Process Documentation

Hiring Workflow

Complete documentation of our hiring process including JotForm, Airtable, and automation integrations

JotForm

Application, prescreen, and interview forms

Airtable

Central database and record management

Zapier/Make

Workflow automation and integrations

Legend

Working Automation
Needs Improvement
Missing/Needed
Manual Process

Application & Prescreen Phase

1

Application Submitted (JotForm)

Candidate completes and submits initial application form

MISSING AUTOMATION

Need automated acknowledgement letter to applicant

2

Record Created (Airtable)

Application data automatically populated in Airtable database

WORKING
3

Prescreen Form Link Emailed (JotForm)

Automated email sent with link to prescreen questionnaire

WORKING
4

Prescreen Status Trigger

Different automation paths based on prescreen results

Declined

Hard stop - process ends

MISSING:

Automated declined letter

Deferred

Maybe later

MISSING:

Automated "maybe later" letter

Interview Scheduled

Standard process

WORKING:

Notice sent to admin

Fast Track

Family caregivers

WORKING:

Notice + early onboarding sent

Interview & Onboarding Phase

5

Interview (30-60 min)

In-person or video interview to assess temperament, reliability, and fit

What We're Evaluating:

Temperament & kindness
Reliability indicators
Common sense & judgment
Professional demeanor
Communication skills
Transportation & availability

Interview Actions:

Help them download HHA Exchange app & show how to clock in/out
Complete Interview Notes Form (drug test, documents, observations)
Make hire/no-hire decision
6

Hire Decision

Critical decision point determining next steps

NOT Hired

Process ends, no further action

TO DO:

  • Add decline reason selection to form
  • Automated decline letter

Hired → Onboarding Begins

Triggered Actions:

1

Paperwork Package Sent

Electronic forms: I-9, W-4, direct deposit, consents, acknowledgments

2

Reference Requests Sent

Automated emails to references from application

7

Complete Paperwork (Electronic)

New hire fills out all required onboarding paperwork

Required Documents:

I-9 (employment eligibility)
W-4 (tax withholding)
Direct deposit authorization
Background check consent
Policy acknowledgment forms
TB screening questionnaire
8

Competency Exam (Must Pass)

16-section exam covering all required competency areas

Exam Details:

16 sections (one per competency area)
4-5 questions per section
Must score 4/5 per section to pass
Taken electronically (phone or computer)
PASS → Proceed

Can begin working and complete orientation

FAIL → Training Required

Must complete training, then retest before working

9

Orientation Assigned

After passing competency exam, employee receives orientation materials

Timeline:

Week 1: Core Orientation

Complete videos + handbook reading (mission, policies, procedures)

Year 1: Ongoing Training

Complete remaining 16 competency training modules throughout the year

Client-Specific Orientation

After core orientation is complete, employees receive hands-on client training:

Simple Cases

Meet & greet with client (companion/homemaking services)

Complex Cases

Shadow experienced employee (personal care, dementia, high-needs)

Current Automations

What's Already Automated

Your existing Zapier and Airtable automations working behind the scenes

Interview Notes → Airtable (Zapier)

6-step automation capturing interview data and documentation

1

JotForm Trigger

New submission on "003 - Airtable Interview Notes" form

2

Create Airtable Record

Creates record in "Interview Information" table with:

Full Name Proceed to Hire? Interview Date Interviewer ID Verification Interview Notes
3

Delay (3 minutes)

Allows PDF download to complete

4

Google Drive Search

Searches "Auto Download F2F Interviews" folder for PDF

{Date}-{Name}-Face-to-Face-Interview-Documentation-{ID}.pdf

5

Google Drive Share

Shares PDF with silverhomecare.com (view-only link)

6

Update Contacts Record

Updates candidate's record with:

Interview Status: "Completed" Interview Link (PDF) Test Results & ID Details

Proceed to Hire (Airtable)

When "Proceed to Hire" is selected:

Sends onboarding documents
Emails references from application

Fast Track (Airtable)

For family caregivers - expedited process:

Sends interview notice to admin
Sends onboarding early (before interview)

Interview Scheduled (Airtable)

Standard interview path:

Sends interview notes to admin
Includes interview form link

Email References (Airtable)

Reference check automation:

Auto-emails JotForm link to references
Tracked via JotForm submissions
OR: Manual verbal reference clears flag

Training Assignment (Automated)

Competency-based training system:

Failed sections auto-assign training
Annual training auto-assigned
Automated reminders sent

Training Added → Notification Email (Zapier)

3-step webhook automation with timing delay

1

Webhook Trigger (Receive Data)

Listens for incoming data from external source

recordID name email

Fires when new training record added in Airtable

2

Delay (5 Minutes)

Gives Airtable time to fully process and save the record

Prevents timing issues between systems

3

POST Back to Airtable

Sends data back via webhook to trigger Airtable automation

Purpose: Bridge between systems - Airtable triggers Zapier → Zapier waits → Zapier triggers Airtable automation → Email sent to trainee

PA Background Check (Automated)

Instant background verification:

Runs automatically at hire
Usually same-day results
Stops hiring if failed or high risk

Confidentiality Certificate File Management (Zapier)

3-step automated file renaming and organization workflow

1

Monitor Google Drive

Watches folder for new certificate files

📁 Training Certificates 7. Confidentiality

Triggers whenever a new file appears

2

Reformat Filename (Custom Code)

Intelligently renames file to standardized format

Logic:

  • • Splits filename by hyphens
  • • Rearranges segments intelligently
  • • Adds "-Confidentiality-Training-Certificate-Z.pdf"

Example:

