Policy Handbook

Mission Statement, Vision, and Values

Mission Statement

To respectfully and compassionately meet the needs of our clients and their families, by communicating, listening, planning, educating, and delivering the highest quality of individualized care and services.

Vision

Our vision is to create a leading high quality service that supports individuals to live as independently as possible. We personalize our services to meet our seniors’ situation respectfully, efficiently, and compassionately. While fostering independence, preserving dignity, and improving quality of life.

Commitment

Everyone assists with the creation of an environment where honesty, integrity, respect, innovation, initiative, and empowerment are valued and encouraged. We will be an open, innovative company that fanatically supports our staff and the individuals we serve.

Our Values

Communication

Integrity

Honesty and Ethical Behavior

Professional Excellence

Mutual Respect

Teamwork

Leadership

Who Are We

History of the Company

Promise Senior Solutions was founded in 2015 as a senior services company that offers affordable & flexible services to our clients. Our focus is always on helping seniors live more independent lives.

Agency Services

Personal Assistance Services

We provide in-home care for seniors and the disabled. From 4 hours to 24 hours a day, 7 days a week. Helping seniors remain independent in their home for as long as possible.

Transportation Services

Promise Senior Solutions is committed to providing families and their loved ones with assistance while going out of their homes. Our drivers assist seniors door-to-door with escorted and unescorted transportation options.

Coming Soon

Skilled Nursing Services

Coming Soon

Home Health Care & Physical Therapy

Equal Employment Opportunity

Promise Senior Solutions’ policy is to hire or contract and promote for all jobs without regard to race, religion, color, national origin, sex, sexual orientation, marital or familial status, physical or mental disability, veteran status, or age. Decisions on are based solely upon an individual’s qualifications, with reference to the skills and abilities of the position for which the individual is being considered.

Immigration and Employment Eligibility

In compliance with the Immigration Reform and Control Act of 1986 Promise Senior Solutions can employ or contract only those individuals who are authorized to work in the United States. All individuals must submit documentary proof of their identity and employment authorization. Full-time & Part-time employees as well as contractors will also be required to complete and sign Immigration and Naturalization Service Form I-9. Form I-9 requires you to attest that you are authorized to work in the job for which you are hired and that the documents you submit are genuine.

If you are authorized to work in this country for a limited period of time, before the expiration of that period, you will be required to submit proof of your employment authorization and sign another I-9 in order to remain employed by Promise Senior Solutions.

Employment Categories

Note: The employee or contractor can terminate this relationship at will.

1. Full-time Regular Employee

See the Addendum for qualification necessary to be classified as a full-time employee. The employee is entitled to available health care benefits. Regular employees can be further classified as exempt or non-exempt salaried (see below).

2. Regular Part-time Employee

See the Addendum for qualification necessary to be classified as a full-time employee. Part-time employees are not entitled to receive group health insurance.

3. Temporary / On-Call Providers

The individual is hired on a contract basis and paid a per visit rate outlined in the Contracted Personnel Agreement. Contracted Employees are not entitled to receive regular benefits.

4. Salaried Employees

Under certain conditions employees may also be classified as non-exempt or exempt salaried employees. These classifications cover the provisions of the Federal Fair Labor Standards Act or any applicable state law. Non-exempt employees are entitled to premium pay for work in excess of 40 hours in a work week. Exempt employees who qualify as executives, professional employees, administrative employees, outside salespersons, etc. are eligible for On-Call pay but may not receive overtime provisions.

5. Contracted Providers

The individual is hired on a contract basis and paid a per visit rate outlined in the Contracted Personnel Agreement. Contracted Employees are entitled to receive benefits as outlined in their contract agreement.

Professional Agreement Addendum

Under the Captain of the Ship Doctrine, Promise Senior Solutions recognizes its limitation on certain issues required of a professional to remain in control over practices and procedures that require greater diligence than normally associated with an employer. If the Professional appears on the payroll and benefits it is as an independent contractor and is not considered as an employer-employee relationship, particularly for those supervisory activities required by a licensed professional. This relationship does not transfer any or some of the professional’s obligations or liabilities. These liabilities remain with the professional and are covered by the professional’s practice insurance.

