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Who are we?

 

Zing Home Health Care LLC (Zing HHC) is state licensed home health care agency which provides PCA and home services to individuals who require individual care services at home and community.

Mission Statement:

Zing HHC is family orientated and devoted to focusing on the client with understanding and compassion.

Zing HHC believes that with a positive attitude we can maintain our clients’ integrity, independence, and choice by providing reliable service that will exceed our clients’ expectations.

Policies and Procedures

 

Person-Centered Planning and Service Delivery Requirements

 

 Policy

 Zing HHC strives to provide person-centered services to all the individuals we support. Person-centered is an attitude, a belief, and a value. It is an attitude of respect. It is a belief that all people have the right to be included. It is about valuing people for their gifts instead of seeing their disability or limitations, and recognizing that all people have gifts. It is not about trying to fix people. It does not cost money or take more time to be person-centered. It is, however, something that you need to ask yourself. What do you believe about people? Do you believe that all people should be included? That all people have gifts? That all people are worthy of respect? These are questions we all need to ask ourselves often. At Zing HHC our person-centered philosophy is a part of everything we do: our mission, our strategic plan, training, and most importantly, it is in the work we do each day. Everyone at Zing HHC should be able to give daily examples of what they do to be person-centered. The philosophy of person-centered is the expectation for all staff in how we treat the individuals we support and is also the expectation for how we treat each other.

 

Procedures

 As a service provider, Zing HHC is required to provide services in response to each person's identified needs, interests, preferences, and desired outcomes as specified in the Support Plan. Zing HHC strives to provide all services in a manner that supports each person's preferences, daily needs, and activities and accomplishment of the person's personal goals and service outcomes, consistent with the principles of:

 Person-centered service planning and delivery that:                                                                                                                                   • Identifies and supports what is important to the person as well as what is important for the person, including                              preferences for when, how, and by whom direct support service is provided;                                                                                    • Uses that information to identify outcomes the person desires; and                                                                                                    • Respects each person's history, dignity, and cultural background;

 Self-determination that supports and provides:                                                                                                                                          • Opportunities for the development and exercise of functional and age-appropriate skills, decision making and                            choice, personal advocacy, and communication; and                                                                                                                            • The affirmation and protection of each person's civil and legal rights; 

 Providing the most integrated setting and inclusive service delivery that supports, promotes, and allows:                                            • Inclusion and participation in the person's community as desired by the person in a manner that allows the person to                interact with nondisabled persons to the fullest extent possible and supports the person in developing and                                  maintaining a role as a valued community member;                                                                                                                             • Opportunities for self-sufficiency as well as developing and maintaining social relationships and natural supports;                   • A balance between risk and opportunity, meaning the least restrictive supports or interventions necessary are                              provided in the most integrated settings in the most inclusive manner possible to support the person to engage in                      activities of the person's own choosing that may otherwise present a risk to the person's health, safety, or rights.

Fraud, Waste and Abuse Defined


Fraud: an intentional act of deception, misrepresentation or concealment in order to gain
something of value. Examples include:

  • Billing for services that were never rendered;

  • Billing for services at a higher rate than is actually justified; and

  • Deliberately misrepresenting services, resulting in unnecessary cost to the

  • Medicare program, improper payments to providers or overpayments.


Waste: over-utilization of services (not caused by criminally negligent actions) and the misuse
of resources.
Abuse: excessive or improper use of services or actions that are inconsistent with acceptable
business or medical practice. “Abuse” refers to incidents that, although not fraudulent, may
directly or indirectly cause financial loss. Examples include:

  • Charging in excess for service of supplies; and

  • Providing medically unnecessary services; and

  • Billing for items or services that should not be paid for by Medicare.


Fraud, Waste and Abuse Compliance Training

We have completed the required training by reviewing the appropriate material available at www.mnhealthplans.org.


Fraud, Waste and Abuse Compliance Plan

The following applies to detect, prevent and correct fraud, waste, and abuse as required by applicable state and federal laws and regulations:


Standards of Conduct

  • Fraud will not be tolerated;

  • Providing false information on a timesheet is fraud;

  • Billing for services not provided is fraud;

  • Prohibited from giving or receiving any type of kick back; and

  • Failure to refund or return overpayments is fraud.


Compliance Plan (measures to detect, prevent and correct fraud, waste and abuse)

  • Random audits of timesheets for overuse and fraud;

  • Background checks to determine whether providers or office staff have been

  • convicted of health care fraud;

  • Open-door policy to report possible misuse of Medicare or Plan funds; and

  • Random audits of billing claims (billing code must reflect the services provided).


Training (addresses detection, preventing and correcting fraud, waste and abuse)

  • Policy and Procedures which address fraud and the reporting of fraud, waste and

  • abuse;

  • Employee contract which addresses fraud and abuse;

  • Responsible Party contract which addresses detection, prevention and correcting

  • fraud, waste and abuse; and

  • Time sheets which address issues of fraud and abuse.


Disciplinary Actions

  • Employee who commit fraud may be terminated;

  • Services could be terminated for a client who commits fraud; and

  • Committing fraud may result in jail time, probation, deportation, fines, exclusion

  • from services or work in this field or a job requiring a background study

, Waste and Abuse Policy

Reporting Fraud

  • Any employee and/or Responsible Party can file a claim of fraud, abuse or waste to Zing HHC

  • Claims will be addressed by a member of Zing HHC management team within business days from receiving the claim;

  • Zing HHC Incident Review Team reviews incidents of fraud monthly; and

  • Compliance concerns, suspected or actual misconduct involving Medicaid

  • programs will be reported to SIRS.

Responding to Detected Offenses and Corrective Action

  • Offenses will be reported to SIRS;

  • Over payment will be returned to the funding source; and

  • Retraining to prevent similar offenses.


Avoiding Fraud

The CDCS program is funded by Federal Medical Assistance. It is a crime to
provide false information for Medical Assistance payments.

The Employee

  • Can only be paid for work done when the employee is physically present and providing necessary care for the consumer;

  • Cannot be asked or told to split pay with the Consumer or Responsible Party;

  • Cannot work when the Consumer is at a HOSPITAL, school, receiving in-patient care, a nursing home, respite care facility, or is incarcerated; and

  • Cannot submit a time sheet for hours not worked.


