Form Testing - Faith Agency Inc

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DOCUMENTATION POLICY
NURSES POLICY AND PROTOCOLS
- It must be legible
- All nurses’ notes are to be signed by the nurse with your full legal signature and nursing credentials. Sign those credentials, you earned them. Be proud of them..LPN/RN
- Documentation must be accurate, detailed objective, precise and timely.
- All nurses’ notes must be signed by the patient or family member. This is proof of the nurse care and presence. Note that it is not legal or ethical to sign a client’s or family member’s signature. It constitutes fraud and is a felony.
- All Initial assessment must be completely filled out. For initial assessment packages, the yellow copies are left in the folder with the client and the white copies are returned back to the office.
- Holding your paperwork for too long only delays your payment for such services rendered.
- Called client’s MD? Document call/time and why.
- Check all appropriate boxes on the visit notes.
- DO NOT use white outs, scribble, trace over to change errors during your documentation. Simply draw a line across and write the correct information.
- Submit visit/progress notes within 7-14 days from the date of visit.
- A supervisory visit has to be done on the dates given on the visit schedule. NO exceptions. If unable to perform visit, contact the office/supervisor immediately. This is a state rule.
DOCTOR’S ORDERS
- Always work with the MD orders. NO EXCEPTIONS! If MD did not order it, don’t do it!
- Doctor (and Faith Medical) must be notified of changes in client’s status. You call the doctor and document the communication.
- Verbal orders are taken, written, signed off and communicated back to your supervisor at Faith Medical Services within 24hrs by the RN/LPN
- All orders from a physician must be brought to the office (or faxed, emailed)
- Call your supervisor with “ALL NEW ORDERS”
MEDICATION ADMINISTRATION At each visit, nurses must review all of the patient’s medications, dose and frequencies. Often, the physician’s office will notify patients of changes but not the nurse or agency. Changes should be called into the office immediately so that the computer records can be changed. At each Start of Care, the RN must review all medications and complete, date and sign the Medication Profile. It is important that you review the actual bottles for both prescription and over the counter medications and supplements to ensure that you have the correct spelling of the name, doses and frequencies. It is also important that you get the patient’s pharmacy name, address and telephone number to record on the form. It is a State regulation that we have the pharmacy name, address and telephone number. At each Follow-up and Resumption of Care, the RN must review the medication list, note changes on the on visit form. If there are no changes, the nurse should write “No changes”. CHECKLIST FOR COMPLETING PROPER STEPS IN THE ADMINISTRATION OF MEDICATIONS < Washes hands using proper technique. < Does not handle pills with bare hands. < Checks the medication 3 times during preparation. < Ensures they have identified the right client. < Explains the administration procedure(s) to the client. < Adheres to the 8 Rights of Medication Administration. < Observes the client take the medication or after the medication administration. < Documents the administration of each medication on the visit note. < Dispose supplies < Wash hands RIGHTS OF MEDICATION ADMINISTRATION
1. Right patient
Check the name on the order and the patient. Use 2 identifi ers. Ask patient to identify himself/herself.
1. Right medication
Check the medication label. Check the order.
1. Right dose
Check the order. Confi rm appropriateness of the dose using a current drug reference. If necessary, calculate the dose and have another nurse calculate the dose
1. Right route
Again, check the order and appropriateness of the route ordered. Confi rm that the patient can take or receive the medication by the ordered route.
1. Right time
Check the frequency of the ordered medication. Double-check that you are giving the ordered dose at the correct time. Confi rm when the last dose was given.
1. Right documentation
Document administration AFTER giving the ordered medication. Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug.
1. Right reason
Confirm the rationale for the ordered medication. What is the patient’s history? Why is he/she taking this medication?
1. Right response
Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant? Be sure to document your monitoring of the patient and any other nursing interventions that are applicable. GENERAL PROCEDURES OF ADMINISTERING MEDICATIONS BY THE VARIOUS ROUTES PREPARATION:
1. Compare the physician order with the medication provided by the pharmacy. Resolve any discrepancy in accordance with facility/agency policies before proceeding with the administration of the medication(s).
2. Obtain the necessary supplies needed for the type of medication(s) to be administered such as medication cups, proper measuring devices, cotton balls, disposable gloves, tissues, crushing or splitting device, round nose tweezers.
METRIC - decimal system of weights and measures using the gram, meter and liter. LIQUID: cubic centimeter (cc) = milliliter (ml) SOLID: 1 gram (gm) = 1000 milligrams (mg) HOUSEHOLD - system based on common, though not standard, measuring devices. tsp. = teaspoon Tbsp. = tablespoon
1. = ounce
1 tsp. = 5 cc 3 tsp. = 1 Tbsp. = 15 cc 2 Tbsp. = 30 cc = 1 oz. START OF CARE/MISSED VISIT POLICY ALL START OF CARE per standard protocol is 24hrs except otherwise stated by the MD orders. Wound Vac standard protocol is 24-48 hrs depending on the last dressing change prior to discharge. When a client refuses services, do the following:
- Call the Office or the clinical supervisor
- Call and report to the client’s MD office
- Document the missed visit and the reason then fax or bring to the office within 24 hours.
- Follow up with the client next day and/or follow the agency’s instructions to you, whichever comes first. Report any problems back to the office
All Nurses are required to inform the Office Staff before missing the visit in advance to allow us locate a suitable cover. However, if you have a missed visit because of a patient (e.g. patient was at the doctor’s appointment), you MUST notify the office immediately. A revisit schedule will be given to you by your supervisory, also communicate any rescheduling done by the patient.
Employee Name
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Date
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Addendum to Company’s Equipment Use.
I acknowledge that if I have been given any company equipment under my care and I am required to handle them with care. I agree to pay/replace in the given condition at the time of receipt of these equipments in the case of loss/theft, physical damage or any other damages that affect the functionality of the above equipment. I will sign for any equipment I receive.
Employee Name
First Last
Date
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Employee Policies

Callout Policy and Procedures

Faith Medical Services goal is to ensure all our clients are staffed always. Read out call-out policy and procedure. All employees requesting off work should inform the agency 2 weeks in advance so that the shift can be covered. In case of emergency please inform the agency as soon as possible with a 4-hr. minimum requirement so that your shift can be covered. Please do not call off work using email format, ensure to speak with your supervisor. Failure to comply with company polices will result in disciplinary actions. We thank you for your cooperation in advance.
No Call/No Show Policy and Procedures
Read our No Call/No Show Policy and Procedures. The company has a zero tolerance for No Call/No Shows. No Call/Shows are ground for automatic termination. Anyone that performs a No/Call Show must be in extreme medical condition which would not allow you to call into work. Proper documentation must be presented to excuse your absence. You are only allowed one call-out per month, any hours on the day or period you call out after the approved one time will be paid at the minimum wage. If you quit an assignment without proper notification (two weeks' notice your last check will be paid at minimum wage. We thank you for your cooperation in advance.
Removal from Case
This is to inform all Faith Medical Services Employees of the policies and procedures when you are removed or want to be removed from a case. All employees that are W2 employees should allow 2 to 4 weeks for reassignment. All employees that are Independent Contractor/1009 employees will be reassigned on as need basis.

Company software and time record
All employees must use our clocking System. This system is a part of your job and is monitored daily. You are to use the system as you enter the client’s home and when you exit. IF YOU FORGET TO CLOCK OUT, OR YOU DID NOT CLOCK IN AT ALL, we will count it as a missed visit unless you have an issue and you called us immediately. After two weeks of the pay day you provided service, we can no longer pay you. Ensure to send in your visit records at the company stated times. The time records must be in compliant with our rule to get paid.

Payroll Calendar
This is to verify that you have received Faith Medical Services Payroll Calendar along with the payroll violation rules and regulations. Violations will attract a $35 fee payable to the 3rd party payroll company.

Name Badges
All employees are always required to wear their name badges while on duty. The fee to replace the company name badges is $25. In the event you are no longer employed with our company, you are required to return the name badge to us within 2 business day; otherwise, a fee $25 will be deducted from your last check.

Employee Handbook
This is to verify that you have received the Faith Medical Services employee handbook along with all policies and procedures. Adhere to all policies and procedures always. Disciplinary actions will follow with any violations to the company’s polices.

Credentials
It is your responsibility to update your credentials always (this includes yearly training), failure to do so will result in disciplinary action and up to termination.
Name
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Date
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INCIDENCES AND OCCURRENCES

ALL EMPLOYEES are to report incidences/occurrences as soon as they happen (no matter how small it may look) after making necessary phone calls like 911or call the nearest family member for help. You must call the office immediately and send in a report on the incidence form provided in your hire packet within 24 hrs. If you do not have this form, send it in on a plain paper or email us immediately at hr@faithagencyinc.com.
Call the office for medically related issues like injury/fall, hospital, change in client’s medical status, client refusing services). YOU MUST REPORT ALL ISSUES EVEN IF THEY HAPPENED OUTSIDE YOUR WORK SHIFT. Report it as soon as you know.
Please note that reporting an incidence/occurrence is a SAFETY issue. It protects YOU, the CLIENT, and FAITH STAFFING AGENCY, INC.
Faith Medical Services, Inc will look into all incidence/occurrence to find out:
• What happened? • Could it have been prevented? • Where there any allegations made? • Are corrective actions required? • Did we take the corrective actions required? • Was it reported to the necessary organizations? • Was it resolved and handled properly to prevent future occurrences?
I have read the above policy and I understand the procedures for reporting incidences/occurrences.
Signature to agree*
Faith Medical Services

1590 Phoenix Blvd, Suite 260 Atlanta GA 30349 U.S.A.

Tel (770) 907-7226 Fax (404) 506-9400

Emergency Procedures

In case(s) of all serious emergencies (falls, unconsciousness, and everything that looks like it)

□ Ensure client is safe
□ Call 911 immediately for all life-threatening issues
□ Report incidence to the office immediately
□ Make an incidence report and send to the office ASAP!

Whenever you have any situation (Client refused bath, bruises or sores, changes in client conditions…) with your client, these are the procedures to follow:

□ Ensure client is safe
□ Call family member (look on your care plan for clients representative contacts)
□ Call and notify the office immediately
□ Make reports on your progress notes or incidence report forms and send to the office ASAP!

You must also report the following to the office immediately:

□ Client hospitalized
□ Client out of home
□ All client complaints about their health status
□ Client refused services

PS: If the incidence happened when you are not on assignment but was brought to your attention, it must still be reported!

Report all incidences no matter how irrelevant it may appear! All incidences must be reported as soon as it occurred (i.e. within the hour).

Numbers to reach us at: 770-907-7226, 404-506-9400(fax)

I acknowledge and pledge to abide by the above instructions.
Name
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Additional DSP Form 1
ACKNOWLEDGE RECEIPT OF NOTICE OF PRIVACY PRACTICES HIPPA EMPLOYEE/SUB-CONTRACTORS I have been given a copy of Faith Staffing Agency Inc. Notice of Privacy Practices (“Notice”), which describes how the health information of the clients in the home is to be used and/or shared. I understand that Faith Medical Services Inc. has the right to modify, amend and/or change this policy notice at any time. As a employee/sub-contractor, it is my duty and responsibility to be aware of any changes to ensure I am in compliance with adhering to all privacy rules. I may obtain a current copy by contacting the office during its business hours Monday – Friday. My signature below acknowledges that I have been given with a copy of the Notice of Privacy Practices.
JOB DESCRIPTION

Direct Support Staff

DEFINITION

Direct Support Staff individuals with disabilities in community – based residential homes and family support services. Direct Support Staff assist individuals with daily living skills development, health and wellness management, medication administration, behavioral and communication development and personal caress. Quality support services will be delivered with dignity and respect for each and individual’s unique needs. Direct Support Staff advocate for individuals to be fully integrated into community life.

Duties and Responsibilities

1. Implement each person’s Individual Daily Program Plan
• Assists each person with his or her personal cares and daily routine.
• Shows respect and dignity while assisting each person.
• Provides choices and promotes independence at home and in the community.
• Supports people in establishing and maintaining relationships with friends, family, and community connections.
• Clearly and accurately documents information related to each person’s daily program plan.
2. Follows Abuse Prevention Plan as written for each person
• Demonstrates ability to support each person’s dignity of risk while following through with specific plan/s to reduce vulnerability in identified areas.
• Clearly and accurately documents incidents related to the person’s vulnerabilities and communicates information as outlined in the person’s individualized plan.
3. Follows Health Plans as written for each person.
• Administers medications and treatments as directed • Is able to locate and use medical information established by the program nurse
• Clearly and accurately documents changes in the person’s condition and communicates this information to the nurse and coordinator.
4. Completes work duties as assigned
• Provides a clean and safe environment for each person.
• Prepares and provides balanced meals according to the basic food groups.
• Clearly and accurately documents and reports maintenance or household needs to the appropriate supervisor
• Arrives on time and works his/her scheduled shift.
• Maintains staff coverage until relief staff are on duty or until a charged person has given the approval to leave
• Accepts and offers guidance and instruction to to//from co-workers in a helpful manner.
5. Work hours range from 10 to 40 hours weekly. All staff is evaluated annually and go through scheduled training to enhance to equality of work being delivered.

