Here are the key points to staying within professional boundaries: - Maintain a helpful relationship focused on the client's needs rather than your own. Do not overshare personal details. - Understand that a client's behavior may be symptomatic of an underlying condition, and avoid taking things personally. - Address clients respectfully without nicknames or terms of endearment, which could imply a non-professional level of familiarity. - Do not discuss private matters like pay or personal lives with clients. Keep conversations focused on their care. - If a situation becomes stressful, remove yourself briefly and re-approach with a calm demeanor. Ask if there are alternative ways to resolve issues. - Recogn

1. PennCares
Summer Training
2023

2. Penncares Summer
2023 Training
• DIRECTOR'S MESSAGE
• AGENCY CHANGES
• COMMUNICATION, ATTENDANCE, AND INOVA
• PROFESSIONALISM – PROFESSIONAL BOUNDARIES
PHILOSOPHY
• POLICIES AND PROCEDURES
• BEAT THE HEAT: HEAT RELATED ILLNESS
PREVENTION, AND THE IMPORTANCE OF
HYDRATION
• ANNOUNCEMENTS AND CURRENT EVENTS
• WELLNESS
• PHA VIDEOS

3. MESSAGE FROM THE DIRECTOR
Hello caregivers and welcome to your summer training. I am Deborah Allen, the
Executive Director of PennCares. Before we dive into your training, I just wanted to
mention that it is with great pleasure that I welcome you to PennCares if you are a
new caregiver, and recognize you if you are one of our current and dedicated
caregivers. Compassion and kindness are sometimes rare to find, and I am thankful
and excited you are here at PennCares. It is individuals like you who make me
believe in humanity. Medicines may heal the body, but it’s the warmth of your soul
that heals the heart. So, I want to say thank you for your dedication to PennCares
and for being one of our devoted caregivers. Please remember some important
Caregiver support strategies-
 Keep your nutritional and physical fitness in mind: Eat right, get the proper amount of sleep, exercise on
a regular basis, and make regular visits with your doctor to get the best possible care.
 Reconnect with your spirituality: Consider what matters to you and how you can connect your values to
the support you provide.
 Focus on problem solving: Often, tactical problems can be solved with a little bit of brainstorming and
cooperation. List challenges and come up with strategies together as a family.

4. MESSAGE FROM THE DIRECTOR
It's easy to lose yourself while you're focused on caring for someone else, but you are not alone. Self-care and
connection strategies include:
•Get support. There are many local resources and caregivers supports. Please talk with your supervisor if you feel
you need any support.
•Set realistic expectations. Have patience and focus on the things that go well, not on setbacks or failures. Be open
to change and look for creative solutions instead of "perfect" results.
•Stay true to your priorities.
•Take time for the things you enjoy, and prioritize your own needs.
“To care for those who once cared for us is one of the highest
honors.”– Tia Walker
Thank you again for all you do for your consumers and for
PennCares. Now please enjoy your summer training.

5. Agency Changes
With the state cracking down please be sure of the following
• Clocking in/out must be done from the clients home with the use of the Generations app
or Telephony 1-866-595-7534 (using the client’s telephone). If you are running errands,
you must first go to the client's house and clock in. If there is a doctor appointment at the
start or end of the shift, please call the office to adjust the schedule. Using these methods
there should seldom be a reason for time sheets. This is how you get paid and how we
verify you were there.
• Every unchecked task needs to have a note stating why it was not completed. The note
needs to say “the client did not need for the day”, or “offered and the client refused”.
• Visit Notes need more detail than “Good shift.” Here is an example of an acceptable visit
note: When I arrived JoJo was still sleeping. I helped them up for the day and get a shower.
While in the shower I noticed an open wound on their thigh. Cleaned and bandaged it. I
helped get their clothes on for the day. I made breakfast and reminded to take their meds.
While they were eating, I made the bed and started laundry and vacuumed. After they ate,
I helped them to the living room and into their chair for the day. They did not need
anything else from me today. JoJo was in good spirits today.