Conduct on the Job (the employee, when at work)

  • Shall provide care as specified in the care plan and shall follow written and oral directions from the Responsible Party;

  • Shall arrive on time and not leave work early;

  • Shall not steal from or mistreat the Consumer;

  • Shall not consume alcohol or be under the influence of any illegal drugs; and

  • Shall not use cell phones, text message or engage in personal business.


Illegal Payment Schemes

  • Both the Employee and the Responsible Party shall be held accountable for signing a fraudulent time sheet

  • The following conduct is not acceptable and is fraudulent:

    • The Responsible Party signs a time sheet for a certain payroll period when the Employee did not actually work those hours that are shown on that time sheet at the times and dates indicated. (As an example, the

    • Employee and Responsible Party send in a time sheet showing the Employee worked on Wednesday of the prior week. On that Wednesday the Employee was out on vacation in another state and could not have actually worked on that day.)

    • The time sheet is signed before hours are actually worked.

 

Identity Theft

Using an identification that does not belong to that person to obtain payment and/or services.


False Claims Act

Prohibits any person from knowingly presenting or causing a fraudulent claim for payment.


Anti-Kickback Statute

Makes it a crime to knowingly and willfully offer, pay, solicit, or receive, directly or indirectly, anything of value to induce or reward referrals of items or services reimbursable by a Federal health care program.

Reporting Fraud, Waste and Abuse

Everyone has the right and responsibility to report actual and possible fraud, waste or abuse. You may report anonymously and retaliation is prohibited when you report a concern in good faith. Report issues or concerns to: Zhiyingyu1961@yahoo.com or 651-578-7851 or

 

Federal government websites are sources of information regarding detection, correction and prevention of fraud, waste and abuse: https://oig.hhs.gov/fraud/report-fraud 

 

Centers for Medicare & Medicaid Services (CMS): https://www.cms.gov/About CMS/Components/CPI/CPIReportingFraud

Annually Participants/Responsible Parties and Employees are required to go through training on Fraud Waste and Abuse and sign off that they received the training and agree to follow the policies

Whistleblower policy

 We encourage our all employees or third party persons to report any concerns about our our company personnel or employment practices.

To do so, you can call our Whistleblower Hotline at 651-675-9673.

When calling, please leave a detailed message with the following information:

  • Your name and phone number in case we need further information. Please note that you do have the right to remain anonymous.

  • Describe what happened, when it happened, and who was involved.

All reports received through the Whistleblower Hotline are processed in a timely manner. We will take every effort to ensure confidentiality to the extent possible. Your call is very important to us and we take all reports seriously.

Mandatory Reporting Requirements

Vulnerable Adult/Children Reporting Requirements

Employees are required to report the suspected or actual maltreatment including abuse or neglect or financial exploitation of a vulnerable adult or child. A vulnerable adult is a person who is 18 years of age or older and who would not by him or herself report abuse or neglect or financial exploitation because of impaired physical or mental function or because of emotional status. Children are defined as any person under the age of 18 years.

  1. Abuse is an act against a vulnerable adult/child that results in assault: use of drugs to injure or assist in crime; prostitution; criminal sexual conduct; non-accidental or non-therapeutic conduct or acts which result in physical pain or injury or emotional distress (e.g., hitting kicking, pinching); malicious oral, written or gestured language or treatment which could be considered disparaging, derogatory, humiliating, harassing or threatening; use of aversive or depravation procedures without permission of the client and not recognized as therapeutic;  sexual contact; forcing a client to perform services for the advantage of another.

  2. Exploitation is the failure to provide financial resources, acquiring possessions or control of funds or property, forcing a vulnerable adult/child to perform services for the profit or advantage of another.

  3. Neglect is the failure to provide care or services including but not limited to food, clothing, shelter, health care, or supervision which are reasonable and necessary for physical or mental health or safety.

 

Reporting Procedure

  1. Employees shall notify their direct supervisor if they believe or have reason to believe that their client has been abused, neglected or financially exploited.

  2. -Employees may also call: The Office of Health Facility Complaints at (651)-215-8713 or The Home Care Ombudsman at 1-800-657-3591, home health care hotline at 1-800-369-7994.

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 MALTREATMENT OF VULNERABLE ADULTS REPORTING POLICY FOR DHS LICENSED PROGRAMS

 

As a mandated reporter, if you know or suspect that a vulnerable adult has been maltreated, you must report it immediately (within 24 hours).

 

Where to Report

 

· You can report to the state-wide common entry point, the Minnesota Adult Abuse Reporting Center, at 844-880-1574.

 

· Or, you can report internally to (name or position)  Zhiying Yu/Case manager. If the individual listed above is involved in the alleged or suspected maltreatment, you must report to Wenchang Huan/manager (name or position).

 

Internal Report

 

· When an internal report is received, Zhiying Yu/Case manager is responsible for deciding if the report must be forwarded to the state-wide common entry point.

 

If that person is involved in the suspected maltreatment, Wenchang Huan/Manager (name or position) will assume responsibility for deciding if the report must be forwarded to the state-wide common entry point. The report must be forwarded within 24 hours.

 

 · If you have reported internally, you will receive, within two working days, a written notice that tells you whether or not your report has been forwarded to the state-wide common entry point. The notice will be given to you in a manner that protects your identity. It will inform you that, if you are not satisfied with the facility’s decision on whether or not to report externally, you may still make the external report to the state-wide common entry point yourself. It will also inform you that you are protected against any retaliation if you decide to make a good faith report to the state-wide common entry point.

 

 Internal Review

 

When the facility has reason to know that an internal or external report of alleged or suspected maltreatment has been made, the facility must complete an internal review within 30 calendar days and take corrective action, if necessary, to protect the health and safety of vulnerable adults. The internal review must include an evaluation of whether:

 

  1. related policies and procedures were followed;

   

   2. the policies and procedures were adequate;

   

   3. there is a need for additional staff training;

 

   4. the reported event is similar to past events with the vulnerable adults or the services involved; and

 

   5. there is a need for corrective action by the license holder to protect the health and safety of vulnerable adults.

