It’s a pleasure to welcome you to (Agency’s Name) ________________________ Inc.  We’re well organized an energetic Home Health Agency dedicated to high standards of excellence and quality of service.  We value each one of our employees, and we hope that you find your work here rewarding and satisfying.

Our handbook introduces you to our Agency’s standards and guidelines and allows you to familiarize yourself with our practices, policies, and goals.  Please read it carefully, so that you can better understand who we are and what we do.  We appreciate the hard work and dedication of our employees. 

Mission Statement

The mission of (Agency’s Name) ________________________ is to provide quality, safe and cost effective home care services to persons in need of the services provided.


The Agency is dedicated to the provision of comprehensive, quality, patient-centered care that is focused on each patient’s unique needs.


We are dedicated to excellence in patient care and to providing the most effective and efficient home care services. We also believe that individuals possess a unique hierarchy of needs as defined by Maslow: physiological needs, safety needs, belonging and love needs, self-esteem needs and self actualization needs. Our agency respects the right of individuals to have autonomy based on their individual needs and values which affects their present and future health status. We also utilize comprehensive interdisciplinary approach and patient education in promoting physical and psychological well-being of our patients and their families.

Our Goals and Objectives are:

  • To provide comprehensive services to our consumers.

  • To provide personalized care designed according to consumer’s needs.

  • To assist consumer to achieve maximum level of independence.

  • To maintain a work environment which provides our employees the opportunity for job satisfaction and personal growth.

  • To act in accordance with all appropriate state and federal standards/regulations.

Scope of Services

  • (Agency’s Name) ________________________, Inc provides Skilled Nursing, Home Health Aid, Physical Therapy, Occupational Therapy, Speech Therapy, and Medical Social Services.  


Organization, services furnished, administrative control and the lines of authority for the delegation of responsibility for patient care are clearly defined in writing and are readily identifiable


(Agency’s Name) ________________________ Inc., provides equal employment opportunities to all employees and applicants regardless of race, color, creed, sex, national origin, age, disability, sexual orientation, marital status or veteran status.

The Agency will employ only individuals who are U.S. citizens or who meet the requirements of the Immigration Reform and Control Act of 1986 and other applicable federal laws. This includes complying with state and federal legislation regarding age limitations.

The Agency will employ and contract with only individuals who meet the licensure or certification requirements for the particular professional position. The individual must be in good standing there under.

The Agency complies with the American with Disabilities Act of 1994.

Following is information on some of the steps in the employment process:

The Employment Application. All applicants for employment with (Agency’s Name) ________________________, Inc. must complete employment application. Even if you submit a resume, we still require a completed employment application. The employment application gathers information on education and training, prior work experience, prior criminal convictions, and references you authorize us to contact. If you are hired by (Agency’s Name) ________________________, Inc., the employment application will become part of your personnel file. 

To complete your hiring process, we require that you submit the following documentation:

  • Valid Driver’s license

  • Proof of citizenship or a green card, or employment authorization (as applicable)

  • Social Security Card

  • Valid car insurance

  • Valid license or certification (RN, LPN, CNA, PT, OT, ST, MSW) as applicable

  • Valid CPR/BLS  card

  • Proof of  PPD test or chest x-ray results and evidence of HBV administration or declination

  • Proof of training/education from other institutions (diploma, certification for specialty area)  

Background Checks. (Agency’s Name) ________________________, Inc.  conducts background checks on all candidates prior to an offer of employment. (Agency’s Name) ________________________, Inc. requires written authorization to conduct background check. If you do not authorize (Agency’s Name) ________________________ to perform a background check, we will no longer consider your application for employment. 

Prior Felony Conviction Relative to a Crime of Dishonesty or a Breach of Trust. In general, a finding that an applicant has a criminal record is not an automatic barrier to employment with (Agency’s Name) ________________________, Inc. (Agency’s Name) ________________________, Inc. will evaluate information about prior convictions. A candidate with a felony conviction on the criminal history record check will not be considered for employment. A candidate with a misdemeanor conviction on the criminal history record check will be interviewed as to the nature if the offense. Additional consideration will be given to the length of time that has passed since the incident. If the explanation of the incident is satisfactory, the candidate may be considered for employment.

Fraud Abuse. As a home health provider, (Agency’s Name) ________________________, Inc  shall comply with the requirement for screening for employees and contractors who have been excluded from participation in Medicaid and Medicare by the US Department of Health & Human Services Office of Inspector General. (Agency’s Name) ________________________, Inc  will utilize  the US Department of Health & Human Services Office of Inspector General’s List of Excluded Individuals/Entities (www.oig.hhs.gov) to determine if a prospective employee or newly signed contractor has been excluded from participation in Medicaid. We do not require written authorization to perform this search. Nevertheless, we inform all job applicants and current staff that we will be reviewing this information.

E-Verify.  (Agency’s Name) ________________________ participates in E-Verify. E-Verify is an Internet-based system that compares information from an employee's Form I-9, Employment Eligibility Verification, to data from U.S. Department of Homeland Security and Social Security Administration records to confirm employment eligibility. Please refer to Right to Work and E-verify posters .

Classification of Employees

All employees will be classified as exempt or nonexempt based upon  their job categories and duties performed.

Exempt employees include executive, administrative and professional salaried employees whose

job duties and rate of pay permit them to be “exempt” from the provisions of the Federal Wage

Hour Law. Exempt employees are not eligible for overtime pay.