Smith-John-Jane-Doe...pdf

Jane, Smith John-Confidentiality-Training-Certificate-Z.pdf

3

Copy to PROCESSING Folder

Creates copy with new name in processing folder

Original file stays in place
Copy moved to PROCESSING for tracking

Part of training documentation workflow

Training Completion Tracker (Zapier)

Multi-path automation: Update existing or create new training records

Example: Ambulation and Transfers Training (Pattern used for ALL trainings)

1

JotForm Trigger

New submission on training completion form

📝 Form: "{Training Name} Training"

Employee submits proof of completed training

2

Search Training Tracking Table

Looks for existing pending training record

Matches on:

Employee ID Status = "Pending" Class = Specific Training
3

Delay (2 Minutes)

Allows time for certificate PDF file processing

4

Find Certificate in Google Drive

Searches for employee's training certificate PDF

{FirstName}-{LastName}-{SubmissionID}.pdf

Branching Logic: Two Possible Paths

A
Record Found

If pending training record exists:

Updates existing record in Training Tracking table

B
Record Not Found

If no pending record exists:

1. Finds contact record

2. Creates new training record

This pattern is replicated for ALL training types:

Each training course has its own Zap using this exact workflow, automatically tracking completions and storing certificates. Employee submits → System finds or creates record → Certificate linked → Training status updated.

Annual Competency Exam Processor (Zapier)

Sophisticated multi-path automation with 20+ nested branches for failed sections

Tracks exam completion AND creates remedial training records per failed competency

1-4

Standard Training Tracker Flow

Same as other training automations:

JotForm Trigger: "Stand Alone Competency" form
Search Airtable: "Annual Competency Exam" record
Delay: 2 minutes
Find Certificate: Google Drive search

Three Parallel Processing Paths

A
Record Found Path

If pending exam record exists:

Updates existing Annual Competency Exam record

B
Record Not Found Path

If no pending record exists:

1. Finds employee contact record

2. Creates new exam training record

C
Failed Sections Handler
20+ Nested Branches

Sophisticated remedial training tracker:

Process:

• Checks each of 20 competency sections

• For EACH failed section → Creates separate training record

• Enables targeted remedial training per skill area

Example Failed Sections Tracked:

Abuse and Neglect Incident Reporting Medication Management Infection Control Emergency Procedures ...and 15 more

Why This Is Sophisticated:

This automation doesn't just track pass/fail - it creates granular remedial training records for each failed competency area. This allows you to:

  • ✓ Target retraining to specific skill gaps
  • ✓ Track remedial progress per competency
  • ✓ Ensure comprehensive skill coverage
  • ✓ Maintain detailed compliance records

Dual-Purpose Training Modules

The same training modules behave differently based on context:

Remedial Training

Triggered by failed competency exam section:

Marked as "Remedial"
Scored (Pass/Fail)
Must pass to retest exam
Annual Training

Ongoing reinforcement learning:

Educational mode (not pass/fail)
Wrong answers show explanation
Allows resubmission until correct

Philosophy: For annual training, the goal is knowledge reinforcement, not assessment. We'd rather employees understand WHY the right answer is correct than simply mark them wrong. This creates deeper learning and better patient care.

Compliance Requirements

Training & Competency Framework

Pennsylvania regulatory requirements driving our automated training system

A. Competency Exam Upon Hire

All direct care workers must complete prior to activation

Per 28 Pa. Code § 611.56(b) and (c)

16 Required Competency Sections

1.

Confidentiality

2.

Consumer Control & Independent Living

3.

Instrumental ADLs

4.

Recognizing Consumer Changes

5.

Basic Infection Control

6.

Universal Precautions

7.

Handling Emergencies

8.

Documentation

9.

Recognizing & Reporting Abuse/Neglect

10.

Dealing with Difficult Behaviors

11.

Bathing, Shaving, Grooming, Dressing

12.

Hair, Skin & Mouth Care

13.

Ambulation & Transferring

14.

Meal Preparation & Feeding

15.

Toileting

16.

Self-Administered Medications

Exam Structure

  • • Each section: 4-5 questions
  • • Passing score per section: 4/5 correct
  • • Must pass overall exam to work

Failed Section Triggers

  • • < 4/5 correct → Training assigned
  • • Failed overall → Retake required
  • • Must complete training before retest

Work Authorization Rules

Passed Overall Exam

✓ May begin working immediately

✓ Complete assigned module training while working

Failed Overall Exam

✗ May NOT be rostered

✗ Must complete ALL training first

✗ Must pass retest before activation

B. Required Orientation & Initial Training

Must be completed prior to roster activation

Orientation Components

Existing Videos & Materials ✓
Our Mission & Values
Dress Code Standards
TB Education
Client Abandonment
Medicaid Fraud, Waste & Abuse

Employee Handbook

Comprehensive policies, procedures, and expectations

Videos to Create
Punctuality & Attendance
EVV System & Documentation
Professional Boundaries
Emergency Procedures
Cell Phone Policy
Videos: 5-10 min each
Accessible by phone or desktop
Attestation required per module
Must complete Week 1 before activation

Purpose:

Introduce core expectations and foundational topics before full training modules. Establishes baseline understanding of agency culture, compliance requirements, and professional standards.

