Advantage Medical Professionals

Policy and Procedure Manual

ADVANTAGE MEDICAL PROFESSIONALS, LLC

POLICIES AND PROCEDURES

Part 2 of 4


TABLE OF CONTENTS

SECTION II – HUMAN RESOURCES MANAGEMENT

License, Employment and Work History Verification

HR 1.0

     Health Screening Immunization

HR 1.1

     Evidence of Identity and Credentials When Reporting for an Assignment

HR 1.2

     Procedures on Maintenance and Documentation of Certifications

HR 1.3

          Tracking Renewal of Licensure and Certifications

HR 1.3.1

          File Purging

HR 1.3.2

     Client Update Procedure

HR 1.4

     Notification of Impending Expirations/Action Taken for Expired Credentials

HR 1.5

     Background Check

HR 1.6

     Drug Screening Policy

HR 1.7

     Primary Source Verification

HR 1.8

     Equal Employment Opportunity

HR 1.9

License Experience Parameters for Hire

HR 2.0

     Job Descriptions

HR 2.1

     Competency and Mandatory Testing

HR 2.2

     Client Driven Competency Tests Policy

HR 2.3

     Testing Procedures and Passing

HR 2.4

     Retesting Policy

HR 2.5

     Field Staff Reassignment/Floating Policy

HR 2.6

     Options for Employees Cancelled for Cause

HR 2.7

     Maintenance of Needs List

HR 2.8

     DNR- Do Not Return Policy

HR 2.9

Employee Orientation

HR 3.0

     Employee Notification of Company Policies and Policy Changes

HR 3.1

     Clinical Handbook

HR 3.2

Assessment and Reassessment of Clinical Staff Competence

HR 4.0

Continuing Education

HR 5.0

Performance Review Policy

HR 6.0

Dress Code

HR 7.0

Discrimination, Harassment, and Retaliation Prevention

HR 8.0

Employee Emergency Contact

HR 9.0

Travel Contract

HR 10.0

     Cancellation of Travel Contract

HR 10.1

Employee Benefits

HR 11.0

Recruitment and Retention

HR 12.0

Medication Variation

HR 13.0

Hire Dates, Active and Inactive Status

HR 14.0

***EMPLOYEE IS DEINED AS EITHER CLINICAL/FIELD EMPLOYEE AND/OR OFFICE/ADMINISTRATIVE EMPLOYEE.


Advantage Medical Professionals, LLC

Mission Statement

Our Mission is to service the Healthcare Community by supplying EXCELLENCE IN STAFFING SERVICES to the healthcare providers.  Excellence is defined by the company operations that meet standards and expectations which are appropriate for meeting the quality care initiatives of our clients and staff.

 


HUMAN RESOURCES MANAGEMENT


Policy: LICENSE, EMPLOYMENT AND WORK HISTORY VERIFICATION         

Policy Origin Date:   07/18/08

Policy No.:  HR 1

Effective date: 02/28/09

Reviewed: 04/05/11, 06/05/2013, 4/10/2015

Revised: 12/22/2016

__________________________________________________________

Purpose        

To confirm that a person’s qualifications are consistent with his or her assignment(s) at the time of hire or reactivation, the employee holds the proper license for his/her occupation and state of employment, and that the license is active and unencumbered, not falsified, under suspension or under investigation.

Policy Statement        

All licenses held by the employee or prospective employee will have primary source verification to confirm licensure, certification, education, work history, social security, sex offender registry, HHS OIG Medicare/Medicaid Fraud, and GSA list of excluded persons for Medicare and Medicaid participation.  

Procedure/Guidelines:

People Facts is an agency contracted by Advantage Medical Professionals, LLC to verify the following information:

  1. Professional background checks (past seven years) inclusive of a national criminal check
  2. Education verification
  3. Seven (7) year work history
  4. Educational preparation
  5. GSA list of excluded persons for Medicare and Medicaid participation
  6. HHS OIG Medicare/Medicaid Fraud
  7. Sex offender register
  8. Social Security verification
  9. Employment verification

Each verification contains a signature and personal identification of the individual investigator conducting the investigation.

All licenses, secondary and current, are verified through the appropriate State Board of Nurse Examiners. If the original license is over seven (7) years old and is no longer active, the original state must be documented but verification is not necessary.

Verification documentation includes state of licensure, expiration date of license, any identified sanctions or limitations, or the type and copy of verification if automated.

All licensed staff is required to carry credentials (Clinical License/Certification, CPR, ACLS, NRP, etc) on their person at all times when on assignment.  The credentials must also be available to host facility.

All candidates have professional work history verification for a minimum of seven (7) years.

If professional licensing applies to previous employment, the licensing verifications must correspond to the employee’s work history.


Policy: HEALTH SCREENING AND IMMUNIZATION

Policy Origin Date:   07/18/08

Policy No.:  HR 1.1

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/05/11, 06/05/2013, 4/10/15, 12/22/2016

_________________________________________________________

Purpose

To assure all agency employees working in a patient care arena have the appropriate vaccinations and health assessment, either a physical or self-assessment to protect themselves and the public from the spread of disease.

Policy Statement

All candidates for hire will have a documented health history; a physical prior to hire is preferred. All employees will maintain current TB and Immunizations as required by agency/host facility. If you decline the Hepatitis B, a declination statement must be signed, dated and witnessed.  Declination will also apply to MMR, and Varicella.  Though declinations are acceptable for employment with Advantage Medical Professionals, LLC, certain facilities may require additional/supporting documentation.

Procedure/Guideline

All candidates for hire will have documented proof of the following: TB screen or chest x-ray with negative results.  TB screens must be performed annually.  Chest X-ray must be done within two years of initial employment and an Annual Health Update Form must be completed annually.

A self-health assessment or health history signed by the employee, referred to as the Post Offer Health Questionnaire, is obtained at hire. Documentation of a physical exam in past 12 months upon hire with evidence that employee is capable of fully performing duties of the job he/she has applied is preferred.

Documentation of Hepatitis B immunity or a declination form signed and dated by the applicant and agency representative.

Documentation of Varicella, and MMR -- either by titer or documented and verifiable history. Rubella titer or immunization record if required by client contract; or a declination form signed and dated by the applicant and agency representative.

Signed and dated consent for Hepatitis B Vaccine if candidate requires or wishes to have Hepatitis series, prior to administering.


Policy: EVIDENCE OF IDENTITY AND CREDENTIALS WHEN

             REPORTING FOR AN ASSIGNMENT 

Policy Origin Date:   07/18/08

Policy No.:  HR 1.2

Effective date: 07/18/08

Revision date:  05/01/09

Reviewed: 04/05/11, 06/05/2013, 4/10/15, 12/22/16

__________________________________________________________

Purpose

To prevent any misrepresentation of medical professionals or professional credentials to a client facility and provide the client facility with current credentials and certifications.

Policy Statement

Employees must maintain their company ID and produce evidence of licensure and certifications upon presenting to any client facility.  A tracking system is used to maintain current status of all licenses and certifications and is provided to each client facility prior to employee presenting for any assignment.

Procedure/Guideline

The employee must bring with them, to all assignment, a current identification (government issued identification or employee ID issued by Advantage Medical Professionals, LLC), licensure, and certifications.

The employee is aware of their responsibility to maintain current licensure and certifications. Each employee will have all current licenses and certifications on file.  The staffing coordinators track this information in the staffing system and have access to all due dates as well as a verification of any licensure or certification in the employee file.  These include, but are not limited to: CPR, BCLS, ACLS, PALS, NALS, TNCC and any other certifications required or maintained by the employee. Only original copies of certifications are accepted and copied.  The copied certification is maintained in the employee file.  

All licensures and certifications will be audited monthly for impending expirations.

The employee will be notified thirty (30) days in advance of all impending expirations and their responsibility to maintain current status of certifications.

Any employee who has allowed their license or certifications to lapse will not work. The employee will provide a copy of current credentials to the agency when certifications are renewed. A copy of the renewed credentials will be placed in the employee file.

                                               


Policy: PROCEDURES ON MAINTENANCE AND DOCUMENTATION OF CERTIFICATIONS 

Policy Origin Date:   07/18/08

Policy No.:  HR 1.3

Effective date: 07/18/08

Revision date:  01/28/09, 12/22/16

Reviewed: 04/05/11, 06/05/2013, 4/10/15

__________________________________________________________

Purpose

To maintain employee files and qualifications are up to day and inclusive of all essential information for client facilities. This procedure will allow for the facility to verify file maintenance and certifications of all employees.  

Policy Statement

Advantage Medical Professionals, LLC maintains all employee files to include each of the following elements:  

  1. Name
  2. Job Title
  3. Birth date
  4. Application (hire date)
  5. Driver’s License Number and Issuing State
  6. Social Security Number
  7. License Number
  8. Drug Screen Report Date
  9. Background Check
  10. Certifications
  1. CPR
  2. ACLS
  3. PALS
  4. NRP
  5. TNCC
  1. Skills Checklist
  2. Job Description
  3. Clinical Handbook/Policy Procedure Manual
  4. Hepatitis B or Declination
  5. MMR or Declinations
  6. Varicella or Declination
  7. Post Offer Health
  8. Core Competencies
  9. National Patient Safety goals
  10. Fit Test/Respirator Evaluation
  11. TB skin Test or Chest X-Ray
  12. Chest X-Ray Update Form (if applicable)
  13. I-9 (filed separately)
  14. W-4
  15. State Tax
  16. Testing Information

Procedure/Guideline

  1. Twenty employee files will be selected monthly for compliance and thoroughness.
  2. A temp profile report is obtained through API to determine employees who have worked for the last 30 days.
  3. Twenty files are randomly selected.
  4. In the event the file is incomplete or any documents are delinquent, the employee is notified and unable to obtain an assignment until full compliance is met.
  5. Employee files are made inactive after two years.
  6. Employee files will be purged every seven years.

Employee files will be reviewed to ensure all agency documents are complete and all certifications are current. (See enclosed file maintenance checklist form).


Policy: TRACKING RENEWAL OF LICENSURE AND CERTIFICATIONS

Policy Origin Date:   07/18/08

Policy No.:  HR 1.3.1

Effective date: 07/18/08

Revision date:  01/28/09, 12/22/2016

Reviewed: 04/05/11, 06/05/2013, 4/10/15

__________________________________________________________                                

Purpose

To assure a system of tracking renewal dates for all licensures, certifications, performance reviews and mandatory requirements of the agency/host facility. To ensure that each employee file contains evidence of current credentials needed for regulatory, client and agency liability.

Policy Statement

Advantage Medical Professionals, LLC has a method for tracking employee credentials, licenses and all mandatory requirements and performance review to maintain current status. This tracking will assure that employees sent to host facilities are compliant with standards of agency and host facility.

The tracking system allows the agency to forecast impending deficits in credentials, allowing time to notify employees weeks/months prior to expiration of credentials.

The tracking system attempts to alleviate a lapse in hiring and annual mandatory in-service and testing requirements of Joint Commission/OSHA and other mandatory hiring requirements that may be agency/facility generated.

Procedure/Guidelines

Advantage Medical Professionals, LLC audits twenty employee files per month for compliance and thoroughness.

The employee will be informed at least 30 days prior to the expiration date of credentials, etc.

It is the employee’s responsibility to keep all mandatory credentials current. Failure to do so will make the employee ineligible to work until credentials are current.

Primary source verification is obtained from the various licensing boards and uploaded into the API system.


Policy: FILE PURGING

Policy Origin Date:   07/18/08

Policy No.:  HR.1.3.2

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/05/11, 06/05/2013, 4/10/15, 12/22/16

__________________________________________________________

Purpose

To cleanse the employee file of any expired credentials such as licensure & certification.