Nonexempt employees include both hourly paid employees whose job duties and rate of pay 

 make them subject to the overtime provision of the Fair Labor Standards Act or Federal Wage-

Hour Law and hourly paid employees whose job duties exclude them from the overtime 

provision of the Fair Labor Standards Act.

The Agency has established written salary scales for each position classification, as well as overtime, on-call and holiday pay rates. Employee salaries are individualized and are based upon their experience and education for a particular position.

Employees are not to share salary information with other employees.

In addition to being classified as exempt or non-exempt, employees may be classified as regular full-time, regular part-time, per-visit or temporary employees:

Regular full-time – an employee that is regularly scheduled to work at least 32 hours a week.  Full-time employees are eligible for benefits as described in the employee handbook and policies.

Regular part-time - an employee that is regularly scheduled to work less than 32 hours per week.  Part-time employees are not eligible for benefits.

Per-visit – an employee that is paid per visit to a patient, based on a pre-determined compensation schedule.  Per visit employees are not eligible for benefits.

Temporary – an employee who works for the Agency on a temporary basis for a specified project or time frame, with a predetermined start and end date of employment.  Temporary employees are not eligible for benefits.


Orientation is conducted with all staff at the time of hire and prior to their assuming patient care responsibilities. All new or reassigned personnel must complete an orientation program designed to familiarize the employee with agency policies and procedures, job description, and other necessary information for successful performance of job duties.

Job description/Professional Standards of Practice

Employee’s duties, responsibilities and requirements for each position will be addressed in the job descriptions. Each employee will be given a written job description to review and sign upon hire and whenever job description changes. A copy of a signed job description will also be retained in the employee file. 

Employees are also responsible for providing the Agency with current licensure/certification documentation required by regulations to practice profession as appropriate. We also ask you to notify the agency of changes in your name, address, telephone numbers or any other demographic information as soon as possible.  

It is also expected that the Agency and staff will comply with accepted professional standards and principles that apply to the personnel who are furnishing care. Consumer care and services will be provided for each consumer according to applicable law and regulation and accepted standards of practice. Agency staff will provide care, treatment and services to each consumer according to the plan of care.


Staff Competency

The Agency has established competency criteria for each job category. Qualified individuals will observe the employee during competency evaluation. The competency evaluation checklist will be completed and retained in the employee’s record

Patient care staff will be competency assessed at defined intervals:

  • For each new employee (including contract employees) during orientation.

  • Annually for all patient care staff.

  • When introducing new procedures/techniques/equipment.

Performance Appraisals/Evaluations

All employees will have a performance appraisal/evaluation based upon their job description after a 90 day probation period and annually. In addition, there will be an ongoing informal performance review process through supervisory interaction to ensure continued employee growth and development. An annual performance evaluation will be conducted for any part-time employees that have worked for 6 months or longer in a year.

Staff Competency

The Agency has established competency criteria for each job category. Qualified individuals will observe the employee during competency evaluation. The competency evaluation checklist will be completed and retained in the employee’s record

Patient care staff will be competency assessed at defined intervals:

  • For each new employee (including contract employees) during orientation.

  • Annually for all patient care staff.

  • When introducing new procedures/techniques/equipment.

Performance Appraisals/Evaluations

All employees will have a performance appraisal/evaluation based upon their job description after a 90 day probation period and annually. In addition, there will be an ongoing informal performance review process through supervisory interaction to ensure continued employee growth and development. An annual performance evaluation will be conducted for any part-time employees that have worked for 6 months or longer in a year.


Consumer Rights

It is a duty of the Agency and Agency’s employees to protect and promote the rights of each individual in Agency’s care. Upon admission, each client and /or client’s authorized representative is given a statement of consumer rights. The client and/or client’s authorized representative are also advised that a compliant may be filed with the Health Facilities and Emergency Medical Services Division of the Colorado Department of Public Health and Environment if client’s rights were undermined. 


Confidentiality is defined as the safekeeping of data/information so as to restrict access to individuals who have need, reason, and permission for such access.

Every client has the right to confidentiality of all the records, communications and personal information. To maintain clients’ confidentiality as mandated by law, the Agency will comply with applicable HIPAA rules and regulations. Agency administrator will determine which employees have access to confidential information.

Disclosing any confidential information or improperly discussing any clients’ condition constitutes grounds for immediate termination.

Conflict of Interest

In an attempt to assure that Agency’s staff performs its duties in ethical manner, our employees are required to sign a statement of conflict of interest. 

  1. Any outside interest that could possibly involve a conflict of interest (directly or indirectly) with any person, vendor, family, purchaser or competitor will be disclosed.

  • The nature of outside interests may be determined as:

  • Ownership in a competing agency/company.

  • Entertainment.

  • Money or gifts (other than of nominal value).

  • Loans.

  • Employment status, e.g., working with a competitor.

  • Related staff members.

  • Conduct in relationships with personnel, customers, and patients

  1. If a conflict or potential conflict of interest arises for a staff member, the staff member must immediately reveal the conflict to his/her immediate supervisor.

  1. The Agency will review its relationships and staff’s relationships with other care providers, educational institutions and payers to ensure that those relationships are according to applicable law and regulation and to determine if conflicts of interest exist.

Non-Compete Agreements

The Agency shall not prevent an employee from terminating the employment relationship and commencing employment at another home care agency.

  1. The Agency shall not coerce, threaten, or use any means of intimidation to prevent an employee from terminating the employment relationship and commencing employment at another home care agency.

