Field Manual

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We want to personally welcome you to our team of dedicated field staff. Our home health agency is licensed to provide services in many counties in North Central Florida. We are licensed to provide home health aide, companion, and homemaking services. Our mission is to provide quality health care services to anyone in need and enable them to live a fulfilling life in their home at the highest level possible.

Presently we provide home health aide services through the following methods:

1. Eldercare of Alachua County

2. Marion Senior Services

3. Veterans Administration

4. Department of Children and Families

5. Long-term care insurance

6. Private Pay

We are very fortunate to have incredible staff working in our clients’ homes. Home health is such a unique form of healthcare delivery because the CNA/HHA must be able to work with limited day to day supervision. We are proud to say we have the most loyal and qualified staff in the region.

The home health aides work is very rewarding yet requires many things to be successful. You may take care of several clients in one day or work longer shifts with one or two. You will be offered jobs if the following is met each week that you work:

1. Review and confirm your schedule weekly and as needed. If a client is added or you have any questions or concerns, you must call the staff line at 352-316-7000.

2. Ensure that can consistently access SharePoint for client information. If you use paper flow sheets, make sure that you have them and know how to document. Call the staff line if you do not.

3. Understand that home health is so unique because it is very difficult to replace someone in the home when there is a call out. If you call out frequently, you will not be offered jobs.

4. Reliable transportation and a backup plan are a must.

5. If you are running late, call the staff line immediately so we can alert the client. If you are able, call the client as well. Same goes if you are lost. Call the staff line then the client to direct you in that case. Getting lost happens to the best of us even with GPS

6. Keep Sherri informed of any issues regarding personal care clients. (ie: change of condition, change of caregivers in the home, etc.)

7. For staff using paper flow sheets, they MUST be handed in by 6pm on Sunday night. If you will be late or are working a client later than that, the staff line must be called…NO EXCEPTIONS! Reimbursement may be delayed if this is not done.

8. Paperwork must be accurate, and we will work with you to ensure that it improves each week.

9. Client care must be consistent and of the quality that Champion staff provides. If you need additional training, we can refer you to get it. We will check with clients weekly to make sure the care is provided as ordered.

10. You MUST follow the schedule exactly as it is posted. If you and/or the client want to change the schedule, you must call the staff line or the client must call the main number. NO EXCEPTIONS because the care plan is set by the authorizing agency and we do not have the authority to make changes without approval.

11. If you leave before the scheduled shift, you must call the staff line.

12. Starting a new type of work and/or a new company can be stressful at times. We are all here to assist and want you to succeed, so maintaining an open line of communication is crucial.

13. Any specific concerns or questions may be directed to Sherri at 352-328-1596

Getting Started: Upon hire, we will make your badge. You must wear your photo badge at all times while working.

If you are going to be working with a client who we believe requires you to have a shadowing session, you will be assigned to “ride along” with a home health aide.

The home health aide is assigned appropriate clients for the level that they can practice. (Appendix A) If there is ever a concern for the safety of the client or you, a call must be made immediately to the staff phone line provided to you.

Each client has a specific care plan, which we call a service order. A service order will be viewable on SharePoint each time you are given a client. Each client will have specific paperwork which needs to be filled in clearly and accurately. Remember: All information is confidential!

Being prepared: Having a reliable car, cell phone, and mapping capabilities are necessities. Being on time is a requirement of this home health agency. Every time you work you should have the following:

1. Your own box of gloves (Champion supplies but do not leave at the client’s home)

2. Necessary paperwork for client

3. Pen

4. BP cuff and stethoscope

5. Antibacterial gel (recommended)

6. Wear scrubs and closed toe shoes

In-service training as it applies to Champion: Upon hire, all home health aides will be required to provide or do the following in-services:

HHA In-services with competency assessment

1. HIV/AIDS/OSHA

2. Understanding Common Medications

3. Infection Control in Home Care (OSHA)

4. Maintaining Confidentiality

5. Advanced Directives

6. Emergency Management Planning (CEMP)

7. Florida Elder Abuse and Exploitation Power Point

8. Incident Reporting

9. Medical Equipment Failure Reporting

Calling in for any reason: Our call-in procedure is strict and needs to be followed to ensure a safe and effective delivery of services. There cannot be any deviation from this order of call or you will not work with this company. Program your phones.

1. FIRST CALL: 352-316-7000 Leave clear message. During office hours, your calls will be answered by the office staff. After hours and weekends, you will receive a greeting with an option to speak to someone. Press option 1. You will be directed to a live answering service and will receive a call back from the office staff on call.