Policy Statement

Systematically purging files assures that any representative of the agency, client facility or accrediting organization can determine the accuracy of all information contained in the files and can easily validate that all current and pertinent documents are current and enforceable. In addition, purging of employee files decreases the space requirements for storage of employee files.

Procedure/Guideline

All employee files may be purged at least every seven (7) years. Licenses and credentials will continue to be checked annually in the event the employee is scheduled to work any assigned shifts.

All licenses, certification, references, application, background check and emergency contact person will remain in file, permanently.

Make a notation in the file register of date and person doing purging.

Any files that are uploaded electronically will be destroyed.


Policy: CLIENT UPDATE PROCEDURE

Policy Origin Date:   07/18/08

Policy No.:  HR 1.4

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/05/11, 06/05/2013, 4/10/15, 12/22/16

__________________________________________________________

Purpose

To keep clients informed of status of agency personnel working at their facility.

Policy Statement

The agency will keep client updated on the status of licenses, certifications, mandatory in services and mandatory requirements of each employee staffed in host facility

Procedure/Guidelines

It is the responsibility of each employee to maintain current credentials as required by the host facility/agency. These include: current license and certifications, all mandatory annual testing, BCLS, ACLS, PALS and other certifications as required, a current TB screening with negative results, and other testing/paperwork as listed in clinical handbook.

The host facility will be informed by the agency/employee of the verified results.

Failure to maintain current status of above will make the employee ineligible to work.

Notification will include a computer generated profile indicating employee information and current licensure/certifications.


Policy: NOTIFICATION OF IMPENDING EXPIRATIONS/ACTION

             TAKEN FOR EXPIRED CREDENTIALS

Policy Origin Date:   07/18/08

Policy No.:  HR 1.5

Effective date: 07/18/08

Revision date:  01/28/09, 12/22/2016

Reviewed: 04/05/11, 06/05/2013, 4/10/15

__________________________________________________________

Purpose

To assure that all employees have current and verifiable credentials and make employees aware of the consequences of carrying expired credentials.

Policy Statement

All credentials and licenses required to work in a client facility must be current at all times.

All employees will be informed in a timely manner of impending expiration of credentials. No employee will be permitted to work if necessary credentials have lapsed.

Procedure/Guidelines

It is the responsibility of the employee to maintain current credentials.

All employees will be informed 30 days prior to expiration of credentials.

If employee has not provided updated credentials to the agency, they will be reminded in one (1) month of impending expiration of credentials.

Employees will be required to successfully complete appropriate testing to assure competency in testing to maintain credentials.

The new credentials will be placed in the electronic employee file.

The employee will keep proper identification on person while on duty at the host facility.

Failure to keep credentials current will make the employee ineligible to work.

The host facility will be given a copy of the renewed credentials and will also be informed of inability to work if credentials lapse.

A electronic system of tracking credentials will be utilized.


Policy: BACKGROUND CHECK POLICY

Policy Origin Date:   05/06/09

Policy No.:  HR 1.6

Effective date: 05/06/09

Revision date:  05/06/09, 4/10/15

Reviewed: 04/05/11, 06/05/13, 12/22/16

______________________________________________________

Purpose

To obtain verification of the candidate’s criminal history or background as stated on their application and to assure the candidate has no federal, state, or local convictions. To assure the candidate has no criminal history or documented and verifiable history of behavior which may negatively affect their ability to work in a healthcare setting.

Policy Statement

Thorough background checks must be done to protect a vulnerable public and consumer population as well as the provider’s liability. This verification provides information on criminal background, according to law, regulation, the firm’s policy and customer requirements.

Procedure/Guideline

Consent for the background check will be signed and dated by candidate. Background checks will be ordered by Advantage Medical Professional staff that have been trained on the People Facts software to maintain the confidentiality and security of information about clinical staff and customers.

Background checks will be done on all candidates prior to hiring. A minimum of seven (7) years criminal background checks will be done. This includes minimally: Social Security Number Verification, National Criminal Check (effective 11/17/14), Sex Offender, Education Verification, Employment History Verification, HHS/OIG list of excluded individuals, a candidate cannot be excluded, debarred, suspended or appear on the General Service Administration List of Parties Excluded from Federal Programs.

The background check results will be reviewed by the appropriate representative and a decision will be made on whether the candidate is appropriate for hire.

If a decision is made to hire knowing a criminal history exists, appropriate documentation must be found defining the nature of the criminal act, the rationale for hiring and the verification of full disclosure to all contracting facilities in the employee’s file if warranted. In addition the history must have been reported to the licensing agency and the employee’s license must not have any restrictions.

The results of the background checks will be placed in the employee’s electronic file.

 

If criminal history is discovered after employment, clinician will be placed on hold and a full investigation into the criminal record will be made.  Upon completion of investigation, a determination will be made on the future employment status of clinician.

Any employee, who has been hired at Advantage Medical Professionals, LLC, after 2/28/09, will have the new background check completed.  Employees hired prior to 2/28/09 will not have a background check repeated to include the current elements.

All background checks are reviewed with employees if the background check returns identifying a misdemeanor or a felony charge. The employee will be required to go the clerk of court in the parish where the incident occurred and provide documentation to Advantage Medical Professionals, LLC that the issue has been resolved.


Advantage Medical Professionals

Policy and Procedure Manual

Policy: DRUG SCREENING POLICY

Policy Origin Date:   07/18/08

Policy No.:  HR 1.7

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/05/11, 06/05/2013, 4/10/15, 12/22/16

__________________________________________________________

Purpose

This policy prevents the assignment of impaired personnel into your client facilities; subsequently this reduces the risk to both client and agency.

Policy Statement

Advantage Medical Professionals, LLC is a Drug Free Workplace.

A negative drug screen is a requirement for employment with Advantage Medical Professionals, LLC.

All drug screening will be done by a certified lab.

Procedure/Guideline

A signed and dated consent form will be obtained at the collection site.

Testing will be done by a certified lab.

The lab will validate the employee via photo identification.

The results will be sent to agency and will be included as permanent part of the record.

The agency will review the results and determine if applicant is a candidate for hire. The results will be placed in employee file or drug screen binder.

Any prescription drugs must be declared to the medical review officer (MRO).  It is mandatory that proof of prescription be verified through documentation by a physician who attests that he prescribed the drug, the employee is taking the medication as prescribed and it will not impair his/her judgment or ability to perform the job to which he/she has been assigned in a safe and ethical manner.

A positive result makes the applicant ineligible for hire.

All positive specimens must be retained by the laboratory for a minimum of one (1) year. There must also be a documented chain of custody in place.

The drug screen will test for the ten (10) most commonly abused drugs. This list is not all inclusive. These drugs are amphetamines, barbiturates (long acting and short acting),

benzodiazepines, cannabinoids, cocaine, methadone, methaqualone, opiates, phencyclidine and propoxyphene

Prior to 1/1/09, the agency utilized various panel screens.  Any employees who effectively tested and passed the drug screen and were hired were not retested when the agency began utilizing the 10 panel screen.  Only employees tested after 1/1/09 and who are tested for probable cause will have the 10 panel screen performed.

If a specimen is challenged, the lab will be available and willing to support their findings with secondary screenings of the same specimen and any other specimens requested by the host facilities.

A drug screen can be requested at any time for cause by the hospital or Advantage Medical Professionals, LLC or if impairment is suspected while on duty or in contract. Appropriate documentation must include the circumstances, person reporting, the date and place of alleged issue.

If “for cause” drug screen is requested and done and the results are positive, the employee will not work. Agency will make employee aware of assistance programs available.

The agency or host facility will report positive “for cause” results to appropriate agencies and document. include date reported and the name of the person reporting.

The employee in question will be informed of his /her status with the agency/host facility.


Policy: PRE-EMPLOYMENT DRUG SCREEN POLICY

Policy Origin Date:   12/22/2016

Policy No.:  HR 1.7.1

Effective date: 12/22/2016

Revision date:  

Reviewed:

__________________________________________________________

(FOR TESTING TO BE CONDUCTED IN ALABAMA, CALIFORNIA [excluding the city of San Francisco], COLORADO [excluding the city of Boulder], FLORIDA, GEORGIA, LOUISIANA, MISSISSIPPI, MISSOURI, NEW MEXICO, NORTH CAROLINA, OHIO, OKLAHOMA, TEXAS, UTAH, PENNSYLVANIA, AND WEST VIRGINIA).

STATEMENT OF PURPOSE

Advantage Medical Professionals (“Company”), is firmly committed to ensuring a safe, healthy, productive and efficient work environment for our employees, as well as our customers and to the public in general.  The Company has a vital interest in preventing accidents and injuries resulting from the misuse of alcohol or drugs.  The unlawful or improper presence or use of drugs or alcohol in the workplace presents a danger to everyone.  For these reasons, the Company has established the following pre-employment drug testing policy for applicants.

POLICY STATEMENT

This policy applies to applicants for all positions, including any applicant for any such position who was formerly employed by the Company.      

Questions regarding the meaning or application of this policy should be directed to the Company’s Human Resources Department.

This policy is not a contract of employment.  If an applicant fails to comply with this policy, the applicant will be ineligible for employment.

PROCEDURE FOR PRE-EMPLOYMENT DRUG TESTING OF APPLICANTS

All applicants to whom the Company has given a conditional offer of employment are required to submit to a pre-employment drug test and must receive a negative result as a condition of employment.

CONSEQUENCES FOR POLICY VIOLATIONS

Positive Test Results:  Any applicant who receives a verified positive drug test result will be ineligible for employment with the Company. 

Refusal To Submit:  Any applicant who refuses to submit to a test will be ineligible for employment with the Company.  The following conduct will be considered as refusing to submit to a test: 

refusing or failing to appear for a substance abuse test within a specified time, as determined by the Company, after being directed to do so by the Company;

failing to sign an authorization form permitting the release of the drug test result to the Company;

failing to remain at the testing site until the testing process is complete;

failing to provide a urine or blood specimen for collection;

failing to provide a sufficient amount of urine when directed, without an adequate medical explanation;

failing or declining to take a second drug test that the Company or collector has directed to be taken;

failing to undergo a medical examination or evaluation, as directed by the MRO as part of the verification process, or as directed by the Company as part of the “shy bladder” procedures;

adulterating or substituting a specimen, or attempting to adulterate or substitute a specimen;

in the case of a directly observed or monitored collection in a drug test, failing to permit the observation or monitoring of the provision of a urine specimen (unless prohibited by law); and,  

failing to cooperate with any part of the testing process, such as by delaying the collection, testing or verification process or otherwise engaging in conduct that clearly obstructs or manipulates, or attempts to obstruct or manipulate, the testing process.

CONSUMPTION OF FOOD OR FOOD-PRODUCTS CONTAINING HEMP

The consumption of food and food-products containing hemp may cause an applicant to test positive.  A test result that is positive as a result of an applicant’s consumption of food or food-products containing or made from hemp or hemp products will be reported as a positive test.

NOTIFICATION OF TEST RESULTS, CONFIDENTIALITY AND TESTING EXPENSES

Applicants will be provided with a copy of their test results if they test positive or if otherwise required by law.

The Company will maintain records of its substance abuse program in a secure location with controlled access.  These records are confidential and will not be disclosed, except in accordance with applicable law.

The Company will pay for all drug or alcohol tests required by the Company, which includes a confirmation drug test performed on an applicant’s urine specimen.

DRUG TESTING PROCEDURES

The Company’s drug testing procedures comply with applicable laws.  The Company’s procedures ensure the integrity, confidentiality and reliability of the testing process, safeguard the validity of the test results and ensure that test results are attributed to the correct individual.  The procedures also minimize the impact upon the privacy and dignity of applicants undergoing such tests.  Drug testing will be conducted via urine testing.  The Company has established a chain of custody procedure for urine specimen collection and testing that will verify the identity of each urine specimen and test result.  

