Home Health Care Service – Policies and Procedures – New Jersey State Licensure

Introducing our comprehensive Home health care service Policies and Procedures package designed specifically for New Jersey State Licensure. We understand the critical importance of adhering to state regulations and maintaining the highest standards of care in the home health industry. Our meticulously crafted set of policies and procedures is your key to achieving and sustaining compliance while delivering exceptional healthcare services.

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Table of Contents 

Introduction
Vision
Mission
Core Values
Document Control
Statement of Policy
Covered Home Health Agency Services Policy
Certification of Need for Home Health Services Policy
Plan of Care Policy
Clinical Records Policy
Basis of Payment for Home Health Services Policy
Limitations on Home Health Agency Services
Personal Care Assistant Services – Purpose and Scope
Basis for Reimbursement for Personal Care Assistant Services Policy
Covered Personal Care Assistant Services Policy
Certification of Need for Personal Care Assistant Services
Duties of the Registered Professional Nurse Policy
Clinical Records – Personal Care Assistant Services
Basis of Payment for Personal Care Assistant Services
Limitations on Personal Care Assistant Services Policy
Prior Authorization for Personal Care Assistant (PCA) Services Policy
Purpose and Scope of Private Duty Nursing (PDN) Services Policy
Basis for Reimbursement for EPSDT/Private Duty Nursing (PDN) Services Policy
Eligibility for EPSDT/Private Duty Nursing (PDN) Services Policy
Limitation, Duration, and Location of EPSDT/Private Duty Nursing (PDN) Services
Determination of Medical Necessity for EPSDT/Private Duty Nursing (PDN) Services
Clinical Records and Personnel Files
Payment for EPSDT/Private Duty Nursing (PDN) Services Policy
Eligibility for MLTSS/Private Duty Nursing (PDN) Services
Limitation, Duration, and Location of MLTSS/Private Duty Nursing (PDN) Services
Basis for Reimbursement for MLTSS/Private Duty Nursing (PDN) Services Policy
Prior Authorization of MLTSS/Private Duty Nursing (PDN) Services Policy
Managed Long-Term Services and Supports (MLTSS)
Eligibility for Managed Long-Term Services and Supports (MLTSS) Policy
HCPCS Codes and Maximum Reimbursement Rates Policy
Client Centered Care (NJCC) Policies and Procedures
Client Rights and Distribution of Required Consumer Materials
Client Rights and Protections
Legal Representation of Clients
Complaint Management
Reporting of Suspected Mistreatment, Neglect, Abuse, or Injuries of Unknown Origin
Assessment & Care Planning (NJAC) Policies and Procedures
Statement of Scope of Services
Pre-Service RN Evaluation and Client Admission
Plan of Care Development and Maintenance
Plan of Care Review and Update
Supervision and Review of the Plan of Care
Reassessment and Revision of the Plan of Care
Corrective Action When Plan of Care is Not Followed
60-Day In-Home Evaluation of the Plan of Care
Maintenance and Distribution of the Plan of Care
Instruction and Assignment of Certified Homemaker-Home Health Aides (CHHAs)
Certified Homemaker-Home Health Aide Task Delegation
Demonstration of Competence by Homemaker-Home Health Aides
Client Record Requirements
Professional Staff, Assessment & Care Planning (NJPS) Policies and Procedures
Skilled Care Client Record Documentation
Skilled Care Plan Development and Maintenance
Acceptance and Documentation of Physician Verbal Orders
Qualifications and Employment Requirements for Skilled Health Care Professionals
Verification of Licensure for Skilled Health Care Professionals
Home Care Professional Services (HCPS) Policies and Procedures
Client Needs Assessment by Qualified Healthcare Professionals
Referral Intake, Admission, and Timing of Client Assessment
Client Assessment Content
Professional Care Service Standards
Staffing and Back-Up Plan for Continuity of Care
Supervision of Healthcare Professionals
Supervisor Availability and Oversight of Care
Termination of Care Services
Human Resource Management – Certified Homemaker-Home Health Aide (NJHR) Policies and Procedures
Use of Certified Homemaker-Home Health Aides (CHHAs)
Personnel Information Requirements Prior to Hire
Employment Application Authorization
CHHA Scope of Services and Supervision
Identification Tag Requirement
Corrective Action for CHHA Non-Compliance with Plan of Care
CHHA Supervision Requirements
Placement of Non-Certified or Non-Licensed Individuals
Home Personal Care Services (HCPC) Policies and Procedures
Termination of Personal Care Services
Home Companion & Environmental Services (HCCE) Policies and Procedures
Termination of Companion or Environmental Support Services
Infection Prevention (NJIP) Policies and Procedures
Infection Control and Prevention
Standard Precautions for Infection Prevention
Provision of PPE and Hand Hygiene Products
Tuberculosis (TB) Screening of At-Risk Staff
Occupational Exposure and Post-Exposure Follow-Up
Emergency Preparedness (NJEP) Policies and Procedures
Emergency Preparedness and Response
Quality Assurance & Performance Improvement (HCQA) Policies and Procedures
Performance Monitoring and Quality Improvement
Performance Data Analysis and Improvement Activities
Management & Governance (NJMG) Policies and Procedures
Administrator/Owner Responsibilities
Regulatory and Operational Compliance
Employment and Oversight by a Health Care Practitioner Supervisor
Home Care Management & Governance (HCMG) Policies and Procedures
Verification of Current State Licensure
Service Availability and Resource Management

Forms

Client Admission/Intake Form
Plan of Care Form (Initial & 60-Day Updates)
Consent to Services and HIPAA Acknowledgment Form
Physician Certification of Need Form
Face-To-Face Encounter Verification Form
Emergency Contact Form
Advance Directive/Healthcare Proxy Form
Nursing Assessment Form (Initial & Reassessment)
Personal Care Assistant Assignment Sheet (Weekly)
Supervisory Visit Form (Every 60 Days)
Delegated Task Documentation Form
Clinical Progress Notes
Incident Report Form
Employee Application Form
Background Check Authorization Form
Orientation & Training Checklist
CHHA License & CPR Verification Log
Prior Authorization Request Form (FD-365)