(402) 975-8079

Company Documents

Shared Living Documents

Welcome to Extended Families of Nebraska’s document storage page for Shared Living Providers. It is our goal to provide you with all of the documents you may need to do your job.

If you have questions or feedback, please contact Abigail Woods, Business Director, via scomm, via email at abigail.woods@efnabilities.com, or via phone at (402) 975-8079 during office hours.

Contractor Resources

Shared Living payments are not considered taxable income. This is detailed in Section 131 of the IRS code. This can put our Shared Living Contractors in unique situations.

See below for resources, and if you have any questions, feel free to contact Abigail Woods, Business Director.

COVID-19 Economic Impact Payments

This link gives directions on how to submit for the Economic Impact Statements if you did not file income taxes in 2018 or 2019 and did not receive Social Security benefits.

Medicaid & Marketplace Insurance

According to this fact sheet, difficulty of care payments should not be considered when calculating gross income for Medicaid and Marketplace insurance applications. Click here for guidance.

IRS Code Section 131(a)

Click here to view IRS information on difficulty of care payments.

Medical Forms

Physician Contact Form

Annual Physical Form

Medication Review Form

Dental Appointment Form

Vision Appointment Form

Frequent Appointment Form

Financial Forms

Billing Statement

Petty Cash Ledger

Reimbursement Statement

Day Services Billing Statement

Spend Down Ledger

Assessments

Developmental Index

Functional Assessment Questionnaire

Residential Preference Assessment

Life Skill Inventory

Quick Screen Assessment

Reinforcement Inventory

Dementia Assessment

Fast Behavioral Assessment

Personnel Packets

Back-Up Staff Packet

Adult In Home Packet

Personnel Documents

Non-Compete

Direct Deposit

CPR/First Aid Training

Drug & Alcohol Test Consent

APS/CPS Check Instructions

2021 EFN Pay Calendar

Drug Free Workplace Notification

Essential Screens Disclosure & Authorization

2022 EFN Pay Calendar

Notice of Arrest

I-9 Form

Personnel documents can turned into your Residential Coordinator or submitted to Tiffany Phelps, Personnel & Facilities Coordinator, via scomm, via fax to (402) 975-2293, or via mail to 4525 F Street, Lincoln, NE 68510.

Therap Guides

GER Guide–Updated August 2020

T-Log Guide

MAR Cheatsheet

Provider and State Policies

EFN Policy & Procedures

State of Nebraska 404 Regulations

State of Nebraska 403 Regulations