SAMPLE POLICY WORK

This sample portfolio shows the depth of our policies and how such detailed policies put them in compliance with both state licensing agencies, Medicaid requirements, and accreditation standards (ACHC, CHAP, Joint Commission). Each manual is backed by our 20 years of experience, a money-back guarantee, and an assignment of a policy specialist to guide your onward submission of the policy to state licensing bodies.

Table of Contents Simpl Care Services Policies Overview ................................................................................................. 13 I. AGENCY IDENTIFICATION ............................................................................................................... 13 a. Purpose and Scope .......................................................................................................................... 13 b. Detailed Policy Statements ........................................................................................................... 14 c. Roles and Responsibilities ............................................................................................................. 15 d. Procedural Guidance ....................................................................................................................... 16 f. Regulatory References and Compliance ................................................................................. 17 g. Implementation Checklist ............................................................................................................... 18 h. Communication and Documentation Standards ................................................................. 18 i. Integration and Continuous Improvement ............................................................................... 19 j. Regulatory Monitoring and Compliance Verification .......................................................... 19 II. MISSION, VISION, AND VALUES ................................................................................................. 20 a. Purpose Statement ........................................................................................................................... 20 b. Detailed Policy Statements ........................................................................................................... 20 c. Roles and Responsibilities ............................................................................................................. 22 d. Procedural Guidance on Implementation ............................................................................... 24 e. Regulatory and Compliance Provisions .................................................................................. 25 f. Implementation Checklist ................................................................................................................ 25 g. Communication and Documentation Standards ................................................................. 26 h. Interdepartmental Coordination and Continuous Improvement ................................... 27 III. ORGANIZATIONAL STRUCTURE ............................................................................................... 28 a. Organization Chart ............................................................................................................................ 28 b. Detailed Roles and Responsibilities ......................................................................................... 28 c. Lines of Authority and Communication .................................................................................... 31 d. Procedural Guidance on Utilizing the Organizational Structure .................................. 32 e. Regulatory References and Compliance Measures ......................................................... 33 f. Implementation Checklist ................................................................................................................ 34 IV. STATEMENT OF COMPLIANCE ................................................................................................. 35 a. Purpose and Commitment ............................................................................................................. 35 b. Detailed Policy Statements and Compliance Guidelines ................................................ 36 c. Roles and Responsibilities ............................................................................................................. 37 d. Procedural Guidance for Maintaining Compliance ............................................................ 38 e. Regulatory Reference Materials and Continuous Improvement ................................. 40

f. Implementation Checklist for Compliance ............................................................................... 41 g. Communication and Reporting Standards ............................................................................. 42 h. Integration with Overall Quality Assurance ........................................................................... 42 V. POLICY MANUAL PURPOSE AND SCOPE ............................................................................ 43 a. Purpose Statement ........................................................................................................................... 43 b. Scope of the Manual ........................................................................................................................ 44 c. Policy Statement on Manual Purpose and Scope .............................................................. 45 d. Procedure for Updating the Manual .......................................................................................... 45 e. Roles and Responsibilities for Maintaining and Updating the Manual ..................... 47 f. Procedural Guidance Summary ................................................................................................... 48 e. Regulatory References and Integration .................................................................................. 48 VI. TARGET POPULATION .................................................................................................................... 49 a. Purpose Statement ........................................................................................................................... 49 b. Detailed Policy Statements and Eligibility Criteria ............................................................. 50 c. Cross-Group Procedural Guidance and Documentation ................................................ 54 d. Roles and Responsibilities in Target Population Verification ....................................... 56 e. Regulatory References and Integration .................................................................................. 57 f. Communication of the Target Population Policy .................................................................. 57 VII. ELIGIBILITY DETERMINATION .................................................................................................. 58 a. Purpose and Overview .................................................................................................................... 58 b. Documentation Requirements for Intellectual Disability .................................................. 59 c. Process for Psychological Evaluations .................................................................................... 60 d. Step-by-Step Eligibility Determination Procedure .............................................................. 61 e. Roles and Responsibilities in Eligibility Determination .................................................... 64 f. Regulatory References and Integration .................................................................................... 65 g. Procedural Guidance Summary .................................................................................................. 66 h. Communication, Feedback, and Continuous Improvement .......................................... 67 VIII. LEVEL OF CARE ASSESSMENT ............................................................................................. 67 a. Purpose and Rationale .................................................................................................................... 68 b. Detailed Policy Statements ........................................................................................................... 68 c. Scope and Applicability ................................................................................................................... 69 d. Roles and Responsibilities ............................................................................................................ 70 e. Step-by-Step Procedural Guidance .......................................................................................... 71 f. Regulatory References and Compliance Integration ......................................................... 74

