ALTCS rules

A Yavapai Care Services, LLC, Business Enterprise


PRESCOTT OFFICE

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Prescott, AZ 86305

Tel: 928-717-1776

Fax: 928-717-2054

prescottoffice@prescotthelpinghands.com




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203 S. Candy Lane, Suite 11AB

Cottonwood, AZ 86326

Tel: 928-639-8450

Fax: 928-639-3927

cottonwoodoffice@prescotthelpinghands.com


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Yavapai Care Services, LLC

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Saturday, February 21, 2015

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Arizona Long Term Care Rules



Caregivers may not transport ALTCS clients, in the client’s car.


Service to ALTCS clients shall be medically necessary, provided to the client only and not to the client’s family, friends or pets.


Some examples of non-covered services are:


Pet Care.

Yard Work.

Household chores for other person(s) in the home.

Running errands that are not medically necessary or that are not solely for the client.


Attendant Care


Attendant care is service that provides routine homemaking, personal care, respite care, general supervision, and companionship for extended time periods to clients for the purpose of keeping clients well integrated with their families.


Homemaking


Homemaking is service that provides routine homemaking and household maintenance for clients and is intended to preserve or improve the safety and sanitation of a client’s living conditions as well as the nutritional value of food and meals consumed by a client.


Caregiver shall ensure and maintain safe and sanitary living conditions for clients by performing the following tasks:


1. Clean the client’s living area, including:

a. Dusting, cleaning floors, carpets, ceilings, walls, bathrooms, and windows as necessary to maintain safe and sanitary living conditions.

b. Cleaning oven, stove, and refrigerator as necessary to prepare food safely; cleaning kitchen, washing dishes, and routine cleaning of household appliances.

c. Change linens and make beds used by the client.

d. Perform laundering tasks for the client, including washing, drying, and folding laundry. Ironing is included if the client cannot wear clothes without ironing.


2. Caregiver shall ensure nutritional maintenance of clients by performing the following tasks:

a. Plan, prepare, cook, and serve meals to meet the daily dietary needs of the client, including a therapeutic diet if prescribed.

b. Feed the client, as necessary.

c. Remind and encourage the client to eat.


3. Caregiver shall perform other tasks to assist the client with maintaining self-sufficiency, including:

a. Performing essential errands such as grocery shopping, and obtaining prescriptions, medical supplies, and household supplies.

b. Caregiver shall perform storage tasks as necessary.

c. Caregiver shall perform other duties and tasks included in the client’s individualized care plan that are necessary to assist the client with maintaining self-sufficiency.


Caregiver may not use the client’s private vehicle or transport the client in the client’s private vehicle to perform errands.  Caregiver may only use the caregiver’s private vehicle when performing errands. Caregivers that are family/relatives of the client are exempt from this provision.


Routine homemaking supplies (such as detergents, sponges, rags, and mops) shall be provided by the client. If a client is not able to provide necessary supplies, notify your supervisor.


Tasks performed apply only to the areas used by the client only and not the client’s family/friends or pets.


Personal Care


Personal Care is service that directly assists a client with activities of daily living, maintaining personal cleanliness, and meeting essential personal physical needs.


Caregiver shall assist clients with performing their activities of daily living and maintaining personal cleanliness, by performing the following tasks:


1. Showering, bathing, toileting, dressing, shampooing, grooming, oral hygiene, and caring for clients’ other physical needs.

2. Routine nail care (cleaning and filing) and skin care, unless the client is diabetic or has circulatory problems. CLIPPING NAILS IS NEVER TO BE PERFORMED BY A CAREGIVER

3. Routine ambulation activities.

4. Transferring to and from the wheelchair, bed, shower, tub, and toilet, this may include use of mechanical lift devices.

5. Assisting with adaptive equipment, assistive devices, special appliances, and/or prosthetic devices, if the procedure is routine and well established.

6. Assisting the movement-restricted client with tasks necessary for comfort and safety (tasks that do not require medical or nursing supervision).

7. Assist the client with the self-administration of medications, including reminding the client to take medications, and/or assisting the alert ALTCS client with the opening of medication containers.