The duties and responsibilities of Promise Senior Solutions are limited to the preparation of payroll and administration of employee or contract benefits. The Professional maintains his or her license as required by law, professional liability coverage and other responsibilities as found under state prime contract law. Promise Senior Solutions is not involved in the day-to-day supervision or decision with regard to client care or dentistry. This remains with the Professional as part of the Professional’s practice. The Professional fully indemnifies Promise Senior Solutions against any and all liability and responsibility associated with his or her professional duties.

This Agreement is in effect at all times regardless of changes in employee or contract status both as to the past and as to the future.

Please Sign Your Acknowledgement Page & Return To The Operations Manager

Drug & Alcohol Abuse Policy

Periodic X-ray or laboratory tests may be required as a condition of employment or contract. You will be informed by management of the required test(s).

An employee or contractor who exhibits inappropriate behavior, which is suggestive of being under the influence of a drug, alcohol or inhalant while on the job will be subject to a test for those items. Any employee or contractor may be required to undergo drug, inhalant or alcohol testing if the supervisor feels there is reasonable suspicion to do so. Reasonable suspicion can be caused by an employee or contractor actions, behavior, smell or physical appearance. If you refuse to submit to such testing you may be immediately disciplined, including termination.

A. PURPOSE

To provide a controlled substance, drug and alcohol free workplace for the safety of all employees, contractors (leased, hired, or otherwise) and customers. In order to further this objective the following rules governing alcohol and illegal drugs and inhalants in the workplace have been established.

B. POLICY

The illegal manufacture, distribution, dispensing, possession, sale, purchase, receipt or transmittal of controlled substances, or an attempt to any of the foregoing, while on Promise Senior Solutions or Client Company’s (“Company”) property or on company related business is prohibited.
The unauthorized possession of alcohol or any alcoholic beverage on Company property or on Company related business is prohibited.
Being under the influence of alcohol or other illegal or intoxicating drugs or inhalants while on Company property or on Company related business is prohibited.
The unauthorized use or possession of prescription drugs or nonprescription over-the-counter drugs on Company property or Company related business is prohibited.
Employees and contractors who violate this policy will be subject to appropriate disciplinary actions, including termination.
This policy applies to all employees and contractors of the Company regardless of rank or position.

C. TESTING

1. Testing of employees and contractors. All present employees (contracted, hired or otherwise) will be requested to sign an Informed Consent and Release of Liability form. Employees and contractors may be tested for the presence of alcohol, drugs including inhalants and/or controlled substances in the event any of the following situations occur:

There exists a reasonable suspicion or belief that an employee or contractor is at work under the influence of drugs, alcohol, inhalant, or a controlled substance;
There exists a reasonable suspicion or belief that drugs, alcohol, inhalants or a controlled substance are affecting an employee or contractors performance, attendance patterns, conduct, or safety of workplace actions;
The employee and contractor are suspected of having caused or contributed to an accident;
When required by a customer or company pursuant to the customer’s drug testing policy. Such testing is not considered a company drug test and may be subject to the customer’s rules regarding drug tests.

2. Voluntary. In all instances, testing will be performed only with the applicant or employee or contractors knowledge and consent. Refusal to submit to requested testing, however, may result in disciplinary action including termination.

3. Company Testing. Urine specimens will be obtained at the Company’s office, lab, testing facility; however, in the event of an accident or injury, samples may be obtained at an appropriate hospital, clinic, emergency room, or doctor’s office.

4. Test Results. A positive test shall mean the presence of alcohol, an inhalant or other drug or controlled substance has been found. An attempt by an employee or contractor to switch, adulterate, or tamper with any test result or sample submitted for medical testing, or otherwise interfere or attempt to interfere with the testing processes, shall result in immediate termination.

D. CONFIDENTIALITY

The Company shall make all reasonable attempts to keep the results of a positive drug test confidential. Such results shall be released to Company personnel only on a need-to-know basis. All positive written test results will be stored in a confidential file and be filed only by authorized Company personnel and kept only at the company.