Qualifications

• Must be at least 18 years of age
• Ability to speak, write, and comprehend the English Language
• A valid driver’s license and satisfactory motor vehicle record is required for morning and evening shifts
• Upon hire, candidates must provide proof of employment eligibility and proof of being free from tuberculosis. All candidates must successfully pass a State of Georgia background check before working unsupervised.

High Performance Objectives/Competencies

• Communicates clear and accurate information to FMS team members, quality circle members, and community stakeholders in a professional manner.
• Maintains confidentiality.
• Accepts and is able to provide constructive feedback in a respectful manner.

Accountability

• Takes responsibility for carrying out essential job duties in a competent manner.
• Adheres to agency policies and procedures
• Completes training requirements according to FMS staff development standards.
• Represents FMS in a positive and respectful manner.
• Works safely; uses equipment properly and as directed.

Proactive

• Uses information and data to improve the quality of service provided.
• Takes initiative to improve personal skills, knowledge and team performance.

Team Player

• Shows respect for others’ perspectives, styles, and ideas
• Works with others to meet agreed timelines and objectives.
• Is flexible and willing to respond to changes needed to improve service.

Documentation

• Documents all program data, including but not limited to: individual plan data, behavior plan data, community integration logs, assessments, individual funds requests, mileage logs, maintenance requests forms, and supply acquisition forms;
• Documents individual’s health (i.e. seizure charts, weight, bowel movements, fluid intake.
• Ensures that all documentation is completed clearly and accurately in a timely manner
• Ensures Medication Administration Record (MAR) entries are completed daily
• Completes communication logbooks during shift
• Clocks in and out before and after every shift and submits Leave Request forms when applicable