8. Accompanying the client to medically necessary appointments using Agency contracted non-emergency transportation caregivers as authorized in advance by the care manager.  Caregiver may not transport the client in the caregiver’s or client’s private vehicle to such appointments. Caregivers that are family/relatives of the client are exempt from this provision.

9. Encouraging the client, family, and/or friends to provide personal care tasks when such persons are available and can provide appropriate care.

10. Encouraging family support of the client's care.

11. Serving food and feeding the client, as necessary.

12. Reminding and encouraging the client to eat.


Respite Care


Respite Care is service that provides routine homemaking, personal care, companionship, social stimulation, and supervision on a limited, intermittent basis to a client, for the purpose of providing an interval of rest or relief to the client’s family or caregiver.


1. Caregiver shall provide respite care services, which include, but are not limited to:

a. Homemaking tasks, as defined above

b. Personal Care tasks, as defined in above

c. Companionship, social stimulation, activities, and supervision.


2. Tasks performed apply only to the areas used by the client and not the client’s family or pets.


Habilitation Service


Habilitation services include the provision of training and/or assistance in independent living skills or special developmental skills, orientation and mobility training, sensory-motor development, behavioral management and supported employment such as:


1. Assistance and training related to personal and physical needs and routine daily living skills.

2. Implementing strategies to address behavioral concerns, developing behavior intervention programs, and coordinating with behavioral health programs to ensure proper review of medication treatment plans.

3. Ensuring that the health needs of the client are being met, including providing follow up as requested by the client’s primary care physician or medical specialist.

4. Implementing all therapeutic recommendations including speech, occupational, and physical therapy and assisting clients in following special diets, exercise routines, or other therapeutic regimes.

5. Mobility training, alternative or adaptive communication training.

6. Opportunities for training and/or practice in basic consumer skills such as shopping, banking, money management, access and use of community resources, and community survival skills.

7. Assisting clients in utilizing community transportation resources to support the client in all daily living activities, e.g., day treatment and training, employment situation, medical appointments, visits with family and friends and other community activities as identified.


Financial / Fiduciary Relationships and Client’s Personal Funds


1. Caregivers may use a client’s personal funds, when necessary to purchase necessary grocery items, toiletries, and other personal items for the client, if requested by the client and written authorization is obtained from the client or their representative in advance of the purchase.

2. When the caregiver is required to use the client’s personal funds      to obtain such items for the client, the agencies require that:

a. Caregiver shall use cash, when possible, when shopping for clients.

b. Caregiver shall obtain written permission in advance from the client or their representative to perform the requested errand using the client’s personal funds. Written permission should include the following:

I. Date the errand is to be performed

II. Type of item(s) the caregiver will be obtaining (i.e. groceries, etc.)

III. Store/location the caregiver will be obtaining items from (i.e. Joe’s Grocery Store in Prescott)

IV. Approximate maximum dollar amount the caregiver is authorized to spend (i.e. twenty dollars)

V. Method of payment the caregiver is authorized to use (i.e. cash, personal check, etc.)

VI. Client’s name

VII. Client or their representative’s signature authorizing such transaction/errand

VIII. Name of caregiver authorized to perform such transaction/errand

IX. Caregiver shall obtain a receipt for all purchases made on behalf of the client and provide such receipts to the client upon completion of each errand.

X. Caregiver shall give the client any balance of money remaining upon completion of each errand, if the purchase was made using cash.

c. It is recommended that the client or their representative document the following and that the caregiver turns this documentation over to their supervisor:

I. Receipt of goods

(a) Date of receipt

(b) Items received

(c) Balance of cash money (if applicable)

(d) Purchase receipts given by the caregiver

(e) Client or their representative’s signature

II. Caregiver shall only use a client’s personal funds to obtain items for the client, as requested by the client or their representative.

III. It is recommended that caregivers not use a client’s personal check(s) or credit card(s) to obtain items on behalf of the client.

IV. Caregivers shall provide records of all written authorizations given by clients or their representatives to use clients’ personal funds to their supervisor.