 

Primary and Secondary Person or Position to Ensure Internal Reviews are Completed

 

The internal review will be completed by (name or position). If this individual is involved in the alleged or suspected maltreatment, (name or position) will be responsible for completing the internal review.

 

Documentation of the Internal Review

 

The facility must document completion of the internal review and make internal reviews accessible to the commissioner immediately upon the commissioner's request.

 

Corrective Action Plan

 

Based on the results of the internal review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any.

 

Staff Training

 

The license holder shall ensure that each new mandated reporter receives an orientation within 72 hours of first providing direct contact services to a vulnerable adult and annually thereafter. The orientation and annual review shall inform the mandated reporters of the reporting requirements and definitions specified under Minnesota Statutes, sections 626.557 and 626.5572, the requirements of Minnesota Statutes, section 245A.65, the license holder's program abuse prevention plan, and all internal policies and procedures related to the prevention and reporting of maltreatment of individuals receiving services.

 

The license holder must document the provision of this training, monitor implementation by staff, and ensure that the policy is readily accessible to staff, as specified under Minnesota Statutes, section 245A.04, subdivision 14.

 

     

MALTREATMENT OF MINORS MANDATED REPORTING

 

      POLICY 

 

   1.  Who Should Report Child Abuse and Neglect

 

  • Any person may voluntarily report abuse or neglect.

 

  • If you work with children in a licensed facility, you are legally required or mandated to report and cannot shift the responsibility of reporting to your supervisor or to anyone else at your licensed facility. If you know or have reason to believe a child is being or has been neglected or physically or sexually abused within the preceding three years you must immediately (within 24 hours) make a report to an outside agency.

 

   2. Where to Report

 

  • If you know or suspect that a child is in immediate danger, call 911.

  • Reports concerning suspected abuse or neglect of children occurring in a licensed child foster care or family child care facility should be made to county child protection services

  • Reports concerning suspected abuse or neglect of children occurring in all other facilities licensed by the Minnesota Department of Human Services should be made to the Department of Human Services, Licensing Division’s Maltreatment Intake line at (651) 431-6600.

 

  • Reports regarding incidents of suspected abuse or neglect of children occurring within a family or in the community should be made to the local county social services agency at 179 Robie St. E St. Paul MN 55107   P: 651-789-2500 or local law enforcement at 425 Grove St. St. Paul MN 55101  P: 651-266-9333

  • If your report does not involve possible abuse or neglect, but does involve possible violations of Minnesota Statutes or Rules that govern the facility, you should call the Department of Human Services Licensing Division at (651) 431-6500.

 

  3. What to report

  • Definitions of maltreatment are contained in the Reporting of Maltreatment of Minors Act (Minnesota Statutes, section 626.556) and should be attached to this policy.

  • A report to any of the above agencies should contain enough information to identify the child involved, any persons responsible for the abuse or neglect (if known), and the nature and extent of the maltreatment and/or possible licensing violations.  For reports concerning suspected abuse or neglect occurring within a licensed facility, the report should include any actions taken by the facility in response to the incident.   

  • An oral report of suspected abuse or neglect made to one of the above agencies by a mandated reporter must be followed by a written report to the same agency within 72 hours, exclusive of weekends and holidays. 

 

  4. Failure to Report

  A mandated reporter who knows or has reason to believe a child is or has been neglected or physically or sexually abused    and fails to report is guilty of a misdemeanor.  In addition, a mandated reporter who fails to report maltreatment that is      found to be serious or recurring maltreatment may be disqualified from employment in positions allowing direct contact     with persons receiving services from programs licensed by the Department of Human Services and by the Minnesota       Department of Health, and unlicensed Personal Care Provider Organizations.

 

  5. Retaliation Prohibited

  An employer of any mandated reporter shall not retaliate against the mandated reporter for reports made in good faith      or against a child with respect to whom the report is made. The Reporting of Maltreatment of Minors Act contains               specific provisions regarding civil actions that can be initiated by mandated reporters who believe that retaliation has   occurred.

 

 6. Internal Review

 

 When the facility has reason to know that an internal or external report of alleged or suspected maltreatment has been   made, the facility must complete an internal review within 30 calendar days and take corrective action, if necessary, to   protect the health and safety of children in care. The internal review must include an evaluation of whether:

 

  1. related policies and procedures were followed;
     

  2. the policies and procedures were adequate;
     

  3. there is a need for additional staff training;
     

  4. the reported event is similar to past events with the children or the services involved; and
     

  5. there is a need for corrective action by the license holder to protect the health and
    safety of children in care.
       

Primary and Secondary Person or Position to Ensure Internal Reviews are Completed

 

The internal review will be completed by Zhiying Yu/Case Manager.  If this individual is involved in the alleged or suspected maltreatment, Wenchang Huan/Manager will be responsible for completing the internal review.

 

Documentation of the Internal Review

 

The facility must document completion of the internal review and make internal reviews accessible to the commissioner immediately upon the commissioner's request.

 

Corrective Action Plan

 

Based on the results of the internal review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any.

 

Staff Training

 

Zing HHC will provide training to all staff related to the mandated reporting responsibilities as specified in the Reporting of Maltreatment of Minors Act (Minnesota Statutes, section 626.556). Zing HHC must document the provision of this training in individual personnel records, monitor implementation by staff, and ensure that the policy is readily accessible to staff, as specified under Minnesota Statutes, section 245A.04, subdivision 14.

                                         

Grievance Policy

          

 Policy

 

It is the policy of Zing HHC to ensure that people served by this program have the right to respectful and responsive services.  We are committed to providing a simple complaint process for the people served in our program and their authorized or legal representatives to bring grievances forward and have them resolved in a timely manner.

 

 Procedures

 

    Service Initiation

     A person receiving services and responsible party will be notified of this policy, and provided a copy, within five working       days of service initiation.

 

​   How to File a Grievance

  1. The person receiving services or person’s authorized or legal representative:                                                           *should talk to a staff person that they feel comfortable with about their complaint or problem;                                          *clearly inform the staff person that they are filing a formal grievance and not just an informal complaint or problem;   and                                                                                                                                                                                                                                         *may request staff assistance in filing a grievance.

  2. If the person or person’s authorized or legal representative does not believe that their grievance has been resolved they may bring the complaint to the highest level of authority in this program.