Working Conditions

The physical demands described below are representative of those that must be met in order to successfully complete essential job functions. In compliance with the Americans with Disabilities Act, reasonable accommodations will be considered.
• Frequent pushing, pulling, grasping, reaching below shoulder level, and lifting/carrying up to 35 lbs. unassisted may be required
• Occasional bending stooping, squatting, kneeling, climbing, crawling, walking on uneven ground, reaching above shoulder level, and lifting/carrying in excess of 35 lbs. unassisted may be required.
• This position requires spending the majority of the work day standing or walking
• This position requires working 75-90 percent indoors and 10-25 percent outdoors.
• This position may require work with household cleaning solutions, electric wheelchair batteries, and refueling vehicles.
• This position may require work with moderate noise and/or pets
• This position may require work with the following equipment: wheelchairs, manual and electric; adaptive positioning equipment; household appliances; household cleaning equipment; manual, hydraulic, electric lifts or ramps; wheelchair hook-ups; battery charger; garbage/recycling bins; manual or electric bed, bed rails; office equipment; oxygen tank; mist or suction machine; augmentative communication device; gas or charcoal grill; sprinkler or garden hose; snow shovel or scraper
I have read and understand the information contained within the job description
Employee Name
First Last
Date
MM slash DD slash YYYY
Signature to agree*
Grievance policy
An individual is free to file a grievance at any given time. When an individual, legal guardian or family member, files a grievance with Faith Staffing Agency, Inc. the following steps below are implemented.
- An individual may bypass Faith Staffing Agency, Inc. procedures at any time during the grievance process and contact the Office of External Affairs. The phone number is 404-657-5964.
- The director will meet with the individual, legal guardian, or family and anyone involved in the grievance within 24 hours to discuss the issue.
- The director will work with the individual, legal guardian or family member to reach a mutually beneficial solution that is satisfactory to the individual.
- The director shall report back to the individual/legal guardian or family member with a resolution within 5 business days.
- If an individual is not satisfied with the outcome of the grievance or complaint, the individual or responsible part may contact the Department of Behavior Health and Developmental Disabilities Office of External Affairs. The contact information is:
Office of External Affairs Phone: 404-657-5964 Fax: 770-408-5439 Email: DBHDDconstituentservices@dhr.state.ga.us [ ] I, an individual of Faith Staffing Agency, Inc. have been fully informed about the grievance procedure for Faith Staffing Agency, Inc. [ ] I, a staff member of Faith Staffing Agency, Inc. have been fully trained and understands the grievance procedure Faith Staffing Agency, Inc.
Employee Name
First Last
Date
MM slash DD slash YYYY
Signature to agree*
Documentation Policy
POLICY: All RN’s, LPN’s, HHA’s, DSP’s documentation of patient care will be submitted to the Faith Medical Services office every Monday of each week. This documentation will reflect the previous week care of the assigned patient(s). PROCEDURE: All staff conducting patient care will document all actions taken on the appropriate forms to ensure that he/she delivers and/or has delivered quality care of their assigned client(s). Once all documentation is completed all paperwork must be submitted into the office Monday of each week. The paperwork can be delivered in person or via mail. No fax submissions will be allowed. All original documents must be placed in the patient’s chart as soon as possible. Non-compliance with this policy and procedure will initially affect the staff’s next paycheck. Continuation of non-compliance of this policy will result in disciplinary action and eventually termination of employment.
Employee Name
First Last
Date
MM slash DD slash YYYY
Signature to agree*
Evacuation Policy
Having a home evaluation plan and knowing how to enact it can mean the difference between life and death. Yet, only a small number of families (*25%) have actually developed and practices a home fire escape plan to ensure they could escape quickly and safely. Make sure your family is prepared
- Create a plan pull together everyone in your household and make a home evacuation plan with two ways out of each room, including windows. Don’t forget to make the location of each smoke alarm and make sure everyone including children knows how to identify the sound of the alarm.
- Make sure family members know to leave the house immediately if the smoke alarm sounds. Do not investigate to find out why it went off.
- Practice your evacuation plan, practice escaping by each route; practice in the dark
- The plan should include an arranged meeting place for your family.
- Teach family members that once they are out of the house during an emergency, stay out never go back into the house or burning property. Call 911 from a neighbor’s home, a cell phone or other electronic device. Do not waste time attempting to save property. If someone is missing fell the firefighters who are equipped to perform rescues.
Family members also need to be educated about what to do if they need to escape through a burning house.
- Crawl low under the smoke
- Use the top of your hand(s) to feel top of doors, doorknobs and the cracks between doors and door frames to make sure fire is not on the other side. If heat and smoke come in when you open the door, slam it shut and use an alternate route.
- If you are unable to leave the building, seal doors and vents with duct tape or towels to prevent smoke from entering the room. Open a window at the top and bottom so fresh air can enter. Be ready to close the window immediately if it draws smoke into the room. Call the fire department and let them know you are trapped inside, wave a flashlight or light-colored clothing to let rescuers know when you are located.
For more information on home escape planning, visit the National Fire Protection Association.
Employee Name
First Last
Date
MM slash DD slash YYYY
Signature to agree*
Fire Safety
Pull the pin at the top of the extinguisher. The pin releases a locking mechanism and will Allow you to discharge the extinguisher. Aim at the base of the fire, not the flames. This is important in order to put out the fire, you must extinguish the fuel. Squeeze the lever slowly. This will release the extinguishing agent in the extinguisher. If the handle is released, the discharge will stop. Sweep from side to side. Using a sweeping motion, move the fire extinguish back and forth until the fire is completely out. Operate the extinguish from a safe distance, several feet away, and then move towards the fire once it starts to diminish. Be sure to read the instructions on your fire extinguishers recommend operating them from different distances. Remember; Aim at the base of the fire, not at the flames!!!!
Employee Name
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Date
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DSP Forms (Continued)
Reporting Abuse or Exploitation of Participants
Short title. This article shall be known as the “Participants Abuse Reporting Act.” Definitions. As used in this article, the term:
- “Abuse” means any intentional or grossly negligent act or series of acts or intentional or grossly negligent omission to act which causes injury to a participant, including, but not limited to, assault or battery, failure to provide treatment or care, or sexual harassment of the participant.
- “Exploitation” means an unjust or improper use of another person or the person’s property through undue influence, coercion, harassment, duress, deception, false representation, false pretense, or other similar means for one’s own profit or advantage.
- “Participant” means any person receiving services from the agency.
Reporting abuse or exploitation; records.
- Any:
- Administrator, manager, physician, nurse, nurse’s aide, orderly or other employee in a hospital or facility;
- Medical examiner, dentist, osteopath, optometrist, chiropractor, podiatrist, social worker, coroner, clergyman, police officer, pharmacist, physical therapist, or psychologist; or
- Employee of a public or private agency engaged in professional services to participate or responsible for inspection of agencies providing services to individuals with developmental disabilities
who has knowledge that any participant has been abused or exploited while receiving services from the facility shall immediately make a report as described in subsection (c) of this Code section by telephone or in person to the department. In the event that an immediate report to the department is not possible, the person shall make the to the appropriate law enforcement agency. Such personal shall also make a written report to the Department of Human Services with 24 hours after making the initial report.
- Any other person who has knowledge that participant of former participant has been abused or exploited while receiving services from the agency may report or cause a report to be made to the appropriate law enforcement agency.
- A report of suspected abuse or exploitation shall include the following:
- The name and address of the person making the report unless such person is not required to make a report;
- The name and address of the participant or former participant;
- The name and address of the facility;
- The nature and extent of any injuries or the condition resulting from the suspected abuse or exploitation;
- The suspected cause of the abuse or exploitation; and
- Any other information which the reporter believes might be helpful in determining the cause of the participant’s injuries or condition and in determining the identity of the person or persons responsible for the abuse or exploitation.
- Upon receipt of a report of abuse or exploitation, the department may notify the appropriate law enforcement agency. In the event a report is made directly to a law enforcement agency, under subsection (a) or (b) of this Code section, that agency shall immediately notify the department.
- The department shall maintain accurate records which shall include all reports of abuse or exploitation, the results of all investigations and administrative or judicial proceedings, and a summary of action taken to assist the participant.
Investigations.
- The department shall immediately initiate an investigation after the receipt of any report. The department shall direct and conduct all investigations; however, it may delegate the conduct of investigations to local police authorities or other appropriate agencies. If such delegation occurs, the agency to which authority has been delegated must report the results of its investigation to the department immediately upon completion.
- The investigation shall determine the nature, cause, and extent of the reported abuse or exploitation, an assessment of the current condition of the participant, and an assessment of needed action and services. Where appropriate, the investigation shall include a prompt visit to the participant.
- The investigating agency shall collect and preserve all evidence relating to the suspected abuse or exploitation.
- All state, county, and municipal law enforcement agencies, employees of the facility, and other appropriate persons shall cooperate with the department or investigating agency in the administration of this article.
Evaluation results of investigation; protection of participant.
- Upon the receipt of the results of an investigation, the department, in cooperation with the investigating agency, shall immediately evaluate such results to determine what actions shall be taken to assist the participant.
- The department or an agency designated by the department shall assist and prevent further harm to a participant who has been abused or exploited. The department may also take appropriate legal actions to assure the safety and welfare of all other participants of the facility where necessary.
- Within a reasonable time not to exceed 30 days after it has initiated action to assist a participant, the department shall determine the current condition of the participant, whether the abuse or exploitation has been abated, and whether continued assistance is necessary.
- If as a result of an investigation a determination is made that a participant has been abuse or exploited, the department shall contact the appropriate prosecuting authority and provide all information and evidence to such prosecuting authority.
Immunity from liability.
- Any agency or person who in good faith makes a report or provides information or evidence pursuant to this article shall be immune from liability for such actions.
- Neither the department nor its employees, when acting in good faith an with reasonable diligence, shall have any liability for defamation, invasion of privacy, negligence, or any other claim in connection with the collection or release of information pursuant to this article and neither shall be subject to suit based upon any such claims.
Confidentiality. The identities of the participant, the alleged perpetrator, and persons making a report or providing information or evidence shall not be disclosed to the public unless required to be revealed in court proceedings or upon the written consent of the personal whose identity is to be revealed or as otherwise required by law. Upon the participant’s or his representative’s request, the department shall make information obtained in an abuse report or complaint and an investigation available to an allegedly abused or exploited participant or his representative of inspection or duplication, except that such disclosure shall be made without revealing the identity of any other participant, the person making the report, or persons providing information by name or inference. For the purpose of the Code section, the term “representative” also shall include a family member of a deceased or physically or mentally impaired participant unable to grant authorization; provided by, however, such family members who do not have written or court authorization shall not be authorized by this Code 31-33-1. Retaliation prohibited. No person or facility shall discriminate or retaliate in any manner against any person for making a report or providing information pursuant to this article or against any participant who is the subject of a report. Nothing in this Code section shall be construed to prohibit the termination of the relationship between the facility and the participant for reasons other than that the facility has been made the subject of a report, that such a report has been made, or that information has been provided pursuant to this article.
Employee Name
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Date
MM slash DD slash YYYY
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Chapter 290-4-9 Client’s Rights Table of Contents 290-4-9-.01 Purpose, Implementation, and Definitions 290-4-9-.04 Remedies for Violations 290-4-9-.02 Treatment or Habilitation 290-4-9-.05 Confidentiality 290-4-9-.03 Treatment or Habilitation Environment 290-4-9-.06 Notification of Rights Chapter 290-4-9 can be found on the Rules and Regulations by Georgia Secretary of State website. 290-4-9-.01 Purpose, Implementation, and Definitions. (1) Purpose. The purpose of these regulations is to safeguard the rights of persons treated pursuant to O.C.G.A. Chapters 37-3, 37-4, 37-5, and 37-7. (2) Applicability. These regulations shall apply to all area community mental health, mental retardation and substance abuse programs, as defined in O.C.G.A. Chapters 37-2, 37-5, and 26-5, which are operated by the Boards of Health or Community Service Boards or funded through contracts with the Boards of Health, the Regional Boards, the Community Service Boards, or the Department of Human Resources, including licensed Personal Care Homes which are under contract with the Department, Boards of Health, Regional Boards or Community Service Boards to receive clients who have mental illness, mental retardation, or are substance abusers. These regulations shall in general apply to all persons served in such programs without regard to the type or source of entry into the program. When the client is a minor or an adult with a legally appointed guardian, the regulations are applicable to that parent or guardian, with certain exceptions, as specifically stated in various parts of the regulations. For persons being served by virtue of a court order related to a criminal matter, the regulations are applicable to the extent that they do not violate the provisions of the order nor the need to provide for the safety of the individual or of others. (3) Implementation. Each Mental Health, Mental Retardation, and Substance Abuse Program shall instruct each staff member in the contents of these regulations. Each Program shall also provide, at the beginning of each client's treatment, the client or his parent or guardian, if applicable, a written summary of the rights and remedies contained in these regulations and their applicability to him. Insofar as is possible, notifications shall be done in such a manner commensurate with the individual's abilities and capabilities of comprehension and understanding and shall be documented in the client's record. Further, prior to the restriction of any client's rights (as permitted in these regulations), a staff member shall again inform the client, or his parent or guardian if applicable, of his right to administrative complaint of that restriction, except in cases where the client's condition makes this impractical, and in such cases the client shall be informed at the time when his condition permits. (4) Definitions. Unless a different meaning is required by the context, the following terms as used in these regulations shall have the meanings hereinafter set forth: (a) "Abuse" means any unjustifiable intentional or grossly negligent act, exploitation or series of acts, or omission of acts by a staff member which causes physical or mental injury, or endangers the safety of a client, including but not limited to verbal abuse, assault or battery, failure to provide treatment or care, or sexual harassment; (b) "Care" means diagnostic services; therapeutic services, including the administration of drugs; habilitation; and any other service for the treatment or habilitation of an individual pursuant to O.C.G.A. Chapters 37-2, 37-4, 37-5, and 26-5; (c) "Chief Medical Officer" means the physician designated by the Program Director with overall responsibility for client treatment or habilitation at the facility receiving the client; (d) "Client" means any person who receives treatment or habilitation for alcohol or drug abuse, mental illness, or mental retardation pursuant to O.C.G.A. Chapters 37-2, 37-4, 37-5, and 26-5 or any person accepted for evaluation; (e) "Court" means, in the case of an individual who is 17 years of age or older, the probate court for the county of residence of the client or the county in which such client is found, and, in the case of an individual who is under the age of 17 years, the juvenile court for the county of residence of the client or the county in which such client is found; (f) "Department" means the Georgia Department of Human Resources and includes its duly authorized agents and designees; (g) "Director" means the Director of the Division of Mental Health, Mental Retardation and Substance Abuse of the Department of Human Resources; (h) "Division" means the Division of Mental Health, Mental Retardation and Substance Abuse of the Department of Human Resources; (i) "Guardian" means an individual appointed as provided by law to be legally responsible for the person of an adult or of a minor. Whenever the word "client" is used in these regulations, a guardian is entitled to exercise the client's rights on behalf of his ward; (j) "Individualized Service/Program Plan"
1. "Individualized Service/Program Plan": An organized statement of the proposed treatment/habilitation process to guide the service provider and client throughout the duration of service at the Program.
2. Each plan shall clearly include but is not limited to:
(i) A statement of the goals or desired outcomes, based upon and related to a proper evaluation of the nature of the specific problem and the specific needs of the client, which can be reasonably expected to be achieved; (ii) The kinds of services to be provided to obtain these goals and the frequency of services; (iii) Identification of professional personnel who planned these services, including appropriate medical or other professional involvement by a physician; (iv) Documentation of client involvement and, if applicable, the client's accordance with the individualized service/program plan; (v) Compliance with the Program's written Quality Improvement Plan; (k) "Mental Health, Mental Retardation and Substance Abuse Program (Program)" shall mean an organized program for the care and treatment of persons with mental illness, mental retardation, or individuals with an alcohol or drug dependence or addiction operated by a County Board of Health or Community Service Board or funded through contracts with a County Board of Health, Regional Board, Community Service Board or the Department of Human Resources. (l) "Mental Health, Mental Retardation and Substance Abuse Program Director" shall mean the Director of a Mental Health, Mental Retardation and Substance Abuse Program. (m) "Physical Restraint" means any mechanical device used to restrict a person's physical movement, except for those devices which are applied for protection from accidental injury or required for the medical treatment of the client's physical condition or for supportive or corrective needs of the client. These latter devices used in such situations must be authorized and applied in compliance with the Program's policies and procedures. The use of such devices shall be documented in the client's record; (n) "Physician" means any person duly authorized to practice medicine in this State pursuant to O.C.G.A. Chapter 43-34; (o) "Psychologist" means any person duly authorized to practice applied psychology in this State pursuant to O.C.G.A. Chapter 43-39. (p) "Professional staff" means staff members who are psychiatrists, psychiatric nurses, physicians, social workers, clinical chaplains, psychologists, or persons who have met Division requirements for Mental Health Professional Equivalency or Mental Retardation Professional. (q) "Quality Improvement Plan" means a written description of a clearly defined, organized program that is designed to promote quality client care through peer review and ongoing objective and systematic assessment of client care and the correction of identified problems. The plan describes the authority and responsibilities of program staff responsible for review of client's rights, mechanisms for choosing representatives from individuals served or their representatives, and individuals not otherwise affiliated with the program to serve on the Quality Improvement Clients' Rights Subcommittee; (r) "Regional Executive Director/Designee" means the person with overall responsibility for the Mental Health, Mental Retardation and Substance Abuse Services. (s) "Representative" means the person appointed, pursuant to section 290-4-9-.02(1)(h) of these regulations, to receive notices; (t) "Staff member" means, for the purpose of Chapter 290-4-9 only, any person who is an employee, independent contractor, or other agent of the Department or of a County Board of Health, Regional Board or Community Service Board who provides services to persons with mental illness, mental retardation, or who are substance abusers. The use of "Staff member" in these regulations for such persons shall in no way alter the legal relationship of such persons and the Department, or subject the Department to any liability to which it is not otherwise subject; (u) "Time-out" means a behavior modification procedure whereby a person is removed from the environment, or stimuli within the environment, which reinforces the undesired behavior which needs to be modified, and to an unlocked area where the client's movement is not restrained. 290-4-9-.02 Treatment or Habilitation. (1) Appropriateness. (a) General. Each client shall receive care that is suited to his needs in the least restrictive environment available offering appropriate care and treatment or habilitation. All clients have the right to a humane treatment or habilitation environment that affords reasonable protection from harm, exploitation or coercion. No client, whether voluntary or involuntary, shall be deprived of any civil, political, personal, or property rights or to be considered legally incompetent for any purpose without due process of law. Temporary restriction or denial or a client's rights may occur only when specific justification is documented, per these regulations. Protection of the client's well-being shall be of primary concern to all staff under all circumstances. (b) Individual Service/Program Plans.
1. The development of an individualized service/program plan shall be governed as
follows: (i) Each client shall be evaluated and assessed by the staff as soon as possible after admission but within the time limits contained in the Community Service Board's Quality Improvement Plan or Division/Department minimum requirements, as appropriate. (ii) Each individualized service/program plan shall be reviewed at regular intervals as specified in the Community Service Board's Quality Improvement Plan or Division/Department minimum requirements, as appropriate, to determine the client's progress toward the stated goals and to determine whether the plan should be modified because of the client's present condition. These reviews should be based upon relevant progress notes in the client's record and upon other related information. (c) Receipt of Service (Day Services).
1. Each client shall have the right to receive prompt treatment services on a voluntary, confidential basis including:
(i) The right to care despite inability to pay; (ii) The right to receive services in the least restrictive environment available; (iii) The right to review and obtain copies of his service record, unless determined by the physician or such other staff as designated by the governing authority to be responsible for the client's treatment or habilitation to be contraindicated. Such determination shall be noted in the client's records along with the specific reason for any denial. A determination that a client may not review or obtain copies of his record shall expire after 30 days. Upon any new request after expiration, a new determination must be made and documented in the client's record. After any denial of his right to review or obtain copies of his record, a client may file a complaint under the procedures outlined in 290-4-9-.04. A client who is permitted to obtain copies of his record may be required to pay a reasonable fee to cover the costs of such copies. (iv) The right to a written individualized service/program plan; (v) The right to be involved in, to the extent possible, his own plan of care; (vi) The right to refuse service, unless it is determined by a physician or licensed psychologist that the client is unable to care for himself, dangerous to himself or others, or mandated by a court. (d) Receipt of Service (Residential Services).
1. Each client shall have the right to retain his own personal effects, clothing, and money.
2. Each client shall have the right to converse privately, have convenient and reasonable access to the telephone and mails, and to see visitors, except if denial is necessary for treatment or habilitation, as documented in the client's record by a physician or licensed psychologist.
3. Each client shall have the right to exercise the civil, political, personal, and property rights to which he is entitled.
4. Each client shall have the right to pursuit of employment, education, and religious expression.
(e) Restriction of any client's rights:
1. A client's rights may be restricted/denied only on a temporary basis and in order to protect the health and safety of the client or others;
2. If restriction, abridgement, or denial of a client's rights are instituted, other than those pursuant to 290-4-9-.02(1)(c)1.(iii) of these regulations, the nature, extent and reason shall be entered in the client's record as a written order approved by a physician or licensed psychologist. Review of such restriction will occur in the approved treatment or habilitation review process. Any continuing denial or restriction shall be reviewed every 15 calendar days and shall be entered into the client's treatment or habilitation record.