New Video Content Outlines (To Be Created)

1. Punctuality & Attendance (3-4 min)
  • • Show up 5-10 minutes early (never late to a shift)
  • • If running late: call client AND office immediately
  • • Call-offs: Must notify office at least 2 hours in advance (emergencies exempt)
  • • No-call/no-show = grounds for immediate termination
  • • Reliability is everything - clients depend on you
2. EVV System & Documentation (5-7 min)
  • • HHA Exchange app demo: Download, login, clock in/out process
  • • Clock in when you arrive, clock out when you leave (never early/late)
  • • Select correct service codes/tasks performed during shift
  • • Missed punch? Text/call office within 2 hours - don't wait until payroll!
  • • Why it matters: Medicaid compliance, accurate pay, client billing
  • • Written care notes: Document what you did, changes you noticed, any concerns

NOTE: We help them download the app at the interview, so this video reinforces expectations

3. Professional Boundaries (4-5 min)
  • • Don't accept gifts, money, or tips from clients/families
  • • Don't loan money or borrow items from clients
  • • Don't share personal problems or involve clients in your life
  • • Don't give out your personal contact info (use agency phone/communication)
  • • Romantic/sexual relationships with clients = immediate termination & abuse report
  • • You're a professional caregiver, not a friend or family member

CRITICAL: This prevents exploitation of vulnerable clients and protects your job

4. Emergency Procedures (5-6 min)
  • Call 911 first if: Chest pain, can't breathe, unresponsive, severe bleeding, fall with injury, stroke symptoms
  • • After calling 911: Call office AND family/emergency contact
  • Don't call 911 for: Minor complaints, chronic conditions (call family/doctor first)
  • • Stay with client until help arrives - never leave during emergency
  • • Know where emergency info is kept (contacts, medications, allergies)
  • • Document everything: what happened, when, who you called, outcome

Show examples: "Client says chest hurts" = 911. "Client's knee is sore from yesterday" = call family

5. Cell Phone Policy (2-3 min)
  • • ✅ Okay to use phone for: Clocking in/out (EVV), calling office, emergencies
  • • ❌ NOT okay: Texting friends, social media, videos, personal calls during shift
  • • Put phone away and focus on client - they're paying for your attention
  • • Emergency personal call? Step outside for 2-3 minutes max
  • • Taking client photos/videos = HIPAA violation (never allowed)

Simple rule: If the client or family sees you on your phone for non-work reasons, you're doing it wrong

Next Steps:

Create 5 short videos (2-7 min each) using these talking points. Keep them conversational and practical - show real examples of what to do and what not to do. Total additional time: ~20-25 minutes added to orientation.

How This Drives Our Automations

These regulatory requirements are the foundation for our sophisticated automation system. The Annual Competency Exam automation's 20+ nested branches directly map to these 16 competency sections, automatically creating remedial training records for failed areas and ensuring every employee meets Pennsylvania's standards before providing care.

Written Orientation Guide

Silver Home Care Direct Care Worker Orientation

Complete orientation document provided to all Direct Care Workers before their first shift

Welcome to Silver Home Care

The people you'll care for used to do these things themselves. Now they can't. Some are scared. Some are grieving. Some are angry about needing help at all. You're walking into that.

As a Direct Care Worker, your actions directly affect the well-being of the people we serve. You can make a client feel safer, more comfortable, and more like themselves. You can also cause harm—through neglect, impatience, inconsistency, or treating the work like a checklist instead of a relationship.

This orientation is your introduction to who we are, what you can expect from us, and what we expect from you.

Part I: Who We Are & What We Do

Our Mission

To improve lives, one visit at a time.

In home care, improvement doesn't look like a big dramatic change. It looks like something quieter: a day that feels more manageable. A routine that holds. A person who feels safe enough to relax. A family member who isn't holding their breath all day wondering if help will show up.

You'll be there when people need help with things they used to do on their own—when they're frustrated, embarrassed, or grieving the loss of independence. In those moments, good care is not just about completing tasks. It's about how you deliver them: with patience, consistency, and genuine respect for the person in front of you.

Every shift you work has the capacity to make someone's day better—or worse. We trust you with that responsibility, and we will hold you to it.

About the Agency

Silver Home Care is a locally owned non-medical home care agency based in Fairless Hills, PA. We serve families throughout Bucks and Philadelphia counties with a hands-on approach—because we're not just building a business. We're invested in the people we serve, the caregivers we employ, and the community we're part of.

We provide non-medical home care services. This means Direct Care Workers support daily living needs but do not perform medical or nursing tasks. Our services are available to clients who pay privately, use most long-term care insurance plans, or receive Veterans benefits. We are also contracted with Pennsylvania's Community HealthChoices (CHC) program.

Organizational Structure

Kelly Schmunk, Administrator

Oversees day-to-day operations. Hands-on and accessible.

Patti Carvalho, Staff Supervisor

Your main point of contact for scheduling, questions, and support.

Bruce Carvalho, Billing & Compliance

Handles billing, payroll, compliance, and administrative operations.

Shanell Day, Office Support

Supports office and field staff, including delivering supplies.

In-Home Services We Provide

Companion Care

Focuses on connection and presence. Engaging in conversation, encouraging hobbies, providing social interaction, and helping reduce loneliness. This is not medical care and it is not babysitting—it is a professional service that provides social and emotional support while maintaining client safety.

Homemaking Services

Light housekeeping, laundry, meal preparation, shopping, or running errands. You are supporting the client, not taking over their household. Tasks should be completed according to the client's preferences when it is safe to do so.

Personal Care (Medication Reminders Only)

Assistance with bathing, dressing, grooming, toileting, mobility, and eating. Personal Care should always be delivered in a way that supports independence and preserves dignity.

IMPORTANT: You may provide medication reminders only. You must never pour, measure, or administer medication.

Respite Care

Provides temporary relief for family caregivers while ensuring the client continues to receive safe and consistent care. When you provide respite services, you are stepping in so a family member can rest, attend appointments, or manage other responsibilities.