g. Communication and Documentation Standards ................................................................. 75 h. Implementation Checklist ............................................................................................................... 76 i. Continuous Quality Assurance and Process Improvement ............................................. 76 j. Integration with Overall Operational Framework .................................................................. 77 IX. ENROLLMENT PROCEDURES .................................................................................................... 78 a. Purpose and Rationale .................................................................................................................... 78 b. Detailed Policy Statements and Procedures ........................................................................ 78 c. Scope of the Enrollment Procedures ........................................................................................ 79 d. Enrollment Process Overview ...................................................................................................... 79 Step 1: Eligibility Confirmation .......................................................................................................... 80 Step 2: Documentation Collection and Verification ................................................................. 81 Step 3: Internal Enrollment Meeting and Review ..................................................................... 82 Step 4: External Coordination with TennCare and Relevant Agencies ......................... 83 Step 5: Official Enrollment and Final Record Update ............................................................ 84 Step 6: Post-Enrollment Follow-Up and Ongoing Quality Assurance ............................ 85 e. Regulatory References and Compliance Integration ........................................................ 86 f. Summary of Roles and Responsibilities ................................................................................... 86 g. Communication and Documentation Standards ................................................................. 87 h. Continuous Quality Assurance and Future Enhancements ........................................... 88 X. COVERED SERVICES ....................................................................................................................... 88 a. Purpose and Policy Statements for Covered Services .................................................... 89 b. Overview of Service Categories ................................................................................................. 90 XI. RESIDENTIAL SUPPORTS ............................................................................................................ 90 a. Residential Habilitation .................................................................................................................... 90 b. Supported Living ................................................................................................................................ 92 XII. DAY AND EMPLOYMENT SUPPORTS .................................................................................. 94 a. Facility-Based Day Supports ........................................................................................................ 95 b. Supported Employment .................................................................................................................. 97 XIII. IN-HOME AND PERSONAL CARE SUPPORTS ............................................................... 99 a. Personal Assistance ......................................................................................................................... 99 b. Respite Care ...................................................................................................................................... 101 XIV. THERAPIES AND CLINICAL SERVICES ........................................................................... 103 a. Nursing .................................................................................................................................................. 103 b. Occupational Therapy (OT) ........................................................................................................ 105

c. Physical Therapy (PT) ................................................................................................................... 106 d. Speech Therapy ............................................................................................................................... 108 d. Behavior Services ............................................................................................................................ 110 XV. SUPPORT COORDINATION ...................................................................................................... 111 a. Service Description ......................................................................................................................... 111 b. Goals and Objectives ..................................................................................................................... 112 c. Delivery Methods .............................................................................................................................. 112 d. Service Limitations and Caps .................................................................................................... 112 e. Roles and Responsibilities .......................................................................................................... 113 f. Procedural Guidance ....................................................................................................................... 113 XVI. ASSISTIVE TECHNOLOGY AND HOME SUPPORTS ................................................ 113 a. Service Description ......................................................................................................................... 113 b. Goals and Objectives ..................................................................................................................... 114 c. Delivery Methods .............................................................................................................................. 114 d. Service Limitations and Caps .................................................................................................... 114 e. Roles and Responsibilities .......................................................................................................... 115 f. Procedural Guidance ....................................................................................................................... 115 XVII. TRANSPORTATION ..................................................................................................................... 115 a. Service Description ......................................................................................................................... 115 b. Goals and Objectives ..................................................................................................................... 116 c. Delivery Methods .............................................................................................................................. 116 d. Service Limitations and Caps .................................................................................................... 116 e. Roles and Responsibilities .......................................................................................................... 117 f. Procedural Guidance ....................................................................................................................... 117 XVIII. ADULT DENTAL SERVICES .................................................................................................. 117 a. Service Description ......................................................................................................................... 117 b. Goals and Objectives ..................................................................................................................... 118 c. Delivery Methods .............................................................................................................................. 118 d. Service Limitations and Caps .................................................................................................... 118 e. Roles and Responsibilities .......................................................................................................... 118 f. Procedural Guidance ....................................................................................................................... 119 g. Regulatory References and Compliance .............................................................................. 119 XIX. ROLES, RESPONSIBILITIES, AND INTERDEPARTMENTAL COORDINATION ............................................................................................................................................................................ 120

