Policy Manual sample

MDT Home Health Care Agency, Inc. must be reinstated. (XIV)This contract is subject to automatic annual renewal, if not canceled for any party. (XV)Our Agency has full responsibility over all contracted services. Employee/Contractor agree to adhere to all Federal/State/Local and other applicable regulations, standares and laws. (XVI) Our Agency has full responsibility to retain and maintain all clinical records of patients served by this Contract and will be in compliance with all Medicare Conditions of Participation. (XVII)The second party must submit evidence of liability and insurance, evidence of current licensure, education or certification, if applicable. (XVIII) Section 1861(w)(1) of the Social Security Act states that an Home Health Agency (HHA) may have others furnish covered items or services through arrangements under which receipt of payment by the HHA for the services, discharges the liability of the beneficiary or any other person to pay for the services. This holds true whether the services and items are furnished by the HHA itself or by another arrangement. Both must agree not to charge the patient for covered services and items and to return money incorrectly collected. (XIX) The contracted agency, organization, or individual providing services under arrangement may not have been: (i) Denied Medicare or Medicaid enrollment; (ii) Been excluded or terminated from any federal health care program or Medicaid; (iii) Had its Medicare or Medicaid billing privileges revoked; or (iv) Been debarred from participating in any government program. PROFESSIONAL RESPONSIBILITY Nothing in this Agreement shall construed to interfere with or otherwise affect the rendering of services by the Employee/Contractor in accordance with his independent and professional judgment. This Agreement shall be subject to our Policies and Procedures, the rules and regulations of any and all professional organizations or associations to which Employee/Contractor may from time to time belong and the laws and regulations governing said practice in this State. Our Agency has full responsibility to retain and maintain all clinical records of patients served by this Contract. Both parties agree that the Employee/Contractor shall submit clinical notes and progress reports to the Director of Nursing, Clinical Manager once every one week or more often if requested, and shall conform with prescribed scheduling of visits and, periodic patient evaluation. Both parties agree that this Agency shall coordinate all job-related activities of the Employee/Contractor, and control all job-related activities of the Employee/Contractor. Both parties agree that the Employee/Contractor participate in our Performance Improvement (QAPI) Program, by suggest according they daily practices, ways to improve our services, treatment, relationship with patients/family/physicians, report needs and expectations of patients and families, participate in the QAPI data collection and analyzes, participate as needed in the Clinical Record review committee to complete and analyzes results and trends, participate in the Infection Control Effectiveness and other programs. Both parties agree that patients are accepted for care, the service will be controlled, coordinated, and evaluated, only by our Agency, the Employee/Contractor must comply with all scheduling of visits according Physician order and initial admission assessment, and report any need of schedule change to the Agency immediately identified the need. Participate in periodic patient evaluation to improve our services and the goals of the Patient Plan of Care compliance, including but no limited to Participate in Case Conference, create progress/deterioration reports, periodic communication with the Agency’s Supervisor and Care Managers. Participate in the Developing of the Plan of Care, suggest any change needed to achieve the treatment goals, make suggestion for improving services and patient care and safety. SIGNATURES Our Agency. (Employer): Employee/Contractor: Administrator or Director of Nursing, Clinical Manager Title: _____________________________________ Date: ___________________ Date: ___________________ Home Health Agency Agreements G-11