2. SECOND CALL: Wait a reasonable amount of time then call Sherri at 352-328-1596 Leave clear message. It is very important that you do not call the 352-371-8600 or any of the staff cell phones as it will delay client care.

Flow Sheets/Payroll: When you are hired, you must show proof of liability insurance. We can provide that for you with an annual payroll deduction of the fee plus processing. After one year of service, Champion will pay for your liability insurance renewal for you. Our work week starts on Monday and ends on Sunday. All paperwork from client care (flow sheets) must be complete, and to the office by Sunday evening. There are a few ways you can get flow sheets to the main office:

1. Fax 352-240-1530(Gainesville number) Make sure your pen works well to fax.

2. Scan and email to Champ.Office@champhhc.com

3. Hand deliver to Gainesville office

4. NO STAPLES

5. If you have an emergency and are unable to get your flow sheets in on time, you MUST call or text Sherri to report or your reimbursement may be affected.

6. Documentation must be complete and accurate to receive payment for services.

7. For all staff using electronic documentation, you must submit signed flow sheets at the end of each shift.

Weekly Reports: A summary needs to be handed in to Sherri with your flow sheets for your first year. The summary should include how your hands-on clients are doing, any non-emergent concerns. “No new changes” is not acceptable as a summary.

The weekly reports may be sent via:

1. Email to Sherri only at sherr.kalishman@champhhc.com ***best way

2. Fax 352-240-1530

3. Hand deliver

4. Phone call message

Flow sheets: The manual will contain sample flow sheets for you to use when filling out the documentation sheets. Each agency has a different way that they require us to complete the paperwork. If you ever have a question about your paperwork, please call and schedule an appointment. Someone is in the Gainesville office Monday through Friday 9:00am-5:00pm.

Fraud and Abuse: Employees/Contractors shall refrain from conduct, which may violate the fraud and abuse laws. These laws prohibit (1) direct, indirect or disguised payments in exchange for the referral or clients; (2) the submission of false, fraudulent or misleading claims to any government entity or third party payer, including claims for services not rendered, claims which characterize the service differently than the service actually rendered or claims which do not otherwise comply with applicable program or contractual requirements; and (3) making false representations to any person or entity in order to gain or retain participation in a program or to obtain payment or excessive payment for any service.

Filling out flow sheets prior to working is fraud. Leaving a client’s home and documenting you were there the entire shift is fraud. A client signing a flow sheet without times marked is fraud for both you and the client. Not performing the authorized duties on the flow sheet and not reporting it is fraud.

59A-18.0081 Certified Nursing Assistant and Home Health Aide.

The certified nursing assistant (C.N.A.) and the home health aide shall:

(1) Be limited to assisting a patient in accordance with section 400.506(6)(b), F.S.;

(2) Be responsible for documenting services provided to the patient or client and for filing said documentation with the nurse registry on a regular basis. These service logs will be stored by the nurse registry in the client’s file. The service logs shall include the name of the patient or client and a listing of the services provided;

(3) Be responsible for observing appearance and gross behavioral changes in the patient and reporting these changes to the patient’s health care surrogate or other person designated by the patient and the nurse registry or to the responsible facility employee if staffing in a facility;

(4) Be responsible to maintain a clean, safe and healthy environment, which may include light cleaning and straightening of the bathroom, straightening the sleeping and living areas, washing the patient’s dishes or laundry, and such tasks to maintain cleanliness and safety for the patient;

(5) Perform other activities as taught and documented by a registered nurse, concerning activities for a specific patient and restricted to the following:

(a) Assisting with the change of a colostomy bag, reinforcement of dressing;

(b) Assisting with the use of devices for aid to daily living such as a wheelchair or walker;

(c) Assisting with prescribed range of motion exercises;

(d) Assisting with prescribed ice cap or collar;

(e) Doing simple urine tests for sugar, acetone or albumin;

(f) Measuring and preparing special diets;

(g) Measuring intake and output of fluids; and,

(h) Measuring temperature, pulse, respiration or blood pressure.

(6) Be prohibited from changing sterile dressings, irrigating body cavities such as giving an enema, irrigating a colostomy or wound, performing gastric irrigation or enteral feeding, catheterizing a patient, administering medications, applying heat by any method, or caring for a tracheotomy tube.

(7) For every CNA, a nurse registry shall have on file a copy of the person’s State of Florida certification.

(8) For every home health aide registered with the nurse registry since May 4, 2015, a nurse registry shall have on file a certificate or documentation of successful completion of at least forty hours of home health aide training, pursuant to section 400.506(6)(a), F.S., from a public vocational technical school or a non-public postsecondary career school licensed by the Commission on Independent Education, Florida Department of Education.

