RELIA HOMECARE LEGAL & COMPLIANCE POLICY

Effective Date: December 23, 2025

1. PURPOSE

This Legal & Compliance Policy establishes Relia Homecare’s commitment to operating in full compliance with applicable federal, Georgia state, and local laws governing homecare, skilled nursing, insurance billing, privacy, and ethical conduct.

This policy applies to all owners, officers, employees, caregivers, nurses, contractors, and agents of Relia Homecare.

2. REGULATORY OVERVIEW

Relia Homecare complies with, including but not limited to:

– Georgia Department of Community Health (DCH) regulations
– Georgia Private Homecare Provider licensing rules
– Applicable skilled nursing regulations
– Federal and state privacy laws (HIPAA-style protections)
– Insurance, Medicaid, and waiver program billing requirements
– Employment and labor laws
– Fraud, waste, and abuse prevention laws

Relia shall not provide services without required licensure or authorization.

3. LICENSING & CERTIFICATION COMPLIANCE

– Relia maintains all required state licenses and registrations.
– Licenses are renewed timely and displayed as required.
– Services provided must align strictly with the scope permitted by licensure.
– Skilled nursing services are performed only by appropriately licensed clinicians.
– Staff credentials and licenses are verified prior to hire and periodically reviewed.

4. SCOPE OF SERVICES COMPLIANCE

Relia provides services only as authorized by:
– Written Service Agreements
– Individualized Care Plans
– Physician orders (when required)
– Insurance or waiver authorizations

Services outside the approved scope are prohibited.

5. WRITTEN SERVICE AGREEMENTS

Before initiating care, Relia ensures:
– A written Service Agreement is executed
– Scope of services, schedule, and rates are documented
– Client rights and responsibilities are disclosed
– Cancellation and billing terms are acknowledged

No services are provided without proper documentation unless legally permitted.

6. INSURANCE, MEDICAID & WAIVER COMPLIANCE

Relia follows all payer-specific rules, including:
– Eligibility verification
– Prior authorization requirements
– Visit limits and documentation standards
– Timely and accurate claims submission
– Coordination of benefits
– Audit cooperation

Relia prohibits:
– Billing for services not rendered
– Billing beyond authorized limits
– Misrepresentation of services or diagnoses
– Duplicate or inflated billing

7. FRAUD, WASTE, AND ABUSE PREVENTION

Relia maintains a zero-tolerance policy for fraud, waste, and abuse.

Prohibited actions include:
– False documentation
– Upcoding or unbundling
– Kickbacks or inducements
– Alteration of records
– Time or visit falsification

Suspected violations must be reported immediately and will be investigated.

8. PRIVACY & CONFIDENTIALITY COMPLIANCE

Relia protects personal and health information by:
– Limiting access to authorized personnel
– Using secure administrative and technical safeguards
– Training staff on privacy obligations
– Maintaining HIPAA-style policies and procedures

Unauthorized access, use, or disclosure of information is strictly prohibited.

9. NOTICE OF PRIVACY PRACTICES

Relia provides clients with a Notice of Privacy Practices (NPP) at intake and maintains acknowledgment documentation in client records.

10. RECORDKEEPING & DOCUMENTATION

Relia maintains accurate and complete records, including:
– Client assessments and care plans
– Visit notes and nursing documentation
– Billing and payment records
– Staff credentials and training records
– Incident and complaint reports

Records are retained according to legal and regulatory requirements.

11. STAFF TRAINING & COMPETENCY

Relia ensures:
– Initial and ongoing compliance training
– Role-specific training for caregivers and nurses
– Documentation and billing education
– Annual policy acknowledgment by staff

Staff may not perform duties without appropriate training.

12. INCIDENT REPORTING & RISK MANAGEMENT

Relia requires reporting of:
– Client injuries or falls
– Medication errors
– Abuse, neglect, or exploitation concerns
– Safety incidents or near-misses
– Privacy or data breaches

Incidents are documented, investigated, and corrective action is taken.

13. ABUSE, NEGLECT & EXPLOITATION PREVENTION

Relia prohibits all forms of abuse, neglect, and exploitation.

Staff are required to:
– Report suspected abuse immediately
– Cooperate with investigations
– Follow mandatory reporting laws

Retaliation for reporting is strictly prohibited.

14. ETHICAL CONDUCT & PROFESSIONAL STANDARDS

Relia expects all personnel to:
– Act honestly and ethically
– Treat clients with dignity and respect
– Avoid conflicts of interest
– Maintain professional boundaries
– Comply with all applicable laws and policies

15. NON-RETALIATION POLICY

Relia prohibits retaliation against anyone who:
– Reports compliance concerns
– Participates in investigations
– Raises safety or legal issues in good faith

16. AUDITS & INSPECTIONS

Relia cooperates fully with:
– State licensing inspections
– Insurance audits
– Medicaid and waiver audits
– Regulatory investigations

All staff must provide accurate information during audits.

17. DISCIPLINARY ACTION

Violations of this policy may result in:
– Retraining
– Suspension
– Termination
– Reporting to licensing or regulatory authorities
– Legal action where appropriate

18. POLICY REVIEW & UPDATES

This policy is reviewed periodically and updated as laws or operations change.

Revisions are communicated to staff and incorporated into training.

19. COMPLIANCE OFFICER

Relia Homecare designates a Compliance Officer responsible for:
– Policy oversight
– Training coordination
– Audit response
– Regulatory monitoring
– Compliance reporting

Compliance Officer Contact:

Relia Homecare

– Website: https://reliahomecare.com
– Phone: 404-630-1202
– Email: support@reliahomecare.com
– Address: 625 Beaver Ruin Road #A, Lilburn, GA 30047

20. ACKNOWLEDGMENT

All staff, contractors, and relevant parties must acknowledge receipt and understanding of this Legal & Compliance Policy.

END OF LEGAL & COMPLIANCE POLICY