6. Agency Changes continued
• Mileage is only to be entered for errands ran for the client using your own
vehicle. Trips to the grocery store, doctor appointments, pharmacy trips etc.
Make sure to include in your visit note where you went for the day and be
specific. Please keep in mind we only reimburse 20 miles per week, per client.
We should not be providing mostly transportation.
• Incident reports are on the HCMtoGo app under HR, other forms.
-When do I fill this out?? Anytime there is an ER visit, hospitalization, fall, they
refuse or forget meds, they have open wounds, anything out of the ordinary.
Reports of abuse, neglect, theft. “When in doubt, Fill it out”.
•Please go into the HCMtoGo app and under HR>other forms>Tb questionnaire
and information, complete this form and submit it. It is 5 pages.

7. Importance
of
Communication

8. Texting
Due to the excessive
number of text messages
being received at all
hours of the day and
night, there is to be NO
texting between the
hours of 8:00pm and
6:00am.
• As a reminder for emergencies and
calling off, you must call the on-call
number. Texting is NOT acceptable. Texting
off will be considered an unexcused
absence.
• PennCares On-Call: 717-632-5552 option 4
Caregivers Email: caregivers@penncares.org

9. Shift
Changes
and
Tardiness
If you are going to be late for a shift, you
MUST inform the office so proper
accommodations can be made, even if you
have discussed with the consumer already.
If a shift time needs to change and you and
the consumer have already discussed it, you
still need to contact the office so the shift can
be adjusted on the calendar and approved.
717-632-5552 option 4

10. PennCares
Attendance
Policy
Absences
• Caregivers who will not be present for their shift must call 717-
632-5552 option 4, at least 2 hours before the scheduled shift
• Absences may require a note from a doctor
• Progressive discipline will begin after 1 unexcused absence, a no-
call/no-show will result in discipline up to and including
termination
Tardiness
• Caregivers are expected to clock in and out within 7 minutes of
the scheduled shift time
• Discipline for tardiness starts after 3 instances
• Without authorization, caregivers will only be paid for the original
shift times
EVV (Electronic Visit Verification)
• If your shift starts immediately after another caregiver’s shift
ends, please make sure that caregiver is logged out before you log
in.

11. Requesting Time Off

12. Missed Punch Forms

13. Participant Complaint Resolution -PennCares
Grievance Policy 200-008
• Penncares Support Services (PENNCARES) provides consumers with a procedure for bringing grievances to the attention of
management, and to resolve such problems promptly. Consumers are encouraged to utilize the grievance procedure and must not,
under any circumstances, be penalized for doing so.
Grievance Steps are as follows:
1. The first step is for the consumer to present the grievance, either verbally with a formal complaint call or written using the
grievance form. The grievance should be presented as soon as is practical.
2. If the grievance is called in to the office the complaint should be documented in the EVV system as such. If the complaint can be
resolved on the phone the resolution should also be documented. That documentation should include the date of the complaint if
different than the date of the note, name of participant, nature of complaint, actions to resolve complaint, and participants
satisfaction of resolution. If resolution cannot be completed immediately then complaint should be resolved within five days
of initial complaint. If that is not possible than an additional note should be added to the EVV system to explain why the complaint
hasn’t been resolved.
3. If the grievance is submitted in written form from consumer that written documentation should be uploaded to the EVV system
when completed. A note should also be put in the EVV system.
4. If the grievance is not or cannot be resolved by the immediate supervisor, the grievance will be escalated to the Program Director.
5. If the written grievance is not or cannot be resolved by the Program Director, the grievance will be escalated to the Executive
Director or Assistant Executive Director.
6. Complaints will be analyzed quarterly during the quarterly in-home meetings.

14. Quality Management Plan –
PennCares Quality Management Policy 100-012
• Penncares Support Services has a quality management plan to ensure program compliance with regulations, safeguard the health and
safety of individuals receiving services, implement promising practices, and offer the highest quality services that promote choice and
control in individual’s everyday lives.
1. The Quality Management Committee (QMC) shall be made of the Director of In-Home and other various members of the In-Home
Program.
2. Committee members should elicit feedback from their direct report staff and report such feedback at the QMC meeting.
3. A Quality Management Plan shall be in place and updated at least annually by the committee. Measurable goals and outcomes will be
detailed in the Quality Management Plan. This plan will contain measurable goals as defined by 52.11(a)(5)(viii).
4. Meetings shall be held quarterly in July, October, January, and April within a fiscal year running July 1 through June 30. Time and location
to be determined and distributed to the QMC two weeks prior to meeting.
5. Standing items on the Quality Management Meeting Agenda shall be:
• a. Review of incidents
• b. Review of complaints
• c. Review of any corrective action plans
• d. Policy and Procedure review
• e. Reports on audits of each program
• f. Review of monthly data for all programs
6. The quarterly meeting will also include an analysis of participants complaints and satisfaction of the resolution of the complaint. This will
allow the agency to determine the root cause of the failures and successes of complaints and help revise the quality plan as needed.