Such restriction, abridgement, denial of a right must be reviewed by the staff responsible for review of client rights as specified in the Program's Quality Improvement Plan. (f) Physical Restraints and Time-out Utilization.
1. Physical restraints shall not be used in any program governed by these rules and regulations; provided, however, that emergency receiving, evaluating and treatment facilities may use restraints in accordance with Rules and Regulations for Patients' Rights, Chapter 290-4-6. For the purposes of this subsection, those devices which restrain movement, but are applied for the protection of accidental injury or required for medical treatment of the client's physical condition or for supportive or corrective needs of the client, shall not be considered physical restraints. However, such devices used in such situations must be authorized and applied in compliance with the Program's policy and procedures. The use of such devices shall be a part of the client's Individual Service/Program Plan.
2. Time-out procedures shall be used solely for the purpose of providing effective treatment and protecting the safety of the client and other persons and shall not be used as punishment or for the convenience of staff. It shall be documented in the client's record, prior to the use of time-out procedures, that less restrictive methods of modifying the problem behavior have been systematically tried and found to be ineffective.
3. The use of time-out shall be governed as follows:
(i) Every use of time-out shall be under the supervision and observation of the Program's professional staff and limited to no more than 15 minutes per episode. (ii) Every use of time-out shall be conducted in a unlocked well lighted, heated or cooled, ventilated area with a means of observation available. The area(s) to be used for time-out shall be identified in the Program's policy and procedure for time-out utilization. (iii) Every use of time-out shall be documented in the client's record. Such documentation shall include but is not limited to: (I) the reasons and justification for time-out utilization; (II) the signature of the person authorizing the time-out. (g) Medications.
1. The attending physician is responsible for assuring, and documenting in the client's record, that the benefits, side effects, and risks of psychotropic medication are explained to the individual, commensurate with the individual's abilities of comprehension and understanding.
2. All medications shall be administered or prescribed solely for the purpose of providing effective treatment or habilitation and/or protecting the safety of the client and other persons and shall not be used as punishment or for the convenience of staff.
3. If not judicially declared incompetent, all adults shall give signed consent to the administration of medication. If an adult client has been judicially determined to be incompetent to give signed consent or to make decisions of a similar nature, signed consent to the administration of medication shall be obtained from the client's guardian with capacity to make such decision. If the client is a minor, such signed consent shall be obtained from the minor's parent or legal guardian.
4. Only in cases of emergency, where the physician determines that immediate intervention is necessary to prevent the death of or serious consequences to a client and where delay in obtaining signed consent would be unsafe for the client or others then immediate essential intervention may be administered without the consent of the client or other person. In such emergency cases, a record of the determination of the physician shall be entered into the client's record, and this will be the prior consent for such intervention. An attempt to expeditiously resolve the emergency situation must then be demonstrated.
(h) Participation of representatives for persons ordered to receive involuntary outpatient treatment at a mental health center on an outpatient basis is governed by the Rules of the Department of Human Resources Rule 290-4-6-.02(3). 290-4-9-.03 Treatment or Habilitation Environment. (1) General. The individual dignity of each client shall be respected at all times and upon all occasions. The provision of all services shall be offered in an environment, which is designed to assure the health and safety of all clients. (2) Abuse and Sexual Activity. (a) Abuse of any client is prohibited. A staff member shall use force only if necessary to prevent a client from threatening imminent harm or committing harm to himself or others. Such force as may be needed to prevent a client from threatening imminent harm or committing harm to self, staff, or others shall not constitute abuse. An incident report of such activity shall be filed with the Program Director and with the Clients' Rights program staff. (b) No staff member shall engage in any sort of sexual activity with any client, or allow sexual activity between or among clients while the client remains under the care or supervision within a program operated or contracted by a County Board of Health, Regional Board, Community Service Board or the Department. (c) No staff member shall abuse any client through physical or verbal attack, exploitation, or coercion. (d) A staff member who witnesses an incident of such abuse or sexual activity shall report the incident to the Program Director within 24 hours, and to the Program Clients' Rights staff as specified in the Program's Quality Improvement Plan as soon as possible, which staff shall notify the Personal Advocacy Unit of the Division within 5 working days. Upon receiving such a report, the Program Clients' Rights Subcommittee shall assist the reporting staff or the client (or his guardian or parent, if applicable) in initiating a complaint pursuant to Section 290-4-9-.04 of these regulations. If the Program Director has reasonable cause to believe that the incident constitutes criminal conduct, he shall notify the Regional Executive Director. If the Regional Executive Director concurs, he shall report the incident to the appropriate law enforcement agency. A staff member who fails to comply with the applicable requirements of this Section 290-4-9-.03(2) shall be subject to adverse action in accordance with personnel procedures of the Department or the governing authority. (e) If a staff member of a program has reasonable cause to believe that a parent or caretaker of a minor has inflicted physical injuries other than by accident, has neglected, exploited sexually or assaulted the child, then the staff member shall notify the program's director or his delegate who in turn shall report the allegation to the appropriate County Department of Family and Children Services by telephone, as soon as possible, followed by a written report. The report shall include the names of the parent(s) or caretaker(s), the name of the client, his age, nature and extent of injuries including evidence of previous injuries and other pertinent information on the cause of injury and the identity of the perpetrator. Abuse or neglect of adult clients shall be reported in accordance with the provisions of O.C.G.A. 30-5-1 through 30-5-8. 290-4-9-.04 Remedies for Violations. (1) Complaint Procedures. Any client (or his guardian or parent of a minor client, if applicable) or his representative or any staff member may file a complaint alleging that a client's rights under these regulations or other applicable law have been violated by staff members or persons under their control. Such complaints shall be governed by the procedure established in this Section 290-4-9-.04. A person who considers filing such a complaint is encouraged to resolve the matter informally by discussing it first with the staff members or other persons involved or Program Clients' Rights staff as specified in the Program's Quality Improvement Plan. The client is not required to use the procedures established by this Section 290-4-9-.04 in lieu of other available remedies, including the right to directly contact the Personal Advocacy Unit at the Division of Mental Health and Mental Retardation and Substance Abuse or to submit a written complaint to the Regional Executive Director or Program Director or Governor's Advisory Council as provided in O.C.G.A. Chapter 37-2-4. (a) General. In order to ensure that such internal quality improvement investigations and monitoring activities are completed fully and in an in-depth manner, to encourage candid evaluations, and to ensure that adequate corrective action is taken in all cases, review actions taken and documentation made in furtherance of this Section 290-4-9-.04 shall remain confidential. (b) Client complaint procedures in Programs funded directly or indirectly by the Department shall be governed as follows:
1. Each Program Director shall appoint a Clients' Rights Subcommittee to review the rights of the clients receiving services from programs contracted by the Department, a Regional Board, or a Community Service Board either directly or indirectly. The Clients' Rights Subcommittee functions as a part of the program's ongoing quality improvement program, as described in the Program's Quality Improvement Plan.
(i) The Clients' Rights Subcommittee staff is chosen from those staff responsible for the Program's Quality Improvement peer review system; and is a subcommittee of the Quality Improvement Committee. Members shall be composed primarily of professional staff and shall also include a service consumer or his representative or person not otherwise affiliated with the program. (ii) The Clients' Rights Subcommittee shall have the authority to investigate complaints, use whatever means are available and appropriate to resolve complaints, and consult with Program management on the development of policies and procedures to safeguard the rights of clients served in the Program. (iii) The Quality Improvement Clients' Rights Subcommittees in the Programs conduct their activities under the auspices of the Program Quality Improvement Committee, and all reports will be channeled through the Quality Improvement Committee to the appropriate Program Director/designee for appropriate corrective action. A copy of all reports will also be channeled to the Division Quality Improvement Committee through the Division Personal Advocacy Unit. (2) First Step. (a) The complaint shall be filed with the Clients' Rights Subcommittee of the client's Program, and it may be filed on a form provided by the Program. If the client states the complaint orally, specific assistance should be given in proceeding with the complaint and completing the form. Complaints may be made by telephone to clients' rights staff persons, who will complete the form. Staff members whose alleged conduct gave rise to the complaint may be informed of the complaint. (b) As soon as possible, but within seven working days after the complaint is filed, the Clients' Rights Subcommittee shall investigate the complaint, resolve it if possible, complete a disposition report, and file it with the Quality Improvement Committee's records. If after interviewing the complainant, however, it is found that the complaint does not state an allegation that, if true, would constitute a violation of these regulations or other applicable law, the complaint may be rejected in writing. In cases of such rejection, the original of the rejection notice shall be filed in the Quality Improvement Committee's records, and a copy shall be sent to the complainant. In all investigated complaints, the staff shall employ the investigatory method deemed most suitable to determine the facts. This method may include, but is not limited to, personal interviews, telephone calls, review of documents, and correspondence. The Quality Improvement Committee and its designees shall have access to all files, documents, records, and personnel of the Program deemed by the Committee to be relevant to its investigation. The Committee shall resolve the complaint through mediation and conciliation whenever possible. The client whose rights are alleged to have been violated or someone in his behalf may appear before the committee. (c) The Program's Quality Improvement Committee shall complete a brief disposition report on each investigated complaint and forward it to the Program Director for approval. The report shall state the parties involved, the gist of the complaint, and whether the complaint was resolved or not. The original report shall be filed on forms provided by the Division in the Committee records, and a copy shall be sent to the Regional Executive Director, the Director of the Program, and to the Division Quality Improvement Committee through the Personal Advocacy Unit. The complainant shall be notified of the action taken by the Committee. (3) Second Step. (a) If the complaint is rejected or is not resolved by the Committee to the satisfaction of the client (or his guardian or parent of a minor client, if applicable) or the complainant, either the client (or his guardian or parent of a minor client, if applicable) or the complainant may file with the Program Director a written request for a review of the complaint. The request shall be filed no later than 15 working days after the person filing the request receives a copy of the rejection notice or the disposition report of the Committee, which report includes notice of the necessity to file for review within 15 working days. The Program Director may reject the request in writing without a review if either the complaint or the request for review is not filed in a timely fashion, or if the complaint does not state an allegation that, if true, would constitute a violation of these regulations or other applicable law. The original of the rejection shall be filed in the Program Director's records, and a copy shall be sent to the complainant and to the Regional Executive Director. In all other cases, the Program Director shall designate a staff member who is a member of the Quality Improvement Committee and has no connection with the complaint to conduct a review of the complaint. (b) The person conducting the review of the complaint shall review all reports and documents which were utilized in Section 290-4-9-.04(2). In addition, the reviewer may interview any person who may have information related to the complaint. The complainant, shall be given an opportunity to discuss the complaint directly with the reviewer and present any information relevant to the complaint. Any staff member(s) whose alleged conduct gave rise to the complaint shall also be given an opportunity to discuss the complaint with the reviewer and present any information relevant to the complaint. This review process is designed to be an informal process and not a formal hearing. The reviewer shall document his findings. The review shall be completed as soon as possible, but within 10 working days after the request for review is filed. (c) Within five working days after the conclusion of the review, the reviewer shall submit to the Program Director a written report of the review. The report shall contain a list of the pertinent provisions of these regulations or other applicable law, and a recommendation for disposition. Within three working days after receiving the reviewer's report, the Program Director shall issue a written decision disposing of the complaint. The Program Director's decision, in addition to the disposition, may incorporate by reference those lists contained in the reviewers report. In this decision, the Program Director may accept, reject, or modify the reviewer's recommendation, or he may return the case to the reviewer for further proceedings. If the Program Director returns the case to the reviewer, the Program Director shall specify the matters to be addressed in the further proceedings and shall specify the period within which those proceedings shall be concluded. In no event shall the period for completing the further proceedings, including the reviewer's submission of an additional report to the Program Director and the Program Director's issuance of a decision, exceed 10 working days. The original of the Program Director's decision shall be filed on forms provided by the Division in the Program Director's records, and a copy shall be sent to the Regional Executive Director, to the complainant, and the Division Quality Improvement Committee through the Division Personal Advocacy Unit. (4) Third Step. (a) The client (or his guardian or parent of minor client, if applicable) or the complainant may appeal the Program Director's rejection or other decision by filing a written request for review with the Regional Executive Director or his/her designee. The request for review shall be filed no later than 10 working days after the person filing the request receives a copy of the Program Director's rejection or other decision. Upon the filing of such a request, the Program Director shall be notified, and the Program Director shall immediately transmit to the Regional Executive Director a copy of the Program Director's rejection or decision, together with a copy of the reviewer's recommendations, the Program Director's decision, and other documents utilized in the review, if any. (b) Within 10 working days of the filing of the request for review the Regional Executive Director, or his/her designee, shall issue a decision disposing of the appeal. The Regional Executive Director may reject the request in writing without a review if either the complaint or the request for review is not filed in a timely fashion, or if the complaint does not state an allegation that, if true, would constitute a violation of these regulations or other applicable law. The original of the rejection shall be filed in the Regional Executive Director's records and a copy sent to the complainant. In all other cases, the Regional Executive Director shall review the pertinent facts, reports, and reviews which were in Section 290-4-9-.04(2) and 290-4-9-.04(3), and issue a written decision disposing of the complaint. The original of the Regional Executive Director's decision shall be filed on forms provided by the Division in the Regional Executive Director's records, and a copy shall be sent to the complainant and to the Division Quality Improvement Committee through the Division Personal Advocacy Unit. (5) Fourth Step. (a) The client (or his guardian or parent of a minor client, if applicable) or the complainant may appeal the Regional Executive Director's rejection or other decision by filing a written request for review with the Director of the Division of Mental Health, Mental Retardation and Substance Abuse. The request for review shall be filed no later than 10 working days after the person filing the request receives a copy of the Regional Executive Director's rejection or other decision. Upon the filing of such a request, the Regional Executive Director shall be notified, and the Regional Executive Director shall immediately transmit to the Director a copy of the Regional Executive Director's rejection or decision, together with a copy of the previous reviewer's recommendations, the Program Director's decision, and other documents utilized in the review, if any. (b) Within 10 working days of the filing of the request for review; the Director or his designee shall issue a decision disposing of the appeal. This decision of the Director or his designee shall be based upon a review of the request for review and the documents forwarded by the Regional Executive Director; no evidentiary hearing shall be conducted by the Director or his designee. In the decision, the Director or his designee, may affirm, reverse, or modify the Regional Executive Director's rejection or other decision, or he may return the case to the Regional Executive Director for further proceedings. If the Director or his designee returns the case to the Regional Executive Director, the Director or his designee shall specify the matters to be addressed in the further proceedings and shall specify the period within which those proceedings shall be concluded. In no event shall the period for completing the further proceedings, including the reviewer's submission of an additional report, the Regional Executive Director's issuance of another rejection or other decision, and the Director's or his designee's issuance of a decision, exceed 14 working days. The original of the Director's or his designee's decision shall be filed in the Director's records, and copies shall be sent to the Regional Executive Director and to the complainant. The decision of the Director shall be final. (6) General Provisions. (a) Whenever the Program's Clients' Rights staff or the Division's Personal Advocacy Unit becomes aware of a situation that appears to require immediate action to protect the welfare and safety of any client, the Program's Clients' Rights staff or the Personal Advocacy Unit shall immediately notify the nearest available staff member with authority to correct the situation. (b) In any situation that requires immediate action to protect a client's welfare or safety, the Regional Executive Director may be notified instead. If adequate corrective action is not taken by that staff member, the Clients' Rights staff or the Personal Advocacy Unit shall immediately notify the Regional Executive Director, or, if necessary, the Division Director or the Commissioner of the Department. (c) No person shall be subject to any form of discipline or reprisal solely because he has sought a remedy through or participated in the procedures established by this Section 290-4-9-.04. (d) Obstruction of the investigation or disposition of a complaint by any person shall be reported to the Program Director, who shall take action to eliminate the obstruction. Staff members are subject to adverse action for engaging in such obstruction, in accordance with personnel procedures of the Department or the personnel procedures of the governing authority. (e) Time limits designated in this Section 290-4-9-.04 may be extended by the decision maker at each step for good cause only. (f) This complaint procedure does not replace or invalidate any other Department policy or procedure pertaining to reporting requirements, disciplinary matters, or the like. (g) Staff members who are involved in a complaint shall not be involved in the processing of that complaint. 290-4-9-.05 Confidentiality. (1) A service record for each client shall be maintained. The record shall include data pertaining to admission and such other information as may be required under regulations and standards of the Department. The service record shall not be a public record and no part of it shall be released except: (a) Service records of clients treated for alcohol and drug abuse shall be maintained in accordance with Volume 42 of the Code of Federal Regulations 42, Part 2, "Confidentiality of Alcohol and Drug Abuse Patient Records," as now or hereafter amended. Volume 42 of the Code of Federal Regulations Part 2 and O.C.G.A. 37-7-166 control the disclosure provisions for clients treated for alcohol and drug abuse; (b) When the chief medical officer of the Program where the record is kept deems it essential for continued treatment or habilitation, a copy of the record or parts thereof may be released upon consent of the client to physicians or licensed applied psychologists when and as necessary for the treatment of or habilitation of the client; (c) A copy of the record may be released to any person or entity as designated in writing by the client or, if appropriate, the parent of a minor, the legal guardian of an adult or minor, or a person to whom legal custody of a minor patient has been given by order of a court; (d) When a client is admitted to a Program, a copy of the record or information contained in the record from another facility, community program, or a private practitioner may be released to the admitting Program. When the service/program plan of a client involves transfer of that client to another Program or hospital, a copy of the record or information contained in the record may be released to that Program or hospital; (e) A copy of the record or any part thereof may be disclosed to any employee or staff member of the Program when it is necessary for the proper treatment of the client; (f) A copy of the record shall be released to the client's attorney if the attorney so requests and the client, or the client's legal guardian, consents to the release; (g) In a bona fide medical emergency, as determined by a physician treating the client, the chief medical officer may release a copy of the record to the treating physician or to the client's psychologist; (h) The record shall be produced by the entity having custody thereof at any hearing held under O.C.G.A. Chapters 37-1, 37-3, 37-4, 37-5, or 37-7 at the request of the client, the client's legal guardian, or the client's attorney; (i) A copy of the record shall be produced in response to a valid subpoena or order of any court of competent jurisdiction, except for matters privileged under the laws of this State; provided, however, that disclosure of alcohol abuse or drug abuse client information shall be produced in response to a court order issued by a court of competent jurisdiction pursuant to a full and fair show cause hearing; (j) Notwithstanding any other provision of law to the contrary, a law enforcement officer in the course of a criminal investigation may be informed whether a person with mental illness or mental retardation is or has been a client in a Program as well as the client's current address, if known; provided, however, that disclosure of alcohol abuse or drug abuse client information is not authorized by this paragraph. (k) Notwithstanding any other provision of law to the contrary, a law enforcement officer in the course of investigating the commission of a crime on the premises of a Program or against Program personnel or a threat to commit such a crime may be informed as to the circumstances of the incident, including whether the individual allegedly committing or threatening to commit a crime is or has been a client in the Program, and the name, address, and last known whereabouts of any alleged client perpetrator. (2) Any disclosure authorized by this section or any unauthorized disclosure of confidential or privileged client information or communication shall not in any way abridge or destroy the confidential or privileged character thereof, except for the purpose for which such authorized disclosure is made. Any person making a disclosure authorized by this section shall not be liable to the client or any other person notwithstanding any contrary provision of O.C.G.A. Section 24-9, Article 2, as now or hereafter amended. 290-4-9-.06 Notification of Rights. In addition to the provision of these Regulations Paragraph 290-4-9-.01(3), each Program shall display a notice in a prominent place of the availability and accessibility of these regulations Chapter 290-4-9 at each appropriate service site. Authority O.C.G.A. Chap. 37-2; Secs. 37-1-23; 37-3-2; 37-4-3; 37-7-2. History. Original Rule entitled "Notification of Rights" was filed on January 9, 1987; effective January 29, 1987. Repealed: New Rule of same title adopted. F. Aug. 18, 1994; eff. Sept. 16, 1994, as specified by the Agency. A SIGNED COPY OF THE RIGHTS MUST BE PLACED IN CLIENT’S OR EMPLOYEE’S FILE By signature below, I, an employee of Faith Staffing Agency, Inc. acknowledges that I have received a copy of the Clients’ Rights that this information has been fully explained to me.
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NEW HIRE ORIENTATION
All employees must sign for receipt of the employee handbook. All applications must be complete with credentials up to date. All employees must complete the pre-employment medical injury. ALWAYS DISCUSS EACH INDIVIDUAL’S SPECIFIC CONDITION (ISP) AND NEEDS WITH YOUR SUPERVISOR BEFORE STARTING ANY CASE (diagnosis and special care requests-use the care plan). Staff should be oriented in the following:
- Completion of new hire paperwork (Use employment packet)
- Faith Medical Services Mission, Vision and Core Values
- Employee policies and procedures
- Code of ethics/Customer service
- Job description
- Individual’s contact information and demographic location
- Cultural Competency
- Documentation task (person- centered notes, goal, HRST and health tracking, etc.)
- Long Term Abuse Act
- Critical Incident Reporting
- HIPPA/Grievance Polices
- Client’s Right and Responsibilities
- Infection Control Procedures
- Emergency Procedures
- Work Schedule/Clock in system
- Absenteeism/Tardiness/Time-Off Request (refer to employee handbook)
- In-service Training (16 hours mandatory) employee will be receive Relias online login info
- Training Log
- Mileage (1XWD MD appointments only, unless otherwise approved)
- Discuss dress code (refer to employee handbook)
- Fingerprint (background check)
- CPI/Crisis Intervention (Relias)
- W-2
- Payroll Calendar
Overtime/Work Holiday (no overtime)
EMERGENCY PROCEDURES