  • That person is program Manager.

  • They may be reached 10164 Dr. Woodbury, MN 55129

 

    Response by the Program

  1. Upon request, staff will provide assistance with the complaint process to the service recipient and their authorized representative. This assistance will include:                                                                                                                     the name, address, and telephone number of outside agencies to assist the person; and                                        *  responding to the complaint in such a manner that the service recipient or authorized representative’s concerns are        resolved.

  2. This program will respond promptly to grievances that affect the health and safety of service recipients.

  3. All other complaints will be responded to within 14 calendar days of the receipt of the complaint. 

  4. All complaints will be resolved within 30 calendar days of the receipt. 

  5. If the complaint is not resolved within 30 calendar days, this program will document the reason for the delay and a plan for resolution.

  6. Once a complaint is received, the program is required to complete a complaint review. The complaint review will include an evaluation of whether:                                                                                                                                                                                                    * related policy and procedures were followed;                                                                                                                 related policy and procedures were adequate;                                                                                                               there is a need for additional staff training;                                                                                                             the complaint is similar to past complaints with the persons, staff, or services involved; and                                     there is a need for corrective action by the license holder to protect the health and safety of persons receiving services.

  7. Based on this review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by staff or the license holder, if any.

  8. The program will provide a written summary of the complaint and a notice of the complaint resolution to the person and case manager that:                                                                                                                                               identifies the nature of the complaint and the date it was received;                                                                         includes the results of the complaint review; and                                                                                                         identifies the complaint resolution, including any corrective action.

 

 The complaint summary and resolution notice must be maintained in the person’s record.

Drug and Alcohol Policy

 

  Policy 

 

It is the policy of Zing HHC to support a workplace free from the effects of drugs, alcohol, chemicals, and abuse of prescription medications. This policy applies to all of our employees, subcontractors, and volunteers.

 

  Procedures

 

  1. All employees must be free from the abuse of prescription medications or being in any manner under the influence of a chemical that impairs their ability to provide services or care.

 

  1. The consumption of alcohol is prohibited while directly responsible for persons receiving services, or on our property (owned or leased), or in our vehicles, machinery, or equipment (owned or leased), and will result in corrective action up to and including termination. 

 

  1. Being under the influence of a controlled substance identified under Minnesota Statutes, chapter 152, or alcohol, or illegal drugs in any manner that impairs or could impair an employee’s ability to provide care or services to persons receiving services is prohibited and will result in corrective action up to and including termination.

 

  1. The use, sale, manufacture, distribution, or possession of illegal drugs while providing care or to persons receiving services, or on our property (owned or leased), or in our vehicles, machinery, or equipment (owned or leased), will result in corrective action up to and including termination.

 

  1. Any employee convicted of criminal drug use or activity must notify the program manager no later than five (5) days after the conviction.

 

  1. Criminal conviction for the sale of narcotics, illegal drugs or controlled substances will result in corrective action up to and including termination.

 

  1. The program’s designated staff person will notify the appropriate law enforcement agency when we have reasonable suspicion to believe that an employee may have illegal drugs in his/her possession while on duty during work hours. Where appropriate, we will also notify licensing boards

 

Temporary Service Suspension Policy

 

Policy

It is the policy of Zing HHC to ensure our procedures for temporary service suspension promote continuity of care and service coordination for persons receiving services.

 

Procedures

 

A. Zing HHC will limit temporary service suspension to the following situations:

   1. The person's conduct poses an imminent risk of physical harm to self or others and either:

              a. positive support strategies have been implemented to resolve the issues leading to the temporary                                              service suspension but have not been effective and additional positive support strategies would not achieve and                      maintain safety; or

              b. less restrictive measures would not resolve the issues leading to the suspension; OR

   2. The person has emergent medical issues that exceed the license holder's ability to meet the person's needs; OR

   3. Zing HHC has not been paid for services.

 

B. Prior to giving notice of temporary service suspension, Zing HHC must document actions taken to minimize or eliminate the need for service suspension.

    1. Action taken by Zing HHC must include, at a minimum:

              a. Consultation with the person's support team or expanded support team to identify and resolve                                                  issues leading to issuance of the notice; and

              b. A request to the case manager for intervention services identified, including behavioral support                                                 services, in-home or out-of-home crisis respite services, specialist services, or other professional                                               consultation or intervention services to support the person in the program.

    2. If, based on the best interests of the person, the circumstances at the time of the notice were such that Zing HHC was            unable to consult with the person’s team or request interventions services, Zing HHC must document the specific                    circumstances and the reason for being unable to do so.

 

C. The notice of temporary service suspension must meet the following requirements:

    1. Zing HHC must notify the person or the person’s legal representative and the case manager in writing of the intended           temporary service suspension.

    2. If the temporary service suspension is from residential supports and services, including supported living services, foster          care services, or residential services in a supervised living facility, including and ICF/DD, Zing HHC must also notify the          Commissioner in writing. DHS notification will be provided by fax at 651-431-7406.

    3. Notice of temporary service suspension must be given on the first day of the service suspension.

    4. The written notice service suspension must include the following elements:

            a. The reason for the action;

            b. A summary of actions taken to minimize or eliminate the need for temporary service suspension; and

            c. Why these measures failed to prevent the suspension.

     5. During the temporary suspension period Zing HHC must:

             a. Provide information requested by the person or case manager;

             b. Work with the support team or expanded support team to develop reasonable alternatives to                                                     protect the person and others and to support continuity of care; and

             c. Maintain information about the service suspension, including the written notice of temporary service suspension                    in the person’s record.

 

D. A person has the right to return to receiving services during or following a service suspension with the following                    conditions.

     1. Based on a review by the person’s support team or expanded support team, the person no longer poses an imminent            risk of physical harm to self or others, the person has a right to return to receiving services.     

     2. If, at the time of the service suspension or at any time during the suspension, the person is receiving                                         treatment related to the conduct that resulted in the service suspension, the support team or expanded support team             must consider the recommendation of the licensed health professional, mental health professional, or other licensed             professional involved in the person's care or treatment when determining whether the person no longer poses an                   imminent risk of physical harm to self or others and can return to the program.

     3. If the support team or expanded support team makes a determination that is contrary to the recommendation of a                 licensed professional treating the person, Zing HHC must document the specific reasons why a contrary decision was             made.