a. Executive Leadership ..................................................................................................................... 120 b. Program Directors and Service Managers ........................................................................... 120 c. Direct Support Professionals and Clinical Staff ................................................................. 120 d. Support Coordinators and Case Managers ......................................................................... 121 e. IT, Records Management, and Compliance Teams ....................................................... 121 XX. PROCEDURAL GUIDANCE AND ACCESS TO SERVICES ...................................... 121 XXI. INTEGRATION OF COVERED SERVICES WITH OVERALL OPERATIONAL PROCESSES ............................................................................................................................................... 123 XXII. REGULATORY AND COMPLIANCE PROVISIONS ..................................................... 123 XXIII, SUMMARY AND ONGOING PROCESS IMPROVEMENT ...................................... 124 XXIV. INDIVIDUAL SUPPORT PLAN (ISP) DEVELOPMENT ............................................ 125 a. Purpose and Rationale .................................................................................................................. 125 b. Person-Centered Planning Process ........................................................................................ 126 c. Comprehensive Assessment Procedures ............................................................................ 128 d. Developing the Individual Support Plan (ISP) .................................................................... 129 e. Ensuring Medical Necessity and Regulatory Alignment ................................................ 131 f. Roles and Responsibilities for ISP Development .............................................................. 132 g. Step-by-Step Procedural Guidance for ISP Development ........................................... 134 h. Regulatory References and Compliance Integration ...................................................... 136 i. Interdepartmental Coordination and Communication ...................................................... 137 j. Roles, Responsibilities, and Accountability ........................................................................... 137 k. Periodic Reviews and Continuous Improvement Mechanisms .................................. 139 l. Integration with Regulatory Standards .................................................................................... 140 m. Best Practices for Implementation .......................................................................................... 140 n. Summary of the ISP Development Process ........................................................................ 141 o. Future Directions and Continuous Improvement .............................................................. 141 XXV. SERVICE IMPLEMENTATION ............................................................................................... 142 a. Overview of Service Implementation Procedures ............................................................ 143 b. Detailed Implementation Procedures by Service Category ......................................... 144 c. Staff Training and Competency Requirements .................................................................. 166 d. Documentation Standards and Communication Protocols .......................................... 168 e. Protocols for Service-Related Issues and Emergencies ............................................... 169 f. Interdepartmental Coordination and Continuous Improvement .................................. 170 g. Summary of Implementation Best Practices ....................................................................... 171

