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If you are Accredited with The Joint Commission or are seeking Accreditation and have Compliance Review Services, Inc. “start up” product you should have this update package.

By inserting  the changes/updates into your already purchased product your agency will be compliant with The Joint Commission 2010 standards .

Replace the revised pages once purchased and remove the original outdated material .

Updates include revisions to the following :  Admit Pack., Application Binder, Incident Binder, Equipment Management, Safety Binder ,Infection Control Binder and policy and procedure manual.

This is the update to the policy manual based upon the 2012 TJC standards. If you previously purchased TJC accredited, Home Health manuals Volume I and II this is the updated version/replacement of Volume I, there are NO changes to Volume II.

This is the policy that includes the national patient safety goals and the agency’s compliance with such. It is an update policy to the 2012 one previously produced by Compliance Review Services, Inc.

This is the updated policy on NSPG for 2015 and includes the revised language for 2015.


 This policy is updated to include the Voluntary Closure per the regulations. 

This binder helps the Administrator to organize all of the administration documents for the agency in one easy location. It is gold tabbed and has all of the areas pertinent to survey that one would need to have ready at your fingertips for the surveyor!

Ring binder 3” Gold ring padded black cover with gold foil imprint on the cover and spine. 12x12 index sets included with black print with gold foil imprint, 3 hole punched, and collated.  If you would like a listing of the tabs included please contact Jayne Jessop at
866-969-3569 (toll free).


This form is to meet the requirements for home health for coordination of care and the physician 60 day summary.

This form allows the client to designate a person who is competent to care for them in the event the agency staff is unavailable. This form can be used for Pediatrics and/or Primary Home Care recipients. It can also be used for any other situation in which the family or friends are providing some of the care to the client outside of the agency staff.

This policy update reflects the DADS requirement Chapter 97,97.301(b) related to Retention of Client Records and will replace your existing two polices entitled PAS Client Records and Protection of Records if you have a CRS policy manual.

This policy update reflects the DADS requirement Chapter 97,97.301(b) related to Retention of Client Records and will replace your current policies entitled Client Records and Protection of Records.

 This policy update reflects the DADS requirement Chapter 97,97.301(b) related to Retention of Client Records and will replace your current TJC section entitled, Record of Care Treatment and Services.(RC)

This home health and hospice form is when the nurse is requesting something of the physician such as permission to get an air-mattress for a patient. When the physician reviews the top portion of the form (the nurse request portion) and then completes his/her section it becomes a physician order. So many nurses document telephone orders when they never spoke to the doctor's office. This tool allows the nurse to truly request orders and document the request legally and within the scope of her practice.

 This policy is intended to meet the requirement for a DRFCA policy and procedure for those agencies who net 5 million dollars or more and must institute such a policy. 

This audit tool enables the agency QA department to audit all discharge charts and make sure that they are compliant in the main component areas prior to closing the chart out or doing final billing.

This policy is for those agencies who want to drug test their employees. It provides for drug testing if the agency suspects via behavior or other evidence that drug testing may be necessary.

 December 17, 2012

To: Community Based Alternatives Providers

Community Living Assistance and Support Services Providers

Medically Dependent Children Program Providers

Primary Home Care Program Providers

Community Attendant Services Providers

Family Care Providers

Consumer Directed Services Agencies

Subject: Information Letter No. 12-89


Required use of the Electronic Visit Verification (EVV) System in Regions 5 and 6 Where Participation is Mandatory Effective November 15, 2012

The information contained in this letter is applicable only to providers in Regions 5 and 6 that were placed under the requirement to use the EVV system effective November 15, 2012. The Department of Aging and Disability Services (DADS) has determined for the period November 15, 2012 through January 14, 2013, the agency will accept the use of paper timesheets as a back-up to the use of EVV to document attendant time worked. While DADS expects providers have begun using the EVV system to document service delivery effective November 15, 2012, for the period November 15, 2012 through January 14, 2013 paper timesheets will also be accepted to demonstrate compliance with agency rules and contract provisions. DADS is providing this flexibility to allow providers an opportunity to gain familiarity with the use of the EVV system before being potentially subject to sanctions for being unable to provide required documentation of time worked solely based on records in the EVV system.

While additional flexibility for demonstrating compliance is being provided for this two-month period, providers are strongly encouraged to make diligent efforts to gain proficiency in use of the EVV system. Beginning January 14, 2013, providers placed under EVV requirements effective November 15, 2012, will not be permitted to utilize paper timesheets to document attendant time worked or to support billing activity for attendant services.

Earlier references to EVV as a “pilot” refer to EVV’s phased introduction across the state and should not be construed as meaning provider use of the EVV system is voluntary after any date

This version was updated August 2011 to incorporate the new changes that became effective 8/1/11. This version meets DADS (97.256) requirements in the State of Texas and Accreditation Standards.

 This is a TWO PAGE policy and procedure for EVV visits for attendant services.

This policy, procedure and form has been created to ensure the home health agency is compliant with CMS’ face-to-face encounter requirement effective January 1, 2011.