In case(s) of all serious emergencies (falls, unconsciousness, and everything that looks like it)
□ Ensure client is safe
□ Call 911 immediately for all life-threatening issues
□ Report incidence to the office immediately
□ Make an incidence report and send it to the office ASAP!

Whenever you have any situation (Client refused bath, bruises or sores, changes in client conditions…) with your client, these are the procedures to follow:

□ Ensure client is safe
□ Call family member (look on your care plan for clients representative contacts)
□ Call and notify the office immediately
□ Make reports on your progress notes or incidence report forms and send them to the office ASAP!

You must also report the following to the office immediately:
□ Client hospitalized
□ Client out of home
□ All client complaints about their health status
□ Client refused services

PS: If the incident happened when you are not on assignment but was brought to your attention, it must still be reported!

Report all incidences no matter how irrelevant it may appear! All incidences must be reported as soon as it occurred (i.e. within the hour).

Numbers to reach us at: 770-996-8180, 404-506-9400(fax)

I acknowledge and pledge to abide by the above instructions.
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New Hire Orientation (DSP)
All employees must sign for receipt of the employee handbook. All applications must be complete with credentials up to date. All employees must complete the pre-employment medical injury. ALWAYS DISCUSS EACH INDIVIDUAL’S SPECIFIC CONDITION (ISP) AND NEEDS WITH YOUR SUPERVISOR BEFORE STARTING ANY CASE (diagnosis and special care requests-use the care plan). Staff should be oriented in the following: Completion of new hire paperwork (Use employment packet) Faith Medical Services Mission, Vision and Core Values Employee policies and procedures Code of ethics/Customer service Job description Individual’s contact information and demographic location Cultural Competency Documentation task (person- centered notes, goal, HRST and health tracking, etc.) Long Term Abuse Act Critical Incident Reporting HIPPA/Grievance Polices Client’s Right and Responsibilities Infection Control Procedures Emergency Procedures Work Schedule/Clock in system Absenteeism/Tardiness/Time-Off Request (refer to employee handbook) In-service Training (16 hours mandatory) employee will be receive Relias online login info Training Log Mileage (1XWD MD appointments only, unless otherwise approved) Discuss dress code (refer to employee handbook) Fingerprint (background check) CPI/Crisis Intervention (Relias) W-2 Payroll Calendar Overtime/Work Holiday (no overtime)
New Hire Orientation (LPN/RN)
All employees must fill out the competency skill form. *All employees must go through the standard nursing protocols. * Completion of the new hire paperwork * Skill/Competency checklist * Faith Medical Services Overview- Vision, Mission and Core Values * Employee policies and procedures (Use new hire orientation booklets) * Code of ethics * Dress code * Job description * Confidentiality of client’s information (HIPPA) * Client’s rights and responsibilities * Documentation (See documentation policy)- * Go over Initial assessment, Visit notes, Supervisory visits, Physician summary report, Physician order form, care plan, Discharge form. * Doctor’s orders (See policy) * Start of care (SOC)/Absenteeism/Tardiness/Missed visit (See policy) * Nursing standard protocols (Use protocol procedures)-IV, Wound care, Medication * Infection control procedures (See policy) * Emergency procedures * Obtaining Supplies * Drug screening * Pay day & pay rates (Use payroll calendar)/W2/1099 * Company clock in system/Mileage (See mileage form) * Updating Credentials
New Hire Orientation
You will be oriented on the following:
• Completion of the new hire paperwork (Use employee packet)
• Faith Staffing Agency, Inc overview – Vision, Mission and Core Values
• Employee policies and procedures (Use both new hire orientation booklets)
• Code of ethics/Client’s funds appropriation form
• Job description/Client diagnosis and specific needs.**Important
• Address and direction to assignment
• Abuse & neglect
• Dementia & Alzheimer
• Mileage* (1XW MD appointments only, unless otherwise approved)
• Discuss dress code (Use employee handbook)
• Documentation of tasks provided/Use of time sheets/Badges
• Company clock in system (give employee clock-in information)
• Bi-weekly progress notes
• Incidence reporting (e.g. falls, injuries, hospitalization….)
• Confidentiality of client’s information (HIPPA)
• Client’s right and responsibilities
• Infection control procedures
• Emergency procedures
• Work schedule (Give employee client care plan before first day at work)
• W 2
• Pay period & payday (Use payroll calendar)
• Overtime work/Holiday policies (No overtime)
• Absenteeism/Tardiness/Time off request (Use employee handbook)
• In-service training (8hrs mandatory per year). Give training website information
• Employee certification updates (Use employee handbook)
• Drug screening
• Marketing ( Referral fee per enrolled client)
* Two store trips per week is part of employee job description, no mileage will be paid.
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New Hire Orientation
New Hire Orientation You will be oriented on the following: • Completion of the new hire paperwork (Use employee packet) • Faith Staffing Agency, Inc overview – Vision, Mission and Core Values • Employee policies and procedures (Use both new hire orientation booklets) • Code of ethics/Client’s funds appropriation form • Job description/Client diagnosis and specific needs.**Important • Address and direction to assignment • Mileage* (1XW MD appointments only, unless otherwise approved) • Discuss dress code (Use employee handbook) • Documentation of tasks provided/Use of time sheets/Badges • Company clock in system (give employee clock-in information) • Bi-weekly progress notes • Incidence reporting (e.g. falls, injuries, hospitalization….) • Confidentiality of client’s information (HIPPA) • Client’s right and responsibilities • Infection control procedures • Emergency procedures • Work schedule (Give employee client care plan before first day at work) •W2 • Pay period & payday (Use payroll calendar) • Overtime work/Holiday policies (No overtime) • Absenteeism/Tardiness/Time off request (Use employee handbook) • In-service training (8hrs mandatory per year). Give training website information • Employee certification updates (Use employee handbook) • Drug screening • Marketing ( Referral fee per enrolled client) * Two store trips per week is part of employee job description, no mileage will be paid.
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Orientation Booklet
WELCOME TO FAITH MEDICAL SERVICES

We have put together this information package so that you can become familiar with our policies and procedures. If you have any questions that are not answered here, please feel free to ask any member of the admin staff.