E. DISCIPLINARY ACTION

Employees and contractors suspected of violating any of the policies contained herein may be suspended or removed from the workplace pending a complete investigation. Employees and contractors testing positive for drugs, alcohol, inhalants or other controlled substances will be subject to immediate discharge. Any employee or contractor who is otherwise found to have violated the policies herein will be subject to disciplinary action, including termination. Should the determination be made that no violation of the policies contained herein have occurred, the employee will be reinstated without penalty.

F. EXCEPTION

An employee or contractor who possesses or uses a drug authorized by a licensed physician or medical practitioner through a prescription, specifically for the employee or contractors use while on the job, and whose facilities are not noticeably impaired by the use of such drug, will not be considered to have violated this policy. Employees and contractors shall be responsible for discussing with the prescribing medical practitioner whether any prescribed drug will or may affect the employee or contractors performance on the job. In the event an employee or contractor is advised that medication may affect performance, it is their responsibility to notify manager of the circumstances prior to reporting to work.

G. CONVICTION UNDER CRIMINAL DRUG STATUS

Every employee or contractor is required to immediately notify the company if they are convicted under a federal or state criminal drug statute, whether the act giving rise to such conviction occurred on or off Company premises.

H. COORDINATION WITH LAW ENFORCEMENT AGENCIES

The sale, use, purchase, transfer or possession of an illegal drug or drug paraphernalia is a violation of the law. The Company will report information concerning possession, distribution, or use of any illegal drugs to law enforcement officials and will turn over to the custody of law enforcement officials any such substances found during a search of an individual or property. The Company will cooperate fully in the prosecution and or conviction of any violation of the law.

Please Sign Your Acknowledgement Page & Return To The Operations Manager

Infection Control & Blood Borne Pathogen Training

Hepatitis B is a disease that causes 200 to 300 deaths each year in health care workers. A vaccine to protect health care workers from hepatitis B is available at your physicians’ office or local health department. The vaccine is highly recommended for all health care providers who have routine or occasional contact with the blood or body fluids of clients. Hepatitis B is passed from person to person by exposure to blood and some body fluids. HIV is passed the same way.

HIV has infected some heath care workers on the job. Most got infected so by a “sharps injury” such as a needle stick. Others got infected with HIV by getting blood splashed on their chapped skin or in their eyes, noses or mouths. The risk of getting infected while working in the personal assistance setting is low but not zero. For example, the risk of infection by an accidental needle stick with an HIV contaminated needle is about three to four chances out of 1000. However, the risk of coming down with AIDS and dying is high if you get infected with HIV. A health care worked infected with a blood borne pathogen may pass it on to his or her partner by sexual contact.

A person who is infected with the cytomegalovirus (CMV) may not have any signs of illness. This virus may be passed from person to person by exposure to infected saliva and urine. If a pregnant woman becomes infected with CMV, it may cause damage to the fetus (unborn child).

Often, we do not know that a client has one of these diseases. Many times a client does not look sick. However, if you are exposed, you can still get one of these diseases. You can protect yourself from exposure by following special precautions know as UNIVERSAL PRECAUTIONS.

WHAT IS EXPOSURE?

Significant exposure to blood or body fluids is defined as:

Injury with a contaminated sharp object (e.g., needle sticks, scalpel cuts)
Spills or splashes of blood or body fluids into non-intact skin (e.g., cuts, hangnails, dermatitis, abrasions, chapped skin) or into a mucous membrane (i.e., mouth, nose, eyes)
Blood exposure covering a large area of apparently intact skin.

Here is a list of examples of exposures:

Getting blood or body fluids in cuts or in breaks in your skin, or in skin sores or on large areas of skin.
Getting blood or body fluids in your eyes, mouth, or nose.
Getting cut or stabbed with any needles or sharp instruments which were used on a client.
Getting cut on the broken glass that was used to hold blood, body fluids, or human tissue (glass tubes, blood collection tubes, bottles, jars, etc.)

WHAT IS NOT EXPOSURE?

Handling food trays or furniture.
Handling assistive devices or wheelchairs with clients.
Using public bathrooms or telephones.
Personal contacts with clients such as shaking hands, giving information, touching intact skin as when bathing intact skin or giving a back rub.
Doing clerical or administrative duties for a client.