LABORATORIES

In general, drug tests will be administered at outside collection facilities and analyzed by laboratories which are certified by the U.S. Department of Health and Human Services (“DHHS-certified laboratory”), or are otherwise required or permitted by applicable state and local laws.  

DRUGS TESTED

Unless otherwise prohibited by law, the Company will test for the following drugs:  amphetamines, barbiturates, benzodiazepines, cocaine, marijuana, methadone, methaqualone, opiates, phencyclidine (PCP), propoxyphene and their metabolites.  If a customer requires it, additional drugs may be tested, as permitted by applicable law.  In Oklahoma, the Company will test for drugs and alcohol as defined in the Standards for Workplace Drug and Alcohol Testing Act, including controlled substances approved for testing by the State Commissioner of Health.

CONFIRMATION AND REVIEW OF DRUG TEST RESULTS

All positive drug test results will be confirmed by gas chromatography and mass spectrometry (“GC/MS”).  All confirmed positive drug test results will be reviewed by a medical review officer (“MRO") to determine whether there is any legitimate explanation for the positive test result. This review may include a medical interview, review of the applicant’s medical history, or review of any other relevant biomedical factors and all medical records made available by the applicant.  

An applicant’s use of prescription and over-the-counter medications may result in a positive test result. Applicants will be given the opportunity to discuss with the MRO any legitimate explanation for the positive test result.  Applicants may provide any information which may be considered relevant to the test, including identification of prescription or nonprescription drugs currently or recently used, or other relevant medical information.  If the MRO determines that there is a legitimate medical explanation for the confirmed positive test result, the MRO will report the test result as negative. If the MRO determines that there is no legitimate explanation for the confirmed positive test result, the result will be verified by the MRO as a confirmed positive test. If an applicant refuses or fails to make himself/herself available to speak with the MRO, the MRO may verify a test as positive without having communicated directly with the tested individual.

If the MRO reports to the Company that a negative drug test was dilute, the applicant will be directed to take another test immediately.  If the applicant refuses to take a second test, this constitutes a refusal to test.  If the second test is negative dilute, the test stands as a negative.

RIGHT TO REQUEST CONFIRMATORY RE-TEST AFTER TESTING POSITIVE 

Applicants who test positive may request a confirmatory re-test of the original specimen, at their own expense, in a different DHHS-certified laboratory (or other laboratory required or permitted under state law) selected by the Company (unless otherwise required by law).  In general, this request must be made by the applicant within 72 hours of notification of the positive test result by the MRO, unless otherwise specified by law.  However, in North Carolina, applicants who test positive will be notified by the Company in writing of their test results and will be advised of the time period in which to request a confirmatory re-test.  No other appeal procedure is available.

INABILITY TO PROVIDE ADEQUATE AMOUNT OF URINE

Applicants must provide at least 45 milliliters of urine for a drug test.  If the applicant is unable to provide such a quantity of urine, then the individual will be instructed to drink a set amount of fluids and, after a set period of time, again directed to provide a complete specimen.  If the applicant refuses to drink the fluids as directed, or refuses to provide a new urine specimen, this will constitute a refusal to submit to a test.  If an applicant has not provided a sufficient specimen within a certain time period after the first unsuccessful attempt to provide the specimen, the Company will direct the applicant to submit to blood testing, where permitted by law.  If blood testing is not permitted by law or is not feasible, the applicant will be directed to submit to a medical evaluation, as soon as possible, from a physician selected by the Company.  If the physician determines that there is no legitimate medical explanation for the individual’s failure to provide an adequate amount of urine, this will constitute a refusal to submit to a test.  If the physician determines that there is a legitimate medical explanation for the individual’s failure to provide an adequate amount of urine, the Company, in consultation with the physician or MRO, will determine whether the applicant should be retested, including whether a reasonable accommodation, if applicable, can be made which will provide an adequate, accurate and timely test result that will not impose an undue hardship on the program.

ADULTERATED OR SUBSTITUTED URINE SPECIMENS

Procedures for collecting specimens allow an individual privacy unless there is a reason to believe that a particular individual may adulterate or substitute the specimen.  In such cases, a specimen may be obtained under the direct observation of a collection site person of the same gender as the applicant, unless prohibited by law.


Policy: SUBSTANCE ABUSE POLICY FOR EMPLOYEES

Policy Origin Date:   12/22/2016

Policy No.:  HR 1.7.2

Effective date: 12/22/2016

Revision date:  

Reviewed:

________________________________________________________

(FOR TESTING TO BE CONDUCTED IN ALABAMA, CALIFORNIA [excluding the city of San Francisco], COLORADO [excluding the city of Boulder], FLORIDA, GEORGIA, LOUISIANA, MISSISSIPPI, MISSOURI, NEW MEXICO, NORTH CAROLINA, OHIO, OKLAHOMA, TEXAS, UTAH AND PENNSYLVANIA, WEST VIRGINIA).

STATEMENT OF PURPOSE

Advantage Medical Professionals (“Company”) is firmly committed to ensuring a safe, healthy, productive and efficient work environment for our employees, as well as our customers, and the public in general.  The Company has a vital interest in preventing accidents and injuries resulting from the misuse of alcohol or drugs.  The unlawful or improper presence or use of drugs or alcohol in the workplace presents a danger to everyone.  For these reasons, the Company has established the following substance abuse policy for employees.  As provided below, drug and alcohol testing is an integral part of our substance abuse policy.  Compliance with the policy is required as a condition of continued employment with the Company.

This policy applies to all Company employees, including employees in managerial or supervisory positions.    

The Company maintains a policy of non-discrimination and will endeavor to make reasonable accommodations to assist recovering addicts or alcoholics and those having a medical history reflecting treatment for substance abuse conditions.  We encourage employees to seek assistance before their drug and alcohol use renders them unable to perform their essential job functions or jeopardizes the health and safety of themselves or others.

Questions regarding the meaning or application of this policy should be directed to the Company’s Human Resources Department.

This policy is not a contract of employment.  All Company employees are employees at-will, except as state or local law may limit such status, and employment can be terminated either by the employee or the Company at any time with or without cause and with or without notice.

PROHIBITED CONDUCT CONCERNING ALCOHOL AND DRUGS

The following conduct by employees is prohibited:

Reporting for work or remaining on duty after the employee has consumed alcohol in any amount that adversely affects the employee’s job performance.

Consuming alcohol at any time during an employee’s workday.  This includes, but is not limited to, while an employee is on or off the premises of the Company, as well as during the employee’s meal and other break periods.

Exception:  This prohibition does not include the authorized and reasonable consumption of alcohol by an employee of legal drinking age at functions or activities sponsored by the Company or a client.  However, responsible, professional, business-like behavior is expected of employees (including management) at all times.  Inappropriate, unprofessional behavior associated with alcohol consumption may subject employees (including management) to disciplinary action, up to and including termination.

Engaging in any illegal or unauthorized use of drugs at any time while on or off-duty.  This includes, but is not limited to, while an employee is on or off the premises of the Company, as well as during the employee’s meal and other break periods.

This prohibition does not apply to prescription or over-the-counter medications taken by employees in safety-sensitive positions which:

  1. have been lawfully prescribed to, or obtained by, the employee;
  2. are being used by the employee in accordance with the prescription’s guidelines (if applicable); and 
  3. before reporting to work under the influence of such medication, the employee has inquired whether the drug manufacturer or the employee's physician warns against driving, operating machinery or performing other work-related safety-sensitive tasks.  If such warnings exist, the employee taking the medication must inform his or her supervisor of such restrictions before reporting to work under the influence of such substances.  When informing his or her supervisor(s) or the Human Resources Department of such restrictions, the employee should not identify the medication(s) being used or the reason for its use.  The Company will evaluate and respond to this information on a case-by-case basis.  Responses may include, among other things, temporary job reassignment or modifications, a request for additional medical documentation and consultation, and/or an instruction that the employee not work until the restriction is removed.  Any employee reporting to work in a safety-sensitive position without first advising the Company about warnings accompanying lawfully prescribed or obtained medications will be subject to disciplinary action up to and including possible termination of employment. An employee's lack of knowledge concerning such warnings will not excuse a violation of this rule where an employee has failed to make the inquiries required by this rule.

 “Safety-sensitive positions” are generally defined as those positions in which impairment caused by drug or alcohol use would threaten the health or safety of any person.

Marijuana – including “medical marijuana” – is illegal under federal law and may not be used in the workplace. All employees are prohibited from being under the influence of marijuana while at work.

Failing to stay in contact with the Company or its medical review officer while awaiting the results of a drug test.

Engaging in the unlawful or unauthorized manufacture, distribution, dispensation, solicitation, sale, purchase, transfer or possession of drugs or alcohol while on Company-paid time, on Company premises, in Company vehicles, or while otherwise engaged in activities for or on behalf of the Company.  This prohibition does not include the authorized distribution, dispensation, solicitation, sale, purchase, transfer or possession of alcohol at Company sponsored functions or activities.  In addition, an employee’s illegal conduct involving drugs or alcohol during non-work times may also result in discipline, up to and INCLUDING discharge.

The refusal to submit to any drug or alcohol test that is required under the Company’s policy will result in the employee’s immediate termination of employment.  This includes tests which employees agree to take in conjunction with rehabilitation provided under Section 7.0.

Testing positive on any drug or alcohol test required under this policy.

Refusal to Submit to a Test:  An employee who engages in any of the following conduct will be considered to have refused to submit to a test:

refusing or failing to appear for any substance abuse test within a specified time, as determined by the Company, after being directed to do so by the Company;

failing to sign an authorization form permitting the release of the drug and/or alcohol test result to the Company;

failing to remain at the testing site until the testing process is complete;

failing to provide a urine, blood, breath or saliva specimen for testing;

failing to attempt to provide a urine, breath or saliva specimen for testing;

failing to provide a sufficient amount of urine or breath when directed, without an adequate medical explanation;

failing or declining to take a second drug or alcohol test that the Company or collector has directed to be taken;

failing to undergo a medical examination or evaluation, as directed by the MRO as part of the verification process, or as directed by the Company as part of the “shy bladder” procedures, or the insufficient breath procedures;

adulterating or substituting a urine specimen, or attempting to adulterate or substitute a urine specimen;

in the case of a directly observed or monitored collection in a drug test, failing to permit the observation or monitoring of the provision of a urine specimen (unless prohibited by law); or,

failing to cooperate with any part of the testing process such as by delaying the collection, testing or verification process or otherwise engaging in conduct that clearly obstructs or manipulates, or attempts to obstruct or manipulate, the testing process.

CONSUMPTION OF FOOD OR FOOD-PRODUCTS CONTAINING HEMP 

The consumption of food and food-products containing hemp may cause an employee to test positive.  A test result that is positive as a result of an employee’s consumption of food or food-products containing or made from hemp or hemp products will be reported as a positive test and subject the employee to discipline, up to and including termination.

PROHIBITION ON EMPLOYEE WORKING:  

No supervisor or manager who has actual knowledge that an employee has engaged in or is engaging in conduct prohibited under this policy shall permit the employee to work or continue working under such circumstances.  Any employee who has been directed not to work or directed to stop working under such circumstances must immediately comply.

DRUG CONVICTIONS 

Pursuant to federal law, employees must notify their supervisor or the Human Resources Department of any criminal drug statute conviction for a violation occurring within the workplace within five (5) days of such conviction.  Within ten (10) days of such notification or other actual notice, the Company will advise the contracting agency of such conviction.  In addition, an employee charged with or convicted of a drug-related offense shall report the occurrence to his or her supervisor before reporting for further duty.  Any employee convicted of a drug-related offense during his/her term of employment, whether based on activity on or off the job, shall be considered in violation of this policy and may be subject to adverse employment action described in Section 4.2 below, including possible termination, in the Company’s sole discretion.  If the employee has been charged with a drug-related offense, the Company may suspend the employee without pay pending the outcome of the charge.