Faith Staffing Agency, Inc (dba Faith Medical Services) is a health care employment and private homecare agency providing excellent services (skilled and non-skilled nursing) in Georgia with over 10 years of experience. We are Georgia State licensed, insured and an active member of Georgia Association of Community Care Provider (GACCP), faithfully serving over 40 counties in Georgia.

The focus of our organization and work has been the provision of quality and timely support services to seniors, youths, children, people with disabilities and people with other challenging needs. As such, we require professional and exceptional caregivers to be part of our team!

Our Vision: To be a preferred provider in home healthcare industry.

Our Mission: We achieve our goals by providing our client with quality, timely and value driven services with high integrity that respects individual needs and uniqueness.

Our Core Value:
- Diversified and specialized services
- On-Site Visitation
- We provide Ongoing Staff Training
- Prompt Response with excellent customer service
- 24 hour On-call Emergency Contact
- Experienced & Professional team
Time Slips/Paychecks

The pay period runs bi-weekly. Check our yearly payroll calendar for details. Our clocking system and notes where applicable should be filled out completely per protocol and signed by your clients. Pay day is on Fridays, all notes and visits for payment must be in by Monday 2pm of the current pay period week. This is an absolute deadline. Any hours received after the deadline will not be processed until the following pay period or processed with $35 late fees. We only allow direct deposit because of postal issues with mailing checks, make sure the HR or Payroll department have a copy of your voided check or bank letter with your account details. (No Exceptions to all these rules!)

Cancellations

If you accept a case or shift, it is expected that the individual will fulfill his or her responsibility by reporting to their assignment. In the event that you encounter an emergency or illness prior to the scheduled shift, call Faith Staffing Agency, Inc Immediately. Failure to notify the office of your inability to fulfill your shift will result in termination unless extreme circumstances can be verified. Please read the call out policy given to you or request one from the office if in doubt.

It is extremely important that you understand patients, clients, Faith Staffing Agency, Inc and God are depending on you, and if one person doesn’t provide excellent care and responsibility, patients are the one who suffers.

Punctuality

It is your responsibility to notify Faith Staffing Agency, Inc if you cannot make it to your assignment on time. We need to have this information in order to notify the client. More importantly, as a member of the Faith Staffing Agency, Inc team, you are an individual asset and the office staff becomes concerned for your safety if we do not know your whereabouts and you are running late.

Dress Code

Dress code for all Staff will be nurse uniforms. When in doubt, please check with the office to clarify. Faith Staffing Agency, Inc expects all contract employees to present a neat, clean, professional appearance within the guidelines of the specific facilities guidelines.

Availability and Scheduling

Frequently update the office on your availability. When needs are received, we will contact you to offer the shift. If you accept the assignment, we will then confirm it with the facility/client. Make every attempt to return our calls promptly, since normally we have contacted a number of members and give the shift to the first person to return our call. Allow 4-6 weeks to be assigned to another case.

Unusual Occurrence

Any unusual occurrence/injury that takes place during your shift should be reported to the office staff immediately. This includes injury to yourself; serious injury to a patient, or any situation that you feel should be brought to our attention. All employees needing medical attention must use agency’s posted workmen’s compensation physician panel for all job related injury.

24 Hour Staffing Service

Your Faith Staffing Agency, Inc staff is available 24 hours a day. After office hours a staff member is on call, and available to assist you. Simply call the 24 hour line (770) 907-7226 and press 1 to talk to our on call rep. We do ask that discretion be used when calling after hours, and we ask that any calls that can wait until the next business day be made at that time.

ALWAYS WEAR YOUR FAITH STAFFING NAME BADGE, AS IT IS OFTEN THE ONLY WAY THAT A FACILITY OR CLIENT WILL KNOW YOU ARE A FAITH STAFFING AGENCY, INC CONTRACT EMPLOYEE.

Staffing
- Contact Faith Staffing Agency, Inc on a weekly basis to report availability, verify work schedule, or request work assignments.
- Have all schedule changes and work assignments arranged, coordinated, and approved.
- Contact Faith Staffing Agency, Inc if a client or client family members desire different staffing arrangements.
- Hours worked by staff members must coincide with the hours approved by Faith Staffing Agency, Inc in order for the staff member to be paid.
- Accept work assignments only if there is certainty that the shifts, days and hours in the assignments can be worked.
- Report for accepted work assignments.
- Arrange schedules to avoid conflict with accepted work assignments.
- Give an advance four-hour minimum notice to the coordinator if a work assignment is cancelled due to unforeseen events such as illness or emergency situations.
- Be on time for scheduled work assignments.
- Contact the Staffing Coordinator if the work assignment is completed before the scheduled time is up.
- Report for work assignments at least 15 minutes early for orientation/report when unfamiliar with policies, procedures, equipment, or routine.
Job Performance

All staff members must participate in annual job performance reviews. Contact the Administrator if you are asked to perform tasks that are not in your job description. Adhere to the following standards in dress, appearance, and conduct:
- Maintain a professional appearance and wear a clean uniform.
- Wear identifying nametag.
- Be courteous and respectful toward clients and families.
- Ensure client confidentiality.
- Do not falsify time slips.
- Do not use slang, foul language, or cell phones (except in emergencies).
- Do not smoke in the client’s home.
- Do not accept gratuities or discuss salary with clients.
- Do not provide services when the client is absent.
Benefits & Bonuses

Salary Raises

Faith Staffing provides salary raises based on:
- Being on time to assignments
- No call-outs or cancellations
- Excellent job performance
- Good conduct
- Appearance & Professionalism
- Length of employment
- Compliance with all policies
Note: Raises are determined solely by periodic performance evaluations.

Compensation & Incentives
- Salary (starting from):
  PCA/CNA – $13; Pediatric PCA – $13–$14; DSP – $13–$16;
  LPN – $33–$35/hour or $35/visit; RN – $46–$49/hour or $50/visit
- $50 referral bonus (client must be enrolled and services initiated)
- Special hourly rates on weekends for on-call work
- Additional incentives where applicable
Electronic Visit Verification (EVV)

What is EVV? Electronic Visit Verification (EVV) is a technology that automates collection of service information by capturing time, attendance, and care plan details at the point of care.

At a minimum, EVV verifies:
- Type of service performed
- Individual receiving the service
- Individual providing the service
- Date the service was provided
- Location of service delivery
- Time the service begins and ends
Employee Acknowledgment

I certify that I:
- Have read and understood Faith Medical Services’ policies and procedures, scope of services, client rights and responsibilities.
- Have been oriented to policies for call-outs, cancellations, and lateness.
- Understand the risks, safety guidelines, and emergency procedures listed in the packet.
I understand:
- My assigned duties and responsibilities.
- How to document tasks completed and client condition.
- Procedures for handling emergencies and reporting incidents.
- My obligation to report known exposure to tuberculosis and hepatitis.
- That I have not been shown by credible evidence to have abused or neglected anyone.
- That I participated in the orientation and training organized by FMS and received the employee handbook.
- That all assignments are PRN and hours are not guaranteed.
- That quitting an assignment improperly may reduce final paycheck rate.
- That I will abide by the State’s Electronic Visit Verification (EVV) requirements.
Certification: I have not made any material false statements concerning my eligibility for employment with Faith Medical Services.
Employee Name
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Job Description
Nursing services shall include but not limited to:
1) Regular assessment of the nursing needs of the client
2) Participate in the establishment and implementation of the client service
plan and re-evaluate the client’s condition at least every two months (60- 62 calendar days)
3) Provide nursing services as needed and in accordance with the client’s service plan (Infusion therapy, wound care, teaching, medication management…. as needed)
4) Report problems and progress of the client to supervisory personnel or client’s personal physician
5) Handle grievance, complaint of abuse by client. Investigate and reports to the Administrator within 5 days on corrective measures taken.
6) Supervise CNA’s and PCA’s, Companion or Sitters out in the field
7) Make supervisory visits for client and employee evaluation
8) Ensure all documentation on client’s chart is accurate, updated and signed by the staff providing the task
9) Develop and maintain training calendar for in-house training and external training needs of the organization and scheduling of staff for training.
10) Conduct in-service-training of staff
11) To attend mandatory provider’s training sessions as organized by the Division of Aging Services.
11) To always be sensitive and caring to the individual culture of the client
12) To keep in constant communication with the Administrator and report changes or unusual occurrences while under employment of Faith Staffing Agency
13) To perform your duties in a professional manner avoiding confrontation with client or client’s family members.

Nursing Supervisor Experience/Qualifications Shall Include But Not Limited To
1. CERTIFICATION FROM THE STATE OF GEORGIA
2. CURRENT CPR CERTIFICATION (MUST RENEW IN TIMELY MANNER)
3. CURRENT PPD SCREENING (CHEST X-RAY) if needed 4. CURRENT GEORGIA STATE DRIVER’S LICENSE OR GEORGIA STATE ID
5. COPY OF SOCIAL SECURITY CARD

MINIMUM REQUIREMENTS:
1. High School Diploma or GED
2. College degree or Nursing Certificate
3. Health related training courses or equivalent of education and experience
I have read the job descriptions and agree to adhere to the policy.
Job Description

CNA/PCA
Nursing Assistant
Duties and Responsibilities Please sign both copies of duties and responsibilities, return one for file and keep the other for yourself.
Overview: The Nursing Assistant must provide personal care and other scope of services for clients as directed in the care plan.
1. PERSONAL CARE TASK: a. Bathing (bed, tub, shower)
b. Routine skin care
c. Hair care (comb, brush, shampoo)
d. Oral hygiene (brush, floss, dentures)
e. Dress/assisting with dressing/grooming
f. Assisting with toileting
g. Nail care (trim, file and clean fingernails, file and clean toe-nails only(Do not trim)
h. Shave (DO NOT SHAVE A DIABETIC CLIENT.)
i. Preparing meals
j. Feeding/assisting with feeding
k. Encouraging proper nutrition
l. Assisting with activities of daily living (ADL)
m. Caring of incontinent patients

2. HOUSEKEEPING TASKS:
1. Following care plan for tasks to be performed
2. Making bed, changing linens as ordered
3. Vacuuming, sweeping, dusting, mopping, doing laundry, emptying trash, wiping spills promptly.
4. Cleaning bathroom, washing dishes (ONLY AREA CLIENTS USES)

3 PROPER NUTIRTION:
1. Preparing meals/clean up
2. Encouraging proper nutrition
3. Assisting with eating
4. Observing and reporting meal accumulation and food storage or cooking equipment.

4. HOME MANAGEMENT
1. Assisting clients with grocery shopping
2. Assisting with paying bills
3. Assisting with food stamp application or applications
4. Making emergency call for client if needed.