UNIVERSAL PRECAUTIONS:

1. You must wear gloves if you touch blood, body fluids, mucous membranes or human tissue of any client. To touch a client’s skin that is broken or cut, wear gloves. Gloves must be worn when cleaning and debriding a surgical incision or open wound, while performing any EMG/NCV diagnostic testing procedure, or suctioning a client. You must wear gloves when performing any vascular access procedures – such as venipuncture. You must wear gloves when touching any surface or object which is reasonably anticipated to be contaminated even if not visibly contaminated, such as the outside of client specimens. Always change gloves when they are torn. Always change gloves after contact with each client. Always remove contaminated gloves before touching clean items such as door knobs, light switches, etc. Always wash hands immediately after taking off gloves. Do not wash or disinfect surgical or examination gloves for reuse. Do not use non-intact or discolored gloves.

2. When mucous membranes (i.e., mouth, nose, or eyes) come in contact with blood or body fluids, you must flush (irrigate) them with large amounts of water. If you have blood or a body fluid splashed into a skin cut, skin puncture or skin lesion, first wash the area with soap and water for at least 10 seconds, then put 70% isopropyl alcohol on the area. You must report any exposure that occurs either as a part of your job or through an emergency outside the scope of your job to The Company as soon as possible. Follow the same procedures used for incident reporting.

3. Do not eat, drink, apply cosmetics, lip balm or handle contact lenses in work areas where there is a potential for occupational exposure to blood or body fluid contaminated surfaces or objects.

4. Wear fluid resistant gowns or plastic aprons if soiling of clothes with blood or body fluids is likely.

5. You must wear a mask and eye protection or a face shield if spraying, splashing, or splatter to your face is possible. Minimal facial protection would consist of a surgical mask and eye glasses with solid side shields. Eyeglasses without solid side shields are never acceptable for the purpose of protection.

6. All personal protective equipment (gloves, masks, eye protection, and fluid resistant gowns or aprons) shall be removed immediately upon leaving the work area and placed in a designated container for washing or disposal. If contaminated, personal protection equipment should be removed immediately or as soon as feasible. If a pullover item is contaminated, remove it in a way that contamination of head or face does not occur. If this is not feasible, then pullover item should be cut off with scissors.

7. CPR masks are essential when performing mouth-to-mouth resuscitation, and are available at the clinic. Gloves, CPR masks, and proper hand washing are essential.

8. Handle anything sharp with care to prevent accidental cuts or punctures. Do not recap, bend or break used disposable needles. Discard all sharp items immediately by placing them in a puncture-resistant needle box or a puncture-resistant contaminated materials container (CMC). Broken glassware that may be contaminated shall not be picked up directly with the hands. Use a mechanical device such as brush and dustpan, tongs or forceps. Remove vacutainer needles only from clean vacutainer holders. Use the needle removal device to do this. Do not remove needles from visibly bloody vacutainer holders. Discard both holders and needles if they are visibly bloody. Needle boxes and CMCs should be closed when nearly full. They should never be allowed to become overfilled. They should also never be placed above eye level.

9. Clean blood or body fluid spills promptly. Wear gloves and use a freshly made dilution of one part chlorine bleach to 9 parts of water to clean a spill. Place paper towels over spill. Flood the spill area with bleach dilution. Leave on for 10 minutes. Discard the paper towels in a contaminated materials container.

10. All client specimens may be contaminated on the outside of the container and must be handled with gloves. Place them inside plastic bags before sending them to a laboratory. Be careful not to contaminate the outside of the plastic bad by handling it with potentially contaminated gloves. If the container is enclosed in a clean dry plastic bad, gloves need not be used for handling the bag. Do not send soiled containers to a laboratory.

11. Do not place food or drink in refrigerators, freezers, cabinets or other areas where any client specimens are placed.

12. A provider should report to The Company if you have a draining skin cut or sore. You must report before you take care of clients or touch client care equipment. If there is a question about a provider’s ability to safely care for clients, they should be cleared through The Company. Cover any non-draining lesions with waterproof dressing before entering the home environment.

13. Laundry visibly soiled with blood or body fluids must be handled with gloves. All laundry must be placed in a fluid proof bag. Do not place laundry in a red bag. If the outside of the bag is visibly soiled with blood or body fluids, the bag must be placed inside another bag. If personal clothing becomes contaminated with blood or other potentially infectious material, it cannot be taken home until it is laundered or disinfected.

