Agreement: Statement of Home Care Services

The Statement of Home Care Services form may be used to meet the requirement that a home care provider must provide to each client a written statement that identifies the services which the provider is authorized to provide, and which services the provider cannot provide under the scope of the provider’s license, as outlined in MN Stat. Sec. 144A.4791, subd. 3.

ResiDex has implemented this information into the "Resident Agreement" feature.  

Specifying Services Your Facility Provides:

  • Go to the Setup Tab: Click on Agreements on the left
  • Select "Home Care Services Offered" on the right
  • Select any service by clicking on the box and it will indicate services your facility offers

Modifying the Agreement:

  • You may wish to review our article on Customizing Your Agreement to assist with this step
  • If you wish to have the above information on its own page, follow the sample below

Note: The sequence creates the order.  When creating your agreement, it is recommended that you place "gaps" in the number sequence so you can add items such as titles or headings in later if you wish.

The sequence numbers themselves are not limited but you ARE limited to 23 line items.  You can have any combination of text and component items UP TO 23 Items.

What it Looks Like:

  • From the Resident Profile screen open your Snap Report: "Resident Agreement"
  • Print or preview this report
  • You will have a page with the "Home Care Services Provided"