Part II: Client Rights, Professional Conduct & Confidentiality

Client Rights and Person-Centered Care

At Silver Home Care, our work is guided by the principle of person-centered care. This means we do more than complete a list of tasks—we focus on the client's goals, preferences, and choices. These rights are protected under Pennsylvania regulations (28 Pa. Code § 611.57 and 55 Pa. Code § 52.11).

What This Means Day-to-Day:
  • Respect client preferences around scheduling, routines, and how care tasks are carried out
  • If a client refuses a task, document it in HHAeXchange and notify the office if it affects safety
  • Always knock before entering private areas and remain mindful of privacy
  • Encourage independence whenever possible—even when it takes a little longer

Important: Person-centered care does not mean doing whatever a client asks. It means balancing respect for the individual with the boundaries and structure of the care plan and agency policies.

Professional Conduct and Boundaries

Professionalism at Silver Home Care is about consistency and judgment, not formality. When you enter a client's home, you represent the agency, and the way you speak, act, and carry yourself shapes the client's experience of care.

Do:
  • • Be warm and engaged
  • • Focus on the client's needs
  • • Maintain respectful conversations
  • • Stay professional and appropriate
Don't:
  • • Share personal struggles
  • • Debate politics or religion
  • • Get pulled into family conflicts
  • • Become personally entangled

Confidentiality & HIPAA

As a Direct Care Worker, you will learn private details about a client's health, routines, and personal life. That information must stay protected. You may only share it with authorized Silver Home Care staff and only for legitimate care or safety reasons.

Never Permitted:
  • • Discussing clients with friends or family
  • • Sharing client information on social media
  • • Talking about clients in public settings
  • • Leaving papers with private information visible
  • • Using unsecured devices to access client information

Financial and Legal Boundaries

Financial and legal boundaries deserve special attention because good intentions can still lead to serious problems.

Direct Care Workers May NOT:
Borrow or lend money
Accept valuable gifts
Use client's debit/credit card
Withdraw money
Be added to client's accounts
Act as power of attorney
Sign documents on behalf of client
Take sides in family disputes

If you are ever unsure whether something crosses a boundary, pause and contact your supervisor or the office for guidance.

Part III: Safety & Protection

Infection Control and Hygiene

Infection control is taken seriously because the clients we serve are often older adults or medically fragile. Something minor for you—like a cold—can pose a serious risk to someone with a weakened immune system.

Hand Hygiene

Wash hands with soap and water:

  • • Before and after every care task
  • • Before preparing food
  • • After using the bathroom
  • • After removing gloves
  • • Any time hands are visibly dirty
Personal Protective Equipment (PPE)

Use correctly:

  • • Gloves required for personal care
  • • Gloves required for toileting tasks
  • • Gloves required with bodily fluids
  • • Masks when required by care plan
  • • Never reuse gloves across tasks
Your Personal Hygiene

Wear your Silver Home Care uniform top and arrive clean and neat, without strong odors such as smoke or heavy perfume. This is part of showing respect to clients and maintaining a professional presence.

Workplace Safety and Hazard Communication

Chemical Safety
  • • All cleaning products must be properly labeled
  • Never mix bleach and ammonia - creates dangerous fumes
  • • Store chemicals safely away from food
Home Hazards

Report to the office if you notice:

  • • Loose rugs or cluttered walkways
  • • Poor lighting or unsafe wiring
  • • Oxygen equipment concerns
  • • Any hazard that puts you or the client at risk
Safe Body Mechanics
  • • Never lift more than 20 pounds without assistance
  • • Use proper techniques for transfers
  • • If a task feels unsafe, stop and ask for guidance
Workplace Injury

If you are injured while working, report the injury to the office immediately so the appropriate workers' compensation process can be followed.

Abuse, Neglect, and Exploitation Reporting

As a Direct Care Worker, you are a mandated reporter under Pennsylvania law. If you ever see, hear, or suspect abuse, neglect, or exploitation, you are required to report it.

Abuse

Physical, verbal, emotional, sexual, or financial harm

Neglect

Failure to provide basic needs: food, hygiene, safety, medical attention

Exploitation

Financial manipulation, stealing, pressuring to sign documents

If You Suspect Abuse, Neglect, or Exploitation:
1

Make sure the client is safe in the moment

2

Contact the office immediately to report what you observed

3

Document your observations in HHAeXchange using clear, factual language

4

Complete an incident or complaint form the same day

You are not responsible for investigating or proving abuse. Your responsibility is to report concerns so the appropriate agencies can respond. Failing to report suspected abuse is a violation of both the law and agency policy.

Critical Incidents and Emergency Preparedness

When to Call 911 Immediately
Fall with injury
Loss of consciousness
Difficulty breathing
Chest pain
Severe bleeding
Seizure

After calling 911: Stay with the client, follow dispatcher's instructions, and notify the office once emergency services are on the way.

Incident Reporting Sequence
  1. 1. Safety First: Make sure the client is safe. If urgent or life-threatening, call 911
  2. 2. Call the Office: As soon as possible, give a clear, factual summary
  3. 3. Document: Report in HHAeXchange and complete incident form the same day
  4. 4. Report Near Misses: Even if harm was narrowly avoided, report it to prevent future incidents
Fire Emergency
  • • Know exits in the client's home
  • • If you smell smoke or see fire, evacuate if safe
  • • Call 911 once outside
  • • Never re-enter the home
Severe Weather
  • • Remain with client until safe to leave
  • • If travel is unsafe, contact office
  • • Never risk your safety without clearance
Client Abandonment

Client abandonment is one of the most serious violations of Silver Home Care's standards. Abandonment occurs when a client is left without care during a scheduled visit—whether by not showing up, leaving early without authorization, or leaving without proper coverage or notification.

