Read-and-sign means each staff member reads the policies for their job and signs, on paper or on screen, to say they have read them. The dated record shows a surveyor that your staff were given your policies. No federal home health or hospice rule asks for a signature on every policy, but federal rules do require training on some policies and a record of it, and some states go further: Texas requires direct care staff to sign a statement that they have read, understand and will comply with the agency's policies. A signature does not show that someone can do the job, so pair it with training and competency checks.
What federal rules require
- Privacy (HIPAA): every member of the workforce is trained on your privacy policies and procedures as their job needs, new members within a reasonable period after joining, and staff whose duties are affected by a material change within a reasonable period after it takes effect. The training is documented and the record kept for six years (45 CFR §164.530(b) and (j)).
- Emergency preparedness: home health agencies and hospices give initial training in their emergency preparedness policies and procedures to new and existing staff, train at least every 2 years after that, train again when the policies are significantly updated, and keep documentation of all training (42 CFR §484.102(d)(1) and §418.113(d)(1)).
- Infection control: home health agencies and hospices give infection control education to staff, patients and caregivers (42 CFR §484.70(c) and §418.60(c)).
- Hospice orientation and in-service: employees and contracted staff with patient and family contact are oriented to the hospice philosophy, and the hospice has written policies on how it assesses competency and keeps a written description of the in-service training given in the last 12 months (42 CFR §418.100(g)).
- Aides: home health aides and hospice aides receive at least 12 hours of in-service training in each 12-month period (42 CFR §484.80(d) and §418.76(d)).
- Bloodborne pathogens (OSHA): employees with occupational exposure are trained when first assigned to those tasks and at least once a year after that (29 CFR §1910.1030(g)(2)).
What some state rules add
| State | What the rule asks | Rule |
|---|---|---|
| Texas, all licensed agencies | Direct care staff with direct client contact, employed or contracted, sign a statement that they have read, understand and will comply with all applicable agency policies. The statement is kept in the personnel record. | 26 TAC §558.245(b)(10) and §558.246(a)(5) |
| Texas, privacy training | Training on the law that protects health information no later than the 90th day after hire, and a signed statement that the training was completed, kept for six years | Tex. Health & Safety Code §181.101 |
| District of Columbia, home care | Staff are oriented to the written policies and procedures, which are kept readily available to staff | 22-B DCMR §9908.3 |
| Georgia, private home care | Employees who provide services are oriented before working with clients, and after the first year receive at least eight clock hours of training a year related to their duties | Rule 111-8-65-.09(6) |
| North Carolina, home care | Written policies on orientation and in-service education, with records of in-service attendance | 10A NCAC 13J .1003(d) |
Each state's manual sets out the orientation and training rules for that license: see the policy manuals by state.
How read-and-sign works
- Give each person a reading list for their job. A caregiver needs the client care, safety and reporting policies, not every office policy.
- Ask new staff to read their list during orientation, before they work alone with clients.
- Have them sign each policy, or one statement that covers the list, with their own name and the date.
- When a policy changes, ask the staff it applies to to read and sign the new version.
- Keep the record with the personnel file, including for staff who have left.
What a good record shows
- Who signed, in their own name. Nobody signs for someone else.
- Which policy they signed, and which version of it.
- The date they signed.
- Who has not signed yet, so you can follow up.
A signature is not training
A signed record shows that staff were given your policies. It does not show they can follow them. Surveyors ask staff what they would do, for example how they report suspected abuse or what happens in an emergency, so pair read-and-sign with the orientation, training and competency checks your rules require. When a policy changes, tell staff what changed, not only that it changed.
Read-and-sign in Cura Core
Staff sign-off comes with every Policy Pack. Staff sign in on your agency's own page with their own username and password, on any phone and with no app. Each person gets a reading list for their job, reads a short summary and then the full policy, and acknowledges it by typing their name. The date, time, version and device are recorded with each acknowledgment, and anyone who signed an older version is asked to sign the new one. See how staff sign-off works.
Next step
Pick your state and license on the policy manuals by state page to see its manual and read three of its policies free.