Initial Application

*** Full INITIAL APPLICATION/ACCREDITATION
... $ 3499.99+tax

(2 easy payment plan)

Including:  ** Employee Chart Forms/Update                  ($1500.00 down payment)

                    ** Policy and Procedures Big Manual

                    ** Patient’s chart Forms/Clinical Forms

                    ** Minimum Standards/Chapter 400 (up to date)

                    ** Infection Control Manual

                    ** Direct Discipline (Contract)/FULL Patient Handbooks (including HIPAA)

                    ** Fill Application/review/provide CLIA Lab - Application/Budget CPA

                          recommendation/Review Resume

                    ** Emergency Management Plan/Biomedical Waste Protocol

                    ** Multiple Logs, interdisciplinary forms/HIPAA Manual

                    ** Full Board Information/Bloodborne Pathogens Manual

                    ** Full NCR Forms needed (carbonless)/Sign Up Package sample

This service reflects the author’s own opinions about Home Health Care services. Although the information and Policies are from sources deemed very reliable, they are not guaranteed. PN System © owner disclaims any personal liability for loss incurred as a result of the applications of any information offered in this application process, or in the use of our services. If expert, professional, medical, clinical assistance is required, the services of a component professional person should be sought. Your Director of Nursing, MUST review/approve the Policies/procedures/forms, also you and your Agency guarantee to comply with all Federal/Local/State laws to use our services/software.

Full Accreditation Graphic step by step:       New Agency Accreditation

What do you Need to start: License Application Data Form

Clia Laboratory Application Data: CLIA Application data

Needs to start:

* Corporation (Articles of Incorporation, Bylaws, Black book)

        * Office rented (at least 300 SF, LEASE/Rent Agreement, Phone/fax

        * Valid e-mail address

We will Fill out your Accreditation and NPI registration Applications in our Office to start your process (CHAP: Community Health Accreditation Program - 1-800-656-9656 or (202) 862-3413 or visit their web site at www.chapinc.org). Also you will receive seminar/training for accreditation in our office, plus visit to your facility.

The Full Process steps:  1) NPI Registration

                                            2) Accreditation Application

                                            3) Sign Accreditation Agreement

                                            4) Receive the request for Self Study

                                             5) Sent Self Study (home-Core) completed,AHCA Application

                                            6) About 2 months later, the "paper" survey, and them

                                                 when ready the 2nd survey with patients

          * 2 Registered Nurses (RN) (Administrator, Director of Nursing, Alternate

            Administrator) (License Number)

        * Tax ID evidence letter from IRS

        * Fingerprint background screening (Owners & Administrator, CFO)

        * Bank Account opened (about $ 25000.00)

        * Certificate of Incorporation registered with the Secretary of State.

        * Evidence of General/Professional Liability Insurance "PER CLAIM"

            ($ 250.000 minimum)

        * All Business Licenses: ZONING letter, Certificate of Use, Occupational

            License and Fire Reports.

        * Signed by Certified Public Accountant, proof of Financial ability to operate

           (7 Tables)

        * Administrator/qualified alternate RESUME

              The Administrator/Alternate must be a:

·        licensed physician, physician assistant, or registered nurse licensed to practice in this state or

·        an individual having at least 1 year of supervisory or administrative experience in

·        home health care or a

·        hospital or ambulatory surgical center or a

·        Assisted Living Facility or a Nursing Home

        * Resume of Director of Nursing (DON, Alternate)

              . The Director of Nursing must be:

·        registered nurse and direct employee of the agency who is a graduate of an approved school of nursing and is licensed in this state

·        who has at least 1 year of supervisory experience as a registered nurse

ALSO:

- Affidavit of Compliance with Screening Requirements (we will supply)

For the survey's date:

* Biomedical Waste Contract

* CLIA License (Laboratory)

* Register you Emergency Plan with the County (We will electronic transmit the Plan)

* Posting in your Office's door, Name, phone, and hours of operations, Emergency

   phone number.

* All Employee charts complete (Administrator, Alt. Administrator, DON, Alt. DON, 

   and HHA)

* All Books/Manual complete fill out.

REFERENCES:

T&A Home Health Care, Inc......................... 305-643-3972

1st Class Home Health................................ 305-513-3885

E&V Health Care ........................................ 305-597-5883

Heavenly Touch Home Health Care, Corp..... 305-406-3648

O&Y Health Care Corp................................. 305-884-4356

Maximum Care Home Health, Inc................. 305-644-2225

Amazing Home Health Care, Inc.................. 407-403-2065

We can help you with your initial Application process..........including every thing that you need to open your OWN Agency.