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Home and CommunityBased Services (HUBS) 2021 Provider Quality Management Reassessment This form is required for entities enrolled to provide services in Section B under the following waivers/programs:

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How to fill out good samaritan home care

01

Gather all necessary information about the person needing care, including medical history, current medications, and any specific care instructions.

02

Contact Good Samaritan Home Care to discuss your needs and schedule a consultation.

03

During the consultation, go over the care plan and services provided by Good Samaritan Home Care.

04

Fill out the required paperwork accurately and thoroughly, including insurance information and emergency contacts.

05

Follow any additional instructions provided by Good Samaritan Home Care for the best care experience.

Who needs good samaritan home care?

01

Individuals who require assistance with activities of daily living due to aging, illness, or disability.

02

Patients recovering from surgery or a hospital stay who need extra support at home.

03

Family members who are unable to provide full-time care for their loved ones and need professional help.

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What is good samaritan home care?

Good Samaritan home care is a program designed to provide care and assistance to individuals in need within the comfort of their own homes.

Who is required to file good samaritan home care?

Healthcare providers or agencies who offer home care services are required to file Good Samaritan home care.

How to fill out good samaritan home care?

To fill out Good Samaritan home care, providers must include all relevant information about the services provided and the patients receiving care.

What is the purpose of good samaritan home care?

The purpose of Good Samaritan home care is to ensure that individuals who require assistance in their homes receive the necessary care and support.

What information must be reported on good samaritan home care?

The information that must be reported on Good Samaritan home care includes the type of services provided, the duration of care, and the patients' medical needs.

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