       Legal Authority: MS § 245D.10, subd. 3

     

 

 Service Termination Policy

 

 Policy

 It is the policy of Zing HHC to ensure our procedures for service termination promote continuity of care and service   coordination for persons receiving services.

 

 Procedures

 A. Zing HHC must permit each person to remain in the program or continue receiving services and must not terminate                services unless:

        1. The termination is necessary for the person's welfare and the facility cannot meet the person's needs;

        2. The safety of the person, others in the program, or Zing HHC staff is endangered and positive support strategies                     were attempted and have not achieved and effectively maintained safety for the person or others;

        3. The health of the person, others in the program, or Zing HHC staff would otherwise be endangered;

        4. Zing HHC has not been paid for services;

        5. Zing HHC ceases to operate; or

        6. The person has been terminated by the lead agency from waiver eligibility.

 

 B. Prior to giving notice of service termination Zing HHC must document the actions taken to minimize or eliminate the              need for termination.

          1. Action taken by the license holder must include, at a minimum:

                 a. Consultation with the person’s support team or expanded support team to identify and resolve issues leading                          to the issuance of the notice; and

                 b. A request to the case manager for intervention services, including behavioral support services, in-home or                               out-of-home crisis respite services, specialist services, or other professional consultation or intervention                                 services to support the person in the program. The request for intervention services will not be made for                                 service termination notices issued because the program has not been paid for services.

          2. If, based on the best interests of the person, the circumstances at the time of the notice were such that Zing HHC is                unable to consult with the person’s team or request interventions services, Zing HHC must document the specific                    circumstances and the reason for being unable to do so.

 

 C. The notice of service termination must meet the following requirements:

       1. Zing HHC must notify the person or the person’s legal representative and the case manager in writing of the                          intended service termination.

       2. If the service termination is from residential supports and services, including supported living services, foster care                   services, or residential services in a supervised living facility, including an ICF/DD, the license holder must also notify             the Department of Human Services in writing. DHS notification will be provided by fax at 651-431-7406.

       3. The written notice of a proposed service termination must include all of the following elements:

              a. The reason for the action;

              b. A summary of actions taken to minimize or eliminate the need for service termination or temporary service                              suspension, and why these measures failed to prevent the termination or suspension. A summary of actions is                        not required when service termination is a result of the when the program ceasing operation;

              c. The person's right to appeal the termination of services under Minnesota Statutes, section 256.045, subdivision                    3, paragraph (a); and

              d. The person's right to seek a temporary order staying the termination of services according to the procedures in                       section 256.045, subdivision 4a or 6, paragraph (c).

      4. The written notice of a proposed service termination, including those situations which began with a temporary                         service suspension, must be given before the proposed effective date of service termination.

              a. For those persons receiving other services, the notice must be provided at least 30 days before the proposed                          effective date of service termination.

       5. This notice may be given in conjunction with a notice of temporary service suspension.

 

 D. During the service termination notice period, Zing HHC must:

        1. Work with the support team or expanded support team to develop reasonable alternatives to protect the person and              others and to support continuity of care;

        2. Provide information requested by the person or case manager; and

        3. Maintain information about the service termination, including the written notice of intended service termination, in                the person’s record.

Legal Authority: MS § 245D.10, subd. 3a

Emergency Use of Manual Restraints

 

 I. Policy

 

 It is the policy of Zing HHC to promote the rights of persons served by this program and to protect their health and safety during the emergency use of manual restraints.

“Emergency use of manual restraint” means using a manual restraint when a person poses an imminent risk of physical harm to self or others and it is the least restrictive intervention that would achieve safety. Property damage, verbal aggression, or a person’s refusal to receive or participate in treatment or programming on their own, do not constitute an emergency.

Zing HHC advocates for and endorses the use of positive approaches for supporting behavioral change. This policy is based on the fundamental regard for the integrity and dignity of each person. When an individual displays behavioral challenges, it is important to identify and address the function the behavior serves so underlying needs can be met. A critical part of this process is identifying the communicative intent of the behavior and teaching individuals alternative ways to communicate the same message.

 

 II. Positive support strategies and techniques required

 

 Zing HHC believes in the use of positive behavioral support strategies and techniques and encourages all staff to use the following strategies to de-escalate an individual’s behaviors before it poses an imminent risk of physical harm to self or others.

    • Follow individualized strategies in a person’s Support Plan;

    • Shift the focus by verbally redirect the person to a desired alternative activity;

    • Model desired behavior; • Reinforce appropriate behavior;

    • Offer choices, including activities that are relaxing and enjoyable to the person;

    • Use positive verbal guidance and feedback;

    • Actively listen to a person and validate their feelings;

    • Create a calm environment by reducing sound, lights, and other factors that may agitate a person;

    • Speak calmly with reassuring words, consider volume, tone, and non-verbal communication;

    • Simplify a task or routine or discontinue until the person is calm and agrees to participate; or

    • Respect the person’s need for physical space and/or privacy.

 III. Permitted actions and procedures

 Use of the following instructional techniques and intervention procedures used on an intermittent or continuous basis are   permitted by Zing HHC.

 When used on a continuous basis, it must be addressed in a person’s Support Plan.

 A. Physical contact or instructional techniques must be use the least restrictive alternative possible to meet the needs of the        person and may be used to:

         1. Calm or comfort a person by holding that persons with no resistance from that person;

         2. Protect a person known to be at risk or injury due to frequent falls as a result of a medical condition;

         3. Facilitate the person’s completion of a task or response when the person does not resist or the person’s resistance                     is minimal in intensity and duration; or

         4. Briefly block or redirect a person’s limbs or body without holding the person or limiting the person’s movement to                     interrupt the person’s behavior that may result in injury to self or others.

         5. Redirect a person’s behavior when the behavior does not pose a serious threat to the person or others and the                           behavior is effectively redirected with less than 60 seconds of physical contact by staff.

 B. Restraint may be used as an intervention procedure to:

         1. Allow a licensed health care professional to safely conduct a medical examination or to provide medical treatment                      ordered by a licensed health care professional to a person necessary to promote healing or recovery from an acute,                  meaning short-term, medical condition; or

        2. Assist in the safe evacuation or redirection of a person in the event of an emergency and the person is at imminent                    risk of harm.