(9) Individuals who earn their CNA certificate in another state must contact the Florida Certified Nursing Assistant office at the Department of Health to inquire about taking the written examination prior to working as a CNA in Florida, pursuant to chapter 464, part II, F.S.

(10) Home health aides registered with the nurse registry since the effective date of this rule who complete their training in another state must provide a certificate of completion of home health aide training from a public vocational technical school or a career education school that is licensed in that state.

(11) CNAs and home health aides referred by nurse registries must maintain a current cardiopulmonary resuscitation (CPR) certification from an instructor or training provider that is approved to provide training by the American Heart Association, the American Red Cross, or the Health and Safety Institute, and that provides CPR training in which the student is required to demonstrate, in person, that he or she is able to perform cardiopulmonary resuscitation.

(12) Licensed practical nurses and registered nurses that are licensed in Florida or another state may work as home health aides. Also, persons who have completed the licensed practical nurse or registered nurse training from a public school, college, or university or a licensed nonpublic career education school or college in Florida who are not yet licensed may work as home health aides.

(13) A certified nursing assistant may work as a home health aide.

(14) C.N.A.s and home health aides referred by nurse registries may assist with self-administration of medication as described in section 400.488, F.S.

(a) Home health aides and C.N.A.s assisting with self-administered medication, as described in section 400.488, F.S., shall have received a minimum of 2 hours of training covering the following content:

1. Training shall cover state law and rule requirements with respect to the assistance with self-administration of medications in the home, procedures for assisting the resident with self-administration of medication, common medications, recognition of side effects and adverse reactions and procedures to follow when patients appear to be experiencing side effects and adverse reactions. Training must include verification that each C.N.A. and home health aide can read the prescription label and any instructions.

2. Individuals who cannot read shall not be permitted to assist with prescription medications.

(b) Documentation of training on assistance with self-administered medication from one of the following sources is acceptable:

1. Documentation of 2 hours of training in compliance with subsection 59A-8.0095(5), F.A.C., from a home health agency if the home health aide or C.N.A. previously worked for the home health agency;

2. A training certificate for assisted living facility staff in compliance with section 429.52(6), F.S.;

3. A training certificate for at least 2 hours of training from a career education school licensed pursuant to chapter 1005, F.S., and rule division 6E, F.A.C., by the Department of Education, Commission for Independent Education;

4. Documentation of at least 2 hours of training by a provider approved by the Florida Board of Nursing, Department of Health.

(c) Documentation of the training must be maintained in the file of each home health aide and C.N.A. who assists patients with self-administered medication.

(d) In cases where a home health aide or a C.N.A. will provide assistance with self-administered medications as described in section 400.488, F.S., and paragraph (e) below, a review of the medications for which assistance is to be provided shall be conducted by a registered nurse or licensed practical nurse to ensure the C.N.A. and home health aide are able to assist in accordance with their training and with the medication prescription and the medication is not required to be administered by a nurse. If the patient will not consent to a visit by the nurse to review the medications, a written list with the dosage, frequency and route of administration shall be provided by the patient or the patient’s health care surrogate, family member, or person designated by the patient to the home health aide or CNA to have reviewed by the nurse. The patient or the patient’s surrogate, guardian, or attorney in fact must give written consent for a home health aide or C.N.A. to provide assistance with self-administered medications, as required in section 400.488(2), F.S.

(e) The trained home health aide and C.N.A. may also provide the following assistance with self-administered medication, as needed by the patient and as described in section 400.488, F.S.:

1. Prepare necessary items such as juice, water, cups, or spoons to assist the patient in the self-administration of medication,

2. Open and close the medication container or tear the foil of prepackaged medications,

3. Assist the resident in the self-administration process. Examples of such assistance include the steadying of the arm, hand, or other parts of the patient’s body so as to allow the self-administration of medication,

4. Assist the patient by placing unused doses of solid medication back into the medication container.

(15) The nurse registry is not obligated to monitor, manage or supervise a certified nursing assistant or home health aide pursuant to section 400.506(19), F.S. The nurse registry is not obligated to review patient or client records per section 400.506(20), F.S., but the nurse registry is not prohibited from reviewing records and may do so. In the event of violation of section 400.488, F.S., or other state laws that comes to the attention of the nurse registry, the nurse registry shall take the actions specified in section 400.506(19), F.S.

Rulemaking Authority 400.488, 400.497, 400.506 FS. Law Implemented 400.488, 400.497, 400.506 FS. History–New 1-27-94, Amended 12-24-00, 8-10-06, 3-15-07, 5-4-15, 2-8-16.