If you are running late, cannot make it, or encounter an emergency, contact the office immediately. Do not call the client directly. Abandonment can result in immediate termination and may carry legal consequences.

Part IV: Employment Standards

Attendance and Punctuality

Dependability is the foundation of home care. Clients rely on you to be present and on time, and even small disruptions can have a real impact on their safety and routine.

Expected:
  • Arrive on time and ready to work for every scheduled shift
  • Contact the office immediately if running late or unable to make a shift
  • Never call the client directly to cancel or explain an absence
Not Acceptable:
  • Repeated lateness without notice
  • Frequent call-outs or no-shows
  • Creating risk for clients due to unreliability

Break Policy

Your well-being matters, and breaks are part of maintaining safe, sustainable care. At the same time, many clients rely on you as their sole source of supervision during a visit, so breaks must always be managed with client safety in mind.

On-Site Breaks (Paid)

For shifts of 4+ hours, you may take an on-site break while remaining in the home and available to the client.

  • • Rest, eat, or pause
  • • Remain on premises
  • • Stay available to client
  • These breaks are paid
Off-Site Breaks (Unpaid)

If care plan allows and client can be safely left alone for a short period (typically 30 minutes):

  • • Clock out and back in using HHAeXchange
  • • Notify the office before leaving
  • These breaks are unpaid
Smoke Breaks

Permitted only when the client's care allows it. Must be brief, and you must return free of smoke odors.

  • • Never smoke inside a client's home
  • • Wear an extra jacket that can be removed
  • • Wash hands before returning
  • • Use mints or gum to reduce odor

Dress Code and Professional Presentation

Required
  • • Wear Silver Home Care uniform top
  • • Arrive clean and well-groomed
  • • Closed-toe, non-slip shoes
  • • Professional appearance
Avoid
  • • Strong smoke odors
  • • Heavy perfume or cologne
  • • Inappropriate clothing
  • • Unprofessional appearance

Holiday Pay Policy

Silver Home Care offers time-and-a-half pay for six major holidays.

Paid Holidays (Time-and-a-Half):
New Year's Day
Memorial Day
Independence Day
Labor Day
Thanksgiving Day
Christmas Day
  • • Holiday pay applies only when you are scheduled and work on the holiday itself
  • • If you are already in overtime, you will be paid your overtime rate instead
  • • To request a holiday off, submit your request at least 60 days in advance

Financial and Legal Boundaries

Clear financial and legal boundaries protect both clients and Direct Care Workers. Even well-intended actions can create serious problems when money or legal authority is involved.

Direct Care Workers May NOT:
Borrow or lend money
Accept valuable gifts
Use client's cards/accounts
Act as power of attorney

If a client or family member asks you to do something involving finances or legal matters, pause and contact the office for guidance.

Cell Phone and Earbud Policy

Acceptable Use
  • • Clocking in/out with EVV
  • • Calling the office
  • • Emergency situations
  • • Brief personal emergencies (step aside)
Not Permitted
  • • Texting friends during shift
  • • Social media browsing
  • • Watching videos
  • • Personal calls (except emergencies)
  • Taking photos/videos of clients

Earbuds and headphones are NOT permitted during shifts. They block important sounds like alarms, timers, or a client calling for help.

Whistleblower Protections

Silver Home Care supports every worker's right to report concerns about safety, abuse, fraud, or policy violations without fear of retaliation. If you raise a concern in good faith, you may not be punished or targeted for doing so.

Non-Discrimination

Silver Home Care complies with all applicable non-discrimination laws, including the ADA and Title VI. Discrimination based on race, color, religion, sex, age, disability, national origin, sexual orientation, or gender identity is not permitted.

Part V: Documentation & Electronic Visit Verification (EVV)

Care Plans and Documentation

Every client at Silver Home Care has a written care plan prepared by the agency. This plan is your guide to what services you provide, how they should be provided, and any specific needs or precautions for that client. Following the care plan exactly is required for consistency, safety, and regulatory compliance.

End-of-Shift Documentation Requirements:
  • Complete documentation in HHAeXchange before you leave
  • Confirm tasks that were completed
  • Document any tasks the client refused
  • Write a clear, professional note about what occurred during the visit
  • If the client's condition changes or a problem arises, contact the office immediately

Why documentation matters: It creates an accurate record of care, supports appropriate follow-up, ensures services are billed correctly, and protects you by showing what care was provided and how concerns were handled.

Electronic Visit Verification (EVV)

Silver Home Care complies with the federal 21st Century Cures Act, which requires Electronic Visit Verification (EVV) for all Medicaid-funded home care services. We use the HHAeXchange mobile app to record visits.

How to Do EVV on a Normal Visit (Step-by-Step)
1

Arrive & Clock In

After you arrive inside the home and greet the client, open HHAeXchange, select the correct client, and clock in

2

During the Visit

Complete task checklists as you perform services

3

Before You Leave

Clock out in HHAeXchange before leaving the home

4

Submit Documentation

Confirm your tasks, refusals (if any), and visit note are complete and the visit has saved/submitted

How to Do EVV When Something Goes Wrong (Step-by-Step)
1

Try Again

If the app won't work, check data/Wi-Fi, close and reopen the app

2

Use IVR Backup

If it still won't work, ask to use the client's authorized landline for IVR at 888-206-5826 (never use your phone or the client's cell phone for IVR)

3

Call the Office

If landline is not available/allowed or IVR fails, call the office immediately while you are still on site

4

Complete Missed Punch Form

Follow instructions from office. A form without a real-time call is not valid and may delay pay

Important: Clocking in from a car, from outside the home, or before seeing the client is not permitted. You must be inside the client's home after greeting them.