        

        REQUIRED TESTS

        Except as otherwise provided in this policy, employees are required to submit to testing under the circumstances described below.  Except where conditions otherwise require, all   tests will normally be conducted either during or immediately after the regular work period, which includes any period when an employee is working overtime.  Employees will be paid for time spent being tested.

“Reasonable Suspicion” Drug and Alcohol Testing

An employee must submit to a drug test and/or an alcohol test whenever the Company has, in accordance with the applicable state law, reason to suspect the employee has or may have used drugs or alcohol in violation of the Company’s policy.

Except as applicable state law may otherwise provide, the Company’s “reasonable suspicion” determinations will be based on specific, current observations that can be verbalized, including but not limited to the employee’s appearance, behavior, speech, or body odors.  These observations may also include indications of an employee’s chronic use of, or the effects of withdrawal from, drugs or alcohol.

All “reasonable suspicion” tests must be administered as soon as possible following the determination.

The Company shall transport or make arrangements for the transport of the employee to and from the collection site.

An employee who is required to submit to a “reasonable suspicion” test will be suspended after the completion of the drug or alcohol tests, pending receipt of the test results.  The Company also reserves the right to evaluate the employee’s conduct that triggered the drug and/or alcohol test, to determine if the conduct in and of itself warrants discipline, up to and including termination.

Post-Accident Drug and Alcohol Testing

Unless otherwise required by applicable state law, whenever an employee causes or contributes to a work-related accident (as defined below), the employee may be required to submit to a drug test and/or an alcohol test.  In California and West Virginia, post-accident drug and alcohol testing will be limited to safety-sensitive employees, generally defined as those positions in which impairment caused by drug use would threaten the health or safety of any person.

        As used in this policy, “work-related accident” means an accident:

which occurs while the employee is on the premises of the Company or at another work-site location, or is off-site while engaged in activities for or on behalf of the Company, or while the employee is operating a vehicle, including the employee’s, for or on behalf of the Company, and
the accident results in one or more of the following:  (i) a fatality; or (ii) bodily injury to any individual who, as a result of the accident, requires immediate medical treatment (excluding first aid) at or away from the scene of the accident; or (iii) property or vehicle damage to Company property or to the property of a customer that is reasonably anticipated to exceed $500.

All post-accident tests must be administered as soon as possible following the accident.  Employees who are involved in a work-related accident must remain readily available for testing or will be considered to have refused to submit to a test.  However, an employee who is involved in a work-related accident is not prohibited from leaving the scene of an accident for the period of time necessary to obtain assistance in responding to the accident or to obtain necessary emergency medical care for the employee or others who injured as a result of the accident.

Except where circumstances do not permit, the Company shall transport or make arrangements for the transport of the employee to and from the collection site.

An employee who is required to submit to a post-accident test will be suspended after the completion of the test, pending receipt of the test results.  The Company also reserves the right to evaluate the employee’s conduct that triggered the test, to determine if the conduct in and of itself warrants discipline, up to and including termination.

PRE-ASSIGNMENT DRUG TESTING REQUIRED BY CUSTOMERS

The Company will conduct pre-assignment drug testing when customers require that employees be drug tested prior to assignment to the customer, and where permitted by law.  In California and West Virginia, pre-assignment drug testing will be limited to safety-sensitive employees, generally defined as those positions in which impairment caused by drug use would threaten the health or safety of any person.  

Employees who refuse to submit to customer-required pre-assignment drug tests, or who test positive, will not be permitted to work for the customer and will be subject to disciplinary action.

DIVERSION-BASED DRUG TESTING REQUIRED BY CUSTOMERS

The Company will conduct diversion-based drug testing when customers report that drugs have been diverted from the locations where the employee works, and where permitted by law.  In California, and West Virginia, diversion-based drug testing will be limited to safety-sensitive employees, generally defined as those positions in which impairment caused by drug use would threaten the health or safety of any person.

Employees who refuse to submit to customer-required diversion-based drug tests, or who test positive, will not be permitted to work for the customer and will be subject to disciplinary action.

OTHER DRUG TESTING REQUIRED BY CUSTOMERS 

The Company will conduct additional types of drug tests when customers require them, e.g., annual drug tests or bi-annual drug tests, where permitted by law.  In California and West Virginia, additional drug testing will be limited to safety-sensitive employees, generally defined as those positions in which impairment caused by drug use would threaten the health or safety of any person.  

Employees who refuse to submit to customer-required drug tests, or who test positive, will not be permitted to work for the customer and will be subject to disciplinary action.

CONSEQUENCES FOR POLICY VIOLATIONS

Employees who violate the Company’s policy are subject to the following consequences:

REFUSAL TO SUBMIT:  Employees who refuse to submit to a test when requested will be terminated from employment.  Refer to section 2.2 of this policy for a description of the conduct which will be considered as a refusal to submit to a test.

POSITIVE TEST RESULTS: Any employee who receives a verified positive drug test result or a confirmed alcohol test result of 0.04 BAC or greater will be terminated.

OTHER POLICY VIOLATIONS: The employee will be immediately removed from his or her job duties and will be subject to discipline, up to and including termination.  In addition to the consequences imposed under this policy, an employee who unlawfully manufactures, distributes, possesses, or uses a controlled substance may be subject to criminal fines and/or imprisonment under federal, state and/or local law.  

FITNESS-FOR-DUTY EVALUATION

Whenever an employee is required to submit to a “reasonable suspicion” test and receives a negative test result, the Company may require the employee to submit to a fitness-for-duty evaluation.  The evaluation may include a review of the employee’s medical records and/or a medical examination.  The purpose of the evaluation is to determine whether the employee poses a significant risk of substantial harm to the health and safety of the employee or others in the workplace, including customers and visitors. Employees will be required to provide the necessary authorizations for obtaining the medical records and conducting the examination.  Depending upon the results of the evaluation, the Company will consider whether the safety or health risk can be eliminated or sufficiently reduced by a reasonable accommodation, if applicable.

POTENTIAL LOSS OF WORKERS’ COMPENSATION AND/OR UNEMPLOYMENT COMPENSATION BENEFITS

 An employee’s violation of the Company’s policy will be considered as gross and willful misconduct.  In addition to the discipline and other consequences imposed under this policy, therefore, such employee misconduct may also result in the denial of unemployment compensation under applicable state law.  Additionally, employees who are injured as a result of using drugs or alcohol in violation of this policy and/or the other Company safety rules also risk forfeiture of workers’ compensation benefits under the applicable state law.

NOTIFICATION OF TEST RESULTS, CONFIDENTIALITY, TESTING EXPENSES AND COMPENSATION FOR TESTS

Employees will be provided with a copy of their test results if they test positive, unless otherwise required by law.    

The Company will maintain records of its substance abuse program in a secure location with controlled access.  These records are confidential and will not be disclosed, except in accordance with applicable law.

The Company will pay for all drug or alcohol tests required by the Company, which includes a confirmation drug test performed on an employee’s primary urine specimen.  The Company will also pay for the cost of the employee’s transportation to a collection site when the test is conducted at a place other than the employee’s normal work site.

All time an employee spends providing a specimen for testing, including travel time to and from the collection site in order to comply with a test required under this policy, shall be considered as working time.

TESTING PROCEDURES

The Company’s drug and alcohol testing procedures comply with applicable state laws.  The Company’s procedures ensure the integrity, confidentiality and reliability of the testing process, safeguard the validity of the test results and ensure that test results are attributed to the correct individual.  The procedures also minimize the impact upon the privacy and dignity of employees undergoing such tests.  

DRUG TESTING

Drug testing will be conducted via urine testing.  The Company has established a chain of custody procedure for urine specimen collection and testing that will verify the identity of each urine specimen and test result.

LABORATORIES AND ON-SITE TESTING

In general, drug tests will be administered at outside collection facilities and analyzed by laboratories which are certified by the U.S. Department of Health and Human Services (“DHHS-certified laboratory”) or are otherwise required or permitted to be used under applicable state law.  On Occasion, when required by clients, or for reasonable suspicion testing, post-accident testing or diversion-based testing, testing may be conducted on-site at the employee’s work location, if permitted by law.


DRUGS TESTED

Unless otherwise prohibited by law, the Company will test for the following drugs:  amphetamines, barbiturates, benzodiazepines, cocaine, marijuana, methadone, methaqualone, opiates, phencyclidine (PCP), propoxyphene and their metabolites.  If a customer requires it, additional drugs may be tested, as permitted by applicable law.  In Oklahoma, the Company will test for drugs and alcohol as defined in the Standards for Workplace Drug and Alcohol Testing Act, including controlled substances approved for testing by the State Commissioner of Health.

CONFIRMATION AND REVIEW OF DRUG TEST RESULTS

All positive drug test results will be confirmed by gas chromatography and mass spectrometry (“GC/MS”).  All confirmed positive drug test results will be reviewed by a medical review officer (“MRO") to determine whether there is any legitimate explanation for the positive test result. This review may include a medical interview, review of the employee’s medical history, or review of any other relevant biomedical factors and all medical records made available by the employee.  

An employee’s use of prescription and over-the-counter medications may result in a positive test result. Employees will be given the opportunity to discuss with the MRO any legitimate explanation for the positive test result.  Employees may provide any information which may be considered relevant to the test, including identification of prescription or nonprescription drugs currently or recently used, or other relevant medical information.  If the MRO determines that there is a legitimate medical explanation for the confirmed positive test result, the MRO will report the test result as negative. If the MRO determines that there is no legitimate explanation for the confirmed positive test result, the result will be verified by the MRO as a confirmed positive test. If an employee refuses or fails to make himself/herself available to speak with the MRO, the MRO may verify a test as positive without having communicated directly with the tested individual.

If the MRO reports to the Company that a negative drug test was dilute, the employee will be directed to take another test immediately.  If the employee refuses to take a second test, this constitutes a refusal to test.  If the second test is negative dilute, the test stands as a negative.

RIGHT TO HAVE CONFIRMATORY RE-TEST

Employees whose primary specimen is verified positive may request a confirmatory re-test of the original specimen, at their own expense, in a different DHHS-certified laboratory (or other laboratory required or permitted under state law) selected by the Company.   In general, this request must be made by the employee within 72 hours of being notified by the MRO of a verified positive test result (unless otherwise required or permitted under state law).  However, in North Carolina, employees who test positive will be notified by the Company in writing of their test results and will be advised of the time period in which to request a confirmatory re-test.  No other appeal procedure is available.

INABILITY TO PROVIDE ADEQUATE AMOUNT OF URINE

Employees must provide at least 45 milliliters of urine for a drug test.  If the employee is unable to provide such a quantity of urine, then the individual will be instructed to drink a set amount of fluids and, after a set period of time, again directed to provide a complete specimen.  If the employee refuses to drink the fluids as directed, or refuses to provide a new urine specimen, this will constitute a refusal to submit to a test.  If an employee has not provided a sufficient specimen within a certain time period after the first unsuccessful attempt to provide the specimen, the Company will direct the employee to submit to blood testing, where permitted by law.  If blood testing is not permitted by law or is not feasible, the employee will be directed to submit to a medical evaluation, as soon as possible, from a physician selected by the Company.  If the physician determines that there is no legitimate medical explanation for the individual’s failure to provide an adequate amount of urine, this will constitute a refusal to submit to a test.  If the physician determines that there is a legitimate medical explanation for the individual’s failure to provide an adequate amount of urine, the Company, in consultation with the physician or MRO, will determine whether the employee should be retested, including whether a reasonable accommodation, if applicable, can be made which will provide an adequate, accurate and timely test result that will not impose an undue hardship on the program.  

ADULTERATED OR SUBSTITUTED URINE SPECIMENS

Procedures for collecting specimens allow an individual privacy unless there is a reason to believe that a particular individual may adulterate or substitute the specimen.  In such cases, a specimen may be obtained under the direct observation of a collection site person of the same gender as the employee, unless prohibited by law.        

