benefits to, or otherwise discriminate against any person for the reasons of race, color, or national origin, or on the basis of disability or age in participation in, or receipt of the services and benefits of any of its programs and activities or in employment therein, whether provided directly by this organization or through independent contracted staff. All referred patients are provided services without discrimination and no inquiries are made requiring race, color or national origin prior to the contact for services. Information regarding the cost and availability of services is uniformly made available to all without regard to race, color, sex, or national origin.