        3. Position a person with physical disabilities in a manner specified in the person’s Support Plan.

 C. Use of adaptive aids or equipment, orthotic devices, or other medical equipment ordered by a licensed health                              professional to treat a diagnosed medical condition that do not, in and of themselves, constitute the use of a                              mechanical restraint.

 D. Positive verbal correction that is specifically focused on the behavior being addressed.

 E. Temporary withholding or removal of objects being used to hurt self or others.

IV. Prohibited Procedures

 

 A. The use of the following procedures as a substitute for adequate staffing, for a behavioral or therapeutic program to                  reduce or eliminate behavior, as punishment, or for staff convenience, are prohibited by Zing HHC:

          1. Chemical restraint;

          2. Mechanical restraint;

          3. Manual restraint;

          4. Time out;

          5. Seclusion; or

          6. Any aversive or deprivation procedure.

 B. Definitions of Prohibited Procedures:

          1. Chemical restraint - Chemical restrain means the administration of a drug or medication to control the person's                        behavior or restrict the person's freedom of movement and is not a standard treatment or dosage for the person's                    medical or psychiatric condition.

          2. Mechanical restraint - Mechanical restraint means the use of devices, materials, or equipment attached or adjacent to                the person's body, or the use of practices that are intended to restrict freedom of movement or normal access to                        one's body or body parts, or limits a person's voluntary movement or holds a person immobile as an intervention                      precipitated by a person's behavior.

                 a. Mechanical restraint does not include devices worn by the person that trigger electronic alarms to warn staff that                       a person is leaving a room or area, which do not, in and of themselves, restrict freedom of movement.

                 b. Mechanical restraint does not include adaptive aids or equipment or orthotic devices ordered by a health care                             professional used to treat or manage a medical condition.

                 c. Mechanical restraint does not include use of a seat belt under Minnesota Statutes, section 169.686; or use of a                           child passenger restraint system as required by Minnesota Statutes, section 245A.018, subdivision 1.

         3. Manual restraint - Manual restrain means physical intervention intended to hold a person immobile or limit a                             person's voluntary movement by using body contact as the only source of physical restraint.

        4. Time out - Time out means the involuntary removal of a person for a period of time to a designated area from which                 the person is not prevented from leaving.

                 a. Time out does not mean voluntary removal or self-removal for the purpose of calming, prevention of escalation,                       or de-escalation of behavior.

                 b. Time out does not mean taking a brief break or rest from an activity for the purpose of providing the person an                          opportunity to regain self-control.

         5. Seclusion - Seclusion means removing a person involuntarily to a room from which exit is prohibited by a staff                          person or a mechanism such as a lock, a device, or an object positioned to hold the door closed or otherwise prevent                the person from leaving the room; or otherwise involuntarily removing or separating a person from an area, activity,                  situation, or social contact with others and blocking or preventing the person's return.

                 a. Time out and Seclusion are often confused. The key distinction between the two procedures is whether the                                  person has the ability to exit when he/she has been involuntarily removed. Seclusion does not allow the person                          to exit that area while time out does.

        6. Aversive procedure - Aversive procedure means the application of an aversive stimulus contingent upon the                                occurrence of a behavior for the purposes of reducing or eliminating the behavior. “Aversive stimulus” is defined as an              object, event, or situation that is presented immediately following a behavior in an attempt to suppress the behavior.                  Typically, an aversive stimulus is unpleasant and penalizes or confines.

        7. Deprivation procedure - Deprivation procedure means the removal of a positive reinforcer following a response resulting in, or intended to result in, a decrease in the frequency, duration, or intensity of that response. Oftentimes the positive reinforcer available is goods, services, or activities to which the person is normally entitled. The removal is often in the form of a delay or postponement of the positive reinforcer.

V. Manual Restraint is Not Allowed in Emergencies

   A. Zing HHC does not allow the emergency use of manual restraint. The following alternative measures must be used by          staff to achieve safety when a person’s conduct poses an imminent risk of physical harm to self or others and less                restrictive strategies have not achieved safety:

                         As an alternative to manual restraint Zing HHC staff may use the following:

                           • Continue to follow individualized strategies in a person’s Support Plan Support Plan;

                           • Continue to utilize the positive support strategies listed above;

                           • Ask the person and/or others if they would like to move to another area where they may feel safer or                                     calmer;

                           • Remove objects from the person’s immediate environment that they may use to harm self or others;

                           • Use an object such as a cushion to block the person’s blows if they are trying to be aggressive towards                                   you;

                           • Call 911 for law enforcement assistance if the alternative measures listed above are ineffective in order to                               achieve safety for the person and/or others. While waiting for law enforcement to arrive staff will                                           continue to offer the alternative measures listed above if doing so does not pose a risk of harm to the                                     person and/or others.

 

  B. Zing HHC will not allow the use of an alternative safety procedure with a person when it has been determined by the          person’s physician or mental health provider to be medically or psychologically contraindicated for a person. This                program will complete an assessment of whether the allowed procedures are contraindicated for each person receiving        services as part of the required service planning required under the 245D Home and Community-based Services                  (HCBS) Standards (section 245D.07, subdivision 2, for recipients of basic support services.

 

Zing HHC does not allow the use of manual restraint in an emergency. If the positive support strategies were not erective in de-escalating or eliminating the person’s behavior, staff will contact “911” for assistance.

 

 VI. Reporting Emergency Use of Manual Restraint

 

 A. While it is the policy of Zing HHC to not allow the emergency use of manual restraints, if a staff witnesses or suspects          an emergency use of manual restraint was used they should report the incident of the emergency use of manual                  restraint according to the following process.

 B. Within 24 hours of an emergency use of manual restraint, the legal representative and the case manager must receive          verbal notification of the occurrence as required under the incident response and reporting requirements in the 245D          HCBS Standards, section 245D.06, subdivision 1. When the emergency use of manual restraint involves more than              one person receiving services, the incident report made to the legal representative and the case manager must not                disclose personally identifiable information about any other person unless the program has the consent of the person.   C. Within 3 calendar days after an emergency use of a manual restraint, the staff person who implemented the                          emergency use must report in writing to the program’s designated coordinator the following information about the              emergency use:

      1. Who was involved in the incident leading up to the emergency use of a manual restraint; including the names of                    staff and persons receiving services who were involved?

