Any person who is determined eligible by the Missouri Department of Social Services, Division of Family Support, for Title XIX benefits (Medicaid) and desires help with personal care (bathing, dressing/grooming, toileting, mobility/transfer, meal preparation, laundry, etc.) can contact the Missouri Department of Health and Senior Services to be assessed for services.

The Department will initially complete a prescreen process over the phone to determine if the individual meets the nursing home level of care and qualifies for a face-to-face assessment in their home. If they qualify during the prescreen, they are placed on a list to be assessed. The Department has fifteen (15) business days to conduct the assessment.

The Department meets with the client and/or family members in their home and completes an assessment based on the client’s unmet needs. If the client meets the nursing home level of care, the Assessor develops a Care Plan with input from the client and/or family. The Care Plan outlines the amount of time a client is authorized to receive, the number of days they are eligible for services, and the specific tasks to be completed during service delivery. Only the Department of Health and Senior Services can authorize services for eligible individuals.

The Department forwards a copy of the Care Plan to the client’s physician and informs Crescent Home Care, LLC by phone that the Care Plan is complete and ready to download. Crescent Home Care, LLC must begin services in the client's home within seven (7) days of notification. The physician must provide comments or request changes within thirty days of receipt; otherwise, the Care Plan stands as written.

The Department of Health and Senior Services will send an Assessor to review and determine the need for Personal Care services every year. The Assessor, along with the client and/or family, may develop a new Care Plan or make revisions as needed. Crescent Home Care, LLC will be informed of any changes. Only the Department may increase or decrease the number of hours an individual is eligible for per month.

Crescent Home Care, LLC works diligently to adhere to the rules and regulations of the Personal Care program. We strive to ensure that all staff members are thoroughly trained and understand their roles.

• The client will be fully informed of his/her rights and responsibilities by Crescent Home Care, LLC.
• The client has the right to be treated with respect and dignity at all times.
• The client has the right to have all personal and medical information kept confidential at all times.
• The client has the right to manage the services provided, to the best of their ability, within the written guidelines of the authorized care plan.
• The client has the right to know Crescent Home Care, LLC's implemented grievance procedure and how to make a complaint about the service and receive cooperation to reach a resolution, without fear of retribution.
• The client has the right to receive a copy of the Code of Ethics under which his/her services are provided.
• The client has the right to refuse treatment and to be informed of the consequences of his/her actions.
• The client has the right to receive services without regard to race, religion, creed, color, age, gender, national origin, or sexual orientation.

If you suspect a senior or disabled adult is being abused, neglected or financially exploited, call the Missouri Adult Abuse and Neglect Hotline at 1-800-392-0210, their hours of operation are 7:00 a.m. to 12:00 a.m. Phone lines are answered 365 days a year, seven (7) days a week. Hearing-impaired persons may call the Telecommunications Device for the Deaf (TDD), at 1-800-735-2466 or 1-800-735-2966 to utilize Relay Missouri. In cases of abuse, neglect of exploitation.....Silence is NOT golden.

• The client is assured confidential treatment of his/her medical records and may approve or refuse the release of records to any individual outside of Crescent Home Care, LLC. With the exception of the client care being transferred to a hospital or nursing home, it is required by law that medical information may be released for reimbursements under Medicaid programs or by third-party fiscal contractors.
• Client(s) medical records are limited to the use of staff on a "need to know" basis. Only those responsible for direct care of the client may have access to his/her records. Records are not available to staff members who are not directly involved in the care of the clients.
• Client(s) records including medical, financial, or social service information will be safeguarded and held confidential at all times by every staff member. Under no circumstances will a client's personal financial information be made available to any individual and/or organization, except authorized persons such as the administrative department, custodian of finances, the client or legal representative.
• The administrative department will ensure all client records are maintained confidentially and never released without proper written authorization from the client or legal representative. Entities that may request such information include: Social Security Administration, Veterans Administration, Missouri Department of Social Services Family Support Division, Missouri Department of Mental Health, and the Missouri Department of Health and Senior Services.

• Do NOT drive the client’s car for any reason; clients cannot drive staff members' cars for any reason.
• Do NOT transport the client in your car for any reason; clients cannot transport staff in their car for any reason.
• Do NOT consume the client’s food or drink (except water; staff may use the client’s bathroom).
• Do NOT use the client’s telephone for personal calls (electronic visit verification is the only exception).
• Do NOT discuss personal problems, religious, or political beliefs with the client.
• Do NOT accept gifts or tips (items, things, or monetary).
• Do NOT bring other persons (including children) to the client’s home.
• Do NOT consume alcoholic beverages, or use medicine or drugs for purposes other than medical, in the client’s home or prior to service delivery.
• Do NOT smoke in the client’s home (even if the client smokes).
• Do NOT solicit or accept money or goods for personal gain from the client.
• Do NOT violate the client’s privacy and confidentiality of information and records.
• Do NOT purchase any item from the client even at fair market value.
• Do NOT assume control of the financial and/or personal affairs of the client or of his/her estate, including power of attorney, conservatorship, or guardianship.
• Do NOT move in with the client, nor spend additional time with the client outside of scheduled work time.
• Do NOT take anything from the client or remove any items from the client’s home.
• Do NOT commit any act of abuse, neglect, and/or exploitation toward the client or any persons in their home.

