Home Health Agency · CMS Conditions of Participation

Your home health policy manual — written, compliant, ready to edit.

32 professionally structured policies + 8 forms, mapped to every CMS Condition of Participation (42 CFR Part 484) — including the new 2025 requirement most manuals are still missing. Editable Word & Excel. Instant download.

Get the kit — $57 instant download
✓ 40 editable files ✓ Word & Excel — not a PDF ✓ Instant download
Home Health Agency Policy & Procedure Kit
The problem

Writing a compliant manual from scratch costs weeks — or thousands.

A consultant charges $2,500–$5,000 to write a home health policy manual. Doing it yourself means weeks of cross-referencing the CMS Conditions of Participation — and surveyors still expect a specific structure. This kit gives you the whole manual, professionally organized the way surveyors review it, ready to make your own.

What's inside

40 editable files — the complete manual

Seven modules of policies and procedures, plus eight ready-to-use forms and logs.

1

Administration & Governance

6 policies · § 484.100–110 + ethics

2

Patient Rights

5 policies · § 484.50 + informed consent

3

Patient Care Delivery

5 policies · § 484.55–60

4

Services & Staffing

5 policies · § 484.75–80 + orientation

5

QAPI Program

4 policies · § 484.65

6

Infection Prevention & Control

4 policies · § 484.70 + employee health/TB

7

Emergency Preparedness

3 policies · § 484.102

+

8 ready-to-use forms & logs (Word + Excel)

Aide competency checklist · complaint log · QAPI minutes + PIP tracker · infection surveillance log · annual policy review log (pre-populated with all 32 policies) · and more.

See the complete list — all 40 files, by folder

Forms & Templates · 8 forms & logs

  • FRM-EP-003A Emergency Preparedness Drill Documentation Form (Word)
  • FRM-GOV-002 Annual Policy Review Log (Excel)
  • FRM-HR-001 Home Health Aide Competency Checklist (Excel)
  • FRM-HR-004 Aide Supervision Visit Form (Word)
  • FRM-IPC-003 Infection Surveillance Log (Excel)
  • FRM-PR-001 Patient Rights Acknowledgment Form (Word)
  • FRM-PR-003 Complaint Log (Excel)
  • FRM-QAPI-005 QAPI Meeting Minutes + PIP Tracker (Excel)

Module 1 - Administration & Governance · 6 policies

  • HHA-ADM-001 Organizational Structure & Governing Body Policy (Word)
  • HHA-ADM-002 Administrator & Clinical Manager Responsibilities Policy (Word)
  • HHA-ADM-003 Patient Acceptance-to-Service Policy (Word)
  • HHA-ADM-004 Compliance with Federal, State & Local Laws Policy (Word)
  • HHA-ADM-005 Clinical Records Management & Retention Policy (Word)
  • HHA-ADM-006 Ethics & Conflict of Interest Policy (Word)

Module 2 - Patient Rights · 5 policies

  • HHA-PR-001 Patient Rights & Responsibilities Policy (Word)
  • HHA-PR-002 Notice of Rights Procedure (Word)
  • HHA-PR-003 Complaint & Grievance Investigation Procedure (Word)
  • HHA-PR-004 Abuse, Neglect & Exploitation Reporting Policy (Word)
  • HHA-PR-005 Patient Representative & Informed Consent Policy (Word)

Module 3 - Patient Care Delivery · 5 policies

  • HHA-CARE-001 Initial & Comprehensive Assessment Procedure (Word)
  • HHA-CARE-002 Individualized Plan of Care Policy (Word)
  • HHA-CARE-003 Care Coordination & Interdisciplinary Communication Procedure (Word)
  • HHA-CARE-004 Physician/Allowed Practitioner Orders & Verbal Orders Policy (Word)
  • HHA-CARE-005 Transfer & Discharge Policy (Word)

Module 4 - Services & Staffing · 5 policies

  • HHA-STAFF-001 Skilled Professional Services Policy (Word)
  • HHA-STAFF-002 Home Health Aide Qualifications, Training & Competency Policy (Word)
  • HHA-STAFF-003 Home Health Aide Assignment & Supervision Procedure (Word)
  • HHA-STAFF-004 Personnel File & Background Check Requirements Policy (Word)
  • HHA-STAFF-005 Orientation & In-Service Education Policy (Word)