      2. A description of the physical and social environment, including who was present before and during the incident                    leading up to the emergency use of a manual restraint;

      3. A description of what less restrictive alternative measures were attempted to de-escalate the incident and maintain              safety before the emergency use of a manual restraint was implement. This description must identify when, how,                 and how long the alternative measures were attempted before the manual restraint was implemented;

      4. A description of the mental, physical, and emotional condition of the person who was manually restrained, leading               up to, during, and following the manual restraint;

      5. A description of the mental, physical, and emotional condition of the other persons involved leading up to, during,                and following the manual restraint;

      6. Whether there was any injury to the person who was restrained before or as a result of the use of a manual                          restraint;

       7. Whether there was any injury to other persons, including staff, before or as a result of the use of a manual                             restraint; and

       8. Whether there was a debriefing with the staff and, if not contraindicated, with the person who was restrained and               other persons who were involved in or who witnessed the restraint, following the incident. Include the outcome of                 the debriefing. If the debriefing was not conducted at the time the incident report was made, the report should                       identify whether a debriefing is planned. 

 

  D. A copy of this report must be maintained in the person’s service recipient record. The record must be uniform and                 legible.

  E. Each single incident of emergency use of manual restraint must be reported separately. A single incident is when the            following conditions have been met:

        1. After implementing the manual restraint, staff attempt to release the person at the moment staff believe the                           person’s conduct no longer poses an imminent risk of physical harm to self or others and less restrictive strategies               can be implemented to maintain safety;

        2. Upon the attempt to release the restraint, the person’s behavior immediately re-escalates; and

        3. Staff must immediately re-implement the manual restraint in order to maintain safety.

 

VII. Internal Review of Emergency Use of Manual Restraint

 A. Within 5 business days after the date of the emergency use of a manual restraint, Zing HHC must complete and                   document an internal review of the report prepared by the staff member who implemented the emergency procedure.

 B. The internal review must include an evaluation of whether:

        1. The person’s service and support strategies need to be revised;

        2. Related policies and procedures were followed;

        3. The policies and procedures were adequate;

        4. There is need for additional staff training;

        5. The reported event is similar to past events with the persons, staff, or the services involved; and

        6. There is a need for corrective action by the program to protect the health and safety of persons.

  C. Based on the results of the internal review, Zing HHC must develop, document, and implement a corrective action plan        for the program designed to correct current lapses and prevent future lapses in performance by individuals or the                      program.

  D. The corrective action plan, if any, must be implemented within 30 days of the internal review being completed.

         1. Zing HHC has identified the following person or position responsible for conducting the internal review and for                     ensuring that corrective action is taken, when determined necessary: 245D Designated Manager can be reached at:              651-675-9673

 VIII. Expanded Support Team Review of Emergency Use of Manual Restraint

 

A. Within 5 working days after the completion of the internal review, Zing HHC must consult with the expanded support           team to:

       1. Discuss the incident to:

             a. Define the antecedent or event that gave rise to the behavior resulting in the manual restraint; and

             b. Identify the perceived function the behavior served.

       2. Determine whether the person’s Support Plan Addendum needs to be revised to:

             a. Positively and effectively help the person maintain stability; and

             b. Reduce or eliminate future occurrences of manual restraint.

  B. Zing HHC must maintain a written summary of the expanded support team’s discussion and decisions in the person’s           service recipient record.

  C. Zing HHC has identified the following person or position responsible for conducting the expanded support team                  review and for ensuring that the person’s Support Plan Addendum is revised, when determined necessary. 245D                  Designated Manager can be reached at: 651-675-9673

 IX. External Review and Reporting of Emergency Use of Manual Restraint

 

   A. Within 5 working days after the completion of the expanded support team review, Zing HHC must submit the                       following to the Department of Human Services using the online behavior intervention reporting form which                         automatically routes the report to the Office of the Ombudsman for Mental Health and Developmental Disabilities:

                 1. Report of the emergency use of a manual restraint;

                 2. The internal review and corrective action plan; and

                 3. The expanded support team review written summary.

 

X. After an Emergency or Crisis Situation

 

  A. When an individual goes through an emergency or crisis situation, it is important to support the individual as well as           yourself after the event. This stage for the individual can be referred to as Tension Reduction. At this stage, the                     individual is regaining control. They may have gone through a very frightening or traumatic experience, and may not           even remember it all. The individual may feel confused, remorseful, sad, etc. Often the event is more frightening for             them than it is for the staff involved in the event.

  B. At this stage, the employee should provide therapeutic rapport or communication. Many times, the individual is                    seeking to communicate. Some things that you can do to support the individual is to ask them to take a few deep                  breaths. This can serve two purposes, deep breathing helps a person relax, and if they follow your direction, they are            showing that they have regained control. Talk with the person. Ask how they are, if they are willing to discuss the                  incident ask how they might act differently next time. It is time to give back their self-esteem, and give back control.

  C. You can also use the following:

           C – control: The person needs to be in control emotionally, physically, and verbally. Make sure the person is able to                                  carry on a conversation with you.

           O – orient: Make sure you are oriented to the facts. Don’t be judgmental. Listen to the client.

           P – patterns: Are there patterns in the person’s behavior, e.g., day of the week, time of the day, in response to the                                        same activity or person.

           I – investigate: Investigate options or alternatives to the inappropriate behavior. What could have been done                                                  differently. Ask the individual how they could have handled it differently.

          N – negotiate: Negotiate together. You both want to win. Shake on it, write an agreement that the individual                                                   understands.

          G – give: Give the individual verbal support. Give them back their dignity, give them back control.

 

 XI. Employee Self-Care

 

  A. As staff involved in emergency or crisis situations, it is important that you take care of yourself after an incident. Learn        to recognize the signs of stress or trauma, resulting from emergency situations, and develop tools, or actions, to best            address these feelings. Those who recover most quickly are those who take specific actions to manage their responses        and feelings.

