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At CareSphere, we prioritize comprehensive care management through meticulous record-keeping. Our records are a crucial part of understanding and catering to your unique needs, preferences, strengths, and abilities. These documents allow us to:
- Record and monitor the services and care provided to you.
- Assess your responses to our services.
- Determine necessary adjustments to your Care Plan.
- Keep accurate logs for billing and payroll purposes.
Types of Documents in Your File
To ensure we deliver personalized and effective care, we maintain various types of documents in your file. While the specifics of each client's file may vary, the following list outlines the usual types of documents we manage:
- Identifying Data: Includes your name, gender, birth date, address, telephone number, next-of-kin, and emergency contact number.
- Initial Service Request or Referral: The initial request for our services or referral from another source.
- Assessment Details: Comprehensive evaluations of your needs and conditions.
- Care Plan: An individualized plan outlining your care requirements and goals.
- Consent for Referral & Release Information: Documentation authorizing us to obtain or share information on your behalf.
- Service Agreement: The contract detailing the services to be provided.
- Progress Notes: Observations and updates on your condition and response to care.
- Direct Care Worker Notations: Notes from your caregivers about the care provided during their visits.
- Service Schedule: Details of service hours, dates, and assigned Direct Care Workers.
- Billing Documentation: Records used for billing purposes.
- Supervisor Visits Records: Documentation of visits by supervisors to ensure quality of care.
- Client Rights Information: Information provided to you about your rights as a client.
- Physician's Orders: Medical orders from your physician regarding your care.
- Health Care Directives: Documentation on any existing health care directives, if applicable.
- Complaints and Compliments: Records of any feedback, positive or negative, regarding our services.
- Incident Reports: Documentation of any incidents that occur during the provision of care.
- Client Satisfaction Questionnaires: Your feedback on the services received.
- Tailored Documentation
While the above list is comprehensive, it's important to note that the specifics of your case might require additional documents not listed or might not necessitate the use of all the documents mentioned. Our goal is to ensure that your file accurately reflects your care journey with us, enabling us to provide the best possible support tailored to your needs.
At CareSphere, your privacy and the confidentiality of your records are paramount. Rest assured, all information in your file is handled with the utmost care and discretion, accessible only to authorized personnel involved in your care.