Division for Aging Services - Homemaker Service Specifications

Homemaker

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STATE OF NEVADA
DIVISION FOR AGING SERVICES

SERVICE SPECIFICATIONS

HOMEMAKER SERVICE
(Revised 7/08)

Any exception to these Service Specifications must be requested in advance in writing and approved by the Administrator.

SERVICE DEFINITION:

This service provides housekeeping and personal care assistance to seniors who are unable to perform self-care.

SERVICE CATEGORIES AND UNIT MEASURES:

The following service categories and unit measures established by the Administration on Aging (AoA) must be used to document the amount of service provided:

Homemaker: Provides assistance to persons having difficulty with one or more of the following activities: preparing meals, shopping for food or prescriptions, bathing or doing housework.

One unit equals one hour of Homemaker/Chore.

SPECIFICATIONS:

1. Required Services:

1.1 General Cleaning: vacuum, mop, sweep, clean bathroom, clean kitchen, empty trash, dust, change linens, do laundry.

1.2 Shop for groceries and prescriptions, pick up mail.

1.3 May provide stand-by bathing assistance.

2. Optional Services:

2.1 Heavy Cleaning and Related Services:

2.1.a Heavy cleaning: Provide heavy cleaning if the home is unsanitary or severely neglected. DAS funding for this service is limited to $300.

2.1.b Related Services: Provide other services deemed necessary to assure good client health and safety. Safety services, such as duct cleaning, pest control and the provision of assistive equipment, smoke detectors, specialized toilet seats, large numbered phones, etc., may not exceed $200. Minor repairs/modification jobs, including the installation of grab bars or door locks, are limited to $200.

2.1.c There will be a financial limit of $700 per client per year. Programs may establish a cost sharing agreement with the client to pay for this service.

2.2 Prepare meals if home delivered meals are unavailable or insufficient to meet client needs. This might include preparation of meals for clients on special diets and preparation of meals in addition to those provided by a nutrition program.

2.3 Homemakers may transport clients. The program must maintain current proof of drivers' licenses and vehicle insurance for all homemakers involved in transporting clients.

3. Service Prohibitions:

3.1 Staff shall not accept tips, gifts, loans, or fees from clients.

3.2 Staff shall not smoke in client homes or while transporting clients.

3.3 Staff shall not purchase alcohol or illegal substances for clients.

3.4 Staff shall not borrow the client’s car or other personal belongings.

3.5 Staff shall not bring family members, other people or pets to the client’s home without client’s permission and supervisory approval.

3.6 Staff shall not eat the client’s food.

4. Safety:

4.1 The grantee cannot assign homemakers to work in conditions that jeopardize their safety.

4.2 Prior to providing services, homemakers are required to have a fingerprint search conducted by the Nevada Highway Patrol Criminal Information Services. The search will include a review of the records contained in the Nevada Criminal History Repository.

5. Assessment/Certification:

5.1 Client Assessment: A client assessment must be completed prior to the start of service. The assessment must document the condition of the client based on the Assessment Criteria contained in Appendix B. An intake form and assessment must be completed on the person over the age of sixty (60) that is requesting the service.

5.2 Care Plan: A Care Plan must be established for each household based on the needs identified in the assessment. The Care Plan Criteria contained in Appendix A are to be used to establish service tasks and frequency of service. A signed copy of the Care Plan must be provided to the client. A new Care Plan must be established whenever changes are made to the plan and a copy of the new plan must be provided to the client.

5.3 Reassessment: A reassessment is required whenever there is a substantial change in a client’s physical condition, support system, or home environment. At a minimum, clients must be reassessed annually through an in-home visit. The reassessment must be based on the assessment criteria contained in Appendix B. Reassessment documentation must be recorded separate from the original assessment documentation.

6. Documentation Requirements:

6.1 Homemaker Activity Record: Service must be provided in accordance with the established care plan. A Homemaker Activity Record must be completed after each service visit and must contain the following documentation: a) name of client and date of service, b) housekeeping and personal care tasks provided to the client, including any services provided in addition to those specified in the Care Plan, c) homemaker’s time of arrival and departure, d) signatures of client and homemaker, and e) a list of authorized care plan services not provided to the client and a brief explanation why they were not provided. Client signatures are to be obtained only after services have been provided.

6.2 Verification System for Shopping: A procedure must be established which allows homemakers and clients to verify the amount of money given to the homemaker, cost of items purchased, and change returned to the client. Documentation of the transaction must be included on the Homemaker Activity Record.

6.3 Prepare a Quarterly Service Summary form that identifies the dates of service and the number of hours of service delivered to each client. The Quarterly Service Summary must be submitted to DAS by the 15th of the month following the end of the quarter.

7. Operating Procedures:

7.1 A waiting list is to be established only after all other measures for improving the efficiency of the service delivery system have been examined and, when feasible, implemented. Grantees are required to establish a waiting list policy that will be activated in the event that demand for service exceeds the program’s capacity. Waiting list documentation must include, at a minimum:

7.1.a The client’s name, address, and telephone number;

7.1.b the date the client was placed on the waiting list; and

7.1.c the description of each client’s need for service.

Clients with the greatest needs are to receive priority consideration. The program must establish a procedure for updating the continued service needs of clients placed on the waiting list.

8. Training:

8.1 Homemakers assigned to provide bathing assistance must receive training, which includes hands-on experience, prior to provision of service. Training must be provided under the supervision of a qualified health professional. (Homemakers licensed as Certified Nurse Assistants are exempt from the training requirement). Documentation of training must include: dates of training; name of homemakers receiving training; name, title, and agency of trainer; list of topics covered during the training; and copies of training material.

9. Quality Improvement:

9.1 A quality assurance visit or phone call must be provided to each client at three-month intervals following each assessment or reassessment. The quality assurance check conducted six months after each assessment or reassessment must be in person. The purpose of the quality assurance check is to: verify that the Care Plan is being followed, assess client satisfaction with the service, and amend the Care Plan as necessary to ensure that the client receives the services needed.

10. Client Contact Time Frames:

10.1 The following is a summary of the client contact time frames for assessments, reassessments, and quality assurance:

10.1.a Begin Date - Initial Assessment

10.1.b 3 Months - Quality Assurance Visit or Phone Call

10.1.c 6 Months - Quality Assurance Visit

10.1.d 9 Months - Quality Assurance Visit or Phone Call

10.1.e 12 Months - Reassessment

APPENDIX A

CARE PLAN CRITERIA

Care Plans must be established based on the following maximum and minimum frequencies for each service task. Homemaker service cannot exceed three hours per visit.

Required Services	Maximum	Minimum
Vacuum, Mop, Sweep	weekly	every two weeks
Clean Bathroom	weekly*	every two weeks
Clean Kitchen	weekly	every two weeks
Empty Trash	as needed	as needed
Dust	weekly	every two weeks
Change Linens	weekly, or more often if soiled	every two weeks
Laundry	weekly	every two weeks
Shop, Pick up Prescriptions and Mail	as needed	as needed
Bathing Assistance	three times a week	weekly

*Permitted more frequently if performed in conjunction with bathing assistance.

Optional Service	Maximum	Minimum
Meal Preparation	Daily	as needed

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