Comprehensive Policy Templates for Tennessee Pain Clinics

Because of the opioid crisis, federal and state regulators have you in their crosshairs! Eagle’s comprehensive policy templates for Tennessee pain clinics will help you pass certification, avoid fines, increase security, and achieve compliance.

• Protect your business
• Eliminate stress
• Save time
• Proven results

Designed specifically for Tennessee pain management clinics, Eagle’s policy and procedure templates speed the process of compliance with state regulations for pain clinics.  The policies include best-practices for clinical management of patients in chronic pain, including patient agreements, the use of periodic urine drug tests, protocols for pill counts, the use of industry-accepted risk scoring, supervision of mid-level providers, review of the state prescription registry, maintenance of rigorous clinical documentation, and more.  Full compliance is also included for DEA, OSHA, the CDC infection control guidelines, and the HIPAA regulations. This template is fully compliant with:

• TN Rule 1200-34-01 Pain Management Clinics
• TN Rule 0880-02 Rules and Regulations Governing the Practice of Medicine
• TN Rule 0880-03 General Rules Governing the Practice of a Physician Assistant
• TN Rule 0880-6 Rules and Regulations Governing the Utilization and Supervision of the Services of a Nurse Practitioner/Prescription Writer
• TN Rule 1050-02 Rules and Regulations Governing the Practice of Osteopathy
• HIPAA: 45 CFR Part 164 – Security Rule, Privacy Rule, and Breach Notification Rule
• AMA Code of Ethics
• T.C.A. 53 Professions of the Healing Arts
• 29 CFR Occupational Safety and Health Administration
• T.C.A. 53-10-301 Tennessee Prescription Safety Act
• CDC Guideline for Prescribing Opioids for Chronic Pain
• Tennessee Chronic Pain Guidelines
• DEA Practitioners Manual
• 21 CFR Food and Drug Administration
• CDC Infection Control Guidelines

While these templates were designed for compliance with Tennessee regulations, they specify best-practices for pain clinics generally and could be readily adapted for pain clinics in other locations.  The policy templates consist of approximately 190 pages and are delivered in Microsoft Word format. Perpetual license is granted to the user to use and modify the policies for a single clinic. Policies may be used in hardcopy format, or electronically via your practice’s server. When used online, all staff have immediate access. On-line citations and references are included with full hyperlink functionality to allow quick access to the relevant HIPAA regulation and/or various reference materials.

Download Today to and Begin the Process of Full Compliance!

The following policy templates are included:

SECTION I ADMINISTRATION AND ORGANIZATIONAL FUNCTIONS

1. General

1100 Mission, Values and Ethics
1110 Definitions
1120 Licensure and Certification
1130 Risk Management
1140 Loss or Theft of Property or Money
1150 Visitor Injury/Mishap
1160 Incident Reports
1170 Advertising and Marketing
1180 Notifications and Reporting to the Department of Health
1190 Closing of Entity or Pain Program
1195 Policy Updates

2. Fiscal Management

1200 Billing Procedures and Collections
1210 Petty Cash Procedures

SECTION II PAIN MANAGEMENT PROGRAM

1. General

2100 Patient Responsibilities
2110 Patient Complaints
2120 Consent Policy

2. Clinical Protocols

2100 New and Established Patient Protocols
2210 Urine Drug Screening
2220 Pain Management Methods and Procedures
2230 Dismissal of Non-Compliant Patients
2240 SOAPP® Version 1.0 Use and Scoring
2250  CESD-R Depression Screening Instrument
2260 Suboxone Therapy Protocol

3. Medications and Prescriptions

2300 Prescriptions — General Rules
2310 Clinic Medications and Storage
2320 Dispensing and Administering Medications

SECTION III HUMAN RESOURCES

1. Employee Practice

3100 General Policies
3110 Employment
3120 Personnel Records
3130 Classification of Employees
3140 Performance Assessment
3150 New Employee Onboarding
3160 Non-Discrimination
3170 Termination of Employment

2. Employee Compensation & Benefits

3200 Employee Compensation & Benefits

3. Employee Responsibilities

3300 Dress Regulations and Appearance
3310 Attendance
3320 Employee Requests for Time Off and PTO
3330 Sexual Harassment
3340 Personal Telephone Calls and Text Messaging
3350 Smoking Policy

