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New Hampshire Policy and Procedure Manual

Skilled Nursing, Therapeutic Services, and Personal Care

The Policy and Procedure Manual is the heart of all Home Health Agencies as well as the first item Surveyors want to review.

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Does your manual follow CHAP, JCAHO, or ACHC accreditation standards?
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Our survey proven policy and procedure manual will allow you to take care of your patients, rather than spend your valuable time researching rules and regulations.

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Policy and Procedure Manual — Policies and PDF Samples

Click underlined documents below to view PDF samples.

Accreditation Specific Table of Content Samples

ADMINISTRATIVE

  • 1.001.1Definition of Organization
  • 1.001.2Mission Statement and Philosophy
  • 1.002.1Services Offered
  • 1.003.1Service Area
  • 1.004.1Payment for Services
  • 1.004.2Fee Schedule
  • 1.005.1Hours of Operation
  • 1.006.1Administrative Control/Governing Body
  • 1.006.2Ethics Committee
  • 1.007.1Professional Advisory Committee (if applicable)
  • 1.008.1Annual Evaluation
  • 1.009.1Admission Criteria
  • 1.009.2Face to Face Encounter
  • 1.010.1Discharge/Transfer from Service
  • 1.011.1Contingency Plan
  • 1.011.2Agency Closure Procedures
  • 1.012.1Backup Coverage of Services
  • 1.013.1Business Associate Contract
  • 1.014.1Anti Fraud Program
  • 1.016.1Professional Standards & Principles
  • 1.017.1Financial Records
  • 1.017.2Financial Planning
  • 1.017.3Capital Expenditures
  • 1.018.1Services Provided under Contract
  • 1.019.1Research Activities/Investigational Studies
  • 1.020.1Public Disclosure
  • 1.020.2Disclosure to Licensing Authority
  • 1.020.3Change of Ownership or Administrative Control
  • 1.020.4Plan of Correction
  • 1.021.1Information Management

HUMAN RESOURCES

  • 2.001.1Reasonable Accommodations
  • 2.002.1Personnel Records
  • 2.002.2OIG Excluded List
  • 2.002.3Employment References
  • 2.002.4Time Records
  • 2.003.1Selection of Personnel
  • 2.003.2Classification of Personnel
  • 2.003.3Volunteers
  • 2.003.4Ethics
  • 2.003.5Employee Dress Code
  • 2.003.6Employee Health Assessments
  • 2.004.1Payday
  • 2.005.1Benefits & Wages
  • 2.006.1Confidentiality
  • 2.007.1Orientation & Staff Development
  • 2.008.1Policy & Procedure Agreement
  • 2.009.1Competency Evaluation
  • 2.010.1Cell Phone and Texting
  • 2.011.1Cultural Diversity
  • 2.013.1Performance Evaluation
  • 2.014.1Employee Discipline
  • 2.015.1Termination/Separation of Employment
  • 2.016.1Employee Grievances
  • 2.017.1Smoking
  • 2.021.1Professional Peer Review
  • 2.022.1Professional Reporting
  • 2.023.1Drug Testing
  • 2.024.1Conflict of Interest
  • 2.025.1Knowledge/Resource Center

RIGHTS, RESPONSIBILITIES, ETHICS

  • 3.001.1Client Conduct, Responsibility & Rights
  • 3.001.2Non Discrimination
  • 3.001.3Program Accessibility
  • 3.002.1Solicitation/Distribution for Referrals
  • 3.003.1Patients Complaints & Grievances
  • 3.004.1Reporting Abuse, Neglect, or Exploitation
  • 3.005.1Criminal History Checks
  • 3.005.2Employee Misconduct Registry
  • 3.005.3National Sex Offender Registry
  • 3.006.1Out-of-Hospital Do Not Resuscitate Order
  • 3.007.1Advanced Directives
  • 3.007.2Declaration for Mental Health Treatment
  • 3.009.1Coordination of Client Care
  • 3.011.1Patient Privacy Rights
  • 3.012.1Facilitating Communication
  • 3.013.1After Hours Care