XXVI. MEDICATION MANAGEMENT ............................................................................................. 172 a. Purpose and Scope ........................................................................................................................ 173 b. Detailed Policy Statements ......................................................................................................... 174 c. Roles and Responsibilities in Medication Management ................................................ 178 d. Procedural Guidance and Step-by-Step Workflow .......................................................... 179 e. Continuous Monitoring, Audit, and Quality Improvement ............................................. 181 f. Integration with Overall Operations .......................................................................................... 181 g. Summary of Best Practices and Key Takeaways ............................................................ 182 XXVII. EMERGENCY PREPAREDNESS ...................................................................................... 183 a. Purpose and Scope ........................................................................................................................ 183 b. Emergency Plans for Various Scenarios .............................................................................. 184 c. Evacuation Procedures ................................................................................................................. 186 d. Communication Protocols During Emergencies ............................................................... 187 e. Staff Training on Emergency Preparedness ....................................................................... 188 f. Roles and Responsibilities for Emergency Preparedness ............................................ 189 g. Procedural Guidance and Implementation Checklist ...................................................... 190 h. Continuous Improvement and Future Enhancements ................................................... 191 i. Integration with Overall Operational Framework ................................................................ 191 j. Summary of Best Practices .......................................................................................................... 192 XXVIII. RECRUITMENT AND HIRING ............................................................................................ 193 a. Purpose and Rationale .................................................................................................................. 194 b. Scope ..................................................................................................................................................... 195 c. Detailed Policy Statements ......................................................................................................... 195 d. Roles, Responsibilities, and Accountability ......................................................................... 198 e. Procedural Guidance and Step-by-Step Workflow .......................................................... 200 f. Job Description Standards and Example .............................................................................. 202 g. Regulatory References and Compliance Measures ....................................................... 202 h. Continuous Process Improvement and Feedback Integration ................................... 203 i. Best Practices for Recruitment and Hiring ............................................................................ 204 XXIX. STAFF TRAINING ........................................................................................................................ 205 a. Purpose and Objectives ................................................................................................................ 205 b. Initial Orientation Program ........................................................................................................... 206 c. Ongoing In ‑ Service Training Program .................................................................................... 208 d. Training on CAC Waiver Regulations and Requirements ............................................ 210

e. Person ‑ Centered Planning Training ........................................................................................ 211 f. Service ‑ Specific Training ............................................................................................................... 212 g. CPR and First Aid Certification Training ............................................................................... 214 h. Documentation Training ................................................................................................................ 214 i. Tracking and Documentation of Staff Training .................................................................... 215 j. Roles and Responsibilities in Staff Training ......................................................................... 216 k. Procedural Workflow and Implementation Checklist ....................................................... 218 l. Regulatory References for Staff Training .............................................................................. 220 m. Continuous Improvement and Quality Assurance .......................................................... 221 n. Summary of Key Takeaways ...................................................................................................... 222 XXX. STAFF SUPERVISION AND EVALUATION .................................................................... 223 a. Purpose and Scope ........................................................................................................................ 223 b. Supervision Policies ........................................................................................................................ 224 c. Performance Evaluation Process ............................................................................................. 226 d. Disciplinary Procedures ................................................................................................................ 227 e. Procedural Guidance and Best Practices ............................................................................ 229 f. Regulatory and Compliance Considerations ........................................................................ 231 h. Ongoing Monitoring and Continuous Improvement ......................................................... 232 i. Application of Best Practices and Conclusion ..................................................................... 233 XXXI. STAFF HEALTH AND SAFETY ............................................................................................ 234 a. Purpose and Objectives ................................................................................................................ 234 b. Scope ..................................................................................................................................................... 235 c. Infection Control Policies and Procedures ........................................................................... 235 d. Injury Reporting Procedures ....................................................................................................... 237 e. Workers’ Compensation Policies .............................................................................................. 239 f. Ongoing Monitoring, Audit, and Continuous Improvement in Health and Safety ....................................................................................................................................................................... 241 g. Interdepartmental Coordination and Communication ..................................................... 242 h. Roles and Responsibilities Summary ..................................................................................... 243 XXXII. QUALITY IMPROVEMENT PLAN ...................................................................................... 243 a. Purpose and Objectives ................................................................................................................ 244 b. Scope and Applicability ................................................................................................................. 245 c. Detailed Components of the Quality Improvement Plan ............................................... 245 d. Roles and Responsibilities .......................................................................................................... 248

