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DMEPOS Operational Policy and Procedure Manual

DMEPOS Operational Policy and Procedure Manual

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Table of Contents 

Chapter 1 

Policy 1-01 - Patient Rights 

Attachment 1-01-01 - Patient Bill of Rights 

Attachment 1-01-02 - Customer Orientation Form 

Policy 1-02 - Staff Comprehension of Rights and Responsibilities 

Policy 1-03 - Patient Participation and Consent for Services 

Attachment 1-03-01 - Organization Objectives 

Attachment 1-03-02 - Equipment and Services 

Policy 1-04 - Refusal of Care and Service 

Attachment 1-04-01 - Release of Liability 

Attachment 1-04-02 - Visit Refusal Report 

Policy 1-05 - Resolution of Conflicts 

Policy 1-06 - Ethical Guidelines 

Attachment 1-06-01 - Code of Ethics 

Policy 1-07 - Conflicts of Interest 

Attachment 1-07-01 - Conflict of Interest Notification 

Policy 1-08 - Resolution of Ethical Issues 

Attachment 1-08-01 - Ethical Resolution Checklist 

Policy 1-09 - Patient Complaints and Compliments 

Attachment 1-09-01 - Patient Communication Form 

Policy 1-10 - Confidentiality, Communication, and Informed Consent 

Attachment 1-10-01 - Employee Confidentiality Agreement 

Attachment 1-10-02 - Authorization for Release of Information, Assignment of Benefits and Deductible/Co-Pay Responsibility 

Attachment 1-10-03 - Consent to Record 

Policy 1-11 - Respect of Patient Confidentiality, Privacy, Security, and Property 

Policy 1-12 - Care Coordination 

Attachment 1-12-01 - Patient Communication Log 

Policy 1-13 - Patient Responsibility 

Attachment 1-13-01 - Responsibilities of the Patients 

Attachment 1-13-02 - Equipment Purchase Certification 

Chapter 2 

Policy 2-01 - Initial Assessment 

Attachment 2-01-01 - Plan of Care/Initial Assessment: General Equipment 

Attachment 2-01-05 - Plan of Care/Initial Assessment: Continuation 

Policy 2-02 - Reassessments and Follow Up 

Policy 2-03 - Assessment Qualifications 

Policy 2-04 - Patient Abuse, Neglect, and Exploitation 

Policy 2-05 - Plan of Care/Service/Treatment 

Policy 2-06 - Orders for Services 

Policy 2-07 - Care Standards 

Policy 2-08 - Patient Education 

Attachment 2-08-01 - Medicare Supplier Standards 

Attachment 2-08-02 - Delivery Invoice 

Attachment 2-08-03 - Patient Education Sheets - English 

Policy 2-09 - Education Review 

Policy 2-10 - Patient Safety Education 

Policy 2-11 - Patient/Family Medication Education 

Policy 2-12 - Referral, Transfer, and Discharge 

Attachment 2-12-01 - Transfer/Discharge/Referral Notification 

Policy 2-13 - Admission/Refusal of a Patient 

Policy 2-14 - Appropriate and Timely Care 

Policy 2-15 - Initial Respiratory Assessment 

Policy 2-16 - Clinical Respiratory Assessment 

Attachment 2-16-01 - Respiratory Assessment Form 

Policy 2-17 - Plan of Treatment or Care 

 

Chapter 3 

Policy 3-01 - Governing Body Authority and Responsibility 

Attachment 3-01-01 - Organizational Chart 

Attachment 3-01-02 - Mission Statement 

Policy 3-02 - Organizational Plan 

Policy 3-03 - Patient Perception of Care 

Attachment 3-03-01 - Perception of Care 

Policy 3-04 - Contract Services 

Attachment 3-04-01 - Contract Standards 

Attachment 3-04-02 - Attachment 1: Payment Rates 

Attachment 3-04-03 - Sample Contract: Individual 

Attachment 3-04-04 - Sample Contract: Entity 

Policy 3-05 - Operating Budget 

Policy 3-06 - Administrative Responsibility/Competency/Backup 

Policy 3-07 - Process Implementation and Review 

Attachment 3-07-01 - Process/Policy Action for Non-Compliant Status 

Attachment 3-07-02 - Acknowledgement of Review of Policies 

Chapter 4 

Policy 4-01 - Safety Program 

Policy 4-02 - Cleaning and Disinfecting 

Policy 4-03 - Identifying Risks & Safety Hazards 

Attachment 4-03-01 - Safety Hazard Report (Organization) 

