Annual Duties of the Agency

Emergency Plan

Same month every year (annually)

Complete the Data Sheet.

Complete the Agreement with another Agency. (Fax to us the information to complete/submit the Plan)

Your License must be renewed every 2 years

Renew License Form: 60 days before to expiration date.    CLIA application form

Training In Our Office

Every semester we offer 1 or 2 in-office training to your employees.

Every year all the following reports must be completed under the supervision of the Agency's Administrator and/or Director of Nursing (REMEMBER Open all new Year LOGS):

Administrator responsibilities:

Annual Agency's Strategic Plan (Must be discussed, approved by the Board of Director in the Annual meeting at the beginning of each year, the template must be updated with your discussion and Agency's reality)

Strategic Plan           

Risk Management Plan                                    Drug Free Workplace program

Risk Mgm Plan                                               Drug Free Program

Agency Program Evaluation: (Voluntary) no longer mandatory after 01/13/2018

Agency Annual Evaluation

Contracts Annual Evaluations:

Every Agency's Contract must be evaluated

every year, including with the Staffing Therapy       Risk Management Annual Report:

Company, if applicable.

Contact Annual Evaluation                Risk Management Annual Report

Administrator: CAPITAL EXPENDITURES PLAN must be evaluated/approval every year

Capital Expenditure Plan                 Accountant Ext. Rev. Sample

Administrator: Three (3) years budget (current year + next 2 years)

Budget. Sample

HIPAA Implementation plan must be evaluated every year.

HIPAA Implementation Eval

Agency's Safety Program Implementation plan must be evaluated every year.

Safety Program Eval                                 Annual Environmental Report

Director of Nursing responsibilities:

Infection Control Prevention and Control Annual Report, Infusion Therapy Summary, TB Risk Annual assessment:

Infection Control Annual Report                Biomedical Waste Compliance

Bloodborne Pathogens Report                 Infusion Therapy Annual Report

TB Risk Annual Assessment                     Exposure Plan Annual review

Florida TB Statistics    Texas TB Statistics    California TB Statistics    Illinois TB Statistics    NJ TB Statistics

Performance Improvement Plan Annual Report (the template must be updated with your discussion and Agency's reality)

PI Annual Report

Intra-cycle Monitoring Process (JCHO only)   Intracycle Monitoring (Self Assessment)

(At approximately 12 and 24 months after the Agency’s triennial survey)

Annual renew of your Emergency Plan: the same month every year (review your approval compliance letter)

Emergency Plan Data                                     Backup Agreement signed with another Agency

 Emergency Plan                                            Emerg. Agreement

Bi-annual renew of the Agency License:         Renew License Data           CLIA:    CLIA Renew

(at least 60 days before the expiration date)

Administrator/DON: Survey Ready Check List

Survey Ready Check List

Disclaimer: Every template is only your Guide/Agenda to complete each report, your Agency Officials must assure that the meeting occur, the quorum is acceptable, and every member had active participation in the discussion and confection of the Reports, Evaluations, Documents.