14. To get rid of large quantities of blood or body fluids, carefully pour them down a toilet. The drain connects to a sewer system. If splash or splatter is likely, you must wear protection for your eyes and a mask or a face shield. You must also protect your cloths – wear a fluid resistant gown or apron. Place small, closed samples of blood in a puncture-resistant contaminated materials container. DO NOT SQUIRT IT IN!

15. ANY MATERIALS OR ITEMS VISIBLY CONTAMINATED WITH BLOOD, BODY FLUIDS OR HUMAN TISSUE MUST BE PUT INTO A CONTAMINATED MATERIALS CONTAINER (CMC). A CMC must be available at your work site if you work with contaminated materials.

16. The following policies and documents are available for your review at the office. A copy of any or all of the following policies or documents is available to you upon request.

Occupational Exposure Training Policy
Hepatitis B Vaccine Policy
Blood borne Pathogens Exposure Control Plan Policy
Provision of Personal Protective Equipment Policy
CPL 2-2.60 - “Exposure Control Plan for OSHA Personnel with Occupational Exposure to Blood borne Pathogens.”
Federal Register, “Blood borne Pathogens Regulatory Text”, OSHA Standard 1910.1030

RATIONALE

Persons of all ages and backgrounds may be carriers of the AIDS virus. In addition, the majority of organisms associated with nosocomial infections are commonly found in faces, airway secretions, blood, urine, and wound drainage. Category specific isolation is usually initiated only after a diagnosis is made. Emphasis is placed on transmission of pathogens via hands of personnel.
Gowns protect clothing from soilage; clothing has rarely been known to be associated with transmission of infectious agents. Masks protect mucous membrane of the wearer as well as prevent droplet transmission to active clients. Private rooms offer additional barriers for airborne disease transmission.
Lab specimens treated in an identical manner addresses the issue of unknown cases as well as known cases.
The environment of all clients should be treated in the same manner. If soilage is present, it should be cleaned promptly. When the client is discharged, their environment should be cleaned with the same attention to detail that would be used if the client was known to have an infection.
Most needle stick injuries occur during the recapping process. Blood borne pathogens are a threat to health care workers via needle stick injuries.

The CDC has changed the requirements if a Health Care Worker (HCW) is exposed to TB. They now require a Tuberculin Skin Test (TST) be placed once exposure is confirmed and then again in 8-12 weeks. Having a “current” TST does not exclude a HCW from this requirement.

Please read over these facts about TB

Tuberculosis (TB) is a disease which usually affects the lungs. It is spread from person to person through the airborne route when a person who has active disease coughs, sneezes or speaks.
TB is caused by a bacterium called Mycobacterium Tuberculosis. If not treated properly TB can be fatal. Symptoms of TB include feeling of weakness, weight loss, fever, night sweats, chest pain, and coughing up blood.
To prevent the spread of TB, HCW’s caring for patients with TB need use appropriate respiratory protection (N95 particulate respirator). Transmission of TB has been associated with close contact of infectious patients by HCW’s during cough-inducing procedures, like a bronchoscopy.
Not everyone infected with TB becomes sick. There are 2 different TB related conditions; latent TB and active TB disease. People with latent TB have the TB germs in their bodies but are not sick because the germs are not active. They do not have symptoms of TB and cannot spread the germs to others although they may develop TB in the future. People with active TB are sick from the germs that are active. They usually have symptoms of TB and are capable of spreading the germs to others. People with active TB can be prescribed medication to help treat the disease.
TB can be treated with medication. People taking medication for TB need to take the medication exactly as they are instructed. People who do not take the medication as prescribed or who stop the medication too soon may become sick again, and the germs that are still present in them may become resistant to the medication and more difficult to treat.
People who are most likely to get sick from TB are; people with HIV, people who inject illegal drugs, babies/young children, the elderly, people who were not treated correctly for TB in the past, and people with certain chronic medical conditions.
Patients with suspected or confirmed TB need to be placed in private rooms with negative airflow or HEPA filter units, on Airborne Precautions, and with the door closed.