Attachment 4-03-02 - Safety Hazard Report (Patient) 

Policy 4-04 - Incidents 

Attachment 4-04-01 - Incident Report 

Policy 4-05 - Sentinel/Adverse Events 

Policy 4-06 - Equipment Incidents 

Attachment 4-06-01 - Equipment Incident Report 

Attachment 4-06-02 - Equipment Incident Tag 

Policy 4-07 - Emergency Preparedness 

Attachment 4-07-01 - Hazard Vulnerability Analysis 

Policy 4-08 - Equipment Tracking, Hazards, Recalls, and Returns 

Attachment 4-08-01 - Medical Device Registration 

Attachment 4-08-02 - Daily Vehicle Log 

Policy 4-09 - Routine and Preventive Maintenance 

Attachment 4-09-01 - Preventive Maintenance/Repair Log 

Attachment 4-09-02 - Equipment Status Stickers 

Attachment 4-09-03 - Vehicle Maintenance Schedule 

Policy 4-10 - Safe, Operable Equipment 

Attachment 4-10-01 - Warehouse Layout Sample 

Attachment 4-10-02 - General Equipment Log 

Attachment 4-10-03 - Equipment Tracing Number Control Log (Page 1) 

Attachment 4-10-04 Equipment Tracking Log (Page 2) 

Attachment 4-10-05 Preventive Maintenance WorkSheet (Page 3) 

Policy 4-11 - Response Procedures 

Attachment 4-11-01 - On-Call Log 

Policy 4-12 - Emergency Maintenance and Replacement 

Policy 4-13 - Staff Safety and Security 

Policy 4-14 - Care/Service at the Organization's Site 

Policy 4-15 - OSHA Compliance 

Attachment 4-15-01 - General Health and Safety Activities Checklist 

Attachment 4-15-02 - Facility Safety Checklist 

Attachment 4-15-03 - Fire Protection Checklist 

Attachment 4-15-04 - Personal Protection Checklist 

Attachment 4-15-05 - Accident Reporting and Record Keeping Checklist 

Attachment 4-15-06 - Medical Services and First Aid Checklist 

Attachment 4-15-07 - Hand and Portable Power-Operated Tool Checklist 

Attachment 4-15-08 - Hoists and Forklifts Checklist 

Attachment 4-15-09 - Flammable and Combustible Material Checklist 

Attachment 4-15-10 - Hazardous Materials, Waste, Disposal, and Exposure Checklist 

Attachment 4-15-11 - Electrical Safety Checklist 

Attachment 4-15-12 - Material Handling Checklist 

Attachment 4-15-13 - Compressors and Compressed Air Checklist 

Attachment 4-15-14 - Compressed Gases Checklist 

Attachment 4-15-15 - Personal Protective Equipment Checklist 

Policy 4-17 - FDA Compliance 

Attachment 4-17-01 - Batch Production Log 

 

