Non-Medical Home Care Agency - Policies and Procedures - Massachusetts state Licensure

Introducing our comprehensive Non-Medical Home Care Agency  Policies and Procedures package designed specifically for Massachusetts 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 Content 

Introduction    
Vision    
Mission    
Core Values    
Document Control    
Statement of Policy    
Eligibility Verification for Services    
Provider Eligibility and Participation Requirements Policy    
Out-of-State Provider Eligibility    
Services Provided Under Contract    
Contract Requirements for External Service Providers    
Administrative Requirements Policy    
Clinical Eligibility Criteria Policy    
Prior Authorization for Home Care Services    
Prior Authorization for Skilled Nursing and Medication Visits    
Home Health Aide Services – Prior Authorization for Non-Capitated Members    
Therapy Services – Prior Authorization Requirements    
Authorization for Capitated MassHealth Members    
Notice of Approval or Denial of Prior Authorization Policy    
Scope of Home Health Services    
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services    
Nursing Services    
Home Health Aide Services    
Payable HHA Services Linked to Nursing/Therapy Policy    
Payable Home Health Aide Services for ADL Support    
Non-payable Home Health Aide Services Policy    
Incidental Services Provided During Home Health Aide Visits    
Physical Therapy Services Policy    
Occupational Therapy Services policy    
Speech and Language Therapy Services Policy    
Maintenance Program Coordination Policy    
Coordination of Medical Supplies    
Provider Responsibilities Policy    
Teaching Activities During Care Coordination   
Visit Verification for Home Health Aide Services   
Recordkeeping Policy   
Statement of Fiscal Soundness Policy    
Plan of Care Requirements Policy    
Content of the Plan of Care    
Certification Period for Plan of Care    
Verbal Orders    
Face-to-Face Encounter Requirements    
Quality Management and Utilization Review    
Transfers and Discharge Planning    
Conditions of Payment    
Intermittent or Part-Time Service Requirements    
Maximum Allowable Fees    
Denial of Services and Administrative Review    
Prohibited Marketing Activities Policy    

Forms    
Client Admission/Intake Form    
Client Service Plan / Care Plan Form    
Client Rights and Responsibilities Acknowledgment Form    
Consent for Services and HIPAA Release Form    
Emergency Contact and Medical Information Form    
Visit Verification Form    
Client Complaint/Grievance Form    
Client Discharge/Termination Form    
Employment Application Form    
Background Check Authorization Form   
Employee Confidentiality and HIPAA Agreement   
Staff Training and Competency Evaluation Form   
Staff Orientation Checklist    
Incident and Accident Report Form    
Prior Authorization Tracking Form    
Discharge Planning/Transition Documentation Form