Instructions for Treating MRSA Clients

MRSA is “Methicillin-Resistant Staph Aureus” infection. It is an infection that is resistant to antibiotic treatment. Usually, clients acquire this infection while in the hospital. Client who are elderly or who are immuno-compromised are most susceptible to this infection.
Contact-Droplet Isolation: gown, gloves, and mask are required for all health care providers. The client may have been instructed to wear a mask, but it is not required.
Schedule MRSA clients for the last appointment of the day.
All clothing that comes in contact during the visit to be washed in HOT water and dried on the HOT setting.
All gowns, gloves and masks worn during the treatment are to be separately bagged in a garbage bag and immediately placed in a bio hazard bag.
GOOD HAND WASHING IS A MUST. THIS IS TO BE DONE BEFORE, DURING (IF APPROPRIATE) AND AFTER THE TREATMENT USING ANTIBACTERIAL SOAP AND HOT WATER FOR AT LEAST 30 SECONDS.

Care of Equipment

You are responsible for equipment used in performing your work. Any damage or failure of this equipment is to be reported to your supervisor immediately. Equipment or supplies are to be used for clients of Promise Senior Solutions. Promise Senior Solutions is not responsible for loss or damage to your personal property. Valuable personal items such as purses and all other valuables should not be left in areas where theft might occur.

PURPOSE

To promote cleanliness of medical supplies and equipment in the personal assistance aide’s and field staff’s car. To prevent transmission of insects or infectious organisms

EQUIPMENT

1. Large plastic or cardboard container with impermeable lining

PROCEDURE

1. Personal assistance aides and field staff who travel by car are to keep a large plastic or cardboard container in a designated clean area of the car, preferably the trunk.

2. The aide bag, extra staff uniform, and medical supplies and equipment are to be kept in this container.

3. Supplies and equipment are to be stored in the car container in a neat and orderly fashion.

AIDE CONSIDERATIONS

Personal assistance aides and all field staff have the potential to transmit insects and infectious microorganisms from household to household. Medical supplies and equipment are to be stored, handled, and transported in a way to minimize this risk. Likewise, medical supplies/equipment in the client’s home are to be stored and handled without compromising integrity.

Do not leave temperature-sensitive equipment in the car overnight or for long periods.

Using non-latex gloves should be considered because of potential staff and client allergies to latex.

Equipment Cleaning

PURPOSE

To prevent the spread of infectious organisms. To maintain clean equipment when providing client care

EQUIPMENT

1. Personal care agency-approved disinfectants

2. Liquid soap and water

3. Antiseptic wipes

4. Utility gloves and an impermeable plastic trash bag (see Infection Control)

PROCEDURE

1. Don utility gloves to protect hands from disinfectants.

2. For initial clean up, wash all equipment with soap and water.

3. After washing equipment with soap and water, disinfect, rinse, and dry.

4. Disinfection methods in the home will vary. The item to be disinfected will primarily determine the disinfectant that is to be used. Bleach corrodes metal but is cited as an all-purpose disinfectant for blood and body substance spills.

5. Seal disposable supplies used to clean equipment in a leak-proof impermeable plastic trash bag separate from the family trash; secure and place in the family trash. Otherwise discard disposable items according to Standard Precautions.

Stethoscope

Routinely clean the bell/diaphragm of the stethoscope with a disinfectant spray, or, using a rotary motion, with an antiseptic wipe each visit.

Glucose Meters

Follow specific manufacturer’s recommendations for cleaning.

Thermometers

Use an antiseptic wipe to clean glass thermometers; otherwise follow the manufacturer’s recommendations.

Respiratory Therapy Equipment

Do not use bleach or caustic disinfectants on respiratory therapy equipment. Consult with the respiratory therapist or home medical equipment (HME) vendor regarding specific guidelines.

Soap and water are effective for cleaning equipment such as nasal cannulas, masks, tubing, the cap and mouthpiece of cartridge inhalers, humidifiers, and surfaces of most respiratory therapy equipment.

Home respiratory equipment may also be soaked in a white vinegar/water (1 cup: 3 cups) solution for 20 minutes, thoroughly rinsed with warm running water, and allowed to air dry. Cleaning should be done daily or at least 2 to 3 times per week. Cleaning of respiratory equipment is also recommended after each intermittent positive pressure breathing (IPPB) or aerosol treatment. After being cleaned, humidifiers should be refilled with fresh distilled water to prevent bacterial growth.

