Contractual Arrangements (10.07.07.08A)

 

POLICY

Contract Personnel are employees of organizations who contract with Agency, or who contract directly with SAMIRRA HEALTHCARE AGENCY LLC. on an hourly, per visit, or other basis to provide service to clients per a written agreement.

 

PURPOSE

• To provide highest quality of client care and increase the scope of home health care services to clients.
• To ensure sufficient numbers to personnel to safely and adequately meet the client’s home care needs.

SPECIAL INSTRUCTIONS

• All contract personnel must be duly licensed or certified by their appropriate professional accrediting organization or licensure board before they may render professional services to clients. They must provide proof of individual or group professional liability insurance.

• Contract personnel or organizations shall execute a written agreement, including charges, with the agency outlining the rules governing professional services rendered by contracted personnel. A copy of the contract shall remain in the Agency’s administrative files.

• Prior to rendering services to agency clients, all contract personnel shall receive an orientation to the agency’s client care policies and procedures and applicable personnel requirements.

• Professional   personnel under contract with the agency to provide professional services shall have complete personnel files available for the agency upon request.  Individuals who contract individually with the agency will have a complete personnel file in the agency which includes references, licenses/certifications, Mantoux/Health screening, and other documentation required by the agency.

• The contracting agency shall have the responsibility to maintain a complete employment application and personnel file for all personnel who provide services to the agency’s clients.

• Additional documents may be maintained for each employee, as may be required  according to the personnel records policy.

• Personnel records will be kept confidential, making such data available only to authorized persons. All client-identifying data shall be removed from the personnel file.

• Only the agency may accept clients to receive services rendered by the contract personnel. Individuals or organizations under contract with the agency shall bill the agency directly for services provided to the clients at the negotiated rate.

• Contract personnel or organizations shall not bill the client directly for services rendered on behalf of the agency

• Contract personnel shall report any significant changes in a client ‘s condition or response to treatment or therapy immediately to the Director of Nursing or nursing Supervisor and the client’s physician.

• The contractual Agreement shall continue and be binding upon the parties from year to year unless terminated by either party with 30 days written notice. If the contractor fails to perform according to the agreement, services will be terminated with 24 hours’ notice by the agency.  

        

Employees Screening COMAR 10.07.07.08B1

 

Policy:

 

SAMIRRA HEALTHCARE AGENCY LLC. will screen employees before assignment. 

 

Procedure:

SAMIRRA HEALTHCARE AGENCY LLC. will maintain a worker file on each of its employee, containing the following:

1. Completed application, which include education, training skills, specialties, and   preferences
2. Documentation of education and training,
3. Skills inventory checklist
4. Two recent work references
5. TB test and evidence of satisfactory health status
6. Current CPR
7. Performance evaluation
8. Copy of current license, registration, or certification
9. Criminal background check

• SAMIRRA HEALTHCARE AGENCY LLC will use its best efforts to match the skills and experience levels of its nurses to the specific needs of the clients.

• A direct observation, verbal validation or written skills evaluation will be performed by the RN supervisor. 

• Employee skills will be observed before work begins. 

• Skilled checklist form attached. ( Attachment A)

Criminal Background Check 10.07.07.08B(1)(a)

 

Policy: 

Thorough background checks must be done to protect a vulnerable public and consumer population as well as the provider’s liability. This verification provides information on criminal background, according to laws and regulations.

 

Procedure:

All offers of employment will be contingent on successfully passing a thorough and comprehensive background check.

• Consent for the background check will be signed and dated by employee. 

• Background checks will be done on each employee prior to hiring. 

• A minimum of seven (7) years criminal background checks will be done. This includes minimally: 

• Social Security Number Verification, 
• HHS/OIG list of excluded individuals, a candidate cannot be excluded, debarred, suspended, or appear on the General Service Administration List of Parties Excluded from Federal Programs. 

• Background checks will be performed by CJIS or a reputable private agency.

• Fingerprinting may be required.

• Only candidates that have advanced to the in-person interview stage of consideration will be asked to complete the Background Check Authorization and Disclosure Form.

• Candidates who refuse a background check will be disqualified from further consideration.

• The selected candidate must satisfactorily clear a criminal background prior to starting work.
• The background check results will be reviewed by the appropriate representative and a decision will be made on whether the candidate is appropriate for hire.

• If a decision is made to hire with the knowledge that a criminal history exists, appropriate documentation must be found defining the nature of the criminal act, the rationale for hiring and the verification of full disclosure to all hiring clients in the employee’s file if warranted. In addition, the history must have been reported to the licensing agency and the employee’s license must not have any restrictions.

• The results of the background checks will be placed in the employee file.

Verification of License/Certification COMAR10.07.07.08B(1)(b)

 

Policy:

The Agency requires that all Employee be properly licensed, certified, registered and/or trained to meet specific job requirements and that all necessary licenses, certificates and/or registrations be kept current.