      2.    Non-compete clauses, agreements or contracts shall only be enforceable in accordance with              Section 8-2-113, C.R.S.


In order for the Agency to carry out its mission to the clients  it serves, it is dependent upon the performance and conduct of each of its employees. 

Your supervisor will talk with you about specific job expectations and the level of performance expected. If you have concerns, questions or suggestions about anything that effects your work, talk with your supervisor immediately. Free and open communication between you and your supervisor make for a healthy and productive work environment. 

Should there be any indications that you are not meeting the job expectations regarding performance and/or conduct, you may be counseled. These counseling sessions are intended to provide an opportunity for you and your supervisor to do some problem solving, to understand the situation, and to determine a plan of corrective action. 

Attendance and Reporting

Regular attendance and punctuality at scheduled work times will be expected of all employees. Attendance and punctuality will be considered when the Agency reviews recommendations for promotions, salary increases and transfers.

Employees will be expected to report at the scheduled work time, including returning from breaks and lunch, as applicable. Any employee not ready to begin work at the scheduled times will be considered tardy.

If an employee expects to be delayed for any reason, he/she will notify and inform his/her supervisor of the reason for late arrival and the expected arrival time.

An absence is the failure to report to work at the scheduled time and is defined as lost time (partial or full day) due to illness, injury, personal business or other reasons for which the Agency is not responsible.

Employees will notify their supervisor as soon as the employee is aware of the need to be absent, but no later than two (2) hours before the scheduled starting time.

  • The expected duration of the absence should be communicated to the supervisor in advance, if possible.

In the event an emergency or hospitalization occurs due to sudden illness or accident, the immediate supervisor will be notified by the employee’s designated emergency contact as soon as possible.

  • A doctor’s statement may be required and should be sent to the Agency within three (3) working days.

  • If the immediate supervisor is not available, the next level of supervision should be notified.

A doctor’s statement may be required for any illness. The Agency may request a corroborating statement from a consulting physician. The doctor’s statement will include:

  • The nature of the illness.

  • The expected duration of the illness.

  • The anticipated return date.

A doctor’s release stating the date an employee may resume normal duties at work may be required at the time an employee returns from an absence and should be submitted to the Agency at the time of return.

When determining whether an employee should be disciplined for excessive tardiness or absenteeism, the supervisor will apply sound judgment based on knowledge of the circumstances.

Any disciplinary action taken will be consistently applied in like situations.


To help maintain a positive image, employees are asked to maintain a neat and professional appearance and are expected to wear their ID badges during working hours.  Discretion should be used regarding styles, garment lengths, transparency, and fit.  Good judgment and common sense are critical for selecting proper and appropriate dress.  The following are examples of what is considered improper business attire;

  1. Excessively worn or tattered jeans

  2. Tank tops may be worn if a cover up shirt is worn over

  3. Excessively tight clothing

  4. Shorts are not allowed (Capri pants are allowed)

  5. Field employees must wear closed toe shoes – NO sandals or heels

  6. If protective clothing is needed to do any specific agency job, it must be worn as per agency regulations. 

If an employee reports for work improperly dressed, the Supervisor may instruct the employee to return home to change clothes or take other appropriate action.   Repeated violations of this policy will be a cause for disciplinary action.  Although the Agency does not require uniforms at this time, we would prefer our caregivers to wear a scrub top and/or scrub pants when caring for our clients.  Please direct any questions you may have regarding professional attire to your immediate supervisor.


We expect our employees to treat everyone they meet during their employment with (Agency’s Name) ________________________, Inc. with courtesy and respect.  Employees are expected to maintain an attitude of caring, consideration and appropriate interest in the client for who he/she works.  Many of our clients are vulnerable adults.  There is to be no verbal, physical, mental or emotional abuse of the client.  No harassment of any kind.  We are to treat the client with utmost respect. Threatening, abusive and vulgar language has no place in our workplace.  It destroys morale and relationships, and it impedes the effective and efficient operation of our business.

As a result, we will not tolerate threatening, abusive or vulgar language from employees while they are on the worksite, conducting Agency’s business or attending Agency-related business or social functions.

Employees who violate this policy will face disciplinary action, up to and including termination.  Any employee concerns are to be brought up to management immediately.

Unacceptable Behaviors

The following behaviors are considered to be unacceptable and may result in immediate termination.

Agency’s employees are prohibited to:

1. borrow money or any of client’s possessions with or without permission;

2. provide false information to the client and/or client’s authorized representative, as well as to record false information in the client’s record.

 3. use alcohol, engage in smoking, drugs, abusive language in client’s homes;

Helpful Tips

.    When traveling by vehicle:

  • Keep your vehicle in good working order with plenty of gas.

  • Consider storing a blanket in your vehicle in the winter and a thermos of cool water in the summer. Keep a snack in the glove compartment.

  • Turn on emergency flashers and wait for the police if you have car trouble.

  • Keep your car locked when parked or driving. Keep windows rolled up if possible.

  • Park in full view of the consumer’s residence when possible.

  • Know your route. If you get lost, look for a safe place to get additional directions or view your map. If you have a car phone, call for directions.

    When walking to the consumer’s home:

  • Walk directly to the consumer’s residence in a professional manner.

  • Be alert of surroundings – buildings, people and animals.

  • Carry car keys in your hand when leaving the consumer’s residence. 

    Some common sense rules regarding personal safety and defense are:

  • Use common walkways in buildings; avoid isolated stairs.

  • Always knock on the door before entering a consumer’s home.