 B. Common reactions to emergency or crisis situations include:

         1. Strong emotions including shock, fear, anger, grief, confusion or horror.

         2. Feelings of helplessness, disbelief, powerlessness or aloneness.

         3. Intrusive or upsetting thoughts or memories of the event.

         4. Difficulties sleeping.

         5. Problems with concentration, learning and decision-making.

         6. Extreme mood swings, irritability, restlessness, or outbursts of anger.

         7. Headaches, stomachaches, rashes, or other allergic reactions.

         8. Increased concern about the safety or loved ones or your own safety.

  C. Self-care strategies or coping techniques:

         1. Stay away from mood-altering substances, including drugs and alcohol.

         2. Eat well-balanced meals.

         3. Exercise – even a little bit.

         4. Engage in activities that are meaningful to you.

         5. Get plenty of rest so that you feel rested and relaxed.

         6. Practice stress reduction techniques like deep breathing or meditation.

         7. Ask others directly for what you need and want.

         8. Do something to help others – give blood, donate food, volunteer.

  D. Caring for people can be emotionally overwhelming or stressful, at times, especially after emergency or crisis                         situations. Our challenge is to maintain our resilience so that we can keep doing our work with care, energy, and                   compassion.

Incident Response, Reporting and Review Policy

 

Policy

 

 It is the policy of Zing hhC  to respond to, report, and review all incidents that occur while providing services in a timely   and effective manner in order to protect the health and safety of and minimize risk of harm to persons receiving services. 

 

 If this is an employee injury, see the Work Comp Policy and report the injury to the Work Comp Coordinator at 651-578-7851

 

 “Incident" means an occurrence which involves a person and requires the program to make a response that is not part of   the program’s ordinary provision of services to that person, and includes:

     A. Serious injury of a person;

             1. Fractures;

             2. Dislocations;

             3. Evidence of internal injuries;

             4. Head injuries with loss of consciousness or potential for a closed head injury or concussion without loss of                           consciousness requiring a medical assessment by a health care professional, whether or not further medical                         attention was sought.

             5. Lacerations involving injuries to tendons or organs and those for which complications are present;

             6. Extensive second degree or third degree burns and other burns for which complications are present;

             7. Extensive second degree or third degree frostbite, and other frostbite for which complications are present;

             8. Irreversible mobility or avulsion of teeth;

             9. Injuries to the eyeball;

            10.Ingestion of foreign substances and objects that are harmful;

             11.Near drowning;

             12.Heat exhaustion or sunstroke; and
             13.Attempted suicide

            14.All other injuries considered serious after an assessment by a health care professional including, but not limited                   to, self-injurious behavior, a medication error requiring medical treatment, a suspected delay of medical                                 treatment, a complication of a previous injury, or a complication of medical treatment for an injury

   B. A person’s death

   C. Any medical emergencies, unexpected serious illness, or significant unexpected change in an illness or medical                     condition of a person that requires Accra staff to call 911, physician treatment, or hospitalization.

   D. Any mental health crisis that requires an employee to call 911, a mental health crisis intervention team, or a similar                mental health response team or service when available and appropriate.

   E. An act or situation involving a person that requires an employee to call 911, law enforcement, or the fire department.

   F. A person’s unauthorized or unexplained absence.

   G. Conduct by a person receiving services against another person receiving services that:

           1. Is so severe, pervasive, or objectively offensive that it substantially interferes with a person’s opportunities to                        participate in or receive service or support;

           2. Places the person in actual and reasonable fear of harm;

           3. Places the person in actual and reasonable fear of damage to property of the person;

           4. Substantially disrupts the orderly operation of the program.

  H. Any sexual activity between persons receiving services involving force or coercion.

          1. “Force” means the infliction, attempted infliction, or threatened infliction by the actor of bodily or commission or                   threat of any other crime by the actor against the complainant or another, harm which (a) causes the                                     complainant to reasonably believe that the actor has the present ability to execute the threat and (b) if the actor                   does not have a significant relationship to the complainant, also causes the complainant to submit.

          2. “Coercion” means words or circumstances that cause the complainant reasonably to fear that the actor will inflict                 bodily harm upon, or hold in confinement, the complainant or another, or force the complainant to submit to                       sexual penetration or contact, but proof of coercion does not require proof of a specific act or threat).

  I. Any emergency use of manual restraint.

 J. A report of alleged or suspected child or vulnerable adult maltreatment.

 K.A report of fraud.

 

 Response Procedures

 

  A. Serious injury

         1. In the event of a serious injury, provide emergency first aid following instructions received during training or as                    directed.

         2. Summon assistance, if available, to assist in providing emergency first aid or seeking emergency medical care.

3. Seek medical attention, including calling 911 for emergency medical care, as soon as possible. B. Death 1. If alone, immediately call 911 and follow directives given to you by the emergency responder. 2. If there is another person(s) with you, ask them to call 911, and follow directives given to you by the emergency responder. 3. Contact the responsible party as soon as possible for directions. C. Medical emergency, unexpected serious illness, or significant unexpected change in an illness or medical condition 1. Assess if the situation requires a call to 911, seek physician treatment, or hospitalization. 2. If it is a life-threatening medical emergency, call 911 immediately. 3. Provide emergency first aid as trained or directed until further emergency medical care arrives or the person is taken to a physician or hospital for treatment. D. Mental health crisis If the employee believes that a person is experiencing a mental health crisis, call 911 or a specific mental health worker if the individual has one. E. Requiring 911, law enforcement, or fire department 1. For incidents requiring law enforcement or the fire department, call 911. 2. For non-emergency incidents requiring law enforcement, call the local nonemergency law enforcement number. 3. For non-emergency incidents requiring the fire department, call the local nonemergency fire department number. 4. Provide all information requested and follow instructions given by the emergency personnel responding to the call. F. Unauthorized or unexplained absence When a person is determined to be missing or has an unauthorized or unexplained absence, take the following steps: 1. If the person has a specific plan outlined in his/her Support Plan Addendum to address strategies in the event of unauthorized or unexplained absences that procedure should be implemented immediately, unless special circumstances warrant otherwise. 2. An immediate and thorough search of the area that the person was last seen will be completed by the employee and others that might be available. 3. If after no more than 15 minutes, the search of the home and neighborhood is unsuccessful, contact law enforcement authorities and the responsible party.

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