SECTION IV EMPLOYEE HEALTH AND SAFETY

1. OSHA Bloodborne Pathogens

4100 General Safety for All Employees
4110 Exposure Control Plan
4120 Tuberculosis Screening Program
4130 Immunizations
4140 Post Exposure Prophylaxis
4150 Reporting Injury on the Job
4160 Fire and Safety Procedures
4170 Building Standards
4180 Emergency Response
4185 Cardiopulmonary Resuscitation
4190 Hazardous Materials
4195 Radiation Safety

SECTION V INFECTION PREVENTION AND CONTROL PROGRAM

5100 Principles, Overview and Staff Training
5110 General Rules
5120 Hand Washing
5130 Universal Precautions
5140 Injection Safety
5150 Disposal of Sharps
5160 Environmental Cleaning/Housekeeping Procedures
5170 AIDS/HIV Positive Guideline
5180 Biohazard Waste
5190 Sterilization Procedures
5195 Evaluation / Audit

SECTION VI CLINICAL STAFF POLICIES

1. General

6100 Medical Director Qualifications and Duties
6110 Coverage for Medical Director

2. Policies Regarding Physician/Mid-Level Personnel

6200 Supervision of Nurse Practitioners
6210 Supervision of Physician Assistants
6230 Credentialing of Physicians and Mid-Levels

3. Education and Training

6300 Staff Training Requirements
6310 Cardiopulmonary Resuscitation Certification

SECTION VII MEDICAL RECORDS AND QUALITY IMPROVEMENT

7100 Medical Record Procedures
7110 Quality Assurance and Improvement Program
7120 Patient Satisfaction Survey

SECTION VIII HIPAA PRIVACY

1. Policies for all Staff

8100 General Rules
8110 Confidentiality, Privacy and Computer Security Definitions
8120 Minimum Necessary Policy
8130 Confidentiality Safeguards (Oral & Written)
8140 Speaking with the Family and Friends of a Patient Receiving Services
8150 Authorizations
8160 Verification
8170 Minors, Personal Representatives and Deceased Patients
8180 Duty to Report Violations and Security Incidents
8190 Disclosures that do not Require an Authorization
8195 Patient Portal

2. Patient Rights

8200 Patient’s Right to Access Records
8210 Patient’s Right to Request Amendment of Records
8220 Patient’s Right to Receive an Accounting of Disclosures
8230 Patient’s Right to Request Additional Restrictions
8240 Patient’s Right to Request Confidential Communications

3. Confidentiality Policies for Supervisors

8300 Mitigation
8310 Notice of Privacy Practices
8320 Non-Intimidation and Non-Retaliation
8330 Privacy Complaints

4. Shared Privacy/Security Policies

8400 Policy Updating and Staff Training
8410 Business Associate Contracts
8420 HIPAA Assignments and Documentation

SECTION IX HIPAA SECURITY

1. Policies for Medical Director, Practice Administrator & Security Officer

9100 HIPAA Security Officer and Security Management Process
9110 Data Backup Policy
9120 Disaster Recovery Plan and Emergency Mode Operation
9130 Facility Security and Access Control
9140 Annual Security Evaluation
9150 Audit Control and Activity Review Policy
9160 Malicious Software Protection Policy
9170 Security Awareness Program
9180 Device and Media Disposal and Re-Use
9190 Technical Safeguards
9195 Breach Reporting

2. Security Policies for Practice Administrator

9200 Employee System Access and Termination Procedures

3. Security Policies for All Staff

9300 Computer Usage
9310 Use of Social Media
9320 Portable Computing Devices and Home Computer Use
9330 Security Incident Response and Reporting

Appendices

Appendix A – Identifying Business Associates
Appendix B – Sample HIPAA Business Associate Agreement
Appendix C – Sample Privacy & Security Officer Duties
Appendix D – Facility Security and Safeguards for Oral and Written PHI
Appendix E – Workforce Access to PHI and Safeguards
Appendix F – Minimum Necessary – Procedures for Routine Disclosures and Requests
Appendix G – Miscellaneous
[CLINIC] Authorization Form
Notice of Privacy Practices
[CLINIC] Disclosure Log
Privacy Instructions
Confidentiality Agreement for Cleaning Agency
Acknowledgement of HIPAA Policies and Procedures
Acknowledgement of OSHA Policies and Procedures
Acknowledgement of CDC Infection Control Policies and Procedures
Incident Report Form
Visitor/Patient Incident Report