RN & LPN

All Initial or Subsequent Assessments, Supervisory Visits must:

Scheduled within 5 Business Days or less of receipt.

Be turned in within 48 hours of completion. If additional time is needed, you must notify the client immediately for support to turn them in at a later time.

Must be completed every 45-60 days to remain compliant.

Can be performed via phone, video chat, or in person when necessary.

At least 1 in person visit after the initial assessment occurs in a 12 month window.

Must be turned in within 48 hours or less of delivery.

All consultants are expected to manage the dates of the assessments and supervisory visits for all assigned cases. Failure to due so can result in an immediate cancellation of this agreement. Failing to do so could lead the client to not being in compliance with Medicaid laws and rules.

If there is a gross mishandling of time management for services needed the Client may opt to end the contract immediately. Payment for all work completed will still be made at the agreed rate and payment schedule listed in Article II of your contract.

LPNs must turn in all work to the agency in the time frames stated above.

The agency will deliver all LPN work to the RN for review.

RN's must review, sign off, and submit back to agency on all LPN work within 24-48 hours of receipt.

RN's must provide feedback to LPN's in 24-48 hours after review and sign off. Please make sure all feedback is in clear and concise written form (can be an email Please be sure to copy agency administration on any feedback using the info@nattingham.com email address in your CC: field.

Each PCA/HHA must complete 8 hours of inservice training annually. When we use a 8-16 week roll out strategy. Nattingham will work with the RN/LPN team to confirm what training topics that the RN/LPN team approves.

We will disperse approved learning materials. Upon completion from the PCA/HHAs, we will deliver to the RN/LPN team for review, feedback, and certificates of completion for each

Expected delivery time will be negotiated at the time of assignment. The class size may factor into the delivery time needs. The Administration team will partner with the RN/LPN Team to determine a reasonable delivery time for in-service training verification.

Standards & Method of Documentation Delivery of all Work To Client

1. Be turned in on time. Be filled out completely and accurately. 2. Must be send in a HIPPA compliant manner. 3. Physical copies are accepted. 4. Digital scanned copies are preferred for time sake. 5. You may email your work to info@nattingham.com 6. You may fax your work into 513-672-1044 7. Please be sure to only use the clients first initial and last name in subject lines for security ex. James Smith would be "Initial Assessment for J. Smith" is the subject line of

an email cover letter of a fax.

Ethical, Professional, Respectful and Legal Service Standards Requirements for Every Type of Provider to Remain Certified

The provider shall not engage in any unethical, unprofessional, disrespectful, or illegal behavior including the following:

(a) Consuming alcohol while providing services to the individual.

(b) Consuming medicine, drugs, or other chemical substances in a way that is illegal, unprescribed, or impairs the provider from providing services to the individual.

(c) Accepting, obtaining, or attempting to obtain money, or anything of value, including gifts or tips, from the individual or his or her household or family members.

(d) Engaging the individual in sexual conduct, or in conduct a reasonable person would interpret as sexual in nature, even if the conduct is consensual.

(e) Leaving the individual's home when scheduled to provide a service for a purpose not related to providing the service without notifying the agency supervisor, the individual's emergency contact person, any identified caregiver, or ODA's designee.

(f) Treating ODA or its designee disrespectfully.

(g) Engaging in any activity while providing a service that may distract the provider from providing the service including the following:

(i) Watching television, movies, videos, or playing games on computers, personal phones, or other electronic devices whether owned by the individual, provider, or the provider's staff.

(ii) Non-care-related socialization with a person other than the individual (e.g., a visit from a person who is not providing care to the individual; making or receiving a personal telephone call; or, sending or receiving a personal text message, email, or video

(iii) Providing care to a person other than the individual.

(iv) Smoking tobacco or any other material in any type of smoking equipment, including cigarettes, electronic cigarettes, vaporizers, hookahs, cigars, or pipes.

(vi) Bringing a child, friend, relative, or anyone else, or a pet, to the individual's place of residence.

(vii) Discussing religion or politics with the individual and others.

(viii) Discussing personal issues with the individual or any other person.

(h) Engaging in behavior that causes, or may cause, physical, verbal, mental, or emotional distress or abuse to the individual including publishing photos of the

individual on social media without the individual's written consent.

