Establishing Well-Documented Policies and Procedures for Home and Health Care

A medical practitioner wearing a stethoscope talking to a patient

Home care services are provided to individuals in need of assistance in the home whether it be aid with personal care or health care. Home care services are typically provided to the elderly, chronically ill, those recovering from surgery, or disabled. Professional care providers may assist with daily activities like dressing and bathing, managing tasks around the house, rehabilitative activities, and/or nursing care for an illness, disease, or disability. Given that home care providers are entrusted with the safety of the patient, they must be well-prepared when assisting the client in the home. In order to assure that home care providers know what they must do in their roles, a home care agency must have comprehensive written policies and procedures

For instance, if a non-medical home care provider is caught in an emergency situation in which the client needs medical attention, there must be procedures in place for the provider to follow to ensure the safety of the provider and the client. Home care policies and procedures provide guidelines for situations in which a care provider may need to call a doctor or ambulance, occupational safety, vaccination policies, and remaining compliant with state and federal laws. Making sure that care providers are properly aware of and have access to written policies and procedures is fundamental in creating a safe environment for the patient and the care provider. 

Home care policies and procedures can be quite extensive, especially for health care home providers. It is crucial that this type of documentation is comprehensive and well documented so that care providers maintain safety. Technical writers can prove to be a valuable asset in this undertaking as they have the expertise and skills needed to produce this kind of documentation. 

Establishing Home Care Policies and Procedures 

For agencies that provide home care services, it is fundamental that the agency clearly outlines the policies and procedures to be followed by care providers. This includes policies and procedures in regards to: 

  • Establishing service agreements with a client
  • Maintenance and security of client records
  • Reporting complaints
  • Reporting client progress
  • Handling emergencies  
  • Discharge criteria
  • Policies regarding compliance with the Health Insurance Portability and Accountability Act of 1996 

Developing home care policies and procedures is important in clearly defining each care provider’s responsibilities when it comes to caring for the client and creating a safe environment for themselves and the client. This document helps care providers understand what is expected of them in rendering home care services in a safe manner that is also compliant with federal regulations. Ensuring that your agency’s policies and procedures are thorough is of utmost importance to the success of the agency. Hiring a technical writer to develop this documentation can help immensely in creating documentation that is well-written and researched, especially in regards to federal and state regulations. 

Compliance and Home Health Agencies 

Establishing well-documented home care policies and procedures is not only meant to provide for the safety of the patient but also to assure that a home care provider is compliant with their state’s laws. For instance, in California the Home Care Services Bureau, under the Department of Social Services, oversees Home Care Organizations via processing applications, responding to complaints, and conducting unannounced visits to ensure compliance. In 2016, California passed the Home Care Services Consumer Protection Act which requires Home Care Organizations to be licensed and creates a public online registry for Home Care Aides who have been background checked. This law was created to ensure the safety of the elderly and disabled who hire private home care aides. With adequate documentation, home care aides know what policies they must follow to remain compliant with state laws and be prepared for surprise visits from government officials. 

Additionally, every state that requires a home health agency license application will also require an inspection. In some cases, an agency will not receive its license until its inspection is conducted. Depending on the state, inspections will occur on a one-year, two-year, or three-year basis. During inspections, state surveyors review a home health agency’s plan of care and check for any areas in which an agency is not in compliance with federal regulations. If they find deficiencies the agency must provide a plan of correction. For this reason, it is vital that an agency have comprehensive written home care policies and procedures to ensure that they comply with federal regulations. 

How EDC Can Help

Home care policies and procedures must be adequately developed so that an agency’s employees understand the type of service that is expected of them and so that they are prepared for any situation. This documentation also helps an agency follow state and federal regulations, to avoid any issues with license applications. However, given the constantly changing landscape of federal regulations in the home health care industry, it can be difficult to maintain policy and procedure documentation. EDC’s technical writers can help develop and maintain excellent documentation of home care policies and procedures to assist an agency in creating a knowledgeable and compliant workforce. Our technical writers have produced technical documentation for all kinds of industries including software companies and biomedical firms. They have the technical expertise and writing skills necessary to produce the kind of technical documentation needed in the home health industry. 

Whether you need a team of consultants to produce a complete line of documentation or a single technical writer for a brief project, Essential Data’s Engagement Manager will lead the project from start to finish. At Essential Data Corporation, the quality of our work is guaranteed. Contact us today to get started. (800) 221-0093 or

Written by Diana Guerra


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