e. Procedural Guidance for Quality Improvement ................................................................. 250 f. Documentation and Communication of Quality Improvement Activities ................. 252 g. Integration with Overall Regulatory Compliance ............................................................... 253 h. Continuous Improvement and Lessons Learned .............................................................. 253 i. Implementation Checklist for Quality Improvement Initiatives ..................................... 254 j. Communication Strategies and Reporting Mechanisms ................................................. 255 k. Integrating QI into Organizational Culture ............................................................................ 255 l. Summary and Future Directions ................................................................................................. 256 XXXIII. INCIDENT REPORTING ........................................................................................................ 258 a. Purpose and Objectives ................................................................................................................ 258 b. Scope of the Incident Reporting Policy ................................................................................. 259 c. Definitions and Types of Reportable Incidents .................................................................. 259 d. Reporting Timelines ........................................................................................................................ 261 e. Internal and External Reporting Requirements ................................................................. 262 f. Investigation Procedures ............................................................................................................... 263 g. Roles and Responsibilities in Incident Reporting and Investigation ........................ 265 h. Communication and Documentation Standards ............................................................... 266 i. Continuous Improvement and Feedback ............................................................................... 267 j. Integration with Overall Operational Policy ........................................................................... 267 k. Procedural Workflow and Implementation Checklist ....................................................... 268 l. Continuous Improvement: Lessons Learned and Future Enhancements .............. 270 m. Communication Strategies and Reporting Mechanisms .............................................. 271 n. Integration with Organizational Excellence ......................................................................... 272 XXXIV. Record Keeping ......................................................................................................................... 272 a. Purpose and Objectives ................................................................................................................ 272 b. Scope ..................................................................................................................................................... 273 c. Detailed Policies and Procedures ............................................................................................ 274 d. Roles and Responsibilities .......................................................................................................... 278 e. Procedural Guidance for Record Keeping ........................................................................... 280 f. Documentation, Reporting, and Compliance ....................................................................... 282 g. Roles and Responsibilities for Record Keeping ................................................................ 283 h. Continuous Improvement: Monitoring, Audits, and Feedback ................................... 285 i. Communication Strategies and Reporting ............................................................................. 286 j. Integration with Organizational Goals ...................................................................................... 287

k. Implementation Summary and Future Directions ............................................................. 287 XXXV. Record Maintenance ................................................................................................................. 289 a. Purpose and Objectives ................................................................................................................ 289 b. Scope ..................................................................................................................................................... 290 c. Detailed Policies and Procedures ............................................................................................ 290 d. Roles and Responsibilities .......................................................................................................... 295 e. Procedural Workflow and Implementation Checklist ...................................................... 297 f. Continuous Improvement in Record Keeping ...................................................................... 299 h. Communication Strategies and Reporting Mechanisms ............................................... 300 i. Integration with Overall Organizational Operations .......................................................... 300 j. Future Directions and Continuous Enhancements ............................................................ 301 XXXVI. INDIVIDUAL RIGHTS ............................................................................................................. 302 a. Purpose and Rationale .................................................................................................................. 302 b. Scope and Applicability ................................................................................................................. 303 c. Detailed Policy Statements ......................................................................................................... 303 d. Roles and Responsibilities for Upholding Individual Rights ........................................ 308 e. Procedural Guidance for Ensuring Individual Rights ...................................................... 310 f. Continuous Improvement and Future Directions ............................................................... 312 g. Final Guidance .................................................................................................................................. 313 XXXVII. GRIEVANCE PROCEDURES ........................................................................................... 314 a. Purpose and Objectives ................................................................................................................ 315 b. Scope and Applicability ................................................................................................................. 316 c. Definitions and Types of Grievances ...................................................................................... 316 d. Filing a Grievance: Step-by-Step Process ........................................................................... 318 e. Roles and Responsibilities in the Grievance Process .................................................... 322 f. Communication of the Grievance Procedures .................................................................... 324 g. Continuous Improvement in Grievance Management .................................................... 324 h. Implementation Timeline .............................................................................................................. 325 i. Quality Assurance and Performance Metrics ....................................................................... 326 j. Reporting and Regulatory Compliance ................................................................................... 326 k. Roles and Responsibilities Summary ..................................................................................... 327 l. Continuous Improvement and Future Enhancements ..................................................... 328 m. Communication Strategies and Reporting .......................................................................... 329 n. Documentation and Training in Grievance Procedures ................................................. 330