It is against Missouri’s Code of State Regulations and Crescent Home Care, LLC’s Policy for employees to provide transportation to a client for any reason. Under no circumstances shall an employee transport a client in their vehicle or ride in a client’s vehicle. This policy applies to all employees, whether on or off the clock.

Crescent Home Care, LLC will not be responsible for any accident involving a car or other transportation that occurs if an employee is violating this policy.

Any employee found in violation of this policy will be counseled, and appropriate disciplinary action will be taken. This policy has been explained thoroughly, and the employee is expected to understand it fully.

It is against the Missouri Department of Health and Senior Services Title XIX and XX regulations for staff members of Crescent Home Care, LLC to provide services to an immediate family member. If it is determined that a staff member is providing services to a client defined as one of the relationships below, the staff member will be released immediately from their position with that client and may face disciplinary action. These relationships include those by blood, adoption, or marriage.

The following family members cannot be serviced by an employee:

1. Mother 2. Father 3. Children 4. Grandchildren 5. Brother 6. Sister 7. Grandparents

Crescent Home Care, LLC encourages all employees to express complaints and grievances without fear of retaliation. All grievances shall be treated confidentially.

Procedure:

1. An employee is to express his/her complaint to their immediate supervisor either in writing or by telephone.
2. If the problem is not resolved within three (3) business days, the employee should present the concern in writing to the agency’s Director.
3. For grievances involving more than one employee, a grievance committee, made up of administrative staff and peers, will be formed.
4. The committee will compile the grievance with possible solutions in writing and present it to the Director within three (3) business days.
5. The Director will review the written information, speak with the employee, and resolve the issue if possible. The Director is responsible for resolving the issue at their level.

All employees must read and sign their acknowledgement and understanding of the following statement:

By accepting employment with Crescent Home Care, LLC, you have obligated yourself to carefully refrain from discussing any client’s condition or personal affairs with anyone outside the agency, unless you are expressly authorized to do so. Do not pass on medical information to clients and visitors unless you have been instructed to do so by your supervisor. In addition, all information seen or heard regarding clients, directly or indirectly, is completely confidential and not to be discussed even with your family. Your job as an employee requires that you govern yourself by high ethical standards. This includes not asking for clinical advice for yourself or your family from client’s physician. Failure to recognize the importance of confidentiality is not only a breach of professional ethics, it can involve an employee in legal proceedings. Information about our clients or Crescent Home Care, LLC shall not be given to the news media. This is essential for the protection of both our clients and Crescent Home Care, LLC. We are bound by strict laws regarding the release of information.

I have read and understand the above statement. I also understand that a violation of this policy is grounds for termination.

This document confirms the agreement between you and Crescent Home Care, LLC, regarding non-disclosure of confidential client and medical information to which you may have access in working at Crescent Home Care, LLC. Crescent Home Care, LLC is required by law to monitor and supervise data use and disclosure practices of its workforce and other persons in our work community. Your agreement to these terms is a condition for your employment with Crescent Home Care, LLC.
Crescent Home Care, LLC is obligated by federal law and other rules to keep confidential most of the personal and medical data supplied to us by or about or clients. Among other things this means not using individually identified health information, or disclosing it, for purposes or to other people outside of those authorized by Crescent Home Care, LLC Agency policies and applicable law.
By signing this agreement, you acknowledge that you will maintain the confidentiality of all the clients personal and medical data made available to you through Crescent Home Care, LLC, except where Crescent Home Care, LLC policies and law permit disclosure; and that you will not use or retain that data in a manner, or for any purpose, other than those permitted under the applicable Crescent Home Care, LLC policies and applicable law.
You will also be required to sign a Non-Compete Agreement as a condition of employment with Crescent Home Care, LLC.

I understand that any omission or provision of false information can result in immediate termination from my position. Crescent Home Care, LLC will not be held responsible for any injuries or losses due to misrepresentation or false information.

While the following list is not all-inclusive, the conduct outlined below may result in termination from employment with Crescent Home Care, LLC.