ALCOHOL TESTING

IN GENERAL 

Except as provided in subsection d. below, alcohol screening tests will be performed either by a screening test technician (“STT”) using a non-evidential screening device which the STT is proficient to operate, or by a breath alcohol technician ("BAT") using an evidential breath testing device ("EBT") which the BAT is proficient to operate.  The Company will only use non-evidential alcohol screening devices that are on the National Highway Traffic Safety Administration's ("NHTSA") Conforming Products List ("CPL") for non-evidential screening devices and EBTs which are on the NHTSA’s CPL for evidential breath measurement devices.  

CONFIRMATION OF ALCOHOL TEST RESULTS AND THRESHOLD FOR POSITIVE TEST RESULTS 

If the result of the screening test is an alcohol concentration of 0.02 or greater, a confirmation test will be performed. The confirmation test will be conducted within 30 minutes from the end of the screening test.  The confirmation test result is the final result upon which any discipline or other action taken under the Company's policy shall be based.  The Company will consider .04 BAC or greater to be a positive test result.

INABILITY TO PROVIDE ADEQUATE SPECIMEN AMOUNT FOR ALCOHOL TESTING

If the employee is unable to provide sufficient saliva to complete a test on a saliva screening device, the STT shall conduct a new test, using a new device.  If the employee refuses to complete the new test, this will constitute a refusal to submit to a test and the employee will be terminated.  If the new test is completed, but there is an insufficient amount of saliva to activate the device, the employee shall immediately take a breath alcohol test using an EBT.  If the employee refuses to submit to the test using an EBT the employee will be terminated.

Each employee shall blow forcefully into the mouthpiece of the EBT for at least six (6) seconds or until the EBT indicates that an adequate amount of breath has been obtained.  If an employee fails to provide or claims that he or she is unable to provide a sufficient amount of breath to permit a valid breath test, the Company will direct the employee to submit to blood testing.  If blood testing is not feasible, then the Company will direct the employee to obtain, within five days, an evaluation from a licensed physician who is acceptable to the Company and who has expertise in the medical issues raised by the employee’s failure to provide a sufficient specimen.  Failure to undergo such an evaluation constitutes a refusal to test.  If the physician concludes that a medical condition has, or with a high degree of probability could have, precluded the employee from providing a sufficient amount of breath, the employee’s test will be canceled.  If the physician concludes that there is not an adequate basis for determining that a medical condition has, or with a high degree of probability could have, precluded the employee from providing a sufficient amount of breath, the employee will be considered to have refused to test.

ALCOHOL TESTING IN LOUISIANA

When alcohol testing is required in Louisiana, the Company will direct the employee to submit to a blood test.  Blood tests will be analyzed at a certified laboratory and positive test results will be subject to confirmatory testing conducted by gas chromatography and mass spectrometry (“GC/MS”) as well as MRO review.

An employee who receives a verified positive blood alcohol test result may request a confirmatory “re-test” of the original blood specimen at a different DHHS-certified laboratory (or other laboratory required or permitted under state law) selected by the Company.  This request must be made by the employee within 72 hours of being notified by the MRO of a verified positive test result (unless otherwise required or permitted under state law).

SELF-IDENTIFICATION OF SUBSTANCE ABUSE PROBLEM

Consistent with and subject to the Company’s policies concerning the Family and Medical Leave Act, and personal leaves and vacations, employees who voluntarily self-identify themselves as having a drug or alcohol problem and who voluntarily request assistance for such problem will be referred to a substance abuse professional for an evaluation and for an appropriate counseling, treatment or rehabilitation program, if recommended. The cost of the evaluation and any counseling, treatment or rehabilitation is the employee’s responsibility.  (For further details concerning the employee’s payment obligations, employees should refer to their individual medical insurance plan.)  

This request must be made before the employee is required to submit to a drug or alcohol test required by this policy.  Employees may not use this self-identification provision to avoid taking a test when required under this policy or to avoid being disciplined for receiving a positive test result or for refusing to submit to a test (refer to Section 2.2 for a description of conduct that constitutes a refusal to submit to a test).

Once leave commences, periodic certification that the employee is actively continuing to participate in the program, together with progress reports, shall also be required.  As a further condition of taking such leave, the employee will be required to authorize the attending substance abuse professional to communicate directly with the Company, including to release the employee’s relevant treatment records to the Company, except as federal or state law may otherwise require.   All such oral and written communications between the substance abuse professional and the Company shall be treated as confidential.

Except where the federal or state law prohibits, all leave time taken for the evaluation, counseling, treatment or rehabilitation will be counted against the leave to which the employee may be entitled under the federal or state Family and Medical Leave laws, or other applicable leave policy, if any. 

In accordance with the applicable “Agreement For Voluntary Treatment and Conditions for Continued Employment” executed by the employee prior to the commencement of such leave, the employee may be required to submit to a return-to-duty drug test as a condition of returning to work and receive a negative result.  In some cases an employee may be required to submit to a return-to-duty alcohol test as a condition of returning to duty, and if tested, must receive a negative test result.  The employee may also be required to submit to unannounced follow-up drug tests and/or unannounced follow-up alcohol tests as part of the program.

INSPECTIONS

Inspections Of Company Property: The Company may conduct unannounced random inspections at any time and without cause for the presence of illegal drugs or unauthorized alcohol on Company facilities and property such as (but not limited to) Company-issued vehicles, desks, file cabinets, and lockers.  Employees are expected to cooperate in the conduct of such inspections.

Inspections Of Individual Property: Personal inspections of employees and their personal property, such as (but not limited to) vehicles, clothing, packages, purses, brief cases, lunch boxes, or other containers brought onto or being taken off of Company premises, may be conducted by the Company when there is reasonable suspicion to believe that the individual may have or has violated the drug or alcohol prohibitions contained in this policy.

EMPLOYEE ASSISTANCE PLAN AND DRUG-FREE AWARENESS PROGRAM

In order to maintain a drug-free workplace, the Company has established a drug-free awareness program to educate employees on the dangers of drug abuse in the workplace, our drug-free workplace policy, the availability of any drug-free counseling, rehabilitation and any employee assistance programs and the penalties that may be imposed for violations of our drug-free workplace policy.

As part of the Company’s commitment to provide a safe, healthy and efficient working environment for our employees, the Company maintains an Employee Assistance Program (“EAP”). The EAP provides information concerning the effects and consequences of alcohol and drug use on an individual’s health, work, and personal life and the signs and symptoms of an alcohol or drug problem.  In addition, the EAP provides referral services to employees and their families seeking help with problems resulting from alcohol misuse and drug use.  Participation in this program is voluntary and confidential.  The EAP can discuss available counseling, treatment and rehabilitation programs, fiscal responsibilities, and can help the employee decide what program might be best for his or her situation.  For further information or to arrange an appointment, employees may contact the EAP at the following numbers: 800-535-4841


Policy: PRIMARY SOURCE VERIFICATION

Policy Origin Date:   07/18/08

Policy No.:  HR 1.8

Effective date: 07/18/08

Revision date:  01/28/09, 4/10/15

Reviewed: 04/05/11, 06/05/2013, 12/22/16

__________________________________________________________

Purpose

To validate the potential employee experience as stated on their application.

Policy Statement

Primary source verification is necessary to assure employment history is accurately reflected on both the application and resume. This will prevent hiring someone who has misstated, falsified or otherwise modified their application.

Procedure/Guidelines

People Facts is a company contracted by Advantage Medical Professionals, LLC to obtain primary source verification of all employment and educational history.  All work history for the past seven (7) years must be verified. In the case of long-term supplemental staff, only verification of the last three years assignments is required.

Verification of history will include duties and responsibilities at each facility or assignment.

The name of the person performing the check and the date of review will be included.

The results of work history verification will be evaluated by the appropriate agency personnel to determine if applicant is a candidate for hire and placed in his/her file.


Advantage Medical Professionals

Policy and Procedure Manual

Policy: Equal Employment Opportunity
Policy Origin Date:   01/4/2017
Policy No.:  HR 1.9

Effective date: 01/04/2017
Reviewed:
Revised:

____________________________________________________

Purpose

Advantage Medical Professionals, LLC provides equal employment opportunities to all employees and applicants for employment without regard to race, color, ancestry, national origin, gender, sexual orientation, marital status, religion, age, disability, gender identity, results of genetic testing, or service in the military.  Equal employment opportunity applies to all terms and conditions of employment, including hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.

Policy Statement

Advantage Medical Professionals, LLC expressly prohibits any form of unlawful employee harassment or discrimination based on any of the characteristics mentioned above. Improper interference with the ability of other employees to perform their expected job duties is absolutely not tolerated.


Advantage Medical Professionals

Policy and Procedure Manual

Policy: LICENSE EXPERIENCE PARAMETERS FOR HIRE

Policy Origin Date:   07/18/08

Policy No.:  HR 2.0

Effective date: 07/18/08

Revision date:  01/28/09, 4/10/15, 12/22/2016

Reviewed: 04/05/11, 06/05/2013, 12/22/2016

Purpose

To validate a potential employee has adequate experience to work for the agency.

Policy Statement

All employee or potential employees will be screened to be sure they have the necessary experience to work for the agency.

Procedure/Guidelines

All clinical employees shall have a minimum of one (1) year satisfactory work experience in the assigned area within the last three years.

This experience will be primary source verification with work history and reference checks.

The documentation will be placed in the employee file.

In addition, all clinicians must satisfactorily complete:

Registered Nurses:        

Medication Test

IV Therapy Test

Area Specific Test

Licensed Practical/Vocational Nurses:

Medication Test

IV Therapy Test

Area Specific Test

Respiratory Therapists:

Area Specific Test

Certified Nursing Assistants:

Area Specific Test

Surgical Technician/OR Tech

Area Specific Test


Policy: JOB DESCRIPTIONS

Policy Origin Date:   07/18/08

Policy No.:  HR 2.1

Effective date: 07/18/08

Revision date:  01/28/09, 06/05/2013, 04/10/15, 12/29/16

Reviewed: 04/05/11

__________________________________________________________

Purpose

To assure that each agency officer, director, manager and employee has an appropriate job description which pertains to their duties and responsibilities within the agency.

Policy Statement

To assure that each agency employee knows the requirements and expectations of his/her job position. The agency employee will sign a signature page acknowledging their understanding of their job description.

Policy/Guideline

Each employee will receive a copy of the appropriate job description that fully defines the minimum clinical competence and qualifications consistent with staff job responsibilities.  

The agency accurately represents clinical staff qualifications, clinical competency, licensure, registration, and/or certification to the consumer.

The agency only places clinical staff in areas of practice within the scope of their license, registration, certification, or clinical competence.

The job description defines duties expected of the employee, position responsibilities and accountabilities.

Each job description identifies to whom the employee reports.

The employee will sign and date the job description signifying understanding of the duties and expectations required for the job and also that he/she has received a copy of the job description.

A note is made on the file checklist that the job description has been signed and witnessed and includes the date.

The signed job description or acknowledgement signature is placed in the employee file.


Policy: COMPETENCY AND MANDATORY TESTING REQUIREMENTS

Policy Origin Date:   07/18/08

Policy No.:  HR 2.2

Effective date: 07/18/08

Reviewed: 04/05/11, 12/29/16

Revision date:  02/28/09, 06/05/2013, 4/10/15

__________________________________________________________

Purpose

The testing standards are a means used to assess the agency’s tools to measure the competence and clinical knowledge base of the applicant in their general field as well as in any specialty areas they declare as experienced. These standards will also assess the agency’s tools for measuring applicant’s knowledge, competency, conflict resolution and expertise in the job area for which they are applying.

To assure the person tested is the person who the test is intended.

To assure any applicant for hire/employee meets or exceeds all mandatory in-service requirements and all subsequent mandatory testing as required by agency/host facility.