15. Attendant Care Program Policy 300-007
Policy Statement: PennCares Support Services states the following purpose of Pennsylvania Attendant
Care Service. This service is to enable eligible adults, ages 18 and older, who are mentally alert and
physically disabled to perform activities of daily living that they would ordinarily perform themselves,
were it not for their disability. Using state and federal funding in addition to the participant’s own
resources. The Attendant Care Service is designed to help disabled individuals to perform these activities
and live as independent as possible.
Procedures:
• 1. The Attendant Care Service is designed to support eligible adults in improving their quality of life
by achieving one or more of the following goals:
a. Enabling participants to live in the least restrictive environments as independently as possible.
b. Enabling participants to remain in their homes and preventing unnecessary admission to nursing
homes or other similar institutional settings.
c. Enabling participants to seek and/or maintain employment.
• 2. Attendant Care Services consist of the following:
a. Basic – Assistance in getting out of bed, wheelchair, and/or motor vehicle. Assistance with routine
bodily functions including, but not limited to: Bathing and personal hygiene, Dressing and grooming,
Eating, including meal preparation and clean up.
b. Ancillary – if a person is assessed for needing one or more of the basic services above, the following
services may be provided in conjunction with the basic services:
1. Homemaker type services
2. Companion type services
3. Assistance wth cognitive tasks type services

16. Attendant Care Program continued…
c. Health Maintenance – Activites may be provided if requested by the participant and/or if required by the service plan. These
activities are necessary to maintain the health where normal bodily functions would be carried out by the participant were they
physically able to.
1. Indwelling catheter care
2. Assistance with self-medication
3. Superficial wound care – gauze and bandage only
4. Assistance with bowel programs – non-invasive
Caregivers may perform health maintenance under the following conditions:
1. The provider has assessed the participant being capable of directing and supervising the caregiver in the specified health
maintenance activities. This includes the participants’ competency for each consumer receiving specialized tasks for each
caregiver assigned.
2. The caregiver’s proper experience and work history do not indicate the unsafe performance of such activities.
3. The caregiver providing the health maintenance activities has read and understands the participant’s service plan.
4. The participant is aware of the risk of caregiver performing requested task and consumer understands the impact of these
choices
5. The participant assumes responsibility for results of the choices.
6. The service plan documents need for assistance with non-skilled activity to facilitate ability to live independently.
7. There is an order from physician or service authorization to perform such tasks.
8. The caregiver and participant have read and understands policies related to the specific task.

17. Attendant Care Program continued…
-3. Minimum Qualifications of Personal Care Assistants – Because of the need to protect the health and welfare of the
participant. The Pennsylvania Attendant Care Program has established the following minimum standards for employment of
Personal Care Assistants for PennCares Support Services.
a. Be 18 years of age or older
b. Have the required skills to perform caregiver care services as specified in the participant’s service plan.
c. Possess basic math, reading and writing skills.
d. Possess a valid social security number
e. Be willing to submit to a criminal records check.
f. Demonstrate the ability to perform health maintenance activities required by the participant and/or specified in the
participant’s service plan or be willing to receive training in performance of the specified health maintenance activity.
-4. PennCares Support Services will design and provide a program that meets the following goals:
a. Participants have the right to make decisions about and direct the provision of and take an active role in their home-care.
b. PennCares Support Services has an array of services available to assist and support a participant. Such assistance will be
provided at the request of the participant.
c. In-Home care may be available any day of the week or any hours of the day or night depending upon the personal care needs
of the participant. If service hours become difficult to fill and the participant’s backup plan fails, participants and PennCares
Support Services will work together to obtain needed care.
5. All PennCares Support Service In-Home employees are fully insured.

