Home Care Policies and Procedures Manual: What to Include
Most licensing states require written home care policies. The 16 sections to include, what Texas, Washington and Pennsylvania require, and how to review them.
By Caregiver Scheduling Team ·
A home care policies and procedures manual needs about 16 sections: organization, client rights, intake, care planning, scope of services, hiring, training, supervision, scheduling, documentation, incidents, infection control, emergencies, privacy, records and complaints. Most state licensing rules require written policies on these topics, and surveyors check that staff follow them. Build the manual from your state’s licensing chapter so every rule has a matching policy.
Do states require a written policy manual?
Yes, in most licensing states, often as a condition of the license. Texas requires every home and community support services agency to “adopt and enforce a written policy that specifies the agency’s client care practices” (26 TAC 558.281) and separate written staffing policies (26 TAC 558.245). Washington makes you submit policies covering each service category with the license application itself, along with proof of $1 million per occurrence in general liability insurance (WAC 246-335-320). Pennsylvania’s rules rarely say “policy” but require a competency program, an annual competency review and a written consumer information packet (28 Pa. Code 611.55 and 611.57).
Check your state in our licensing tool and do you need a license for non-medical home care.
What sections should the manual include?
Each row below is a policy. Each policy needs a procedure that says who does what, when, and where it is recorded.
| Section | Covers |
|---|---|
| Organization | Ownership, administrator, services, service area |
| Client rights | Rights statement, grievance process, non-discrimination |
| Intake and assessment | Eligibility, assessment, service agreement |
| Care planning | Writing, reviewing and updating the plan of care |
| Scope of services | What caregivers do and do not do, including medication |
| Hiring | Background checks, references, credentials |
| Training | Orientation, pre-service and annual training, competency checks |
| Supervision | Supervisory visits, annual evaluations, discipline |
| Scheduling and attendance | Call-outs, no-shows, backup coverage |
| Visit documentation | Check-in and check-out, tasks, notes, filing deadlines |
| Incidents | Falls, injuries, abuse and neglect reporting, incident reports |
| Infection control | Handwashing, PPE, illness, exposure |
| Emergencies | Client emergencies, disasters, communication plan |
| Privacy | HIPAA or state privacy, confidentiality of records |
| Records | What is kept, for how long, and what happens on closure |
| Complaints | Receipt, investigation, resolution, state hotline |
What do Texas, Washington and Pennsylvania actually require?
Each state names different must-have policies. The table shows where three states overlap and differ.
| Requirement | Texas (26 TAC 558) | Washington (WAC 246-335) | Pennsylvania (28 Pa. Code 611) |
|---|---|---|---|
| Written client care policy | Yes, 558.281 | Yes, submitted at licensure, 246-335-320 | Not named |
| Staffing and training policy | Yes, 558.245, including annual evaluations | Yes, in the plan of operation, 246-335-415 | Competency program and annual review, 611.55 |
| Client rights and grievance policy | Yes, 558.282, with HHSC hotline 1-800-458-9858 | Yes, 246-335-415 | Consumer rights and information packet with hotline 1-866-826-3644, 611.57 |
| Emergency preparedness | Yes, 558.256 | Yes, in the plan of operation | Not named |
| Notice before ending services | Transfer and discharge notice, 558.295 | Inform clients of alternatives, 246-335-415 | 10 calendar days written notice, 611.57 |
Texas is the most prescriptive. Its client care policy must address assessment, start of care, holds, transfer and discharge, emergencies in the home, staff safety, care planning and medication monitoring. Its staffing policy must cover orientation, job descriptions, background screening, annual evaluations, discipline and a signed statement from each direct care worker that they have read the policies. Washington wraps most of this into a plan of operation that must be kept current with practice and law (WAC 246-335-415). Pennsylvania focuses on worker files and the consumer packet: services, hours, fees, hiring and competency requirements, and whether the worker is an employee or a contractor.
How do you write policies staff will follow?
Write each policy in plain words, then attach the form or checklist that proves it was followed. A call-out policy with no call log is unenforceable. Keep each policy to one page, in the order of your state’s chapter. Strip anything from a template that you do not actually do. Surveyors cite agencies for breaking their own written rules as often as for breaking the state’s.
Ready-made pieces: call-out policy, visit note examples, emergency plan and record retention.
How often should you review the manual?
At least once a year, and whenever a rule, payer contract or service line changes. Date every policy, keep the old version, and record who approved the change. Have staff sign an acknowledgment whenever a policy that affects them changes. Put the annual review on your compliance calendar with license renewal and training due dates. See preparing for a state survey.
How Caregiver Scheduling handles this
Policies only help if the records show staff followed them. Caregiver Scheduling produces those records as a side effect of normal work: geofenced GPS check-in and check-out, client signatures, task checklists, AI-drafted visit notes, credential checks at assignment (Growth and up) and an audit log that keeps the original record when a visit time is corrected. When a surveyor asks how you know a visit happened, the answer is on screen. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Can I buy a policy manual template? Yes, but edit it against your state’s chapter and your actual practice. A template that promises nurse supervision you do not provide invites a citation.
Do caregivers need to read the whole manual? They need training on the policies that apply to them, with a signed acknowledgment. Texas requires that signature under 26 TAC 558.245.
Does a private-pay agency with no license still need a manual? Yes. Insurers, payers and courts will ask what your policy was.
This article is general information, not legal advice. Check your state’s licensing rules.