Policy Statement

Competency of the applicant is determined through consistent and standardized methods. These particular tests validate the required knowledge base for clinical expertise.

The testing standard assures the client and agency of the quality and competence of the individual.


Mandatory testing will be done on hire. A passing grade of at least 80% must be obtained in each areas of testing.  Core competencies are tested annually.

Procedure/Guideline

It is the responsibility of the employee to maintain current annual testing requirements as a condition of employment.

Mandatory testing and annual testing includes OSHA and Joint Commission requirements, age specific competency, Infection Control, Body Mechanics, Fire and Safety and any other requirements of the agency or host facility.

All candidates for hire and all employees will establish their knowledge base and expertise for the job for which they apply via testing.

Testing can be done electronically or orally. Electronic testing via API Testing, or with host facility may be done off site. All other testing will be done on site. All on site testing will have a proctor.

A passing score of 80% is mandatory on each area of testing.

You may retest two (2) times. If an applicant fails to successfully complete the testing requirements with a passing score of 80% on three consecutive attempts, then the employee may not reapply for a position for a period of one year.

Documentation will include test name and test scores.  Some clients require remedial testing to 100% and agency will comply.

Host facilities may have additional testing to assess competency and critical thinking (PBDS, for example). Agency will receive the results and they will be placed in employee file.

If mandatory testing is not completed in the specified time frame, the employee is ineligible to work until testing is current.

Policy: CLIENT DRIVEN COMPETENCY TESTS POLICY

Policy Origin Date:   07/18/08

Policy No.:  HR 2.3

Effective date: 07/18/08

Revision date:  01/28/09, 12/29/16

Reviewed: 04/15/11, 06/05/2013, 04/10/15

__________________________________________________________

Purpose

The purpose of this policy is to establish a method of communication to share testing results between host facility and employee.

Policy Statement

Testing of all employees is essential to assure the client and the agency of the competence of the employee.

Policy/Guideline

It is the responsibility of the employee to keep all mandatory requirements current.

A client may want additional testing (PBDS) to further evaluate the competency of the employee. This testing will be done at the client facility. The employee must take and pass with 80% or greater in each aspect of the testing elements.

Any testing required by the client facility will be required of any employee desiring to accept assignments at the client facility.

The test results will be communicated to the agency and placed in employee file. The date of the test and the person reporting will also be documented.


Policy: TESTING PROCEDURES AND PASSING PROCEDURES

Policy Origin Date:   07/18/08

Policy No.:  HR 2.4

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

__________________________________________________________

Purpose

To assure a standardized system for testing any individual and alleviating any disadvantage in the testing process.  To validate competency a minimum grade of 80% is required on all mandatory tests.

Policy Statement

To assure the client and the agency that the most qualified and competent healthcare professionals are hired. Testing standards assure that patient care will be delivered in a safe and competent manner.

Procedure/Guideline

It is the responsibility of the employee to maintain all mandatory testing.

The testing format will be decided by the agency and host facility.

Any on site testing will be proctored by a qualified staff member.

A passing score of minimally 80% is required.

You may retest two (2) times and if you do not remediate to a score of at least 80%, you will no longer be considered for employment for a period of one year.


Policy: RETESTING POLICY

Policy Origin Date:   07/18/08

Policy No.:  HR 2.5

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

__________________________________________________________

Purpose

To define an avenue for second testing in the event that a score does not meet the minimum standard allowing for fair and equitable treatment of all employees who are tested for competency and medication administration as well as mandatory and specialty testing.

Policy Statement

All test scores will be documented in employee file. The results of both tests will be reviewed with the employee.

Policy/Guideline

You may retake a test two (2) times.

Failure to pass test a third time will make the employee ineligible for placement in a client facility for a period on one year.

Results of all testing will be placed in employee file and staffing system. The retesting policy must minimally remediate to 80% with the understanding that some clients will require 100% remediation. If this is the case, the agency will comply.


Policy: FIELD STAFF REASSIGNMENT/FLOATING POLICY

Policy Origin Date:   07/18/08

Policy No.:  HR 2.6

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

_________________________________________________________

Purpose

To assure employees who are reassigned/floated as necessary are re-assigned to areas that fall within their scope of practice.

Policy Statement

The agency has a firm policy and procedure for handling staff reassignment by clients only to their areas within their scope of practice or documented area of expertise. A policy defining appropriate assignment areas for agency employees assists in guarding against placement of staff outside their area of training or expertise. This reduces risk of liability.

Procedure/Guideline

The policy on floating and re-assignment should have what the agency considers acceptable and safe “floatable areas” for their staff.

Contracts will identify and define re-assignment parameters, including areas for appropriate re-assignment given the credentials of the staff to be re-assigned.

Any employee who is asked to float should notify the agency immediately if it is out of their area of expertise. This should be done before you accept any assignment.

The agency will contact the client and discuss the situation and help to resolve the issue.

Refusing to float in an area that is in your scope of practice will not be tolerated.


Policy: OPTIONS FOR EMPLOYEES CANCELLED FOR CAUSE

Policy Origin Date:   07/18/08

Policy No.:  HR 2.7

Effective date: 07/18/08

Revision date:  01/28/09, 12/29/16

Reviewed: 04/15/11, 06/05/2013, 04/10/15

__________________________________________________________

Purpose

To assure the policy for employees who have been terminated from an assignment or contract for cause will receive fair and equitable treatment.

Policy Statement

The agency has a policy for any employee whose contract has been terminated or cancelled for cause. The purpose of the policy is to be sure the employee is treated fairly and equitably in the review process.

Procedure/Guideline

Any employee who has had their contract terminated or cancelled for cause will have an opportunity to present their side of the events leading to the termination.

The agency policy for options for employees terminated for cause assures there are clearly defined guidelines for documenting any termination and to guarantee fairness to the individual throughout the process.

The complaint/terminations will be handled through peer review or an ad hoc grievance committee of the Advisory Committee.

Reporting practices should have a documented chain of custody for all official documents.

All documentation will include the date and time of the incident/issue, nature of the incident, all actions taken, all actions considered to correct or otherwise resolve the situation with the client facility.

The incident will be documented in the employee file and will be shared only with people on a need to know basis. Maintain HIPPA in dealing with issues of employee counseling.


Policy: MAINTENANCE OF NEEDS LIST

Policy Origin Date:   07/18/08

Policy No.:  HR 2.8

Effective date: 07/18/08

Revision date:  01/28/09, 12/29/16

Reviewed: 04/15/11, 06/05/2013, 04/10/15

__________________________________________________________

Purpose

The standards for Needs List Maintenance are to assure the agency is portraying an accurate picture of the placement needs as to specialty, required skills, certifications required and experience level.

Policy Statement

The Needs List Maintenance Policy assures that the needs list is all inclusive, including the specific nature of the facility needs as well as any specific credentials and skills required by the facility in order to assure the best and most accurate match.

Procedure/Guideline

The needs list is kept in API that identifies any shift requests and shifts filled by the agency.

The needs list electronically defines the date and time the request was logged, the date and time the shift is needed, the requested personnel RN, LPN, LRT & CNA and any certifications required, and specific skills.

The name of the person receiving the information and the person who filled the shift should also be documented.

The needs list will identify the person, date, shift and person filling the shift.

The credentials of the person who is making the assignments and their experience must be documented to assure that qualified staff is being is assigned to the appropriate place.

The system has to be user friendly so that other persons can follow the system and schedule staff if necessary.

The needs list is available 24 hours a day.


Policy: DNR – DO NOT RETURN POLICY

Policy Origin Date:   07/18/08

Policy No.:  HR 2.9

Effective date: 07/18/08

Revision date:  01/28/09, 12/29/16

Reviewed: 04/15/11, 06/05/2013, 04/10/15

__________________________________________________________

Purpose

The agency has a policy defining options for employees who have been Do Not Return by client facility.

Policy Statement

This policy will assure the employee has rebuttal opportunities in the event they are determined to be a Do Not Return employee.

Procedure/Guideline

The employee will be informed by the agency of the DNR.

The incident causing the DNR will be discussed with the employee.

The agency will discuss at length with the client the allegation. The incident, date and time as well as any others involved should be discussed.

The client and the agency will attempt to resolve the situation to have the best outcome for all concerned.

The agency will discuss the final decision and findings with the employee.

If the employee is not satisfied with the final outcome, he may use the grievance process.   Refer to the grievance procedure.


Policy: EMPLOYEE ORIENTATION

Policy Origin Date:   07/18/08

Policy No.:  HR 3.0

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

__________________________________________________________

Purpose

To assure the agency has communicated all significant operational information to all new hires. Orientation is the appropriate place to introduce all new hires to the company code of conduct, to outline all company policy and procedures, to address all mandatory all annual credentialing and employee responsibility to comply with all company policies and procedures.

Policy Statement

A formal orientation program must be in operation. This prepares new staff for successful employment with the company. Defining clearly all expectations the agency has via policies and procedures, directives and any other information that is necessary for the employee to function within the company will be reviewed.

Procedure/Guidelines

All newly hired employees will receive a company orientation. This is done via completion of all human resources paperwork, reading the policy and procedure manual or electronically. There will always be an agency representative available to answer any employee questions.

The orientation will minimally include review of the following: Mission Statement, Compliance with OSHA, Joint Commission, federal and state regulations, and payroll/time card procedures. Policy relating to any lapse in credentials, client information and needs, competency issues, agency governance, HIPAA, confidentially, performance reviews, quality improvement committee, discipline, and grievance procedures. Other policies and procedures considered important for the employee so that he/she will better represent the agency to the host facility.

All employees will sign an acknowledgement page stating they have had an opportunity to review the agency policy and procedure manual and have also had an opportunity to ask any questions. Your signature indicates an understanding of the policy and procedures and also an agreement between the agency and yourself that you will abide by these policies and procedures.

The Policy and Procedure Manual will be available for review in the agency office during normal working hours.


Policy: EMPLOYEE NOTIFICATION OF COMPANY POLICIES AND  

             POLICY CHANGES

Policy Origin Date:   07/18/08

Policy No.:  HR 3.1

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

__________________________________________________________

Purpose

To ensure employee is aware of policies and any changes of Advantage Medical Professionals, LLC policies.

Policy Statement

To assure that each employee adheres to the rules and regulations and that all new and changed policies and procedures are adhered to accordingly.

Policy/Guideline

Notice of new policies or policy changes will be posted on the Advantage Medical Professionals, LLC website for employee review.  

Any policy changes are posted on the bulletin board and will be brought to the attention of the employees by office and staffing coordinators, or through electronic notification (email).

All employees are made aware in advance on the acknowledgment page that from time to time there may be additions or revisions to the employee handbook and/or policy and procedure manual and it is the employee’s responsibility to keep informed and updated.


Policy: CLINICAL HANDBOOK

Policy Origin Date:   07/18/08

Policy No.:  HR.3.2

Effective date: 07/18/08

Revision date:  01/28/09, 04/10/15

Reviewed: 04/15/11, 06/05/2013, 12/29/16

__________________________________________________________

Purpose

To ensure that each employee file contains evidence the employee has been informed of the agency’s policies and procedures and is in receipt of the Clinical Handbook.

Policy Statement

The Clinical Handbook is available, informative and distributed to every newly hired employee. The Clinical Handbook is available for employees to reference any policy and procedure of Advantage Medical Professionals, LLC The employee will sign a statement that acknowledges they have read, understand and had the opportunity to ask questions and have been given a copy of the Clinical Handbook.

Procedure/Guidelines

All employees will receive a copy of the Clinical Handbook during orientation. The employee will have an opportunity to ask questions during the orientation process and will sign an acknowledgement statement of receipt and understanding of the contents. The date of receipt will also be included on the signature page. A representative of the agency will sign acknowledging employee’s signature and receipt.