18. Elder Abuse and Neglect
Please review the OLTL Critical Incidents Adult
Protective Services and Older Adult Protective Services
Webinar Powerpoint. It contains every bit of
information you might need regarding abuse including
definitions of different types of abuse, how to spot it,
and how to report it. I have attached links to the OLTL
presentation and ACT 28 document at the bottom of
the slide. (Copy and paste the web address into a
separate browser page).
Web address for the OLTL Adult Protective Services Webinar:
https://www.dhs.pa.gov/providers/Documents/Training/OLTL%20Critical%20Incidents,%20Including%20Adult%20Protec
tive%20Services%20Older%20Adult%20Protective%20Services%20Webinar%20PowerPoint.pdf
Act 28:
https://www.aging.pa.gov/organization/advocacy-and-
protection/Documents/Acts%20Three%20Panel%20updated%202016.pdf#:~:text=%20Neglect%20of%20Care%20Depend
ent%20Person-
%20%28Act%2028,their%20needs%20for%3A%20food%2C%20shelter%2C%20clothing%2C%20personal%20care%2C

19. Professional Boundaries for Caregivers
Main Learning Points:
-Identify professional boundaries for caregiver
-Maintain a helpful relationship with clients
-Learn how to stay in bounds
-Understand why professional boundaries are important
Professional Boundaries are guidelines for maintaining a positive and
helpful relationship with your clients. Understanding boundaries helps
caregivers avoid stress and misconduct, recognize boundary crossings and
provide the best possible care.
-Maintaining professional boundaries helps you maintain a helpful or
"therapeutic" relationship with your consumer.
-Are my actions more about my needs than about the needs of my clients?

20. How to Stay In-Bounds
Crossing the Boundary
• Sharing Personal Information: Talking about
your own personal life or problems may
cause the client to see you as a friend as
opposed to a home care professional.
• Not Seeing Behavior as Symptomatic:
Responding emotionally to behaviors caused
by symptoms
• Nicknames/Endearments: Calling a client
'honey' or 'sweetie' may be comforting or
may suggest a more personal interest than
you intend. Some clients could find it to be
offensive.
Staying In Bounds
-Use caution when talking about your personal life
-Don't share information because you need to talk
-Don't discuss your payrate with clients or other caregivers
-Remember that your relationship is not social
-Client's behavior may be the result of a disorder
-Know the client's care plan
-Step back and re-approach the client later
-Ask yourself if there is a way to problem solve
-Avoid using terms like honey or sweetie
-Ask your client how they'd like to be addressed
Some may allow you to use their first name. Others might
prefer a more formal approach.

21. How to Stay In Bounds
Crossing the Boundary
• Touch: Touch is a powerful tool. It can be
healing and comforting, or it can be
confusing, hurtful, or simply
unwelcome.
• Unprofessional Demeanor: Demeanor
includes appearance, tone and
volume of voice, speech patterns, body
language, etc. Personal and professional
demeanor may be different.
• Gifts/Tips/Favors: Giving or receiving of
gifts, or doing special favors, can blur the
line between a personal relationship and
a professional one. Accepting a gift from a
client might be taken as fraud or theft
by another person, family member, or
even the law.
Staying In Bounds
-Use touch only when it will serve a good purpose
-Ask your client if they are comfortable with your
touch
-A client may react differently than you intend
-Be sure you are serving clients needs and not your
own
-Clients may be confused by loud voices or fast talk
-Good personal hygiene is a top priority due to close
proximity to clients
-Off-color jokes, racial slurs, profanity are
inappropriate
-Be aware of your body language and facial
expressions
-Do not accept tips, gifts, or favors from a client or
family
-Practice saying NO graciously
-It is ok to tell clients that you are not allowed to
accept tips or gifts
-To protect yourself, report any offer or gift that is
unusual or large.

22. How to Stay In Bounds
Crossing the Boundary
• Over-involvement: Signs may include
spending inappropriate amounts of
time with a client, visiting the client
when off duty, trading assignments to
work with a particular client. Under-
involvement is the opposite and may
include disinterest or neglect.
• Secrets: Secrets between you and a
client are different than
client confidentiality.
Confidential information is
shared with few other members of a
team providing care. Personal secrets
compromise role boundaries and can
result in abuse or neglect of a client.
Staying In Bounds
-Focus on the needs of those in your care,
rather than personalities
-Don't confuse the client's needs with
your own needs
-Maintain a helpful relationship. Treat
each client with the same quality of care
and attention
-Ask yourself; Are you becoming overly
involved with a client's personal life. If so,
please let us know!
-Do not keep personal or health-related
secrets with a client
-Remember that your role is to accurately
report any changes in your client's
condition