 

DEFINITIONS

 

Certification/Licensure

Certification/licensure is the successful completion of recognized training and/or examination by an accredited, certifying body, which enables an employee to demonstrate excellence in an area.

 

Registration

Registration is the recognized, successful completion of mandated requirements for the practice of a profession.

 

Procedure:

• Employees shall not commence work until proof of required licenses, certificates and/or registrations is verified.

• Licenses, certificates, and registrations shall contain the following:
  • Name of issuing authority
  • Name of the employee
  • Expiration date
  • License number 

• Manager/Administrator shall validate licensure/certifications and registrations. 

SAMIRRA HEALTHCARE AGENCY LLC  admin will verified all nursing staff licenses with the Maryland State Board of Nursing for eligibility, validity, and identity purposes.

 

• Employees shall be responsible for ensuring licenses, certificates and/or registrations are kept current, in accordance with applicable state laws and regulations.

• Employees, who fail to maintain required licensures, certifications and/or registrations may be subject to disciplinary action or termination for inability to perform the duties of the positions to which they are assigned.

• Proof of current licensures, certifications, and/or registrations shall be kept in the Employee files in the Agency Office.

• Employees, who are not required to have specific licensure, certification, and/or registration, shall demonstrate competency.
• Medhub Manager/ Administrator QA personnel files quarterly to ensure all employee credential and license are current and valid.

 

Health Screening COMAR 10.07.07.08B(1)(c) 

 

Policy: Each employee and independent contractor having direct contact with patients may be required to have documentation of baseline health screening prior to providing care to patients. 

 

Procedure: 

1. On the date of hire the employee will be asked to furnish a physical that has been completed within one year. The physical must be performed by a M.D, D.O or ARNP and include at a minimum: 
   1. A statement of good health: the employee can perform the physical tasks associated with the job. 
   2. A statement that he/she is free of communicable diseases with evidence of TB testing if required by the job site. 
   3. The employee will be counseled about the potential occupational hazard of Hepatitis exposure. 
   4. If the employee has been vaccinated, evidence will be entered into the Employee file. A personal statement of vaccination is enough to satisfy this requirement. 
   5. If the employee has not been vaccinated: 

• The vaccine will be offered at no cost to the employee. 
• If the employee refuses the vaccine, evidence will be entered into the Employee file. 
• If any employee or contractor develops symptoms of an infectious disease, he/she will immediately inform the Administrator. Symptoms to be reported include but are not limited to: 

• Fever 
• Weakness 
• Unexplained weight loss 
• Night sweats 
• Productive cough 
• Occasional coughing of blood 
• Chest pain 

• The employee will not be allowed to return to the job site until he/she furnishes a Physician’s Statement of Good Health. 
• All infections requiring an employee to take antibiotics will be logged. 
• All health-related information entered in personnel files is confidential. D&A Holdings will not release the information unless required by law.
• Employees will be notified via e-mail, special notice posted on web site, and verbally of seasonal availability of the flu vaccine. Employees may be required to receive flu vaccinations on a yearly basis to comply with assignment. Employees are required to submit proof of vaccination to the Director/ Administration. 

TB TESTING POLICY: 

Health care workers may be required to have annual TB screening; no person with active TB will be allowed to see patients at their assigned job site. Applicants provide certification of TB Testing prior to hire and this documentation is filed in the Employee health file. 

 

Procedure: 

 

1. Pre-employment physical evaluation questionnaire to be filled out and signed by  employees, verifying absence of any signs and symptoms of communicable diseases  including: 

1. Fever 
2. Weakness 
3. Unexplained weight loss 
4. Night sweats 
5. Productive cough 
6. Occasional coughing of blood 
7. Chest pain 

 

• Employee or contract Employee shall provide documentation of completion of a  tuberculin (TB) skin test, via the Mantoux method. 

• Following the baseline tuberculin skin testing, repeat skin testing shall be completed at least once a year, after any possible exposure and as required by the State Health Department due to local outbreaks of the disease.

• If the employee has had a significant reaction to a Mantoux test upon employment or within the two (2) years prior to working in a position involving direct client contact or has a significant reaction to a Mantoux test in repeat testing during employment, the employee and D & A Holdings Health Solutions, LLC must have documentation of a negative chest x-ray.

• If the employee has had a significant reaction to a Mantoux test upon employment or within the two (2) years prior to working in a position involving direct client contact, the employee must provide documentation of a non-significant chest x-ray taken within the previous twelve (12) months or documentation that they have completed a course of tuberculosis preventative therapy.

• Employees who have been exposed to active tuberculosis must document a non-significant result of a Mantoux test or chest x-ray administered no earlier than ten (1) weeks after the exposure.

