Home Health Forms

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Miscellaneous Forms

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Orientation Manual for a Licensed Agency

Employee Orientation is critical to a successful agency and a large requirement to meet accreditation standards. With our Orientation Manual your employees will become a knowledgeable force about your company and home health regulations.

PDF Samples Linked Below

Section I: Getting Started

Name Badges Chain of Command
Agency Services Vision & Mission Statement
Patient Rights & Responsibilities Complaints and Grievances
Public Disclosure

 

Section II: Human Resources

Employee Handbook Acknowledgment of Employee Handbook (Sign & Return)
Drug, & Alcohol Abuse (Sign & Return) Employee Supervision & Continuing Education Requirements
Inventory Checklist (Sign & Return) Professional Agreement Addendum (Sign & Return)
Policy & Procedure Manual Agreement (Sign & Return) Performance Evaluations
Agreement to Arbitrate Employment (Sign & Return) Conditions of Employment (Sign & Return)
Direct Deposit Form (Sign & Return)  

 

Section III: Office Policies

Coverage Map Office Policy & Procedural Manual
Fax Cover Sheet Intake Referral Sheet
Visit Time Sheet Complaint Form
Release of Information Release of Information Authorization

 

Section IV: New Patient Admissions

New Admit Packet Part A Chart Organization

 

Section V: Infection Control

Blood-Born Pathogens Infection Control Policies & Procedures
MRSA Exposure Report (Sign & Return)
Hepatitis B Training Hepatitis B Declination (If declined Sign & Return)
Home Care Bag Procedures Maintaining Equipment in the Car
Equipment Cleaning Spills in the home
Tuberculosis  

 

Section VI: Clinical Information

Nursing Policy & Procedural Manual Abbreviations
Missed Visit Report Physician Telephone Orders
Communication Wound Care Form
HHA Care Plan 60 Day Summary
Case Conference MAR
Documentation Rules Nurses Documentation Bible

 

Section VII: Location of Teaching Guides and Reference Materials

Office Policy & Procedural Manual Nursing Policy & Procedural Manual
Drug Guide ICD-9 Coding

 

Section VIII: Safety

Fire Extinguisher Locations & Usage MSDS Manual Location
Safety Training Reporting Emergencies

 

Section IX HIPAA Training

HIPAA Training HIPAA Test
HIPAA Certificate

 

Section X Aide Instruction

Nutrition Components Erikson's Stages of Development
Communication and Interpersonal Skills Body Mechanics
Maslow's Hierarchy of Needs Assistive Technology
The emotional effects of having a serious physical illness

 

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Some forms utilize the ability of a Laser Printer to print nearly to the edge of the page. These forms will not print correctly on an ink jet printer.