This product is a written test for Glucometer and a written test for PT/INR targeted for your nurse competency evaluations. This meets the accreditation and State requirements to show that your nurses are competent in these two areas by written testing, you will also need to observe their skills visually to complete the competency.

This product updates your current HIPAA manual with the newest federal requirements. Track breaches to confidential information. Included is: Policy on breaches, investigative form, breach log, and breach risk assessment tool.


This is an updated drug disposal policy based on the latest federal guidelines.

This form has been updated from the previous version to include assisting with medications per the COP’s.

 This includes the most recent Conditions of Participation updates, revised 1/2020. 

Influx Risk Analysis for Infection Control Accredited form: This is the influx report form required by accredited bodies for home health and hospices. This form has all the elements required within the report to be compliant.

This policy addresses the use of internet within a business. It also addresses acceptable behavior by employees when using the internet for work and addresses employees using the internet during work hours for personal use. The policy addresses only on break time can an employee access the internet for personal use.

The policies in this package address intravenous therapy services as required by the Department of Aging and Disability Services in the State of Texas for home health and hospice. These are basic policies on intravenous infusion. If your agency is providing IV services, you MUST have policies and procedures in place. In addition to these policies, the agency must also purchase a clinical manual on IV therapy to adopt with their clinical policies and procedures. We recommend the following text: Principles & Practice of Intravenous Therapy by Sharon M. Weinstein (Lippincott)

This policy is for all DADS agencies that have a Medicaid contract in place. It is required that all DADS agencies who contract with Medicaid have policies and procedures in place to ensure that their employees/contractors are not on the Medicaid list forbidding them to provide services to Medicaid clients.

MSW Field Competency Form
This form is designated to show that a social worker is competent in the skills for their profession by being checked off in the field by another social worker. This form meets TJC and CHAP requirement for social work competency in the field.

Attention All Non-Accredited Home Health and Hospice Agencies.  Make sure that your agency meets the minimum requires related to DADS HCSSA Rule 97.287 Quality Assessment and Performance Improvement (QAPI).  As a part of your QAPI Program refer to HCSSA rule 97.287(a)(1)(A)(ii)(V)(a), you as an agency must ensure effective and safety of all services provided including the competency of the agency's clinical staff.  In order to meet this requirement you must ensure that all your clinical staff are competency evaluated. We now offer Competency Evaluation Forms for Therapy & Social work on our site, bundled together for $50. You’ll find these on our Online Store under General Forms.

This policy is a policy that meets the Board of Nurse Examiner’s requirement passed in 2008 that if a nurse has multiple employers how many hours they can work combined per week. Compliant with the Board of Nurse Examiners Rules for the State of Texas.

Fill your Nurses Notes - This nurses’ note is electronic. It can be loaded onto your nurses laptops, computers at the office, and is easy to complete! This will save your nurses time, energy, and effort and your notes will be legible.

This policy incorporates LVN/RN peer review processes since the 2 boards joined together in the State of Texas.

This policy covers the mandatory requirement to check employees to make sure that they are not on the OIG exclusion list prior to hire.

To ensure that the agency follows the State laws regarding the screening of all employees, contractors/entities for exclusion from participation in federal healthcare programs. This requirement for screening extends to include administrative and management services not directly related to patient care

This form for home health or hospice is when the nurse receives actual orders from the physician himself or his representatives.

 In order to stay in compliance with State regulations, new language has been incorporated to these job descriptions relating to the increased accountability of agency Administrators and Alternate Administrators. These 2 new job descriptions will need to be in the personnel files of your Administrators as soon as possible.

This change effects all home health and hospice categories Administrators and Alternate Administrators in Texas:
1- Licensed and Certified Home Health with or without PAS, Accredited or non Accredited 
2- Licensed Home Health
3- Personal Assistance Services(PAS)
4- Hospice Licensed and Certified, Accredited or non Accredited
5- Licensed Home Health - Therapy only
Refer to: Chapter 97, along with portions of the 7/12 Senate Bill (SB) 223 and House Bill (HB) 1720, 82nd Legislature

Therapist Field Competency Form
This form is designated to show that a PT,OT, SLP is competent in the skills for their profession by being checked off in the field by another Pt/OT/SLP. The discipline must be checked off by the same discipline i.e. PT by a PT. This form meets TJC and CHAP requirement for therapist competency in the field.

This is an updated abuse policy based upon the revised Texas DADS rule Chapter 97.249. This policy is specifically for CHAP accredited agencies.

This is an updated abuse policy based upon the revised Texas DADS rule Chapter 97.249. This policy is for all non-accredited agencies Licensed and Certified, PAS, Licensed Home Health, Hospice and also JCAHO accredited agencies.

 This policy is an update to reflect recent changes in the Act.

This policy is an update to reflect recent changes in the Act.

Effective September 14, 2016: Updated barr form to employment in home health and hospice agencies. This meets the 9-14-16 update which added Bars pursuant to Texas Administrative Code, Title 40, Part 1, Chapter 3, §3.201 Texas Health and Safety Code Chapter 481 and Texas Penal Codes.