  • Scream or yell “fire”; consider having a whistle attached to your key ring.

Unlawful Harassment

The Agency will not tolerate conduct by any employee who harasses, disrupts or interferes with another employee’s work or creates an offensive or hostile work environment. While all forms of harassment are prohibited, the Agency emphasizes that sexual harassment is specifically prohibited.

 Any employee who believes he/she has been subjected to sexual or racial harassment in the workplace by a manager, coworker or consumer should report the alleged incident to the Administrator as soon as possible.

Any employee who violates the policy against sexual harassment, or encourages another to violate the policy, will be subjected to appropriate disciplinary action depending on the severity and type of violating behavior, up to and including discharge.

Sexual harassment is a form of sex discrimination and is an unlawful employment practice under Title VI of the 1964 Civil Rights Act. Unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct constitutes sexual harassment when:

  • They are part of a supervisor’s or manager’s decisions to hire, fire, promote or transfer. 

  • They are used to make other employment decisions, e.g., pay.

  • They interfere with the employee’s work performance.

  • They create an intimidating, hostile or offensive work environment.

Sexual harassment is defined as deliberate or repeated behavior of a sexual nature which is unwelcome. It can include verbal and/or nonverbal behavior.

Incident reporting

Agency staff will report all incidents/occurrences that deviate from routine Agency operations

and will result in injury or potential harm to a patient/caregiver or Agency staff to the

Administrator or appropriate designee within 24 hours of discovery of the incident.  The

Administrator or appropriate designee will investigate, document and report, as applicable, all

incidents/occurrences. Such incidents may include, but are not limited to:

  • Security issues resulting in injury, or identifying the potential for harm.

  • Mistreatment, neglect, verbal, mental, sexual or physical abuse, including injuries of unknown source and misappropriation of patient property by anyone furnishing services on behalf of the Agency.

  • Ethical issues.

  • Environmental safety hazards, malfunctions or failures, including equipment and/or medical device failure with resulting injury or harm.

  • Injury or endangerment of staff and/or patients.

  • Procedure error which results in trauma and/or injury.

  • Medication and treatment errors, complications or reactions, if applicable.

  • Motor vehicle accidents involving an Agency vehicle or the employee's vehicle while employee is conducting Agency business.

  • Any staff accidents that require treatment, lost work days, hospitalization or that identify new safety hazards that were previously unrecognized.

  • Unusual occurrences.

  • Suicide threats or attempts.

  • Unexpected patient death.

  • Client/patient/family injury, including falls.

  • Adverse patient service/care outcomes.

  • Sentinel events.

The Agency will immediately investigate all alleged violations involving anyone furnishing services on behalf of the organization and immediately take action to prevent further potential violations while alleged violation is being verified. Investigations and/or documentation of all alleged violations must be conducted in accordance with established procedures.

The organization takes appropriate corrective action in accordance with state law if the              alleged violation is verified by the organization’s administration or an outside body having jurisdiction, such as the accreditation body, the State survey agency or local law enforcement bodies having jurisdiction (including to the State survey and certification agency) within 5 working days of becoming aware of the violation.

The Agency will not discharge or in any manner discriminate or retaliate against any patient, relative, legal representative or sponsor thereof, or any other person because such person, relative, legal representative, sponsor, or employee has made in good faith or is about to make in good faith, a report pursuant to this section or has provided in good faith or is about to provide in good faith evidence in any proceeding or investigation relating to any occurrence required to be reported by the Agency.

No copies will be made of incident/occurrence reports and confidentiality of involved individuals will be maintained.

Disciplinary Action/Grievance Procedure

Disciplinary Action

When a staff member’s job performance or work behavior does not meet those standards for continued employment and/or results in negative patient outcomes, it is the policy of the Agency to initiate disciplinary action for corrective purposes in the following manner:  

  • Verbal Reprimand:  Considered to be a notice to the employee that the job performance or work behavior does not meet standards of employment.

  • Written Reprimand:  Considered to be further notice to the employee of undesirable work behavior or unacceptable job performance, submitted in writing and placed in the personnel file for permanent record.

  • Suspension without Pay:  Considered to be the final notice to the employee that undesirable work behavior or unacceptable job performance must be corrected at once.

  • Discharge/Termination:  Considered to be the most extreme form of disciplinary action and final step in this process.  This will occur when all previous steps have been followed or in the event that immediate discharge is considered to be justifiable by the Supervisor, Director of Clinical Services and Administrator.

  • Furthermore, it is the policy of the Agency that all employees shall have the right to initiate an internal grievance procedure in connection with any aspect of this policy.

Standards of Conduct

The following standards of conduct are prescribed to assure continuation of employment.  Employees are at all times expected to:  

  • Give primary consideration to the welfare of patients, employees and visitors.

  • Respect established authority.

  • Use facility equipment and supplies judiciously and with extreme care.

  • Perform all duties and responsibilities in an acceptable manner, according to applicable standards, laws and regulations.

  • Be honest; seek help in resolving problems.

  • Present a neat and clean personal appearance.

  • Comply with Agency policies and procedures.

  • Conduct themselves as responsible members of the staff and as good citizens.

Initiation of  Interdisciplinary Action

When an employee's job performance or work behavior ceases to meet acceptable standards for continued employment, disciplinary action procedures are initiated by persons in authority.  Those persons having this authority are as follows:  

  • The employee's immediate supervisor.

  • The Director of Clinical Services.

  • The Administrator.