A notation will be made in applicant checklist of date of receipt and signature.

The Clinical Handbook will minimally include the following:

Terms and Conditions of Employment

Drug Abuse Policy

Confidentiality Statement

Sentinel Event Policy and Procedure

Report a Complaint about a Healthcare Organization

Standard List of Abbreviations

Hand Washing Indications

Annual Competencies and Qualifications

Medication Variation

Proper Lifting Instructions

Loans, Gifts, and Gratuities

Ebola Information Guidelines

The employee will be informed of any changes in the Clinical Handbook in a timely manner via writing, email, etc.


Policy: ASSESSMENT AND REASSESSMENT OF CLINICAL

             STAFF COMPETENCE

Policy Origin Date:   07/18/08

Policy No.:  HR. 4.0

Effective date: 07/18/08

Revision date:  01/28/09, 08/29/11, 12/19/16

Reviewed: 01/28/09, 08/29/11, 06/05/2013

__________________________________________________________

Purpose

To establish a process to assess and reassess staff clinical competency on an ongoing basis which is a systematic process that measures the ability of a clinical staff member to perform required activities.  Current competency may be reviewed through information obtained from past and current employers, peer recommendations, validation of specialty certifications and/or licensure tests, performance data, and or skills observation done either separately on in partnership with customers.

Policy Statement

Advantage Medical Professionals, LLC assesses the clinical competency of staff upon hire and   on an ongoing basis.  

Procedure/Guidelines

 Any employee hired to work in a clinical capacity at Advantage Medical Professionals, Inc., will have an initial assessment performed upon hire and on an ongoing basis.  

The initial assessment includes the completion of the following:

Employees hired at Advantage Medical Professionals will have a probationary and biannually evaluations (every two years) completed.  The initial 90 day evaluation will include an evaluation of the employee’s clinical competency by the clinical staff supervisors.  

Advantage Medical Professionals obtains clinical evaluations on all employees upon hire and on an ongoing basis. Clinical evaluations may be obtained verbally from the client facility by administrative personnel upon hire and on an ongoing basis. Clinical facility evaluations are maintained in the API.    

In the event an evaluation identifies performance issues, the employee is notified by the Director of Clinical Services and their performance is reviewed.  

In the event the employee demonstrates a pattern of performance problems and is unwilling to improve, the employee will not be assigned to client facilities and may be terminated.

The firm identifies and reports aberrant or illegal behavior to professional boards and law enforcement agencies.


Policy: CONTINUING EDUCATION

Policy Origin Date:   04/25/09

Policy No.:  HR 5.0

Effective date: 04/25/09

Revision date:  04/25/09, 04/10/15, 12/29/16

Reviewed: 04/15/11, 06/05/2013

__________________________________________________________                        

Purpose

Advantage Medical Professionals, LLC believes it is critical for their employees to engage in continuing education since it facilitates the services we provide to our client facility.  Advantage Medical Professionals, LLC utilizes the performance improvement process to assess the needs of the clinical staff and seeks educational opportunities to improve in areas identifying opportunities for performance improvement.

Policy Statement

Advantage Medical Professionals, LLC utilizes the skills competency check lists and competency testing to identify opportunities for improvement for clinical staff.  

In addition the organization utilizes information provided by client facilities as they relate to complaints and do not returns to assess opportunities for continuing education.

Advantage Medical Professionals, LLC will host various educational offerings to improve clinical outcomes for clinical staff.

Advantage Medical Professionals, LLC will host free Crisis Prevention Intervention (CPI) classes to all employees free of charge.

Advantage Medical Professionals, LLC performs skills validation on any employee who has completed the online education for the following programs:  Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Cardiopulmonary Resuscitation (CPR).

Advantage Medical Professionals, LLC encourages staff to participate in ongoing work-related in-services, training, or other activities.  Employees may request Advantage Medical Professionals, LLC to reimburse them for attendance at an educational offering if a request for educational offering is submitted prior to attendance.  Once the educational activity is approved, Advantage Medical Professionals, LLC will reimburse the employee for any conference fees excluding lunch, travel, and hotel accommodations.  

Clinical employees must submit evidence of continuing education on an annual basis.

Procedure/Guidelines

In the event Advantage Medical Professionals, LLC is hosting an educational offering, clinical staff is encouraged to attend.  Employees of Advantage Medical Professionals, LLC will not be charged for program registration.

If an employee desires to attend a conference outside of an Advantage Medical Professionals, LLC offering, the employee will need to submit a request for educational reimbursement prior to the educational offering.  Once the educational offering is approved by the Director of Clinical Services, the employee can submit the receipt for reimbursement with the validation of attendance.  

Reimbursement for any educational event may take 7 to 10 days for processing.


Policy: PERFORMANCE REVIEW POLICY

Policy Origin Date:   07/18/08

Policy No.:  HR 6.0

Effective date: 07/18/08

Revision date:  01/28/09, 08/29/11, 12/29/2016, 05/30/17

Reviewed: 04/15/11, 08/29/11, 06/05/2013, 04/10/15

_________________________________________________________

Purpose

To assure that current active employees are continuing to perform within the expected guidelines as provided by both the host facility and the agency.  

To assure issues of clinical competence are addressed when identified by either performance reviews or by client reporting.    

Evaluations provide a method to evaluate performance on an ongoing basis while maintaining a current competency assessment.

Policy Statement

Employee Performance Review and requirements are clearly defined. When competency issues are identified, actions to improve and performance assessment pertinent to the competency issue should be well documented. Trends in clinical performance and professional behaviors are tracked, assessed and analyzed through the company Quality Improvement Committee.

Advantage Medical Professionals, LLC employees are considered active as long as they have no break in service and have current credentials.  

Once an employee file is not current with respect to their current credentials, the employee is considered inactive.

Procedure

The minimum requirements for and Employee Performance Review are:


Policy: DRESS CODE

Policy Origin Date:   07/18/08

Policy No.:  HR 7.0

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

__________________________________________________________

Purpose

What we wear to work is a reflection of the pride we have in our company.

Policy Statement

To favorably impress our customers, members of the public, and industry representatives, it is important for all employees to present a professional appearance.

Procedure/Guideline

Clothing should not constitute a safety hazard.

All employees should practice common sense rules of neatness, good taste and comfort.  As an example tight fitting clothing, low cut uniforms or shirts, excessive jewelry, long fingernails, and visible body piercings are unacceptable.

Employees who do not meet the uniform dress code standards will be counseled on proper dress etiquette.


Advantage Medical Professionals

Policy and Procedure Manual

Policy: Discrimination, Harassment or Retaliation

Policy Origin Date:   07/18/08

Policy No.:  HR 8.0

Effective date: 07/18/08

Revision date:  01/28/09, 12/29/16

Reviewed: 04/15/11, 06/05/2013, 04/10/15

__________________________________________________________

Purpose

To ensure the understanding that harassment of any form, including sexual harassment is not tolerated in the workplace by Advantage Medical Professionals, LLC.

Policy Statement

Advantage Medical Professionals, LLC (the “Company”) does not tolerate and prohibits discrimination, harassment or retaliation of or against our job applicants, contractors, interns, volunteers, or employees by another employee, supervisor, vendor, customer, or any third party on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition as defined by state law (cancer or genetic characteristics),  genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, military service and veteran status, pregnancy, childbirth and related medical conditions, or any other characteristic protected by applicable federal, state, or local laws and ordinances.  The Company is committed to a workplace free of discrimination, harassment and retaliation.  Discrimination, harassment and retaliation are also prohibited by law.

Procedure/Guideline

Discrimination Defined.  Discrimination under this policy means treating differently or denying or granting a benefit to an individual because of the individual’s protected characteristic. 

Harassment Defined.  Harassment is defined in this policy as unwelcome verbal, visual or physical conduct creating an intimidating, offensive, or hostile work environment that interferes with work performance.  Harassment can be verbal (including slurs, jokes, insults, epithets, gestures or teasing), graphic (including offensive posters, symbols, cartoons, drawings, computer displays, or e-mails) or physical conduct (including physically threatening another, blocking someone’s way, etc.) that denigrates or shows hostility or aversion towards an individual because of any protected characteristic.  Such conduct violates this policy, even if it is not unlawful.  Because it is difficult to define unlawful harassment, employees are expected to behave at all times in a professional and respectful manner.

Sexual Harassment Defined.  Sexual harassment can include all of the above actions, as well as other unwelcome conduct, such as unwelcome or unsolicited sexual advances, requests for sexual favors, conversations regarding sexual activities and other verbal or physical conduct of a sexual nature. 

Examples of conduct that violates this policy include:

Retaliation Defined.   Retaliation means adverse conduct taken because an individual reported an actual or perceived violation of this policy, opposed practices prohibited by this policy, or participated in the reporting and investigation process described below.   “Adverse conduct” includes but is not limited to:  shunning and avoiding an individual who reports harassment, discrimination or retaliation; express or implied threats or intimidation intended to prevent an individual from reporting harassment,  discrimination or retaliation; and denying employment benefits because an applicant or employee reported harassment, discrimination or retaliation or participated in the reporting and investigation process described below.

ALL DISCRIMINATION, HARASSMENT AND RETALIATION IS UNACCEPTABLE IN THE WORKPLACE AND IN ANY WORK-RELATED SETTINGS SUCH AS BUSINESS TRIPS AND BUSINESS-RELATED SOCIAL FUNCTIONS, REGARDLESS OF WHETHER THE CONDUCT IS ENGAGED IN BY A SUPERVISOR, CO-WORKER, CLIENT, CUSTOMER, VENDOR, OR OTHER THIRD PARTY.

Reporting Procedures.  The following steps have been put into place to ensure the work environment at the Company is respectful, professional, and free of discrimination, harassment and retaliation.  If an employee believes someone has violated this policy or our Equal Employment Opportunity Policy, the employee should promptly bring the matter to the immediate attention of Human Resources or Anna Martin, CFO/Vice President at hr@advantagemedicalprofessionals.com; 504-888-8818.  If either of these individuals is the person toward whom the complaint is directed you should contact any higher level manager in Human Resources or your reporting chain.  

The Company’s policy is to respond to all complaints in a prompt and timely manner.  If the employee makes a complaint under this policy and has not received a satisfactory response within seven (7) business days, he or she should immediately contact Anna Martin; CFO/Vice President; anna@advantagemedicalprofessionals.com; 504-888-8118.

Every supervisor who learns of any employee’s concern about conduct in violation of this policy, whether in a formal complaint or informally, must immediately report the issues raised to senior management (Anna Martin; CFO/Vice President) or to Human Resources 504-888-8118. 


Policy: EMPLOYEE EMERGENCY CONTACT

Policy Origin Date:   07/18/08

Policy No.:  HR 9.0

Effective date: 07/18/08

Revision date:  01/28/09

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

__________________________________________________________

Purpose

Provide Advantage Medical Professionals, LLC the ability to contact a designated person in the event of an emergency situation.

Policy Statement

Advantage Medical Professionals, LLC will contact a designated emergency contact of the employee’s choice in the event of an emergency.

Procedure/Guideline

An emergency contact person is obtained from the employee upon hire.  In the event of an emergency situation, the emergency contact person will be contacted and informed of the situation.  No other contacts will be made by Advantage Medical Professionals, LLC unless the employee specifically designates an emergency contact.

In the event of Advantage Medical Professionals, LLC deems it necessary to contact the emergency contact, the only information that will be provided will be the current situation requiring contact and any information available regarding the emergency.  

In the event Advantage Medical Professionals, LLC must contact an employee for an emergency situation, once all employee contacts provided to the employee have been exhausted, the firm may contact the emergency contact and inform the employee to contact Advantage Medical Professionals, LLC at their earliest convenience.  