o. Integration with Overall Organizational Goals .................................................................... 331 p. Future Directions in Grievance Management ..................................................................... 332 q. Implementation Checklist for Grievance Procedures ..................................................... 332 r. Continuous Improvement in Grievance Management ..................................................... 334 s. External Reporting and Regulatory Compliance ............................................................... 334 t. Summary of Key Takeaways ....................................................................................................... 335 u. Final Remarks ................................................................................................................................... 336 XXXVIII. BUDGETING AND FINANCIAL REPORTING ......................................................... 336 a. Budget Development and Monitoring Process .................................................................. 337 b. Financial Reporting Requirements .......................................................................................... 340 c. Internal Financial Controls and Fraud Prevention ............................................................ 342 d. Roles and Responsibilities for Budgeting and Financial Reporting ......................... 343 e. Procedural Workflow of Budgeting and Financial Reporting ...................................... 345 f. Communication Strategies and Reporting Mechanisms ................................................ 347 g. Continuous Improvement and Future Enhancements ................................................... 347 h. Summary and Key Takeaways .................................................................................................. 349 XXXIX. CONFIDENTIALITY ................................................................................................................. 350 a. Purpose and Scope ........................................................................................................................ 350 b. Confidentiality Policies and Procedures ................................................................................ 351 c. Roles and Responsibilities for Confidentiality .................................................................... 355 d. Incident Reporting and Breach Management ..................................................................... 356 e. Training and Compliance on Confidentiality ....................................................................... 357 f. Regulatory References and Compliance ............................................................................... 358 g. Implementation and Continuous Improvement .................................................................. 359 h. Final Guidance .................................................................................................................................. 361 XL. CONFLICT OF INTEREST ........................................................................................................... 362 a. Purpose Statement ......................................................................................................................... 362 b. Detailed Policy Statements ......................................................................................................... 362 c. Roles and Responsibilities ........................................................................................................... 363 d. Procedural Guidance ..................................................................................................................... 364 e. Regulatory References ................................................................................................................. 364 XLI. ETHICAL CONDUCT ..................................................................................................................... 365 a. Code of Ethics for All Staff Members ..................................................................................... 365

b. Procedures for Addressing Ethical Dilemmas and Reporting Ethical Violations ....................................................................................................................................................................... 366

Simpl Care Services Policies Overview I. AGENCY IDENTIFICATION Introduction : This section outlines the fundamental aspects of agency identification for Simpl Care Services LLC. It establishes the necessary policies and procedures that ensure clarity regarding the agency’s official identity, contact details, and operating addresses. This identification framework is critical for internal consistency, regulatory compliance, and providing a reliable reference point for external stakeholders, including auditors, TennCare representatives, service users, and community partners. The following components are detailed in this section: • Official Agency Name: Simpl Care Services LLC • Headquarters Address: 2229 N Canal View Ln, Heber City, UT 84032 • Tennessee Operating Address: 123 Main Street, Nashville, TN 37201 • Contact Information: – Phone: 435-395-8213 – Email: wyatt@simplcareservices.com – Website: www.simplcareservices.com The policy is structured to include purpose statements, detailed policy statements, scope definitions, roles and responsibilities, step-by-step procedural guidance, and supporting regulatory references. Each section below explains the guidance and requirements for implementing and maintaining agency identification information.

a. Purpose and Scope

Purpose Statement The primary purpose of the Agency Identification policy is to ensure that all communication, documentation, and administrative processes accurately reflect the official information of Simpl Care Services LLC. This promotes transparency, regulatory adherence, and consistency across all operations, whether internal or external. It serves to outline the agency’s core identification elements that serve as the foundation for legal, operational, and support functions in accordance with CAC Waiver TN.0357.R05.00 and relevant state and federal regulations. Scope This policy applies to all Simpl Care Services LLC staff at every level, including executive leadership, administrative personnel, care service directors, and technology development teams. Additionally, it is essential for maintaining compliance with regulatory bodies such as TennCare and other state or federal agencies. External auditors and stakeholders must also reference this section when assessing the agency’s operational framework.

b. Detailed Policy Statements

Official Agency Name

Policy Statement: Simpl Care Services LLC is the official and legal name of the agency. All policies, communications, promotional materials, contracts, and regulatory documentation must use this exact name to prevent any misinterpretation or ambiguity regarding the entity's authority and responsibility. • Principle: The use of the official agency name fosters identity and trust among service users, partners, and regulatory bodies. • Requirement: All internal and external materials must strictly refer to the agency as “Simpl Care Services LLC” with no variations or abbreviations, unless explicitly approved by executive leadership.

