Level 1

Level 2

Level 3

Aide$16.50

Aide$17.00

Aide$17.50

Feed pets and water plants.

Special projects at the clients direction such as cleaning

Maintain Calendar and organize mail.

Engage in activities such as board games and memory

Client Care Worksheet

Assist with personal care i.e. bathing, dressing, grooming and

hygiene, companionship and medication reminders.
Linen Change and laundry including sheets, towels and
clothing
Meal preparation including special diets followed by dishes
and kitchen clean up.
Grocery shopping, pharmacy pick up and other errands Such
as Transportation or accompaniment to the bank, salon,
religious services, airport, medical and other appointments.
Maintenance of an already clean home including vacuuming,
dusting, mopping, counter tops, sweeping house, patio,
bathroom, kitchen care, and taking out the garbage.
Provides a supportive environment and ongoing reality
orientation to confused patients using appropriate
interpersonal behavioral techniques.

closets.

books and reading.

Record daily notes and report any change in patients mental

Use of special equipment i.e. Hoyer lift.

Assisting patient on and off bedpan, commode and toilet.

Assistance with exercises programs and range of motion as

Administer special skin care as directed.

Collect stool, sputum and urine specimens using appropriate

and physical condition or situation to the nurse.

Preparing and serving normal diets. Assisting patient with
eating monitors intake.
Assisting with care of teeth and mouth.
Assistance with exercise programs and range of motion as

Stand by

directed by a medical professional.

Assisting patient with self-administered, oral medications that
have been ordered by the Doctor.

directed by a medical professional.

techniques.
Reinforce dressing and change simple non-sterile
dressing.**
Assist with the use of devices geared to disability to aid in
daily living.**
Assist patient with prescribed exercises which the Home
Health Aide has been taught by the appropriate professional
personnel. **
Apply prescribed ice cap or ice collar. **

Perform simple Urine test for sugar, acetone or albumen and

record results. **
Take and record Temperature, pulse and respiration as

directed.
Measure and record intake and output.

Reinforce Sterile dressing.

Empty Urinary or Ostomy Bag, and changes to a Colostomy

bag.
Cleanse Catheter Insertion Site.

Assisting patient in transferring from bed to chair, to

wheelchair and in walking with or without devices.

ADDITIONAL SERVICES:
Bath Visits:
*$50 per person not to exceed 1 hour of care. Add $25.
Additional per half over or part thereof.
Rise and Shine Visit:
*$50 per person not to exceed 1 hour of care. Add $25.
Additional per half over or part thereof.
Fluff and Tuck:
*$50 per person not to exceed 1 hour of care. Add $25.
Additional per half over or part thereof.
* All additional services are based on availability and care for
1 person.

* Requires transportation by the caregivers vehicle which will be reimbursed in the amount of .75 cents per
mile

** Functions permissible for Home Health Aides under special circumstances. If a Family member is present
or capable of providing care for a specific patient, using the nurse as a guide, teach the Aid to perform the **
tasks.

A PCA or HHA will not perform these functions under any circumstance:

1.

Foley Catheter irrigation

2.

Apply a sterile dressing

3.

Give enemas or remove impactions

4.

Perform Gastric Lavage gavage

5.

Applications of heat in any form