Missed Punch Policy

Missed punches are handled through the Missed Punch Form process. The form is not a substitute for EVV; it is a controlled way to document an exception.

Non-Compliant Exception

If you forget to clock in or out, call the office as soon as you realize it and follow the Missed Punch Form process.

This may result in coaching or corrective action if repeated

Compliant Exception

If the app has a technical issue and you report it in real time and follow the backup process (including attempting IVR when possible).

Treated as compliant for your record

Community Visits

If a visit starts or ends in the community, you must still clock in/out in the app from your actual location and complete a Missed Punch Form to document the off-site visit. Never leave or drop off a client anywhere unless approved by the office.

The office verifies Missed Punch Forms with the client before approving the visit. This verification may delay approval and payment, even when a signature is obtained at the visit.

Overnight Awake Requirements (CHC)

Some clients require overnight services. Under Community HealthChoices (CHC) regulations, Direct Care Workers assigned to overnight shifts must remain awake for the entire shift. This requirement exists for client safety.

Required Check-Ins:

1:00 AM

Check-in required

3:00 AM

Check-in required

5:00 AM

Check-in required

How to Do Overnight Awake Shifts:
  1. 1. Plan ahead so your phone is charged and you can access the employee app
  2. 2. Complete the 1:00 a.m., 3:00 a.m., and 5:00 a.m. check-ins during the shift
  3. 3. If the office calls after a missed check-in, answer immediately to confirm you are awake

Repeated missed check-ins or sleeping on duty will result in removal from overnight assignments.

Part VI: Training & Professional Development

Required Competency Training

Before working independently with clients, you must complete Silver Home Care's required competency training program. This training covers essential topics such as infection control, personal care, client rights, and workplace safety.

Competency Requirements Include:
  • Demonstrating skills such as safe transfers and infection control practices
  • Effective communication and maintaining ethical boundaries
  • Completion under supervision with signed approval

Most Direct Care Workers complete the initial competency evaluation prior to their first client assignment.

Mandatory Annual Training and Monthly Updates

Training continues throughout your employment. Silver Home Care requires annual refresher training and competency reviews, as mandated by regulation.

Annual Training Includes:
  • • Infection control
  • • Abuse recognition and reporting
  • • Confidentiality
  • • Client rights
  • • Workplace safety
  • • Emergency procedures
Monthly Updates:

Monthly trainings are required to maintain eligibility to work. These address:

  • • Changes in regulations
  • • Evolving client needs
  • • Reinforcement of critical topics

Professional Development

Training at Silver Home Care is not only about compliance. It is also an investment in your professional growth. Each completed training strengthens your skills, confidence, and ability to handle complex situations.

Optional Development Opportunities:
Dementia and Alzheimer's care
Advanced transfer techniques
Cultural competency training
Communication workshops

Failure to complete required training or demonstrate competency may result in temporary removal from client assignments until requirements are met.

Part VII: Employment Lifecycle

Hiring and Provisional Employment

Silver Home Care follows all state requirements for background checks, child abuse clearances, and OIG exclusion checks. These checks must be completed before a Direct Care Worker can work independently with clients.

Provisional Employment

In some situations, Direct Care Workers may be hired provisionally while required clearances are still pending, as permitted under Pennsylvania law.

  • • All background checks must have been requested and be actively in process
  • • Worker must not be disqualified by any initial findings
  • • Worker must remain under direct supervision
  • • May not work independently until all final clearances are received
  • • Provisional status is time-limited

Health Screening (Tuberculosis Policy)

Pennsylvania regulations require tuberculosis (TB) testing and screening for all Direct Care Workers prior to client contact.

TB Requirements:
  • Initial TB testing or screening before your first shift
  • Annual TB screening thereafter, including a symptom review
  • Report TB symptoms immediately if they occur
  • Documentation must be kept current to remain eligible to work

Termination of Employment and Services

Employment or client services may be terminated under certain circumstances.

Reasons for Termination:
  • • Policy violations
  • • Repeated attendance issues
  • • Client abandonment
  • • Failure to maintain clearances/training
  • • Unsafe or unprofessional conduct
Other Reasons Services May End:
  • • Client relocation
  • • Client ineligibility
  • • Client's personal request

Direct Care Workers are expected to provide notice of resignation whenever possible so coverage can be arranged. Leaving without notice may be considered abandonment.

Grievances and Complaints

Silver Home Care wants workers to feel respected, supported, and heard.

  1. 1. First Step: Speak with your supervisor
  2. 2. If Unresolved: Escalate to the Administrator
  3. 3. If Needed: Submit a formal complaint using the appropriate form

All complaints are reviewed promptly, confidentiality is respected, and retaliation is not permitted.

Whistleblower Protections

Direct Care Workers are protected under Pennsylvania's Whistleblower Law when reporting concerns such as safety issues, fraud, or abuse in good faith.

  • • You may report concerns internally or directly to state agencies
  • • Retaliation for good-faith reporting is prohibited
  • • All reports are taken seriously and reviewed carefully

Part VIII: Closing & Appendices

Acknowledgment and Signature

All Direct Care Workers are required to sign the Orientation Acknowledgment Form. This form confirms that you have:

  • Received and reviewed the Silver Home Care Orientation Guide
  • Understand your responsibilities as outlined in agency policies and procedures
  • Agreed to follow Silver Home Care's rules, standards, and expectations
  • Received required information regarding client rights, abuse reporting, confidentiality, HIPAA, and workplace safety

The signed acknowledgment is maintained in your personnel file, as required by regulation (28 Pa. Code § 611.56; 55 Pa. Code § 52.21).