Other


1. Caregivers must maintain and provide to their employer:

a. A valid fingerprint clearance card or provide proof of being in the process of receiving a valid fingerprint clearance card. Caregiver shall verify the current status of a caregiver’s previously issued fingerprint clearance card. Caregiver shall prohibit a caregiver from providing service if the caregiver has been denied a fingerprint clearance card.

b. If running errands:

  1. Current Automobile Registration
  2. Current Automobile Insurance

c. Current CPR certification.

d. Current First Aid certification, unless the Caregiver licensed as a Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN), or Registered Nurse (RN) in good standing with the Arizona State Board of Nursing.

2. Be knowledgeable and/or competent in the following through Current nursing licensure (Registered Nurse, Licensed Practical Nurse, Certified Nursing Assistant); or written or verbal examination, or physically demonstrated skills to the supervisor:

a. In-home accident prevention

b. Homemaking tasks

c. Personal care tasks

d. Toileting techniques

e. Transferring techniques

f. Basic nutrition and meal preparation

g. Disability types and associated disease processes

h. Assertiveness

i. Time management

j. Member and employee rights

k. Providing care according to the member’s care plan and within the limitations of attendant care services

l. Verbal and written communication


Ongoing Training for Caregivers


1. Caregivers must complete at least 6 hours of continuing education per year.

a. Training topics shall include, but not be limited to:

  1. In-home accident prevention
  2. Homemaking tasks
  3. Personal care tasks
  4. Toileting techniques
  5. Transferring techniques
  6. Basic nutrition and meal preparation
  7. Disability types and associated disease processes
  8. Assertiveness
  9. Time management
  10. Member and employee rights
  11. Providing care according to the member’s care plan and within the limitations of attendant care services
  12. Verbal and written communication


Timesheet documentation


1.    Must include the following information:


a. Dates of service

b. Time of service

c. Duties performed

d. Caregiver name preferred

e. Caregiver signature

f.  Client name

g. Client signature verifying each service provided. If the client is unable to sign his/her own name, it must be noted in the client’s file. The client’s designee may sign for the client only if designated in the client’s case file.

2. The client or designee shall sign the timesheet at the time of service and not in advance of service provision. If the designee signs on behalf of the client, the signature shall include the designee’s relationship to the client and conform to the following format: “John Smith, husband of Jane Smith.”

3. Caregiver’s timesheet or caregiving/nursing notes shall be completed, signed, and dated by the caregiver and client only at the time service is provided.

4. Caregiver’s timesheet or caregiving/nursing notes shall not be completed, signed, and dated in advance or after the fact.

5. Service provided shall be medically necessary, provided to the client only and not to the client’s family or pets.

6. Services shall be provided to the client while the client is in an approved home based setting in the geographic area of Yavapai County and eligible to receive services.


Staff shall:


1. Not accept gifts, gratuities, or donations from clients or their families.


2. Not accept any funds from a client or their family without Agency approval.


3. Not borrow from or loan money to clients.


4. Not accept any transfer of property or other assets from a client.


5. Not serve as fiduciary, guardian, conservator, executor, financial or health care power of attorney, surrogate decision maker, representative, or agent for a client, unless that individual is a relative or has a familial type of relationship with the client.



Long Term Care Client Rights.


  1. To receive courteous, considerate care regardless of race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information or source of payment.
  2. To be treated with respect and dignity
  3. To have your privacy and confidentiality maintained
  4. To be able to see and copy your health records in agreement with Federal and State laws at no cost to you
  5. To help decide about your care
  6. To refuse services and/or treatments
  7. To receive services as authorized. Please call the agency any time an authorized attendant care, homemaker, in-home respite, or personal care service is not provided as scheduled. This is called a gap in service
  8. To file a complaint, grievance, appeal, or request for State Fair Hearing
  9. To receive language interpretation at no cost if English is not their main language, if they have limited English, are hearing-, sight-, or speech impaired, or have a hard time reading
  10. To be free from any form of restraint or seclusion used as a means of  coercion, discipline, convenience or retaliation.