23. Getting Back In-Bounds
What should you do if you're not sure about stepping over boundaries? Have you crossed
the professional boundary? Have you thought about it? Have you observed someone else
crossing the line?
• Talk to a trusted colleague
• Talk to you supervisor
• Consider a re-assignment
• Explain to clients that you are unable to behave in certain ways due to professional guidelines (ex. Accept
gifts, keep secrets, etc.)
• To protect yourself, draw a line between your work life and your private life
Why do you believe that professional boundaries are important?

24. Beat The Heat:
Tips for the
Summer

25. Beat The Heat...

26. Beat
the
Heat...

28. Announcements and Current Events
-Join PennCares VIP group on FaceBook
Gain access to news and current events
Share your stories and ideas, interact with
fellow team members
Daily themes including Motivation Monday,
Trivia Tuesday, Wellness Wednesday and
more…

29. MAJOR
ANNOUNCEMENT
• Starting with our fall training in
October, we will be hosting all
mandatory trainings live, in-person
at our home office in Hanover.
There will be hands-on training
covering many skills and
techniques. You will be given a
choice of sessions to attend based
on your schedule and availability.
More details will be released in the
near future.

30. Could one conversation gift YOU
with a NEW BREATH OF LIFE?
95% Success Rate
Take the First
Step Toward
OFFERING 30 MINUTES
COMPLEMENTARY SESSIONS!
Book an appointment to discover
Are you feeling stuck between the
desire to smoke and the desire to
be free? Are you looking for an
effectiv
e
way to qui
t
smoking
without missing cigarettes, but feel
you’ve heard it all before and don’t
know where to start?
It’s time to make a choice for lasting change and make a real shift happen. To
move away from self-sabotage to self-care, to feel your very
best.
Do you wonder about:
• Getting your health back on track and improving your breathing, energy, and finances
even if you’ve been smoking all your
life?
• Becoming mentally healthier, happier, and more confident even if those things seem
hard or out of reach right now
?
• And letting go of the constant worry and guilt of how you might be harming your health
and the anxiety of thinking about your next cigarette
?
fivepillarshealthcoaching@gmail.com
A Tobacco-Free Life

31. PHA Video Training
-Direct Care Workers and Medication Assistance (8:03)
-Importance of Nutrition and Diet for Good Health (12:20)
-Tools to Help Lift and Transfer Consumers Safely (16:21)
-Back Anatomy and Body Mechanics (9:51)
-Improving Cultural Competency in Home-Based Care (9:57)
-Professionalism (21:34)
-Caregiver First Aid (16:31)
-CPR for Caregivers (13:19)
-Being Safe While Bringing Care Home (9:23)
-The Importance of Protecting a Senior’s Skin (17:40)
-Caring for Obese, Paralyzed, or other Immobile Consumers (17:33)
-Understanding Activities of Daily Living (9:01)
-Incident Reporting (11:50)
-Elder Abuse and Neglect (7:19)
-Preventing Fraud and Financial Abuse of Seniors (13:40)
-Ethical Behaviors-What’s Right and Wrong (12:56)
-Understanding HIPAA and Confidentiality (5:54)
learningcenter.pahomecare.org
contact me at rfarbman@penncares.org or 717-213-8275