• If the employee was immunized and has tested positive over the course of years, that employee will require documentation of a medical evaluation, which may consist of a chest x-ray and/or prophylactic antibiotic therapy.

Verification of References COMAR 10.07.07.08B(1)(d)

Policy:

To validate the potential employee’s references and experience as stated on their application.

 

Procedure:

1. SAMIRRA HEALTHCARE AGENCY LLC. Administrator and/or Human Resources Manager will verify employment and character references to ensure employment history is accurately reflected on both the application and resume.  
2. Verification will be done by mail, email or telephone and will be documented in employee files. This will prevent hiring someone who has misstated, falsified, or otherwise modified their application. 
3. All reference for the past five (5) years must be verified. 

Verification of Employment COMAR 10.07.07.08B(1)(e)

Policy: 

Primary source verification is necessary to assure employment history is accurately reflected on both the application and resume. This will prevent hiring someone who has misstated, falsified, or otherwise modified their application.

 

Procedure:

• SAMIRRA HEALTHCARE AGENCY LLC. Director or Administrator will verify past or present employment history.  

• Verification of history will include duties and responsibilities at past or present employment. 

• The name of the person performing the check and the date of review will be signed, dated, and then included in the employee file. 

• The results of work history verification will be evaluated by the appropriate agency personnel to determine if an applicant is a candidate for hire and a copy of the verification form placed in the employee file. 
• Two references verification is required before assigning employment. 

I-9 verification COMAR 10.07.07.08B(1)(f) 

 

Policy:

1-9 Verification & E-Verify Policy and Procedure

To comply with federal regulations of the Immigration Reform and Control Act (IRCA), all employees are required to complete an Employment Eligibility Verification form (1-9 form). This law applies to all individuals hired, including part-time/temporary employees.

SAMIRRA HEALTHCARE AGENCY LLC. is an E-Verify employer. E-Verify is a web-based program administered by the U.S. Department of Homeland Security, USCIS Verification Division, and the Social Security Administration that supplements the current 1-9 employment eligibility verification process. The program determines whether the information provided by the new hire matches government records and whether the new hire is authorized to work in the United States.

 

Procedure:

• All employees must complete Section 1 of the 1-9 form on day one of their employment. All employees must complete the 1-9 form within three (3) business days of the date employment begins by providing appropriate documentation.

• Any employee who fails to complete the l-9 within the three (3) daytime period cannot continue to work at SAMIRRA HEALTHCARE AGENCY LLC.

• To maintain compliance, the appropriate Agency designee must also certify Section 2 of Form 1-9, and then prepare the E-Verify report within three (3) business days of the date of hire. 

In- person Interview COMAR 10.07.07.08B(1)(g)

 

Policy:

SAMIRRA HEALTHCARE AGENCY LLC will perform an in- person interview with new applicant to assess the applicant’s suitability for the position.

 

Procedure:

• SAMIRRA HEALTHCARE AGENCY LLC will conduct the interview prior to hiring the applicant.  
• The interviewer would review and inquire about any gaps in the applicant’s work record, ambiguous or contradictory entries on the application, etc.
• SAMIRRA HEALTHCARE AGENCY LLC will address question about the duties and responsibilities of the position and the immediate and extended working environment.
• The form used to record the applicants’ responses to questions posed will be included in the employee’s personnel file, and it will be signed and dated by the interviewer. 

Disclosure to Client COMAR 10.07.07.08B(2)

Policy:

SAMIRRA HEALTHCARE AGENCY LLC has an obligation to assist clients receive optimal levels of service and care. It is our mission to protect the rights of our clients and disclose these rights to each client before service begins. The family or representative may exercise these rights if a client is not competent or able to exercise them for themselves. Upon receiving referral, the nurse staffing agency will notify the client and their representative that determination to provide services are applicable to the needs of the client.

Procedure:

• Clients will be admitted for service only if it is agreed with the client or their representative that the agency can provide safe, professional care at the level of intensity needed. 

• It is expected that all personnel caring for a client will be knowledgeable, duly licensed or certified as applicable and have completed a training–program or competency evaluation regarding the employee’s respective areas of employment. 

• The Agency will inform, orally and in writing, at the time of admission and/or in advance if the agency determine it cannot service the needs of the client.

Client Participation COMAR10.07.07.08D 

 

Policy: 

In choosing to receive home care services, a client shall have the right to be involved in the decisions made about the care they receive. SAMIRRA HEALTHCARE AGENCY LLC sources highly qualified, good quality and appropriate personal care for clients based on their needs. 

Procedure: 

• SAMIRRA HEALTHCARE AGENCY LLC will inform clients and/or their representative about their condition(s) and how best to manage them. Clients have the power to decide and consent to who may have access to their medical records. 

• Clients may be required to have a legal representative provide consent depending on their capacity to make decisions.