Headquarters Address

Policy Statement: The registered headquarters of Simpl Care Services LLC is located at 2229 N Canal View Ln, Heber City, UT 84032. This address is the central locus for official corporate records, administrative operations, and legal correspondence. • Principle: Identifying a precise headquarters reinforces the accountability structure and supports accurate record keeping. • Requirement: All legal documents, contracts, and official communications must include the headquarters address as the primary point of contact for corporate matters.

Tennessee Operating Address

Policy Statement: Simpl Care Services LLC operates in the state of Tennessee at the designated service delivery location. The operating address for our Tennessee operations is ________________________________________________. This office is responsible for the execution of person-centered care services in line with state regulations and CAC Waiver requirements. • Principle: Specifying the Tennessee operating address ensures that state oversight agencies and local service users can easily locate and access services. • Requirement: All regulatory submissions, local licensing documents, and operational records will include the Tennessee operating address.

Contact Information

Policy Statement: To facilitate clear and consistent communication, Simpl Care Services LLC has

designated the following contact details. These ensure that inquiries — whether administrative, support-related, or regulatory — are directed to the appropriate channels.

•

Phone: 435-395-8213

•

Email: wyatt@simplcareservices.com

•

Website: www.simplcareservices.com

• Principle: Providing unified contact details minimizes communication errors and establishes a single point of contact for all stakeholders. • Requirement: Every external communication channel, whether digital or print, must reflect these contact details accurately. Updates or modifications must be reviewed and authorized by the executive leadership team before dissemination.

c. Roles and Responsibilities

Agency Leadership:

• Executive Director/CEO: Responsible for the final approval and periodic review of the Agency Identification policy. The executive director ensures that all published materials consistently display the correct agency identification information. • Compliance and Regulatory Affairs: This team is tasked with updating regulatory references and ensuring that any changes in addresses, names, or contact details are promptly reflected in all submissions and reports. • Communications Department: Charged with the creation and distribution of official documents, this department verifies that all materials contain the updated and correct agency identification details. • Administrative Personnel: Ensures that databases, file systems, website content, and other informational repositories are up-to-date with the correct agency identification details.

Roles of Specific Personnel:

• Policy Coordinator: Oversees the overall maintenance of the Agency Identification section, ensuring that it is up to date and compliant with regulatory standards. • Office Manager (Heber City): Maintains records at the headquarters and coordinates with administrative teams to update any changes in contact information. • Regional Manager (Tennessee): Monitors the Tennessee operating address and ensures that local compliance with state regulations is maintained. • IT Support: Ensures that the agency’s website and digital communications consistently reflect the correct agency information and that any changes are quickly implemented.

d. Procedural Guidance This section provides step-by-step instructions for ensuring proper implementation and maintenance of agency identification information across Simpl Care Services LLC operations.

Verification and Documentation:

– Step 1: The designated office manager or policy coordinator verifies that the agency’s official name, headquarters address, and Tennessee operating address are correctly listed in all central records. – Step 2: Conduct an annual review of the agency’s official records. This review includes verifying that printed materials, online content, and regulatory submission documents use the accurate and authorized agency identification information.

Internal Communication and Training:

– Step 3: Disseminate the updated Agency Identification information to all staff during periodic training sessions. Include a dedicated module outlining the significance of accurate agency identification for compliance purposes. – Step 4: Provide quick reference guides and digital call-out cards that list the official agency name, addresses, and contact details. These guides should be accessible via the agency’s internal portal.

Change Management:

– Step 5: If any modifications are necessary (e.g., change of headquarters address, updates in contact details), the changes must be submitted in writing to the Policy Coordinator. – Step 6: Upon receipt of the change request, the executive leadership evaluates the implications, enforces regulatory compliance mandates, and authorizes the change. – Step 7: Once approved, the updates are communicated to the Compliance and Regulatory Affairs team and then to all relevant departments. The designated IT Support personnel then update all digital and print formats.

Regulatory and External Communication:

– Step 8: Ensure that all regulatory submissions, including TennCare reports and CAC Waiver documentation, include the correct addresses and contact information. – Step 9: Implement a tracking mechanism to log all changes made to the Agency Identification details. This log must include the date of the change, the rationale, and the approving authority.

Audit and Compliance Monitoring:

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