Closing Statement

We hired you because we saw something in you that matters—you're kind, you're reliable, and you understand that treating people with respect and dignity isn't optional. Those qualities are exactly what this work requires.

At Silver Home Care, every visit is more than a task. It is an opportunity to improve someone's life by providing steady, respectful, and thoughtful care in their own home. The work you do makes a real difference—one visit at a time.

By following the guidance in this Orientation Guide, respecting client rights, and maintaining professional standards, you play a direct role in creating safety, dignity, and continuity for the people we serve.

Thank you for choosing this work and for being part of Silver Home Care. We're glad you're here, and we're here to support you every step of the way.

Glossary of Terms

Abuse

Any action that causes harm, including physical, emotional, sexual, or financial harm. Direct Care Workers are mandated reporters of suspected abuse.

ADA (Americans with Disabilities Act)

Federal law prohibiting discrimination against individuals with disabilities and requiring reasonable workplace accommodations.

Care Plan

A written document prepared by Silver Home Care that outlines approved services, client needs, and specific instructions. All services must follow the care plan exactly.

Chapter 52

Pennsylvania regulations (55 Pa. Code Chapter 52) governing home and community-based services.

Chapter 611

Pennsylvania regulations (28 Pa. Code Chapter 611) governing home care agencies and registries.

Client (Participant)

The individual receiving services from Silver Home Care. "Participant" is the term used in Medicaid regulations.

Client Abandonment

Leaving a client without care during a scheduled shift. Considered a serious violation that may result in termination.

Competency

The demonstrated ability to perform caregiving duties safely and effectively, as required by regulation and agency policy.

Confidentiality

The obligation to protect private client information in compliance with HIPAA and Silver Home Care policy.

Direct Care Worker (DCW)

An employee of Silver Home Care who provides non-medical services and support to clients in their homes.

Electronic Visit Verification (EVV)

A federally mandated system used to record the start and end of home care visits through GPS-enabled mobile technology.

Exploitation

The illegal or improper use of a client's resources, property, or person for personal gain.

HHAeXchange

The mobile application used by Silver Home Care for EVV, task documentation, and visit notes.

HIPAA

The Health Insurance Portability and Accountability Act, a federal law protecting the privacy and security of health information.

Mandated Reporter

A professional legally required to report suspected abuse, neglect, or exploitation. All Direct Care Workers at Silver Home Care are mandated reporters under Pennsylvania law.

Missed Punch

A failure to clock in or out in the EVV system. Requires immediate contact with the office and submission of a Missed Punch Form.

OIG Exclusion List

A federal list identifying individuals barred from participating in federally funded health programs. Individuals on this list cannot work in Medicaid-funded services.

Overnight Awake Requirement

A Community HealthChoices (CHC) rule requiring Direct Care Workers assigned to overnight shifts to remain awake for the entire shift, with required check-ins at designated times.

PPE (Personal Protective Equipment)

Equipment such as gloves or masks used to reduce the risk of infection.

Provisional Hire

A Direct Care Worker who begins employment under supervision while background checks are pending, in compliance with Pennsylvania law.

Whistleblower

A worker who reports suspected fraud, abuse, or safety violations and is protected from retaliation under state and federal law.

Ready to Begin?

This orientation guide is your foundation. Review it thoroughly, ask questions, and prepare to make a real difference in the lives of the people you'll serve.

Questions?

Contact Your Supervisor

Need Support?

We're Here to Help

Automated Compliance Monitoring

Real-Time Compliance Warnings Dashboard

Airtable interface that automatically monitors 8+ regulatory requirements and flags issues before they become violations

Airtable Compliance Warnings Dashboard

Driver's License

Checks:

  • • Valid DL on file
  • • Expiration date monitoring
  • • PA residency status

Flags: If not PA OR less than 2 years → Requires proof of residency OR FBI check

Social Security

Checks:

  • • SS Card on file
  • • I-9 completion
  • • SS verification

Flags: Missing any of the three required documents

TB Testing

Checks:

  • • Two-step test OR TB Gold
  • • Initial screening on file
  • • Annual screening schedule

Reminds: Annual TB screening due in 1 year

PA Background Check

Manual Process:

  • • Results reviewed manually
  • • Admin enters review confirmation
  • • Compares to criminal attestation

Flags: Empty check OR mismatch with attestation

Medicaid Attestation

Checks:

  • • Onboarding attestation status
  • • Pulled from onboarding form
  • • Displayed in compliance view

Flags: Missing attestation from onboarding

Risk Assessment

Conditional:

  • • Required if triggered by BG check
  • • Displayed when needed
  • • Part of compliance review

Flags: If required but not completed

References

Checks:

  • • Minimum 2 references required
  • • Reference completion count
  • • Auto-tracks from reference forms

Flags: Less than 2 completed references

Training Overdue

Checks:

  • • Overdue training assignments
  • • Displayed in dashboard
  • • Currently informational only

Status: Visible but not flagging yet (coming soon)

FBI Background Check

Required When:

  • • Non-PA DL holder
  • • PA resident less than 2 years
  • • Proof of residency not provided

Tracks:

  • • Receipt collected (must have within 3 days)
  • • Result received (90-day window)
  • • Days remaining until deadline

Flags:

• No receipt after 3 days

• 90-day deadline approaching

• No result received within 90 days

Roster Eligibility Failsafe System

Intelligent roster eligibility system with manual override capability and daily automated notifications. Prevents employees from being scheduled when compliance requirements aren't met.