• Consent by the client or legal representative must be provided before any medical information will be divulged to relatives or other people by any agency staff or clinicians.

• SAMIRRA HEALTHCARE AGENCY LLC and staff respect the rights of our clients to make their own decisions whether to accept or reject care given to them in their home which will include the following: 

• Admission Agreements 
• 2-Data collection and verification of services delivered 
• Methods of billing for services by the organization or Caregiver 
• Client notification of changes in fees and charges  

• The most important goal of the informed consent is that the patient has an opportunity to be an informed participant in his/ her health care decisions. 

• The Information is given prior to providing services. The client will have a copy of all assessments done by the nurse in their home the day of the initial assessment.  

• Clients and/or their legal representative will be provided an agreement between the client and this agency that may be signed showing their voluntary consent that SAMIRRA HEALTHCARE AGENCY LLC will organize their provision of care. 

When a client chooses not to accept an offer of care, SAMIRRA HEALTHCARE AGENCY LLC will work with the client to address concerns and work to find alternative suitable care. 

 

Complaint Process COMAR 10.07.07.08C(1)(a)

Policy:  

SAMIRRA HEALTHCARE AGENCY LLC will receive, document, address and resolve conflicts that involve complaints made by a patient, a patient’s family or guardian, or a patient’s health care provider. Agency will provide a written statement that informs the client of the complaint procedure at time of admission.  

SAMIRRA HEALTHCARE AGENCY LLC will not retaliate against a person for filing a complaint, presenting a grievance, or providing, in good faith, information relating to services provided by Agency. An employee may be terminated for an evidence-based reason due to their involvement in a complaint.  

 

Procedure: 

• Be informed of the procedures for submitting client complaints with respect to client care, that is, or fails to be furnished or regarding the lack of respect for property by anyone who is furnishing services on behalf of Nursing Referral Service Agency with suggested changes in services without coercion, discrimination, reprisal, or unreasonable interruption of services. 

• Be informed of the procedure for submitting a written complaint / grievance to the Agency.

• All complaints / grievances are to be referred in the following manner.  If not satisfied with any steps in chain of command, continue to the next person.  Contact Continuum Medical Staffing and speak to the following:
  • Administrator / Director 
  • Office coordinator 

• Receive prompt and reasonable response regarding complaint / grievance. 

• Administrator or designee documents and investigates the grievance/complaint within 10 calendar days of receipt of the complaint.  

• The Administrator or designee must complete the investigation and documentation within 30 calendar days after receipt of the complaint unless documentation exists that provides a reasonable cause for delay. 
• Clients will be informed of the Maryland State home health complaint hotline and its hours of operation. The purpose of the Hotline is to answer questions and receive complaints. 

The Client, patient, a patient’s family, or guardian will be given complaint process information at time of admission to SAMIRRA HEALTHCARE AGENCY LLC or on request. 

 

Written complaints may be submitted via the Office of Health Care Quality website at: https://app.smartsheet.com/b/form/483176a200fc44858f42772adb9283d1

 

Or through the mail to:

 

Office of Health Care Quality

Attn: Administrative Officer for Staffing Agencies

7120 Samuel Morse Drive, Second Floor

Columbia, MD 21046

(410) 402-8015

Toll-free HOTLINE: (800) 492-6005

 

All voicemail messages will be returned during the next business day.

 

Public Information Requests: ohcq.pia@maryland.gov

 

Investigate Complaints COMAR 10.07.07.08C(2)

POLICY – SAMIRRA HEALTHCARE AGENCY LLC receives, records, and investigates complaints. 

PURPOSE – SAMIRRA HEALTHCARE AGENCY LLC will investigate all complaints and incidents.

 

 PROCEDURE 

• The Director / designee will review the information presented and investigate to determine if the matter a reportable incident. If so, the information will then be reported to the Administrator. 

• A copy of the report will be sent to the appropriate outside entity such as Law Enforcement, Adult or Child Protective Services, and/or the Office of Health Care Quality as required by state and local law.

Reporting information: The report must include and identify: 

• the name, address, telephone number 
• the nature and extent of complaint 
• the person reporting the complaint 
• When and where the incident occurred (date, time, address, place) 
• Any   evidence of previous abuse or neglect 
• Any additional information pertinent to the complaint.
• As the mechanism for making files or records available during an inspection or investigation, SAMIRRA HEALTHCARE AGENCY LLC will retain all documents regarding its investigations of complaints and incidents.  The files will be stored confidentially in a locked cabinet. 
• Properly authorized and identified representatives of state and federal agencies and survey or accreditation organizations shall have access to present and past clinical records. 
• Inspections and investigations will take place during regular business hours. In the event there is a need to review documents beyond business hours, or documents are not currently on-site, an appointment can be scheduled with an administrator.