On Assignment:

• Bringing children or visitors to work
• Refusing to provide services called for in your job description
• Entering into a confrontation with a client or client’s family
• Theft, including receiving any goods belonging to a client
• Excessive tardiness, excused or unexcused
• Excessive absence, excused or unexcused
• Consuming drugs or alcohol before or during work
• Accepting assignments that you know you cannot service
• Modifying your assigned hours without contacting the office
• Doing personal work on assignment (e.g., laundry or shopping)
• Sleeping, eating client food, visiting persons or places, or any activity that is not job-related during your assignment
• Administering prescribed medications
• Failure to keep employee files updated (health certificates, licenses, PPDs, etc.)
• Failure to show up for and/or call in to cancel a scheduled shift
• Physical abuse, sexual abuse, or verbal abuse
• Unprofessional or unethical behavior or conduct
• Soliciting payment from a client for services

Policies and Procedures:

Not informing your supervisor when you will be absent from work for any length of time

Not informing your supervisor or appropriate office staff when you will be late to a scheduled visit

Not showing up for scheduled visits

Not attending mandatory trainings and/or meetings

Not following the client’s care plan as written

Payroll:

• Entering false information into the Electronic Visit Verification System (e.g., clocking in from a location that is not the client’s home, or clocking in and leaving the client’s home for personal reasons)
• Allowing someone else to clock you in or out of the Electronic Visit Verification system
• Working more hours than the client is authorized to receive
• Not completing all of the hours a client is authorized to receive
• Failing to clock in and out when providing services to an authorized client
• Clocking in and/or out but not providing authorized services to the client

We understand that circumstances arise that can prevent staff from servicing their scheduled clients. Crescent Home Care, LLC understands this and is compassionate about our staff. However, Crescent Home Care, LLC’s priority is our client.
Servicing our clients according to their authorized care plan has become an increasing problem due to staff lack of communication, no-call, no-show and repeatedly calling in. Please note the following:

• You must inform the office if any schedule change (ex. if you cannot go to your client, if you are going to be late or need to change your day). Schedule changes are permitted for emergency purposes only and not as a weekly routine for your convenience. No more than one schedule change per month will be permitted without prior approval from the office.
• Call the office: (314) 741-3800 or the after-hours on call phone (314) 954-4005. When calling off for a scheduled shift during business hours or after business hours you must speak with a staff person. You are not considered properly excused until you have spoken with a staff member. If you call and have not received a call back within 30 minutes please call again
• You must work your hours as printed on your Service Plan. Consistently changing your schedule creates problems with the office and our clients.
• If you are going to be more than 30 minutes late you must notify the client and the office.
• When you accept an assignment, we expect you to fulfill the agreement. Emergencies do happen and in that circumstance every effort will be made to get coverage for you.
• When sick, give appropriate time for us to cover your shift (3 hour minimum). Failure to give a three (3) hour notice may result in you being placed on a thirty (30) day probation. Failure to give a three (3) hour notice while on probation may result in a separation from Crescent Home Care, LLC.
• Canceling shifts will be disciplined as follows:
• Canceling three (3) or more times within one (1) month: verbal warning
• Canceling three (3) or more times within two (2) months: 30-day probationary period
• Canceling three (3) or more times while on probation: possible separation from Crescent Home Care, LLC
• If you are experiencing problems that prevent you from providing the services as scheduled you may need to consider taking some time off until you are able to resolve your problems. Please discuss this with the office, so that we can ensure the client is covered

A NO-CALL, NO-SHOW is grounds for automatic separation from the agency and will be considered a voluntary resignation.

Mandated Reporting

Crescent Home Care LLC takes the safety of our clients seriously. All employees of Crescent Home Care, LLC are considered Mandated Reporters of Elder Abuse, Neglect and/or Exploitation.
The Missouri Department of Health and Senior Services (DHSS) investigate abuse, neglect, and exploitation of vulnerable individuals 60 and older and people with disabilities between 18 and 59. These individuals may live in the community or in long-term care facilities. Either way, they are unable to protect their own interests or adequately perform or obtain services necessary to meet their essential human needs (192.2400, RSMo).
Missouri’s Adult Abuse and Neglect Hotline respond to reports of abuse, neglect, and financial exploitation. If you suspect someone is being abused, neglected or exploited, call the hotline at 800-392-0210. The hotline operates 365 days per year from 7 a.m. to 12 a.m. Hearing-impaired persons may call the Telecommunications Device for the Deaf (TDD), at 800-735-2466 or 800-735-2966 to utilize Relay Missouri. Due to the possible need for mandated reporters to report a concern to the Central Registry Unit (CRU) during the hours of 12:00 a.m. and 7:00 a.m. (when the hotline is not in operation). A Mandated Reporter Form is available if a report needs to be made outside of operating hours.
Definitions of Abuse, Neglect and Exploitation:
Abuse – the infliction of physical, sexual, or emotional injury or harm including financial exploitation by any person, firm, or corporation (192.2400, RSMo).
Neglect – the failure to provide services to an eligible adult by any person, firm or corporation with a legal or contractual duty to do so, when such failure presents either an imminent danger to the health, safety, or welfare of the client or a substantial probability that death or serious physical harm would result (192.2400, RSMo).
Financial Exploitation - A person commits the crime of financial exploitation of an elderly or disabled person if such person knowingly and by deception, intimidation, or force obtains control over the elderly or disabled person's property with the intent to permanently deprive the elderly or disabled person of the use, benefit or possession of his or her property thereby benefiting such person or detrimentally affecting the elderly or disabled person (570.145, RSMo).