  • A supervisor or department manager, not directly associated with the employee, in the case of an event occurring while the employee's supervisor and/or department manager are not present.

  • Verbal Reprimand:  The first step in the process is the verbal reprimand issued to the employee as an initial warning.  Although this reprimand is not a formal disciplinary action, the Director of Clinical Services is made aware of it for future reference.

  • Written Reprimand:  The next step in the process is the written reprimand issued to the employee as the second warning.  This reprimand is presented to the employee in writing and is documented on a Disciplinary Action Form requiring the signature of the counselor and the employee.

  • The employee is asked to sign this document not as an admission of guilt, but to acknowledge that the counseling did occur.

  • The document is placed in the employee's personnel file as a part of the permanent employment record regardless of signature.  Failure to sign the form must be documented on the Disciplinary Action Form.

  • Suspension without Pay:  The next step in the process is suspension without pay issued to the employee as the third and final warning.  This action is presented to the employee in writing and is documented on a Disciplinary Action Form requiring the signature of the counselor and the employee.

  • The employee is asked to sign this document not as an admission of guilt, but to acknowledge that the event did occur.

  • This document is placed in the employee's personnel file as a part of the permanent employment record regardless of signature.

  • The employee will not be allowed to return to work until the suspension period has expired and the appropriate corrective action has been completed.

  • Discharge/Termination:  The final step in the process is discharge/termination.  At this time, the employment status is terminated and termination documents are processed.

  • When the decision is made to enter into this step of the process, it has been fully determined through previous steps that the employee does not intend to correct the undesirable work behavior or unacceptable job performance and thus fails to meet those standards required for continued employment.

  • The action is documented on the Disciplinary Action Form requiring the signature of the counselor and the employee.

  • The employee is asked to sign the document not as a direct admission of guilt, but to acknowledge that the event did occur.

  • Immediate Suspension:  Automatic suspension occurs when it is determined by those persons having authority that the employee has:

  • Violated Agency and/or department policy to the extent that damage is done, or the results and consequences of the action will be severely detrimental to the Agency or to patients.

  • Exhibited extremely undesirable work behavior and/or job performance or neglect of job performance.

  • Substantially violated those standards of conduct set forth in the Agency’s policies to the extent that damage is done, or the results and consequences of the violation will be severely detrimental to the Agency, the department, and/or patients.

  • Other undesirable actions as deemed sufficient to justify automatic and immediate discharge.

  • Those persons having the authority to execute immediate suspension are as follows:  

  • The employee's immediate supervisor, upon the direction and approval of the Director of Clinical Services.

  • The Director of Clinical Services.

  • The Administrator.

  • A supervisor and/or department manager not in a regular or routine working relationship with the employee, if the undesirable action occurs at a time when the employee's supervisor and/or department manager are not present.

General Procedures Involving Disciplinary Action

  • The employee, at all times, shall have the right to initiate the internal grievance procedure for matters related to the disciplinary action process.  The employee may obtain information regarding the grievance from the Administrator/Director of Clinical Services.

  • The disciplinary action process is to be administered fairly and consistently to all employees at all times and in a manner consistent with policy, rules and regulations to assure equal treatment to all employees.

  • Employees shall be informed of their status throughout the disciplinary action process of the following items:

  • What he/she can expect to occur next if the problem is not corrected.

  • What actions he/she can take to correct the problem.

  • What specifically leads to the disciplinary action.

  • Specifically, what is necessary for the employee to meet standards for continued employment.

  • What is a reasonable period of time in which corrective action is to occur.

Procedure –Employee Grievance Reporting Methods

  • Problems arise in any group of people working together.  It is important to all that these problems be solved as quickly and as fairly as possible so that small problems do not grow out of proportion.  Occasionally, however, it may be necessary to investigate certain problems in greater detail.  The grievance procedure enables the employee to have a fair review of any work-related controversy, dispute or misunderstanding.

  • If the employee feels there is a valid grievance, the following procedure is used:  

  • Step One:  An employee may submit, in writing or orally, the problem to his/her immediate supervisor or department manager within three (3) days after the problem becomes known to the employee.  The supervisor or department manager will attempt to resolve the employee's grievance during the initial meeting.  If unable to reach a mutually agreed upon solution, the supervisor or department manager will investigate the situation further and within three (3) working days, meet with the employee with a proposed solution to the grievance.  If the employee is still not satisfied, then he/she may request a Step Two meeting.

  • Step Two:  If the employee is not satisfied in Step One, he/she must submit in writing within five (5) working days the problem or grievance.  Human Resources will investigate the problem with all involved parties and schedule a meeting with the employee and the supervisor or department manager.  The employee may elect to have a fellow employee accompany him/her to this meeting to assist in the presentation of the problem.  A concerted effort will be made at this meeting to resolve the problems.

  • Step Three: If the employee does not feel there has been a satisfactory resolution reached by speaking with the supervisor, he/she may submit a written grievance/complaint to the Director of Clinical Services/Administrator. The Director of Clinical Services/Administrator will review the complaint/grievance, if necessary review the information with the employee and/or supervisor, and within five (5) working days of completing the review, render a decision about the grievance/complaint. The employee and the supervisor will be notified of the decision. 

  • Step Four: if the employee is not satisfied with the decision or feels the grievance/ concern has not been resolved to his/her satisfaction, the employee has the option of requesting that the grievance/complaint be forwarded to the Governing Body. The Governing Body will review the grievance/complaint within ten (10) working days of receiving the complaint/grievance and render a decision. The decision will be delivered to the employee in writing. The decision of the Governing Body is final and binding.