5. MOBILITY
1. Assisting in out of bed/wheel chair
2. Using of Hoyer lift for transfer (if needed)
3. Assisting with ambulation
4. Encouraging physical activity as condition permits
5. Transferring in and out of handicap vehicles
6. Turning/repositioning patient in bed
7. ROM/ambulating with walker

6. HEALTH CARE ACTIVITIES:
1. Catheter care with soap and water
2. Assisting client with self-administration of medications.
3. Picking up prescription
4. Reminding client to take medication
5. Taking vital signs if applicable
7 OBSERVATION AND DOCUMENTATION:
1. Documenting all tasks performed on duty sheets
2. Making sure all tasks have been completed and paper work completed before departing.
3. Observing and reporting to supervisor any change in patients condition.

4. Continually making sure of client’s comfort and safety
5. Reporting any unknown abuse or suspected abuse to supervisor.

6. Reporting any unsafe condition in home to supervisor
7. Being sensitive and caring to the Individual culture, dignity and self-respect of client
8. Performing tour duties in professional manner, avoiding confrontations with client/client representative or family members.
9. (CNA OR PCA) MUST CALL 4 HOUR PRIOR TO YOUR SHIFT IF YOU ARE GOING TO BE ABSENT/LATE.
8 EMERGENCY PROCEDURE Making emergency calls for client if need be. • Calling 911 • Performing CPR/First Aide if needed • Calling client family or designated person • Calling your Supervisor at Faith Staffing Agency Inc (770) 907-7226

Aides Experience/Qualifications Shall Include But Not Limited To 1. CERTIFICATION FROM THE STATE OF GEORGIA 2. NAME ON GEORGIA STATE REGISTRY LISTING 3. CURRENT CPR CERTIFICATION (MUST RENEW IN TIMELY MANNER) 4. CURRENT PPD SCREENING (CHEST X-RAY) if needed 5. CURRENT GEORGIA STATE DRIVER’S LICENSE OR GEORGIA STATE ID 6. COPY OF SOCIAL; SECURITY CARD
MINIMUM REQUIREMENTS:
1. High School Diploma or GED
2. Health related training courses or equivalent of education and experience.

I have read the job description and qualification and agree to adhere to the policy.
DUAL DIAGNOSIS

What you should know about Dual Diagnosis: Dual diagnosis (also referred to as co-occurring disorders) is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience.
Symptoms:
Because many combinations of dual diagnosis can occur, the symptoms vary widely. Symptoms of substance use disorder may include: withdrawal from friends and family, Sudden changes in behavior, Using substances under dangerous conditions, Engaging in risky behaviors, Loss of control over use of substances, Developing a high tolerance and withdrawal symptoms, Feeling like you need a drug to be able to function. Symptoms of a mental health condition can also vary greatly. Warnings signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, maybe reasons to seek help. How Is Dual Diagnosis Treated?
The best treatment for dual diagnosis is integrated intervention, when a person receives care for both their diagnosed mental illness and substance abuse. Treatment planning will not be the same for everyone, but here are the common methods used as part of the treatment plan:
Detoxification. The first major hurdle that people with dual diagnosis will have to pass is detoxification. Inpatient detoxification is generally more effective than outpatient for initial sobriety and safety. During inpatient detoxification, trained medical staff monitors a person 24/7 for up to seven days. The staff may administer tapering amounts of the substance or its medical alternative to wean a person off and lessen the effects of withdrawal.
Inpatient Rehabilitation. A person experiencing a mental illness and dangerous/dependent patterns of substance use may benefit from an inpatient rehabilitation center where they can receive medical and mental health care 24/7. These treatment centers provide therapy, support, medication and health services to treat the substance use disorder and its underlying causes. Supportive Housing, like group homes or sober houses, are residential treatment centers that may help people who are newly sober or trying to avoid relapse. These centers provide some support and independence. Sober homes have been criticized for offering varying levels of quality care because licensed professionals do not typically run them. Do your research when selecting a treatment setting. Medications are useful for treating mental illnesses. Certain medications can also help people experiencing substance use disorders ease withdrawal symptoms during the detoxification process and promote recovery. Self-Help and Support Groups. Dealing with a dual diagnosis can feel challenging and isolating. Support groups allow members to share frustrations, celebrate successes, find referrals for specialists, find the best community resources, and swap recovery tips. They also provide a space for forming healthy friendships filled with encouragement to stay clean. Here are some groups NAMI likes: Double Trouble in Recovery is a 12-step fellowship for people managing both a mental illness and substance abuse.
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NOTICE OF DRUG-FREE WORKPLACE
POLICY:
It is the policy of FMS to inform and make all employees aware of their Drug-Free Workplace policy and the Drug-Free workplace act. FMS prohibits any and all unlawful possession, use, dispensation, distribution, manufacture of controlled substances in the workplace, and/or on its premises or her client’s premises. Any violation of this policy will result in disciplinary action which may include immediate termination of employment. Depending upon the circumstances, other action including notification of appropriate law enforcement agencies may be taken against any violator of this policy.
THE DRUG-FREE WORKPLACE ACT
In the later part of 1988 the federal government passed into law a requirement that all government contractors establish guidelines, which specifically identify a company’s posture regarding drugs in the workplace. In accordance with the Drug-free workplace act of 1989, as a condition of employment, staff members must comply with this policy and notify management within (5) days of conviction of any criminal drugs charge. Failure to do so will result in immediate termination of employment. Any staff member arrested in connection with a criminal drug violation occurring in the workplace will be placed on a personal leave of absence without pay and could face termination of employment pending the outcome of the in-house investigation, and/or legal investigation and conviction.
FMS shall require mandatory drug testing and /or may conduct random drug tests at their discretion of any employee. Such test may be necessary based on observed inconsistent or erratic behavior that constitutes a health or safety hazard to other employees or client’s home. If the employee or staff refuses to comply with the testing, he/she will be terminated immediately without any further notice.
By signing below, you certify that you are fully aware of this policy and adherence of the same is required.
POLICIES ACKNOWLEDGEMENTS

Callout Policy and Procedures

Faith Medical Services goal is to ensure all our clients are staffed always. Readout call-out policy and procedure. All employees requesting off work should inform the agency 2 weeks in advance so that the shift can be covered. In case of an emergency please inform the agency as soon as possible with a 4-hr. minimum requirement so that your shift can be covered. Please do not call off work using email format, ensure to speak with your supervisor. Failure to comply with company policies will result in disciplinary actions. We thank you for your cooperation in advance.

No Call/No Show Policy and Procedures

Read our No Call/No Show Policy and Procedures. The company has a zero-tolerance for No Call/No Shows. No Call/Shows are ground for automatic termination. Anyone that performs a No/Call Show must be in an extreme medical condition that would not allow you to call into work. Proper documentation must be presented to excuse your absence. You are only allowed one call-out per month, any hours on the day or period you call out after the approved one time will be paid at the minimum wage. If you quit an assignment without proper notification (two weeks' notice your last check will be paid at minimum wage. We thank you for your cooperation in advance.

Removal from Case

This is to inform all Faith Medical Services Employees of the policies and procedures when you are removed or want to be removed from a case. All employees that are W2 employees should allow 2 to 4 weeks for reassignment. All employees that are Independent Contractor/1009 employees will be reassigned on as need basis.

Matrix and time record

All employees must use our Matrix clocking System. This system is a part of your job and is monitored daily. You are to use the system as you enter the client’s home and when you exit. IF YOU FORGET TO CLOCK OUT, OR YOU DID NOT CLOCK IN AT ALL, we will count it as a missed visit unless you have an issue and you called us immediately.
After two weeks of the payday you provided service, we can no longer pay you. Ensure to send in your visit records at the company stated times. The time records must be compliant with our rule to get paid.

Payroll Calendar

This is to verify that you have received Faith Medical Services Payroll Calendar along with the payroll violation rules and regulations. Violations will attract a $35 fee payable to the 3rd party payroll company.

Name Badges

All employees are always required to wear their name badges while on duty. The fee to replace the company name badges is $25. In the event you are no longer employed with our company, you are required to return the name badge to us within 2 business day; otherwise, a fee $25 will be deducted from your last check.

Employee Handbook

This is to verify that you have received the Faith Medical Services employee handbook along with all policies and procedures. Adhere to all policies and procedures always. Disciplinary actions will follow with any violations of the company’s policies.