Current: Manual Override

How it works:

  • • Set eligibility expiration date manually
  • • Example: Employee owes document → Set 3-day deadline
  • • Daily auto-roster eligibility notice sent each morning
  • • Admin can override anytime if issue resolved

Use Case: "Give me that form by Friday or you're not on the roster" → Set expiration to Friday → System enforces automatically

Future: Automated Triggers

Will auto-set based on:

  • • Overdue training assignments
  • • Missing compliance documents
  • • Expired certifications
  • • Failed background check elements
  • • Any flagged warning from dashboard

Failsafe: Admin can still override, but system provides safety net to catch issues before scheduling

Why This Matters:

This creates a safety net between compliance tracking and scheduling. You can always override if needed (employee brought in the missing document), but the default is SAFE - employees can't slip through the cracks and get scheduled when they shouldn't be working. Combines human judgment with automated enforcement.

Proactive Compliance Management

This real-time dashboard automatically monitors 8+ regulatory requirements across all employees, flagging issues before they become violations. Complex logic handles residency calculations, document cross-referencing, and timeline tracking.

8+

Compliance Areas Monitored

Real-Time

Automatic Flag Updates

Proactive

Catch Issues Early

Summary & Action Items

8+

Working Automations

Plus training variants

6

Missing Automations

1

Needs Improvement

1

Major Rework Needed

High Priority

1

Add Application Acknowledgement Letter

Automated email immediately after application submission to improve candidate experience

Zapier/Make Email Template
2

Prescreen Declined Letter

Automated professional decline letter when prescreen status = "Declined"

Zapier/Make Email Template Airtable Trigger
3

Post-Interview Decline Letter

Add decline reason field + automated decline letter when "Proceed to Hire" = NO

JotForm Field Zapier/Make Email Template

Medium Priority

4

Prescreen "Deferred" Letter

Automated "maybe later" letter when prescreen status = "Deferred"

Zapier/Make Email Template
5

Interview No-Show Handling

Tighten up process and add automated no-show letter

Process Design Zapier/Make Email Template
6

Interview Confirmation to Candidate

Auto-send interview details (date/time/location) with JotForm prefill link

JotForm Prefill Zapier/Make Email Template Calendar Integration

Major Project

8

Rework Entire Onboarding Process

Complete redesign: Remove TB screen & competency test, streamline forms, improve workflow

JotForm Redesign Airtable Fields Automation Updates Process Design

Scope: Remove TB screen, remove competency test, streamline to: Confidentiality, BG consent, Skills checklist, I-9, W4/DD at Workforce

Low Priority / Future Enhancements

7

Compliance Document Reminders

Auto-reminders to employees for expiring/missing documents (currently manual daily review)

Airtable Automation Email Templates Scheduled Checks

Ready to Improve Your Workflow?

Let's prioritize these improvements and start implementing automated solutions to streamline your hiring process

Database Architecture

Silver Home Care Airtable Structure

13 interconnected tables managing the complete employee lifecycle

Table Relationships

Contacts

Central Hub

329 Records • 196 Fields

All tables link to Contacts as the primary record for each person

Core Tables & Data Flow

Hiring Pipeline

Contacts

329 Records 196 Fields

Central hub tracking everyone from applicants to active employees

Personal Information:

Name, phone, email, address, emergency contacts

Application & Status:

Hiring status, application date, onboarding progress

Compliance Docs:

ID, TB tests, background checks, I-9, SS verification

Training & Employment:

Training tracking, pay rate, EVV bonus rate

Automated Flags:

ID, TB, FBI, SS, PA BG, References expiration alerts

Pre-screening

210 Records 15 Fields

Tracks pre-interview screening data

Links to: Contacts

Captures:

  • • Interview recommendation
  • • Interview date & time
  • • Screening conductor
  • • Onboarding link generation

Interview

190 Records 24 Fields

Face-to-face interview details

Links to: Contacts

Captures:

  • • Hire decision
  • • Interviewer & date
  • • Provisional status
  • • ID information
  • • GO status & notes

References

1,455 Records 31 Fields

Reference checks for applicants

Links to: Contacts

Automated Workflow:

  • • Email sent to references from application
  • • References complete JotForm
  • • OR: Verbal reference via phone call
  • • Completing either clears Reference Flag

Onboarding

138 Records 32 Fields

Onboarding form submissions & data

Links to: Contacts

Current Forms (JotForm):

  • • Confidentiality agreement
  • • BG check consent
  • • Skills checklist
  • TB screen (removing)
  • • I-9 (+ W4/DD at Workforce)
  • Competency test (removing)

NEEDS REWORK

Entire onboarding process requires redesign

Ongoing Employee Management

Training Tracking

4,037 Records

Individual training assignments and completion tracking

Automated Process:

  • • New hires start with competency test
  • • Failed sections auto-assign training
  • • Annual training auto-assigned
  • • Automated reminders sent
Links to: Contacts

Training Classes

30 Records

Master list of available training courses and requirements

Observations

29 Records

Direct observation assessments and evaluations

Links to: Contacts

Built-In Compliance Tracking

Automated formula-based flags in Contacts table alert you to compliance issues

ID Flag

Missing or expiring IDs

TB Flag

TB test requirements

FBI/PA BG Flag

Background check status

PA checks: Auto at hire, usually same day

I-9 Flag

I-9 completion status

SS Flag

Social Security verification

References Flag

Reference check requirements

Cleared by completing form or verbal call

Training Flag

Training due dates

More Flags

Additional compliance alerts

Current Process:

Daily list reviewed manually

PLANNED IMPROVEMENT:

Auto-reminders to employees for expiring/missing documents