  • Employees who are discharged for cause may appeal that decision by using the grievance procedure.  However, discharged employees shall appeal as in Step One and the appeal must be in writing.  In order to be considered, any discharge appeal must be received within seven (7) working days of the discharge.


The Fair Labor Standards Act (FLSA) does not require payment for time not worked, such as vacations, sick leave or federal or other holidays. These benefits are matters of agreement between an employer and an employee (or the employee's representative).

Vacations/Paid Time Off

At this time, the Agency offers a two (2) week paid  time off for full time employees only .We understand that you may need time off to pursue your personal interests outside of work. If you are planning to take time off, we ask you to inform us in advance at least with two week notice.

Sick Time 

If you are going to be absent from work due to illness, you must contact your immediate supervisor prior to your scheduled starting time. We realize that there can be time when it is impossible to report for work; however, every effort to attend should be made. Sick time is considered time off without pay.

Please see the "Attendance and Performance" section of this handbook for additional information on absenteeism. 

Leaves of Absence 

The Agency realizes that there may be times when you will need time off for medical, family, personal or military reasons. A leave of absence is defined as an authorized absence from work for an extended period of time, generally not less than two weeks and no more than 12 weeks. These leaves are leaves without pay. 

Family and Medical Leave 

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled to: 

  • Twelve workweeks of leave in a 12-month period for:

    • the birth of a child and to care for the newborn child within one year of birth; 

    • the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement; 

    • to care for the employee’s spouse, child, or parent who has a serious health condition; 

    • a serious health condition that makes the employee unable to perform the essential functions of his or her job;

    • any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or 

  • Twenty-six workweeks of leave during a single 12-month period to care for a covered service members

To be eligible for FMLA benefits, an employee must:

  • work for a covered employer; 

  • have worked for the employer for a total of 12 months; 

  • have worked at least 1,250 hours over the previous 12 months; and

  • work at a location in the United States or in any territory or possession of the United States where at least 50 employees are employed by the employer within 75 miles. 

While the 12 months of employment need  not be consecutive, employment periods prior to a break in service of seven years or more need not be counted unless the break is occasioned by the employee’s fulfillment of his or her National Guard or Reserve military obligation (as protected under the Uniformed Services Employment and Reemployment Rights Act (USERRA)), or a written agreement, including a collective bargaining agreement, exists concerning the employer’s intention to rehire the employee after the break in service.  See “FMLA Special Rules for Returning Reservists.”



(Agency’s Name) ________________________ is offering health insurance benefits including dental and vision coverage effective January 1, 2017

All health benefits will be administered by a major medical insurance carrier. Attached Summary Plan Description (SPD) contains more details about these plans; please refer to the specific SPD that governs each of the plans.

The Company will offer insurance coverage to all employees meeting eligibility criteria as follows.

To be eligible for health insurance, an employee must:

Make at least 32 visits per week  (office/hourly based personnel will be required to work at least 32 hours per week)

Maintain 32 visits per week for two consecutive pay periods

The number of visits will be calculated as follows:

OASIS Start of Care would be calculated as 2 visits

OASIS Resumption of Care/Recertification of Care would be calculated as 1.5 visits

Initial evaluation by PT/OT/ST and MSW and therapy reassessments would be calculated as 1.5 visits

All other visits (RN re-visits, therapy re-visits, prn visits, LPN visits and CNA visits) will be calculated as 1 visit each. 

New Employees meeting the above eligibility criteria will be eligible to enroll into the health benefits after a 90 day probation period. Existing employees will be able to enroll any time an employee meets the eligibility criteria as described above. 

Agency’s Administrator and Office Manager will be closely monitoring the number of visits per week for each employee on a monthly basis and notify insurance company of any changes to the employee’s status as appropriate. An employee will receive a notification each time the number of visits falls below 32 visits, and a termination of insurance notice will be issued to the employee if the employee is not able to maintain 32 visits per week after three consecutive pay periods.  Timely submission of documentation will be vital for tracking purposes.  Axxess (EMR) will be utilized for tracking of the number of visits each pay period. Visits not submitted timely will not be counted into 32 visits required for eligibility criteria. 

(Agency’s Name) ________________________ will cover 50% of employee’s health insurance premium, dental insurance premium and vision insurance premium. Dependents will have to pay a 100% of the premium. 

An employee contribution for coverage will be deducted from pay checks every pay period based on your benefit selections.

These plans are subject to change at the Company’s discretion. Additionally, the amount that you may be required to contribute towards the premiums for any of these plans may be changed at the Company’s discretion.

Holiday Pay

The Fair Labor Standards Act (FLSA) does not require payment for time not worked, such as vacations or holidays (federal or otherwise). These benefits are generally a matter of agreement between an employer and an employee. 

At this time, (Agency’s Name) ________________________ will pay Holiday Pay to the employees working on the following Holidays:

Thanksgiving Day

Christmas Day 

New Year Day

Independence Day


Employees will be compensated at 1.5 of the scheduled rate. 

Pay Period /Pay Checks

Paychecks are issued bi-weekly on every other Friday. You will receive a pay day schedule during your orientation. Your bi-weekly paycheck is based on the number of visits that you performed during the two weeks period ending on Saturday. Your pay is based on the visit notes and visit log that you are required to turn in for each week that you worked. Only visit notes completed  in EMR (Axxess) accompanied by corresponding visit logs will be included in current payroll processing. If one or the other is not complete by payroll process time,  pay for  these visits will be transferred to the next pay period. 