Credentials

It is your responsibility to update your credentials always (this includes yearly training), failure to do so will result in disciplinary action, and up to termination.
Employee Name
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EMERGENCY PROCEDURE
EMERGENCY PROCEDURE Making emergency calls for the client if need be. • Calling 911 • Performing CPR/First Aide if needed • Calling client family or designated person • Calling your Supervisor at Faith Staffing Agency Inc (770) 907-7226
INFECTION CONTROL PROCEDURES
All employees must observe the following procedures in the provision of services to prevent exposure to prevent exposure to infectious disease. These procedures are universal precautions to prevent the spread of infectious diseases.
All blood and body fluids visible with blood are to be treated as potentially infectious. Wash hands and other skin surfaces immediately and thoroughly if soiled with blood or body fluids, and change gloves after contact with each client. Wash hands before and after giving care to clients.
A. Wear latex gloves when: 1. Touching blood/body fluids, mucous membranes, or non-intact skin. 2. Handling items or surfaces soiled with blood/body fluids visible with blood. 3. Performing venipuncture and other vascular access procedures. 4. Cleaning and decontaminating spills of blood/body fluids. 5. Although no diseases are known to be spread by direct skin contact with feces or other body fluids, gloves should be worn when having contact with feces and any body fluids as a basic hygiene measure. B. Standard housekeeping cleaning procedures to be used. 1. For spills of blood and body fluids, wipe up spill with soap and water and then disinfect area with a commonly used germicide or freshly prepared 1:10 bleach solution (1 part bleach to 9 parts water). 2. All soiled linen should be bagged at the location where it was used; not be sorted or rinsed in client-care areas. Linen soiled with blood fluids should be placed and transported in bags that prevent leakage. 3. Linens and personal clothing items laundered should be washed using routine laundering procedures. 4. Dish washing using routine cleaning procedures effectively destroys pathogenic (disease causing) organisms. Dishes of clients with hepatitis B or AIDS do not need to be separated from the rest of the facility clients. Do not share unwashed utensils or use common drinking glasses with any client.
C. Environmental procedures to be used:
1. Use a gown or apron during procedures that are likely to generate splashes of blood or other body fluids. Universal precautions also recommend the use of masks/eye wear during procedures that are likely to generate droplets of blood or other body fluids to prevent exposure of the mucous membrane of the mouth and nose/eyes. 2. Dispose of secretions directly into the toilet. An individual toilet for a client is not required, but is recommended if the person has diarrhea. 3. Care should be taken to prevent injuries caused by needles and other sharp instruments or devices. 4. To prevent needle stick injuries, needles should not be recapped, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand. After they are used, disposable syringes and needles, and other sharp items should be placed in puncture-resistant containers for disposal. The puncture-resistant containers should be located as close as practical to the use area. 5. Direct mouth-to-mouth contact is not recommended. It is recommended that mouthpieces, ventilation bags or other ventilation devices be kept in areas where the need is predictable. However, if such devices are not available an employee should not hesitate to provide CPR (Cardiopulmonary Resuscitation) procedures.
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RESTRICTIVE COVENANT AGREEMENT
This Restrictive Covenant Agreement (this “Agreement”) is made and entered into by and between Faith Medical Services (the “Company”) and the (“Employee”) as of the date entered above this agreement.
Whereas, the Company is in the business of providing personal care attendants/aides, home health aides, companion/sitters and skilled nursing care to patients in their homes (the “Company’s Business”); and Whereas, Employee understands and acknowledges that, from the outset and through the term of Employee’s employment, Employee shall receive specialized training from the Company and have access to the Company’s clients, referral sources and Confidential information, as defined below, the unauthorized use, or, disclosure of which will irreparably damage, affect or impair the Company’s Business and business relationships.
Now, therefore, for and in consideration of employment or continued employment of Employee by the Company, the Company’s provision of its Confidential Information, specialized training, and client relationships to Employee, and other good and valuable consideration, the receipt, adequacy and sufficiency of which are hereby acknowledged, the parties hereto covenant and agrees as follow:
1. Confidential Information. Employees agree not to access, use, disclose or exploit, directly or indirectly, any confidential information except as necessary to perform Employee’s duties on behalf of the Company.
“Confidential Information” means data and information (1) relating to the Company’s Business, regardless of whether the data or information constitutes a trade secret under applicable law, (2) disclosed to Employee or of which Employee became aware as a consequence of Employee’s relationship with the Company, (3) having value to the Company, (4) not generally known to competitors of the Company, and (5) which includes trade secrets (as defined by applicable law), manuals, policies, procedures, processes, forms, business plans, software, marketing plans, financial information, client and/or vendor lists, referral sources, client information, and all other types of confidential information related to the Company and/or the Company’s business; provided, however that Confidential information shall not mean data or information (a) that has been voluntarily disclosed to the public by the Company, except where such disclosure has been made by Employee without authorization from the Company, (b) that has been independently developed and disclosed by others, or (c) that has otherwise entered the public domain through lawful means. Confidential information also includes any information that the Company may receive or has received from customers, vendors, or others with any understanding, express or implied, that the information would not be disclosed.
2. Non-Solicitation of the Company’s Employees. During Employee’s employment with the Company, and for a period of twelve (12) months thereafter, Employee will not recruit, solicit or induce any employees of the Company to leave the employ of the Company for the purposes of becoming employed or affiliated with any business in competition with the Company’s Business.
3. Covenant Not to Solicit the Company’s Clients. Employee agrees that, during the twelve (12) month period immediately following the cessation of Employee’s employment with the Company, Employee shall not, directly or indirectly, on behalf of Employee or any other person or business; solicit any business related to the Company’s Business from any client of the Company. The restrictions set forth in this Paragraph 3 shall apply only to clients of the Company with whom Employee had material contact during the last twelve (12) months of Employee’s employment with the Company. For purposes of this Agreement, “material contact” means contact between Employee and each client (1) to whom Employee provided services on behalf of the Company; (2) whose dealings with the Company were coordinated or supervised by Employee; or (3) about whom Employee obtained confidential information in the ordinary course of business as a result of Employee’s employment with the Company.
4. Noncompete Covenant. Employee agrees that during the twelve (12) month period immediately following the cessation of Employee’s employment, Employee will not, within the Territory, directly or indirectly, engage in the Company’s Business or provide Restricted Services to any other person or entity engaged in the Company’s Business. For purposes of this Agreement, “Restricted Services” means the provision of skilled nursing and/or personal attendant care services to patients in their homes of the type conducted, authorized, offered or provided by Employee within the twelve (12) month period prior to cessation of Employee’s employment with the Company. For purposes of this Agreement, “Territory” means a two (2) mile radius from any client’s home or other location where Employee provided Restricted Services to such client on behalf of the Company during the last twelve (12) months of Employee’s employment with the Company.
5. Ownership Covenants. All Company files, records, client lists, compilations, reports, studies, manuals, memoranda, data, and similar items containing information relating to the Company’s Business, and all notes, sketches, formulas, computer program source and object codes and other computer codes and data, whether prepared or developed by Employee or otherwise coming into Employee’s possession in the course of Employee’s employment, and all copies thereof, are, and shall remain, the exclusive property of the Company, and shall be promptly delivered to the Company in the event of employee’s termination, or at any other times the Company may request.
6. Remedies for Breach of Contract. Employee acknowledges that the covenants specified in Paragraph 1-5 contain reasonable limitations as to time, geographic area, and scope of activities to be restricted and that such promises do not impose a greater restraint on Employee than is necessary to protect the goodwill, Confidential Information, client and employee relations, and other legitimate business interest of the Company. Employee also acknowledges and agrees that any violation of restrictive covenants set forth in Paragraph 1-5 would bestow an unfair competitive advantage upon any person or entity which might benefit from such violation, and would necessarily result in substantial and irreparable damage and loss to the Company. Employee further acknowledges and agrees that Employee is capable of readily obtaining employment following termination of Employee’s employment with the Company that does not breach or threaten to breach the restrictions contained in Paragraph 1-5 of this Agreement. Accordingly, in the event of a breach or a threaten breach by Employee of any restriction contained in Paragraph 1-5 of this Agreement, the Company shall be entitled to an injunction restraining Employee from such breach or threatened breach, as well as recovery of its costs and attorney’s fees. Nothing therein shall be construed as prohibiting the Company from pursing any other remedies available to it for such breach or threatened breach including the recovery of damages from Employee. In the vent that the Company should seek an injunction hereunder, Employee waives any requirements that the Company post a bond or any other security. Employee understands and agrees that, in the event of litigation arising out of a breach or threatened breach of this Agreement, any applicable time period shall be tolled during the pendency of such litigation, including appeals.
7. No Inconsistent Obligations. Employee is aware of no obligations, legal or otherwise, inconsistent with the terms of this Agreement or with Employee’s undertaking employment with the Company. Employee will not disclose to the Company, or use, or induce the Company to use, any protected confidential information or trade secrets of others. Employee represents and warrants that Employee has returned all property and protected confidential information belonging to all prior employers.
8. Severability. Except as noted below, should any provision of this Agreement be declared or determined by any court of competent jurisdiction to be unenforceable or invalid for any reason, the validity of the remaining parts, terms and provisions of this Agreement shall not be affected thereby and the invalid or unenforceable part, term or provision shall be deemed not to be a part of this Agreement. The Covenants set forth in this Agreement are to be reformed pursuant to Paragraph 9, below, if held to be unreasonable or unenforceable, in whole or in part, and, as written and as reformed, shall be deemed to be part of this Agreement.
9. Reformation. If any of the covenants or promises of this Agreement are determined by any court of law or equity, with jurisdiction over this matter, held to be unreasonable or unenforceable, in whole or in part, and, as written Employee hereby consents to and affirmatively requests that said court reform the covenant or promise so as to be reasonable and enforceable and that said court enforce the covenant or promise as so reformed. 10. Assignment. The terms and provision of this Agreement shall inure to the benefit of and be binding upon the Company and its successors and assigns. This Agreement may not be assigned, in whole or in part, by Employee without the written consent of the Company. This Agreement may be assigned by the Company to any successor, parent companies, divisions, or affiliates thereof, and those entities are specifically acknowledged to be third party beneficiaries of the terms of this Agreement.
11. Survival of Obligations. The covenants contained in this Agreement shall survive termination of Employee’s employment to the extent provided herein, regardless of who causes the termination and under what circumstances.
12. Governing Law/Selection of Forum. This Agreement shall be governed by, and construed in accordance with, the laws of the State of Georgia. Employee acknowledges and agree that the negotiation of the provisions of this Agreement took place in the State of Georgia and that this Agreement was executed, made, delivered and materially performed in the State of Georgia. Employee hereby (a) submits to personal jurisdiction in the state of Georgia for any action arising out of or in connection with this Agreement; (b) waives any and all personal rights under the laws of any state to object to jurisdiction within the State of Georgia and (c) agrees that for any cause of action arising out of or in connection with this Agreement, Employee shall not file a claim or lawsuit in any court or arbitral forum except for a state or federal court located with Clayton County, Georgia.
13. At- Will employment. Employee acknowledges that nothing contained herein is intended to constitute a contract of continued employment, but instead Employee recognizes that Employee’s employment with the Company is on an “at-will” basis and may be terminated by either Employee or the Company at any time, for any reason, with or without cause, and with or without notice.
14. Entire Agreement. This Agreement contains the entire agreement between the parties hereto regarding the subject matter hereof, and the same shall not be amended, modified or altered except by a written instrument executed by both parties.
In Witness whereof, the parties hereto have set their hands and seals as of the day and year first above written
Signature to agree*

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NURSE NEW HIRE ORIENTATION

All employees must fill out the competency skill form. *All employees must go through the standard nursing protocols. You will receive a link to orientation after this application.

Completion of the new hire paperwork
Skill/Competency checklist
Faith Medical Services Overview- Vision, Mission, and Core Values
Employee policies and procedures (Use new hire orientation booklets)
Code of ethics
Dress code
Job description
Confidentiality of client’s information (HIPPA)
Client’s rights and responsibilities
Documentation (See documentation policy)-
Go over Initial assessment, Visit notes, Supervisory visits, Physician summary report, Physician order form, care plan, Discharge form.
Doctor’s orders (See policy)
Start of care (SOC)/Absenteeism/Tardiness/Missed visit (See policy)
Nursing standard protocols (Use protocol procedures)-IV, Wound care, Medication Infection control procedures (See policy)
Emergency procedures
Obtaining Supplies
Drug screening
P-ayday & p-ay rates (Use p-ayroll calendar)/W2/1099 Clock in system /Mileage (See mileage form)
Updating Credentials
Nurse Name
First Last
Nurse Signature*
Date
MM slash DD slash YYYY
Employee Authorization For Direct Deposit
How To Enroll For Direct Deposit? Please read and complete this form to initiate automatic direct deposit for your entire payroll check or a portion of your net pay. When Does Direct Deposit Start? Approximately 2 weeks after your form has been received and processed.
Please Remember The Following When Signing Up For Direct Deposit:
1. In accordance with the Federal Reserve Policy, Direct Deposits may take up to 48 business hours to be posted to your account. It is your responsibility to verify funds prior to writing checks against your account.
2. Direct deposit items are processed using the routing number from your voided check. However, some financial institutions require a different number for electronic transmissions. If your financial institution is a savings and loan, credit union, or you wish to deposit into a savings account, please verify with your Financial Institution that the routing number on your deposit slip is the same number we should use for electronic transmissions.
3. Financial Institutions may post electronic transactions at different times. Please check with your Financial Institution
to determine what time they post electronic transactions before trying to access your balance.
4. For your first initial payroll deposit, call your Financial Institution to confirm that your direct deposit(s) have been posted properly.
Financial Institution (Bank Name)
Upload your account details or voided check if you have it (must include your names)
Drop files here or

Max. file size: 32 MB.
Choose the kind of deposit (Checking or Savings)
- Checking
- Savings
* A maximum of 3 payroll deductions and one net pay direct deposit are allowed.
Please attach a copy of a personal VOIDED check from all Accounts you wish to be directly deposited.
I authorize deposit of my payroll check with the financial institution I have indicated. The financial institution is authorized to credit those deposits to the account(s) indicated. This authority will remain in effect until I have given written notice of its termination. If my Employer does not provide funds to cover my paycheck, I authorize you and the Financial Institution, at anytime, to reverse the credit transaction and withdraw money from my Account in an amount equal to the amount credited, and regardless whether the original amount credited is still in my account. I understand that I must give advance notice to allow reasonable time for my instructions to be executed. If ever an incorrect amount should be entered into my account, I direct and authorize my financial institution and Employer to make the appropriate adjustment.
Signature to agree
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Phone
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Onboarding-Application New

Step 1 of 14

CODE OF ETHICS

CERTIFICATE OF ETHICAL COMPLIANCE

DOCUMENTATION POLICY

Addendum to Company’s Equipment Use.

Employee Policies

INCIDENCES AND OCCURRENCES

Faith Medical Services

Emergency Procedures

CONFIDENTIALITY POLICY

Nursing Policy

MEDICATION ADMINISTRATION

CHECKLIST FOR COMPLETING PROPER STEPS IN THE ADMINISTRATION OF MEDICATIONS

RIGHTS OF MEDICATION ADMINISTRATION

GENERAL PROCEDURES OF ADMINISTERING MEDICATIONS BY THE VARIOUS ROUTES PREPARATION:

START OF CARE/MISSED VISIT POLICY

Additional DSP Form 1

JOB DESCRIPTION

Direct Support Staff

DEFINITION

Duties and Responsibilities

Qualifications

High Performance Objectives/Competencies

Accountability

Proactive

Team Player

Documentation

Working Conditions

Grievance policy

Documentation Policy

Evacuation Policy

Fire Safety

DSP Forms (Continued)

Reporting Abuse or Exploitation of Participants

NEW HIRE ORIENTATION

EMERGENCY PROCEDURES

New Hire Orientation

Orientation Booklet

WELCOME TO FAITH MEDICAL SERVICES

Time Slips/Paychecks

Cancellations

Punctuality

Dress Code

Availability and Scheduling

Unusual Occurrence

24 Hour Staffing Service

Staffing

Job Performance

Benefits & Bonuses

Salary Raises

Compensation & Incentives

Electronic Visit Verification (EVV)

Employee Acknowledgment

I certify that I:

I understand:

Job Description

Nursing Supervisor Experience/Qualifications Shall Include But Not Limited To

MINIMUM REQUIREMENTS:

Job Description

CNA/PCA

DUAL DIAGNOSIS

NOTICE OF DRUG-FREE WORKPLACE

POLICIES ACKNOWLEDGEMENTS

Callout Policy and Procedures

No Call/No Show Policy and Procedures

Removal from Case

Matrix and time record

Payroll Calendar

Name Badges

Employee Handbook

Credentials

INFECTION CONTROL PROCEDURES

RESTRICTIVE COVENANT AGREEMENT

NURSE NEW HIRE ORIENTATION

Employee Authorization For Direct Deposit