O-7-162 Start of Care Packet (Home Chart Folder) Tipsheet

🎯 PURPOSE

Outlines the required paperwork/forms to be included in the Adara Home Health Start of Care Packet/Client Home Chart.

🔄 PROCESS

Copies of documents indicated with ** must be requested from corporate by submitting a Forms Order to the corporate Business Manager and corporate Administrative Assistant. The Forms Order form is located here: P&P Manuals > Forms Manual > General Office & Miscellaneous Forms.

Copies of all other documents may be printed at the branch office and are stored in this location: P&P Manuals > Forms Manual > Client Home Chart Forms.

Items should be placed in the Start of Care Packet in the order they are listed below:


Front of Folder:

  • Client Home Chart Label**

Left Side of Folder:

  • Client Handbook**
  • Welcome Letter Template (branch-specific)
  • Family Link Instructions (branch-specific)
  • Client Calendar Individualized Plan of Care (branch-specific) - print two-sided
  • Adara HHCAHPS Home Chart Handout
  • Client and Caregiver Treatment and Handwashing Instructions (2 copies) - print two-sided
  • Home Health Aide/Homemaker Care Plan -  print two-sided
  • Minnesota Aging Pathways Handout

Right Side of Folder:

  • Adara Home Health Brochure**
  • NOMNC
  • HHCCN
  • Detailed Information of Non-Coverage

📅 Effective: 09.23.2024  | 🛠️ Revised: 06.10.2026 |  ✅ Approved: JFJ

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