(i) Engaging in behavior a reasonable person would interpret as inappropriate involvement in the individual's personal relationships.

(j) Making decisions, or being designated to make decisions, for the individual in any capacity involving a declaration for mental health treatment, power of attorney, durable power of attorney, guardianship, or authorized representative.

(k) Selling to, or purchasing from, the individual products or personal items, unless the provider is the individual's family member who does so only when not providing

(I) Consuming the individual's food or drink, or using the individual's personal property without his or her consent.

(m) Taking the individual to the provider's business site, unless the business site is an ADS center, RCF, or (if the provider is a participant-directed provider) the individual's

(n) Engaging in behavior constituting a conflict of interest, or taking advantage of, or manipulating services resulting in an unintended advantage for personal gain that has detrimental results to the individual, the individual's family or caregivers, or another provider.

If you or the client are in immediate danger call 9-1-1 for emergency services 1st before proceeding.

Anytime a client is transported to a hospital, doctor's office, or urgent care facility, or needs dental attention during the caregiver shift we need to document what occurred and report the incident immediately to the Nattingham Home Care office manager. In addition, if you suspect any form of abuse has occurred call the office immediately. Anytime a client falls while in your care call the office and use this form to document the incident.

Items to observe and reported: Breathing

Cyanosis/Change in skin color Pus, draining for an open area to the skin

Pain Level of consciousness Mood and behavior

Changes in appetite and eating habits Changes in functional ability Decreased fluid intake

And any other physical condition that are not normal for the client or PCA that you observe.

CALL THE OFFICE IMMEDIATELY IF THERE IS AN INCIDENT at 513-509-0604.

The following reportable incidents will be taken care of as determined by the care management entity (Nattingham Home Care) or recovery management entity.

At a minimum, all incident reports shall include the following information when available:

I HAVE READ AND UNDERSTAND THE STEPS THAT NATTINGHAM HOME CARE WILL TAKE IN PARTNERSHIP WITH ALL OF THOSE INVOLVED SHOULD THERE BE AN INCIDENT AS DESCRIBED ABOVE TO REPORT. I ALSO UNDERSTAND THE MINIMUM INFORMATION NEEDED FOR AN INCIDENT REPORT AS STATED IN THIS DOCUMENT. I ALSO UNDERSTAND THE RESPONSE TIME FOR CRITICAL INCIDENTS AS STATED IN THIS DOCUMENT.

Standard Precautions are used for all patient care. They're based on a risk assessment and make use of common sense

practices and personal protective equipment use that protect healthcare providers from infection and prevent the spread of infection from patient to patient.

All Independent Contractors and PCA/HHA Employees are expected follow Standard and Universal Precautions set by the CDC:

Use PPE equipment whenever there is expectation of possible exposure to infectious materials

Follow respiratory hygiene /cough etiquette principles

Ensure appropriate patient placement

Properly handle and properly clean and disinfect patient care equipment and instruments/devices

Clean and disinfect the environment appropriately

Follow safe injection practices(RN/LPN if contracted or hired fro skilled care)

Ensure safety including proper handling of needles or sharps

Additional Information can be found at:

https://www.cdc.gov/infectioncontrol/basics/standard-precautions.html

The following orientation checklist is for RN/LPN Contracted employees:

ORIENTATION CHECKLIST FOR CURRENT EMPLOYEES ASSIGNED TO A NEW JOB

1. Review of all Agency policies and procedures. √

2. Review confidentiality of patient/client information √

3. Review contracts for all programs, agencies, and individuals. √

4. Review infection control, safety, and disaster programs. √

5. Consultation workflow with other staff in the same job classification regarding patient/client job issues (RN to LPN). √

6. Reviewing and delivering implementation of patient/client goals and objectives. √

7. Ensuring safe and effective services to patients/clients and families. √

8. Establishing and maintaining effective lines of communication. √

9. Practicing staff development, including orientation, in-service education, and continuing. V

10. Following the job description in the performance of duties. √

11. Implementing and evaluating patient/client care services. √

12. Participating in selected in-service programs/conducting them. √

13. Encouraging staff participation in problem-solving. √