Module 5 - QAPI · 4 policies

  • HHA-QAPI-001 Quality Assessment & Performance Improvement Program Policy (Word)
  • HHA-QAPI-002 Performance Improvement Project (PIP) Procedure (Word)
  • HHA-QAPI-003 Adverse Event Tracking & Analysis Procedure (Word)
  • HHA-QAPI-004 Quality Indicator Data Collection Policy (Word)

Module 6 - Infection Prevention & Control · 4 policies

  • HHA-IPC-001 Infection Prevention & Control Program Policy (Word)
  • HHA-IPC-002 Standard Precautions & Bag Technique Procedure (Word)
  • HHA-IPC-003 Infection Surveillance, Reporting & Education Procedure (Word)
  • HHA-IPC-004 Employee Health & TB Screening Policy (Word)

Module 7 - Emergency Preparedness · 3 policies

  • HHA-EP-001 Emergency Preparedness Plan (Word)
  • HHA-EP-002 Emergency Communication Plan (Word)
  • HHA-EP-003 Emergency Preparedness Training & Testing Program Policy (Word)
Inside the kit

See real pages from the material

These images were generated straight from the files you receive — nothing was mocked up or redrawn. Tap to enlarge.

Real excerpt from the file FRM-EP-003A Emergency Preparedness Drill Documentation Form (Word)
FRM-EP-003A Emergency Preparedness Drill Documentation FormWord · page 1 of 2
Real excerpt from the file HHA-ADM-001-organizational-structure-governing-body (Word)
HHA-ADM-001-organizational-structure-governing-bodyWord · page 1 of 10
Real excerpt from the file HHA-PR-001-patient-rights-responsibilities (Word)
HHA-PR-001-patient-rights-responsibilitiesWord · page 1 of 10
Real excerpt from the file FRM-GOV-002 Annual Policy Review Log (Excel)
FRM-GOV-002 Annual Policy Review LogExcel · spreadsheet
Real excerpt from the file FRM-HR-001 Home Health Aide Competency Checklist (Excel)
FRM-HR-001 Home Health Aide Competency ChecklistExcel · spreadsheet
The value

A consultant's manual — for the price of lunch with the team.

Same document discipline used in accredited organizations: purpose, scope, RACI, step-by-step procedure, KPIs, records, and revision control.

$2,500–$5,000 consultant
$57
Get the kit — $57
See it

Professional 15-section structure on every page

Purpose · Scope · Definitions · RACI · Step-by-step procedure · Flowchart · KPIs · Risk table · Records · Revision control.

Sample pages from the kit
How it works

From download to implemented

1

Download instantly

Get the ZIP right after purchase — 40 files organized by module. Nothing ships.

2

Edit in Word & Excel

Add your agency's name and logo in the marked fields. Adapt to your state requirements.

3

Review & implement

Roll out to your team and keep records current with the built-in logs and trackers.

Questions

Good to know

Are the files really editable?

Yes — Microsoft Word (.docx) and Excel (.xlsx). Not a PDF, not Canva. You add your agency name, logo, and state-specific details in the marked fields.

Is this specific to my state?

The kit is mapped to the federal CMS Conditions of Participation (42 CFR Part 484), which apply nationwide. State-specific items are left as marked blanks for you to complete. Always verify your state's requirements.

Who is it for?

Home health agency owners, administrators, and clinical managers — whether you're preparing for initial Medicare certification, a state survey, or replacing an outdated manual.

How do I get it?

Instant digital download after checkout. You'll receive the ZIP immediately and by email.

A note on advice

These templates are for informational purposes only and do not constitute legal or regulatory advice. Always verify current federal and state requirements for your agency.

Get started today

The complete home health policy manual — $57

32 policies + 8 forms · editable Word & Excel · instant download · includes the 2025 § 484.105(i) requirement.

Get the kit — $57 instant download

Secure checkout · Created by a quality management specialist (MBA, 15+ years in regulated industries).