QAPI Program Utilization_Manual

professional and regulatory bodies. 3. The agency employees categories of staff, both clerical and paraprofessional, sufficient to insure effective utilization of professional workers. 4. Consultation is provided in specialized areas, such as mental health care, nutrition, and clinical procedures. 5. Personnel policies have been developed and are available to all staff, these described working conditions, fringe benefits, and job responsibilities. 6. Sufficient staffs are provided for fiscal management including bookkeeping, billing and financial reports. b. Records and Reporting 1. The agency has a family-centered record system that provides documentation of services given by all personnel. Elements of the record include physical and social assessment data, physician’s orders, care plans and goals, information about care provided, evidence of movement toward goals, and discharge summaries. 2. A mechanism has been developed and is used to inform referring agencies and individuals concerning care provided, problems noted, and future plans. c. Written policies cover the following: 1. Patient care by the agency a. Admission criteria b. Criteria for continuation of services, scope and limitations of services (e.g. frequency of medical supervision) c. Criteria for discharge d. Professional practice (e.g. treatments and techniques) 2. Working with other agencies and physicians a. Referral procedures (e.g. selection of patients, information to be included on referral forms) b. Reporting (e.g. frequency of reporting, content of report) c. Allocation of responsibility of continuing care d. Billing arrangements d. Coordination of Services 1. The agency is responsible for the coordination of all home health services rendered to the patient by its staff. 2. The agency has developed contracts or agreements to assure the coordination of its services with those proved by other health or social agencies. II. Expansion of services a. The agency is aware of and attempts to be responsive to community needs. (Evidence of this might include formalized approaches to long-range planning (e.g. position statements, community studies, and review and restatement of agency purpose and objective). b. If the agency has had some experience with adding new services through special funding, such new services have been incorporated into the on-going program. c. Where other health organizations and institutions exist in the area, the agency has developed cooperative programs and policies that will contribute to smooth expansion of services. 9