32. Direct Care Workers and Medication Assistance
Objective 1: Gain understanding of the 2016 Department of Health policy expanding the services direct care workers can perform in the home
Objective 2: Understand the characteristics of consumers who meet the criteria to receive specialized care at home.
Objective 3: Learn about the types of care that are allowed under the policy, and those that are still restricted.
Importance of Nutrition and Diet for Good Health
Objective 1: Educate homecare aides about the importance of nutrition and a healthy diet for their clients' health
Objective 2: Provide the basics of healthy food preparation
Objective 3: Learn the cornerstones of a healthy diet, especially for those with medical conditions
Objective 4: Discuss the importance of proper hydration, as well as nutrition, in preventing and treating pressure ulcers. Learn the dos and don'ts for treating these wounds.
Tools to Help Lift and Transfer Consumers Safely
Objective 1: Understand the proper mechanics for lifting and transferring consumers
Objective 2: Identify specific tools, technologies and resources to assist homecare aides with lifting and transferring, including Hoyer lifts, slipsheets, etc.
Objective 3: Learn from demonstrations about the right and wrong way to transfer a consumer
Back Anatomy and Body Mechanics
Objective 1: How understanding the anatomy of the back can help prevent injury
Objective 2: Why practicing proper body mechanics is essential to your quality of life
Objective 3: Learn the B.A.C.K. method of lifting and when to apply it
Improving Cultural Competency in Home Based Care
Objective 1: Educate homecare aides about the importance of nutrition and a healthy diet for their clients' health
Objective 2: Provide the basics of healthy food preparation
Objective 3: Learn the cornerstones of a healthy diet, especially for those with medical conditions
Objective 4: Discuss the importance of proper hydration, as well as nutrition, in preventing and treating pressure ulcers. Learn the dos and don'ts for treating these wounds.
Professionalism
Objective 1: Understand what makes a professional direct care worker
Objective 2: Learn why physical appearance is important to the care of the consumer
Objective 3: Learn the appropriate way to address the consumer

33. Caregiver First Aid
Objective 1: Discuss basic first aid tips for caregivers
Objective 2: Explore scenarios, including choking, falls, cuts, allergic reactions, and other common dangers
Objective 3: Understand the importance of having a plan in place for common emergencies
CPR for Caregivers
Objective 1: Learn how to safely prepare for performing CPR in a home environment.
Objective 2: Learn the steps to performing CPR on your consumer.
Objective 3: Demonstrate the steps to perform CPR.
Being Safe While Bringing Care Home
The Importance of Protecting a Senior’s Skin
Objective 1: Learn how aging skin is sensitive and susceptible to diseases and conditions, such as irritation, scaling, and infection, as it becomes more thin and dry over
time.
Objective 2: Discuss the best practices of a proper skin care routine for aging skin.
Objective 3: Review the Pennsylvania Department of Health’s specialized care policy expanding services direct care workers can perform in the home, including basic wound
care.
Objective 4: Learn how direct care workers can play a vital role in managing basic wounds, preventing pressure ulcers, and changing dressings, as well as how to recognize
when additional intervention is needed and how to report.
Caring for Obese, Paralyzed, and Other Immobile Consumers
Objective 1: Understand the challenges related to caring for someone who is obese (BMI greater than 40), suffers from full or partial paralysis or who is otherwise unable
to move
Objective 2: Learn about the effects immobility can have on a consumer’s overall health, including skin breakdown and pressure ulcers
Objective 3: Discuss home equipment options that may help aides care for these consumers
Understanding Activities of Daily Living
Objective 1: Identify the six major ADLs
Objective 2: Understand how ADLs affect the consumer
Objective 3: Implementing skill modifications for ADLs
Objective 1: Learn about precautionary measures to take before entering a consumer's home
Objective 2: Learn safety tips while in the consumer's home
Objective 3: Learn the appropriate steps to take if in an unsafe condition

34. Course Content Index
-Elder Abuse and Neglect-
Objective 1: To recognize the signs of abuse
Objective 2: To understand what constitutes neglect
Objective 3: To recognize subtle forms of abuse
-Preventing Fraud and Financial Abuse of Seniors-
Objective 1: Understand common types of fraud and financial exploitation of
seniors
Objective 2: Discuss ethical standards for direct care workers in the home with
the people they care for
Objective 3: Identify potential fraud and exploitation and learn how and where
to report through discussion of scenarios
-Incident Reporting-
Objective 1: Understand which incidents are reportable.
Objective 2: Understand why they need to report the incidents.
Objective 3: Learn how to report the incident to the proper people.

35. -Understanding HIPAA and Confidentiality-
Objective 1: Why HIPAA is important
Objective 2: What “need to know” means
Objective 3: Understanding who should have access to sensitive documents
-Ethical Behaviors – What's Right and Wrong-
Objective 1: Discuss the basic definition of ethics, the difference between law and
ethics and how it applies to homecare aides
Objective 2: Understand how the basic principles of ethics - honesty, respect,
safety and reliability - apply to homecare aides serving consumers in their homes
Objective 3: Learn the rights of clients and the rights of the homecare aide
Objective 4: Case studies on ethical situations