Policy: TRAVEL CONTRACTS

Policy Origin Date:   07/18/08

Policy No.:  HR 10.0

Effective date: 07/18/08

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

________________________________________________

Purpose

To define the process of obtaining a travel contract with Advantage Medical Professionals, LLC.

Policy Statement

Advantage Medical Professionals LLC, is a supplemental staffing agency capable of providing client facilities with per diem assignments of temporary medical personnel as well as contractual agreements with employees for short term assignments (ranging from 1 month to 3 months).  

Procedure/Guideline

If contract extension is agreeable between the hospital and agency, the guidelines for the extension will be submitted to both parties in writing for review and signature.  Extension will cover all terms agreed upon by both parties.


Advantage Medical Professionals

Policy and Procedure Manual

Policy: CANCELLATION OF TRAVEL CONTRACT

Policy Origin Date:   07/18/08

Policy No.: HR 10.1

Effective date: 07/18/08

Reviewed: 04/15/11, 06/05/2013, 04/10/15, 12/29/16

Purpose:        To define the process required to accommodate client facility and Advantage Medical Professionals, LLC obligations in the event the contractual period is unmet.

Application:

  1. The hospital/facility shall be able to cancel the service of a medical professional at any time when it determines that the job performance of that individual is unsatisfactory.  The Hospital supervisor must in turn, document fully the unsatisfactory performance.

If an Advantage Medical Professionals, LLC employee is canceled under these conditions, Advantage Medical Professionals, LLC shall have the option of replacing the employee for the remainder of the contract period with another appropriately credentialed employee approved by the Hospital.

  1. If an Advantage Medical Professionals, LLC employee initiates early cancellation of the contract, he/she must document fully the rationale.   Acceptable conditions for such action include: serious illness requiring extended recuperation time, family illness/death, placement in areas for which the individual is not competent and should not be assigned (this last would require review by the Director of Clinical Services of Advantage Medical Professionals, LLC and appropriate facility management staff.)

If an Advantage Medical Professionals, LLC employee is canceled under these conditions, Advantage Medical Professionals, LLC shall have the option of replacing the employee for the remainder of the contract period with another appropriately credentialed employee approved by the Hospital.

        

  1. Advantage Medical Professionals, LLC realizes there are extenuating circumstances often and is always willing and able to sit down and discuss any placement or problem and arrive at solutions that are in the best interest of all parties and acceptable to all.

  1. In the event an employee cancels a contract without cause, the employee is responsible for any and all expenses spent by Advantage Medical Professionals, LLC as they relate to housing, travel, and any other costs associated with the execution of the contract.


Policy: EMPLOYEE BENEFITS

Policy Origin Date:   07/18/08

Policy No.: HR 11

Effective date: 07/18/08

Reviewed: 04/15/11, 06/05/2013, 12/29/16

Revised:  04/10/15

Purpose

To inform all clinical employees of the benefits available while employed with Advantage Medical Professionals, LLC

Policy Statement

The policy is delineated to inform clinical employees of available benefits.

Procedure/Guideline

Holidays:        Clinical employees will be paid time and one half at most facilities for holidays predetermined by the individual facilities.  Clinical employees will be informed of holiday shift prior to start of shift.

Overtime:        Clinical employees will be paid time and one half for hours worked in excess of 40 hours in a work week.  Overtime must be pre-approved by the facility before the agency will be allowed to schedule the clinician.

Insurance:        Advantage Medical Professionals, LLC is an employee based corporation and provides Professional and General Liability Insurance and Workers Compensation Insurance to all clinical staff.  

        Effective January, 1, 2015 Advantage Medical Professionals needs to become compliant with the Affordable Care Act. Currently all contract employees and full-time office staff are offered insurance as defined below:

 

        Full-time clinicians (non-variable) who agree to work 30 hours or more per week as defined in their signed contract.  

        Example:  A clinician who accepts a contract to begin on June 25 may be eligible for benefits July 1.

Variable clinicians are all other clinicians that do not fall into the full-time status.  New variable clinicians will be considered full-time if they average working 30 hours or more per week for their initial 11 months after their hire date.  If they qualify, they will be eligible for insurance on the first of the month following the 13 month of hire.  Qualifying new variable clinicians will have their stability period of insurance for 12 months.  

Example:  A clinician whose hired date is June 25 may be eligible for benefits August 1.  

        Ongoing variable clinicians will be considered full-time if they work 30 hours or more per week for the 12 month period of April-March.  Ongoing variable clinicians that qualify will be eligible for insurance every June 1st, which is open enrollment.

        Example:  A clinician who works with us ongoing, may be eligible for benefits July 1.  

        It is the employee’s responsibility to notify Advantage Medical Professionals, LLC’s Human Resources health insurance department in writing of any change in employment status that affects their eligibility for insurance.

        It is the employee’s responsibility to inquire about their insurance eligibility based on the defined categories.

        If the Advantage employee does not return the required insurance application or the waiver form before the specified deadline, the Advantage employee then waives their right to insurance until the next open enrollment or a qualifying event.  

        **It is the clinician’s responsibility to make Advantage Medical Professionals, LLC aware of his or her availability on a daily basis. Due to the nature of the temporary staffing business, Advantage Medical Professionals, LLC cannot and does not guarantee work availability or work for its variable employees**

        Eligible dependents:

        

Making Changes During The Year

If you elect to participate in Section 125, pretax deductions; due to IRS regulations, once a clinician has made the choice for the enrollment period, changes to benefits cannot be made until the next enrollment period.

Clinicians cannot change or revoke any of the elections or this compensation redirection agreement at any time during the Plan Year (with exception of the HAS) unless there has been a “change in status” and the election change is consistent with the “change in status”, this means:  marriage, divorce, death of a spouse or child, birth or adoption of a child, termination of commencement of employment of a spouse, change in clinician or spouse’s employment status from full-time to part-time or from part-time to full-time, clinician or spouse taking an unpaid leave of absence, a substantial change in family’s health coverage due to a change in spouse’s employer-sponsored health coverage, or such other events as the Plan Administrator determines will permit a change or revocation of an election.  

To change benefits, notify Human Resources within 31 days of the change in family status. Clinician will need to provide proof of the change, such as marriage certificate, record of birth or adoption, etc.


Policy: RECRUITMENT AND RETENTION

Policy Origin Date:   07/19/09

Policy No.: HR 12

Effective date: 07/19/09

Reviewed: 04/15/11, 06/05/2013

Revised: 04/10/15, 12/29/16

Purpose

To provide facilities who contract with Advantage Medical Professionals, LLC the best alternative to any supplemental staffing agency to meet their needs on a per-diem or short-term contractual basis.  

Policy Statement

Our Mission is to service the Healthcare Community by supplying EXCELLENCE IN STAFFING SERVICES to the healthcare providers.  Excellence is defined by the company operations that meet standards and expectations which are appropriate for meeting the quality care initiatives of our clients and staff. As a result, Advantage Medical Professionals, LLC is committed to hiring the most qualified health care personnel to provide services to facilities who possess a current contract to supply supplemental staff.  Our primary concern is to provide facilities with highly qualified professionals for general and special floor duty to achieve excellence in patient care.

Procedure/Guideline

Recruitment

Advantage Medical Professionals utilizes various modalities to recruit qualified nursing and allied health personnel.  These modalities include web page advertisement, new paper ads, national nursing publications, attendance at job fairs, social media advertisement, and through word of mouth when employees are on assignment in facilities.

Individuals responsible for the recruitment of field staff include the Director of Marketing, Director of Clinical Services, Director of Travel, Assistant to the Director of Clinical Services, and Staffing Coordinators.

To address all facility needs, recruitment is not only focused on the various disciplines employed by Advantage Medical Professionals, LLC but additional attention is paid to the various general, specialty, or intensive care areas.  All individuals who work for Advantage Medical Professionals, LLC are employees and not independent contractors.  

Employees obtain applications by going to the Advantage Medical Professionals, LLC website and completing an employment application, contacting the office to have an application mailed to them via the United States Postal Service, obtaining an application at a job fair, or by coming directly into the office.

The first point of contact or initial interaction is made by the assistant to the CNO.  This individual reviews the applicant and assists the applicant with completion of the application process.  Employees are not allowed to begin work until they have completed the entire application process.  

The second step in the employment process is for the employee to attend any orientation required by the facility and complete any facility programs.

Retention

Advantage Medical Professionals utilizes various modalities to retain qualified nursing and allied health personnel.  These modalities include:


Policy: MEDICATION VARIATION POLICY

Policy Origin Date:   01/03/11

Policy No.: HR 13

Effective date: 01/03/11

Reviewed date: 06/05/2013, 04/10/15, 12/29/16

Purpose

To establish medication variation guidelines for any employee who has a self-reported or facility reported medication variation.    

Policy Statement

Advantage Medical Professionals, L.L.C. views the administration of mediation as an important role of our nursing staff.  

Procedure/Guideline

Medication variations will follow the process as outlined below.  In the event any medication variation resulted in patient harm, the Director of Clinical Services will review the circumstances of the incident and determine if the employee will follow the process or no longer be assigned to client facilities by Advantage Medical Professionals, L.L.C.  

It should be noted that the following guidelines are in effect for a two year period.  If two years have elapsed since the first medication occurrence, the employee returns to the guidelines as outlined in the first occurrence section of the policy.

First Occurrence

Any employee who has a medication variation reported to the agency will be required to review the five rights and responsibilities of medication administration.  It is the Director of Clinical Services’s responsibility to contact the employee on their first occurrence and inform them to review the five rights as well as the medication variation policy for Advantage Medical Professionals, LLC.

Second Occurrence

In the event an employee has a second reported medication variation, the employee will be required to complete a minimum of 3 continuing education units on medication safety and medication variations.  Advantage Medical Professionals, L.L.C. will not assign any employee with two medication variations to any client facility until the employee is capable of demonstrating successful completion of the required continuing education units.

Third Occurrence

In the event an employee has a third medication variation, the Director of Clinical Services will review the seriousness of the variations and develop a plan of corrective action with the employee. It

should be noted that at any time during this process the Director of Clinical Services may decide not to assign the employee to any future client facilities.


Advantage Medical Professionals

Policy and Procedure Manual

Policy: HIRE DATES, ACTIVE AND INACTIVE STATUS

Policy Origin Date:   10/24/11

Policy No.: HR 14

Effective date: 10/24/11

Reviewed date: 06/05/2013, 12/29/16

Revised date: 04/10/15

Purpose

To identify how Advantage Medical Professionals, LLC identifies hire dates, active and inactive status of all employees.

Policy Statement

The policy is delineated to identify the hire dates, active and inactive status of any Advantage Medical Professionals, LLC employee.  

Procedure/Guideline

Hire Dates:        The hire date for any Advantage Medical Professionals, LLC employee will be when the employee completes or signs the post offer health questionnaire, the final pre-hire documents that must be completed by all clinicians. Employees are screened and complete the necessary paperwork to become an Advantage Medical Professionals, LLC employee prior to signing the post offer health questionnaire.  

Active Status:        Advantage Medical Professionals, LLC employees are considered active as

long as they have no break in service and have current credentials.  

Inactive Status:         Advantage Medical Professionals, LLC are considered inactive if they have a break in service or if their current credentials are expired.  

Break in Service:         Occurs when there is not service for 13 weeks or a Parity rule, if there is no service for at least four consecutive weeks and the break exceeds the prior time of service.  Any employee with a break in service will be treated as a voluntary resignation and will be treated as a rehire immediately preceding the resumption of service completing the rehire process.  Break in service policy is subject to the Family and Medical Leave Act and all other applicable laws.  

Rehire Process:         A clinician must complete rehire process if he or she has not actively worked in the field for Advantage Medical Professionals, LLC for a period of six months in order to be active. The rehire process includes updating the clinicians file and completing all necessary credentials must be up-to-date.

Rehire Date:          As in the hire date, the rehire date will be taken from the post offer health questionnaire.