PATIENT INFORMATION

  • 4.001.1Security of Clinical Information
  • 4.002.1Retention of Clinical Records
  • 4.003.1Timeliness of Entries in Clinical Record
  • 4.003.2Client Records
  • 4.004.1Physician Orders/Plan of Care
  • 4.004.2Physician Signatures
  • 4.004.3Physician Delegation
  • 4.004.4Physician Verification
  • 4.004.5RN Delegation
  • 4.005.1Clinical Record Review/Quarterly Review
  • 4.006.1Abbreviations
  • 4.007.1Prohibition on Transporting Patient
  • 4.008.1Data Entry/Transmission OASIS Info
  • 4.009.1Medication Profile
  • 4.009.2Medication Administration Record
  • 4.009.3Medication Storage
  • 4.009.4Emergency Medication
  • 4.009.5Medication/Prescriptions Orders
  • 4.009.6Confused Drug Names
  • 4.009.7Administration of Blood
  • 4.009.8Adverse Drug Reactions
  • 4.009.9Trasporting Vaccinations
  • 4.010.1Medication Reminding

NON-CLINICAL

  • 5.001.1Billing
  • 5.001.2Referrals
  • 5.001.3Medical Supplies
  • 5.002.1Verification of Primary Payor
  • 5.004.1Staffing Issues
  • 5.005.1Faxing
  • 5.006.1Protected Health Information Password/Usernames
  • 5.007.1Red Flag Rules

CLINICAL

  • 6.001.1 In Service Education
  • 6.002.1Patient Education
  • 6.004.1Wound Care Management
  • 6.006.1Pain Management
  • 6.011.1Reporting Emergencies in the Home
  • 6.012.1Cardiopulmonary Resuscitation (CPR)
  • 6.014.1Sharp Debridement of non viable tissue
  • 6.015.1Clinical Procedures
  • 6.016.1Care Planning
  • 6.017.1RN Pronouncement
  • 6.019.1Assessment of Patients
  • 6.020.1Nurse Supervision
  • 6.021.1Certified Nursing Aide
  • 6.022.1Physical Therapy Services
  • 6.022.2Physical Therapy Evaluation
  • 6.023.1Medical Social Worker
  • 6.023.2Medical Social Worker Evaluation
  • 6.024.1Dietician Services
  • 6.024.2Dietician Evaluation
  • 6.025.1Occupational Therapy Services
  • 6.025.2Occupational Therapy Evaluation
  • 6.026.1Speech Therapy Services
  • 6.026.2Speech Therapy Evaluation

SAFETY/INFECTION CONTROL

  • 7.001.1Infection/Exposure Control Plan
  • 7.001.2CLIA Waiver
  • 7.002.1Universal Body Substance Precautions
  • 7.003.1Management of Infections/Exposures
  • 7.004.1Personal Protective Equipment
  • 7.005.1Hand washing
  • 7.006.1Aseptic Technique
  • 7.007.1Sterile Technique
  • 7.009.1Respiratory & Tuberculosis Precautions
  • 7.010.1Tuberculosis Exposure Control Plan
  • 7.011.1Contaminated Reusable Materials Disposition
  • 7.012.1Contaminated Waste Disposal
  • 7.013.1Therapy Bag Techniques
  • 7.015.1Communication of Hazards to Personnel
  • 7.016.1Hepatitis B Vaccination
  • 7.017.1Information & Training
  • 7.018.1Evaluating & Maintaining Records of infections
  • 7.019.1Reporting of Communicable Diseases
  • 7.020.1Record Keeping
  • 7.021.1Medical Equipment Malfunction
  • 7.022.1Hazardous Waste Handling & Labeling
  • 7.023.1OSHA Bloodborne Pathogen Training
  • 7.024.1Sentinel Event/Incident/Accident Reporting
  • 7.025.1Agency Personnel Safety/ Personal Safety
  • 7.026.1Agency Personnel Safety/ Unsafe Home Visits
  • 7.027.1Accidental Exposure
  • 7.028.1Accidental Prevention
  • 7.028.2Fall Prevention
  • 7.029.1Car Accident Reporting
  • 7.031.1Emergency Preparedness
  • 7.032.1Material Safety Data Sheet
  • 7.033.1Fire Safety

QUALITY MANAGEMENT

  • 8.001.1Quality Assessment/Performance Plan
  • 8.002.1Patient Satisfaction Survey
  • 8.003.1Non Patient Satisfaction Survey

PROVISIONS OF INTRAVENOUS THERAPY

  • 9.001.1Provisions of Intravenous Therapy
  • 9.002.1Administration of IV Therapy
  • 9.003.1Nurse Responsibility
  • 9.004.1Patient Education
  • 9.005.1Anaphylaxis Protocol
  • 9.006.1Possession of Supplies
  • 9.007.1Possession of Saline, Certain Vaccines & Dangerous Drugs

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Sincerely,

David Anderson
Home Health Forms Owner
Established 2007

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