It is very important that we have accurate records of all of the home visits that you  performed. This will ensure compliance as well as an accurate  payroll process.

At this time, (Agency’s Name) ________________________ is maintaining hybrid patient record: it is a combination of paper, EMR, and document imaging.

Documentation Submission Policy

The following documentation submission policy is in place:

All clinicians who are responsible for completion of admission documentation have 48 hours from the date of admission to submit an admission packet to the office. 

All clinicians who are responsible for OASIS documentation have 48 hours from the date of assessment to complete all OASIS documentation.

All clinicians will submit progress visit notes three times a week, on Mondays, Wednesdays and Fridays. Progress notes /documentation for Friday, Saturday and Sunday are to be submitted on Monday. All the progress notes/documentation for Monday and Tuesday will be submitted on Wednesday and all the notes/ documentation for Wednesday and Thursday will be submitted on Friday. If the day of submission falls onto a holiday, the documentation is to be submitted on the next business day. Two days grace period is allowed under extenuating circumstances. Administrator, Director of Clinical Services and/or Office Manager must be notified if the extenuating circumstances present. Proof of extenuating circumstances is preferred.

Late and untimely documentation submission compromises Agency’s compliance with regulatory requirements pertaining to home health documentation.  In addition to a regulatory compliance, untimely documentation submission is also effecting proper care coordination, communication and agency’s financial stability. 

Please understand that late documentation is a violation of professional practice standards and places the agency and its clients at risk

If you have any technical difficulties preventing you from completing documentation in timely manner, please call the main office number _____________________

Electronic Visit Verification (EVV)


Effective March, 1 2017 (Agency’s Name) ________________________ Agency implemented utilization of Electronic Visit Verification (EVV). Electronic visit verification is a documented proof of the visit, via GPS location, where the patient can verify a visit (sign electronically) utilizing Axxess mobile application. The date and time of the signature is recorded. 

Electronic Visit Verification is a new feature offered by Axxess Software Company that is currently used by (Agency’s Name) ________________________ for Agency’s EMR documentation. EVV is a secure and password protected application and is compliant with HIPPA requirements.



The purpose of this policy is to establish the standards for Electronic Visit Verification (EVV) system for home health care providers as a part of compliance program by verifying  visits at the point of care., as well as to schedule and track visits in real time. EVV is also expected to enable the agency to improve administrative efficiencies in areas of data tracking and scheduling in real-time and payroll.



Axxess EVV


Related Documents

Training Video http://www.axxess.com/help/tutorials/axxess-mobile/mobile-app/ and Q&A



  1. (Agency’s Name) ________________________ employees will upload Axxess mobile application on their mobile devices 

The following devices are compatible or able to support the mobile application

  • iOS-based (iOS 6.0 platform or higher) or Android-based (4.0.3 platform or higher) device with a compatible operating system

  • iOS – Apple (iPhone and iPad)

  • Android – Samsung, Google, HTC, and other devices

  1. Employees will receive instruction, written and/or verbal, on the use of mobile application and its EVV feature. 

  • EVV will become a part of new employee orientation.

  • (Agency’s Name) ________________________ Administrator, DON and Staffing Coordinator will be available to assist agency’s employees and provide support with the use of EVV on ongoing basis. 

  1. Electronic visit verification is a documented proof of the visit, via GPS location, where the patient can verify a visit (sign electronically) on the application. The date and time of the signature is recorded. Employee must be in the patient’s home to verify visits. By selecting a verify button in task details, employee will be able to review the information, collect patient’s signature and verify the visit. The patient’s signature will be captured in the application.

  1. As soon as a visit is verified, a green house icon will appear next to the patient’s scheduled visit in patient’s record in Axxess


  • If the patient is unable to sign, a clinician will need to add an explanation of the reason of patient’s inability to sign in the comment section and sign with own signature, as a provider/caregiver, while at the patient’s residence.

  • In case of a technical difficulty (poor internet connection, no internet connection, Mobile application related issues, or malfunctioning of a mobile device, etc.), a clinician may use an alternate method of documentation (paper time log, comment/details section in patient’s record in EMR. 

  • Staff members that have no data plan for their mobile device or do not own a smart phone/device are to be exempt from using EVV at this time. Paper time sheets must be used instead. 



It is Agency’s goal to continue utilize Axxess EVV and its future enhancement to promote compliance within the agency, as well as regulatory compliance in anticipation of a mandatory implementation of EVV under CURES Act as well as Save Medicaid Access and Resources Together (SMART) Act, Sec. 5-5f., sub-part (g).

EVV could be used not only to record the location of the visit and confirm employee’s presence at the patient’s residence, but also  to record precise time service begins and ends (multiple employee are already using this feature).

The Agency anticipates to have no exemptions to the use of EVV and have disciplinary action in place for non-compliance with the mandatory requirement. 


Nurse, Home Health Aide and other Staff Bags

Bags used by nurses, home health aides and other staff which contain equipment, e.g., a thermometer, stethoscope, blood pressure cuff, etc., and are brought into the home are classified as clean on the inside. The outside of the bag, because it is exposed to all environments, is considered “soiled.”

  • The inside and outside of the bag will be cleaned when visibly soiled.

  • A barrier under the bag is not required but may be used if needed to protect the patient’s environment or equipment bag. 

Nursing Bag Technique

1.    Before entering the home, make sure the bag is stocked with bacteriostatic foam/ liquid/wipes and plastic trash bags (preferable in a side pocket).