Chapter 5 

Policy 5-01 - Personnel Policies/Procedures 

Policy 5-02 - Employee Qualifications 

Policy 5-03 - Personnel Selection 

Attachment 5-03-01 - Receipt of Job Description 

Attachment 5-03-02 - Job Descriptions 

Policy 5-04 - Supervision 

Policy 5-05 - Staff Orientation 

Attachment 5-05-01 - New Employee Orientation Checklist 

Attachment 5-05-02 - Competency Checklist Page 1 

Attachment 5-05-03 - Competency Checklist Page 2 

Attachment 5-05-04 - Competency Checklist Page 3 

Attachment 5-05-05 - Competency Checklist Page 4 

Policy 5-06 - Staff Education 

Attachment 5-06-01 - Six Steps to Safe Lifting 

Attachment 5-06-02 - Fire Safety 

Attachment 5-06-03 - Basic Home Safety 

Attachment 5-06-04 - Equipment Operation 

Attachment 5-06-05 - Training Outline: Occupational Exposure to Tuberculosis 

Attachment 5-06-06 - Training Outline: Hepatitis B 

Attachment 5-06-07 - Training Outline: Severe Acute Respiratory Syndrome 

Attachment 5-06-08 - Inservice Training Log 

Attachment 5-06-09 - Inservice Training New Product or Process 

Attachment 5-06-10 - Mandatory Annual Inservice Training 

Attachment 5-06-11 - Procedural Checklist: Deliveries 

Attachment 5-06-20 - Procedural Checklists: Enteral Nutrition Pumps 

Policy 5-07 - Staff Competency and Performance Evaluation 

Attachment 5-07-01 - Performance Review 

Attachment 5-07-03 - Delivery Procedures Competency Test 

Attachment 5-07-04 - Equipment Cleaning Competency Test 

Policy 5-08 - Determining and Assessing Learning Needs 

Attachment 5-08-01 - Competency Report 

Policy 5-09 - Clinical Procedures 

 

Chapter 6 

Policy 6-01 - Information Management Planning 

Attachment 6-01-01 - Information Management Assessment 

Attachment 6-01-02 - Information Management Improvement Plan 

Policy 6-02 - Record Confidentiality, Security, and Integrity 

Policy 6-03 - Record Keeping Authorization/Authentication 

Attachment 6-03-01 - Signature Sheet 

Attachment 6-03-02 - Computer Key/Password Authorization 

Policy 6-04 - Documentation Standardization 

Attachment 6-04-01 - Approved Medical Abbreviations 

Attachment 6-04-02 - Unacceptable Medical Abbreviations, Symbols, and Dose Designations 

Policy 6-05 - Record Review 

Attachment 6-05-01 - Record Review Form 

Policy 6-06 - Patient Documentation 

Policy 6-07 - Record Retention 

Chapter 7 

Policy 7-01 - Infection Control Program 

Policy 7-02 - Occupational Exposure - Prone Task List 

Attachment 7-02-01 - Occupational Exposure Risk and Protection Chart 

Policy 7-03 - Hepatitis B Vaccination 

Attachment 7-03-01 - Hepatitis B Declination 

Policy 7-04 - Infection Control - Universal Precautions 

Policy 7-05 - Equipment Management - Universal Precautions 

Policy 7-06 - Communicable Disease Protection/Exposure 

Policy 7-07 - Health Record 

Policy 7-08 - TB Identification/Prevention Protocols 

Policy 7-09 – Infection, Identification, Monitoring, And Tracking 

Attachment 7-09-01 – Infection Control Monitoring Log (Part 1) 

Attachment 7-09-02 – Infection Control Monitoring Log (Part 2) 

Chapter 8 

Policy 8-01 - Performance Improvement Plan 

Attachment 8-01-01 - Performance Improvement Team Members 

Attachment 8-01-02 - Performance Team Responsibilities 

Attachment 8-01-03 - Staff Responsibilities 

Attachment 8-01-04 - Performance Team Rules 

Attachment 8-01-05 - Meeting Minutes 

Attachment 8-01-06 - Performance Improvement Annual Education Schedule 

Attachment 8-01-07 - Summary Tool for Scope of Service 

Attachment 8-01-08 - Performance Management System Diagram 

Policy 8-02 - Designing Performance Improvement Processes 

Attachment 8-02-01 - Design Worksheet 

Policy 8-03 - Measurement (Data Collection) 

Attachment 8-03-01 - On-Going Monitoring 

Attachment 8-03-02 - Annual Staff Competency Assessment 

Attachment 8-03-03 - Methods of Data Collection 

Attachment 8-03-04 - Sample Check Sheets 

Attachment 8-03-05 - Governing Body Competency Report 

Policy 8-04 - Aggregation and Analysis 

Attachment 8-04-01 - Instructions for Completing the Assessment of Data Form 

Attachment 8-04-02 - Assessment of Data Worksheet 

Policy 8-05 - Performance Improvement 

Attachment 8-05-01 - Improvement Worksheet 

Attachment 8-05-02 - Record of Improvement 

Policy 8-06 - Outcomes Measurement Benchmarking 

Our DMEPOS accreditation policy and procedure manual is a comprehensive and user-friendly guide designed to help Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers navigate the accreditation process with ease and confidence. This manual provides detailed policies and procedures, along with step-by-step instructions, templates, and checklists to ensure compliance with accreditation standards. It is an essential resource for DMEPOS suppliers seeking to achieve and maintain accreditation, demonstrating their commitment to quality and patient safety.
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