2.    Upon entering the home, place the bag on a clean surface; paper towels or plastic bag may be used to create a clean area if indicated. Open the bag near the care area and, if possible, near the water supply.

  • Wash hands thoroughly with bacteriostatic foam/liquid/wipes.

  • Remove all items which will be needed for the visit.

  • Place items on a firm clean surface. Close the bag and give the patient care.

  • If additional items are needed after care has started, wash hands before re-entering bag.

  • Clean any visibly soiled items, which will be returned to the bag.

  • Wash hands and return equipment to the bag; close bag.

  • Tidy up the work area disposing of wastes.

Methods of Disinfection

1.    Reusable articles in the patient’s home contaminated with blood or body fluids, e.g., feces, pus, mucous or other organic matter, will be washed with soap and water.

  • If a danger of contamination of body parts or adjacent areas exists, items will be washed in a specific container for that purpose and the subsequent solution discarded into the toilet bowl.

  • Full strength disinfectant will be used to clean toilet bowl and seat.

2.    Whenever it is necessary to use equipment which must be disinfected after use and which will be used by or for a patient over a period of time, e.g., bedpans, urinals, bedside commodes, etc., the nurse will instruct the family to provide this equipment or will assist them in obtaining it.

3.    Blood glucose monitors are cleaned when visibly soiled or according to manufacturers’ recommendations.

4.    All solutions will be checked for expiration date prior to patient use.

  • When the patient no longer needs the treatment, all opened solutions and supplies will be discarded.

  • Other disposable supplies, e.g., irrigation trays, syringes, suture removal sets, solution containers, etc., will be discarded after use.

5.    Thermometers will be wiped with alcohol pad after each use. The effectiveness of this technique is dependent on vigorous friction. Allow to air dry. Thermometers with disposable shields are to be cleaned with alcohol pad after disposal of shield.

6.Stethoscopes and blood pressure cuffs not provided by the patient/family will be cleaned when visibly soiled by the employee who has possession of the equipment. The chance of transmission of infection through use of blood pressure cuff or stethoscope is small, therefore wiping with disinfectant when visibly soiled is adequate.

7.All patient dirty laundry is to be handled minimally and not shaken or placed against the employee’s clothing or body. Laundry will be placed immediately in the patient’s laundry area or washing machine to minimize employee and family exposure.

8.Broken glassware, e.g., contaminated blood collection tubes, will not be picked up directly by hand.

  • Use the contents of the spill kit by sprinkling the spill with the absorbent material.

  • Wear gloves to scoop up the absorbed spill and broken glass.

  • Dispose in container and place container into a contaminated garbage bag. 

  • Wear gloves to scoop up the absorbed spill and broken glass.

  • Dispose in container and place container into a contaminated garbage bag.

Employee Protection

Skin irritant: rubber or latex gloves are worn to protect the hands from the chemical, according to the information provided on MSDS. Gowns and other body coverings that are impervious to the chemical are worn to protect exposed skin from the chemical.

Eye irritant: protective goggles are worn to prevent the chemical from contact with the eyes.

Oral toxicant: eating or drinking is not permitted when handling hazardous chemicals.

Dermal toxicant: rubber or latex gloves, impervious gowns or body coverings, according the MSDS, are worn to prevent the hazardous chemical from direct contact with the skin.

Inhalation toxicant: use hazardous chemicals in a well-ventilated area. Follow specific instructions in MSDS for the use of respirators or other protective equipment.

Flammable products: liquids, gases or solids identified as flammable are stored in areas designated for flammable substances only. Flammable chemicals are not stored, delivered nor handled near areas of heat, spark or fire. Follow the instructions for handling of the flammable chemical identified on the MSDS.

Detection methods and observations: refer to MSDS for each hazardous chemical for specific information on the color, appearance or odor of the product to detect the presence of the chemical in the workplace. Follow the instruction on the MSDS for containment of the chemical, clean up and disposal.


Medical Emergency

Agency clinical staff is required to submit proof of successful completion of Basic Life Support for Healthcare Providers (CPR) training at time of hire and to maintain current certification. 

The course must be approved by the American Heart Association/American Red Cross, conducted in a classroom setting by a qualified instructor and include successful return demonstration of skills on a mannequin.

On-line CPR courses are acceptable but must include successful return demonstration of skills on a mannequin in the presence of a qualified instructor.

Qualified Agency personnel shall provide appropriate emergency interventions should the patient exhibit changes that are judged to be life-threatening while Agency personnel are in the home.

Agency personnel shall respect and honor competent patients’ wishes and any advance directives that are in place.

Patients and/or their families are provided information about the Agency’s policies for resuscitation, medical emergencies, and accessing 911 services at the time of admission.

In the event of a medical emergency, the staff member is to activate the emergency medical system (EMS) by calling 911.

Qualified personnel may take appropriate measures to maintain/sustain life including:

  • Initiating basic first aid.

  • Maintaining an open airway.

  • Initiating CPR.

The above actions shall not be initiated if a valid “Do Not Resuscitate” order has been signed by the patient’s physician and is in the patient’s medical record.

Staff members are to:

  • Remain with the patient until EMS personnel arrive.

  • Provide pertinent information to EMS personnel.

  • Notify the Director of Clinical Services, including all pertinent information.

  • Document the events in the patient’s medical record.

The Director Clinical Services/staff member shall notify the physician, describing all events, including disposition of the patient.