Other

Soiled bedpans and commodes should be cleaned with soap and water and then disinfected. Instruments may be boiled on the stove for 15 minutes in a clean pan or metal tray and then stored in the aide bag.

AIDE CONSIDERATIONS

Always read the label on the disinfectant and follow directions. Remember, disinfectants are designed for inanimate objects and may damage the skin; use with caution and instruct the family to store out of reach of children.

Use disinfectants in a well-ventilated room. If possible, totally submerge contaminated articles in the disinfecting solution for the required time-period.

If disinfection of contaminated equipment is not possible in the client’s home, seal in an impermeable plastic trash bag and transport to the personal assistance agency for disinfection. Never place soiled or contaminated equipment in the aide bag.

Whenever possible, use disposable equipment/supplies for home care clients.

Personal Care Bag Technique

PURPOSE

To prevent contamination of the aide bag. To prevent cross-contamination and spread of infectious organisms

EQUIPMENT

1. Aide bag with impermeable lining

2. Paper towels

3. Fresh newspapers or other suitable barrier

4. Leak-proof and puncture-proof container for bag storage in the car

5. Liquid soap (bar soap can be a haven for bacteria) (Note: antiseptic hand cleanser may be used instead of liquid soap) and an impermeable plastic trash bag (see Infection Control)

PROCEDURE

1. Observe the principles of Standard Precautions at all times. The inside of the aide bag should be regarded and maintained as a clean area.

2. Transport the aide bag in the car on top of a supply of fresh newspapers. In addition, the bag should be stored in a clean area of the car, preferably in a plastic or cardboard container designated for such use.

3. Once in the client’s home, select the cleanest and most convenient work area and spread the newspaper.

4. Place the bag on the newspaper.

5. Prepare a receptacle (impermeable plastic trash bag for disposable items).

6. Open the aide bag and remove items needed to wash hands (hand washing supplies should be kept at the top of the bag). Close the bag. Use the aide bag as few times as possible.

7. Wash and dry hands according to the procedure for Hand washing.

8. Return to the aide bag, open it again, and remove necessary items for the visit. Apply personal protective equipment as needed. Keep the bag closed during the visit. Leave all plastic containers in the bag. If additional equipment or supplies are needed from the bag during the home visit, the hand washing procedure must be repeated.

9. Discard disposable personal protective equipment in an impermeable plastic trash bag. To discard a disposable gown or plastic apron, remove the apron by folding the exposed side inward.

10. After providing care, clean all equipment with soap and water or a personal assistance agency-approved disinfectant before returning it to the bag.

11. Return unused clean supplies to the aide bag after care is given. Contaminated equipment or equipment that cannot be cleaned in the client’s home may be transported for disinfection to the personal assistance agency in an impermeable sealed plastic bag placed on the floor of the car. Never place used needles, soiled equipment, or dressings in the aide bag.

12. Wash hands. Discard any remaining items according to Standard Precautions. Return cleaning supplies (e.g., liquid soap) to the aide bag.

13. Close the aide bag and fasten. When leaving the client’s home, pick up the bag and place the newspaper that was underneath it in the family trash. When traveling, store the aide bag in a clean place (see procedure for Maintaining Medical Supplies and Equipment in the Car).

AIDE CONSIDERATIONS

The aide bag should be cleaned and restocked weekly at the personal assistance agency.

The following should be considered when selecting work areas in the client’s home:

a. Adequate work space (preferably a clean surface)

b. Protection of the family’s property

c. Protection of the aide bag (place in a safe place area from children and/or pets)

d. Convenience of water

Reporting and Managing an Exposure Incident

PURPOSE

To report an exposure incident. To prevent infectious disease or staff injury. To acquire personal assistance agency support services for possible staff exposure to infectious disease.

EQUIPMENT

1. Hydrogen peroxide, alcohol

2. 4- x 4-inch gauze pads

3. Soap and water, paper towels, and an impermeable plastic trash bag (see Infection Control)

PROCEDURE

1. When an exposure incident occurs in the workplace, the following guidelines will be followed:

a. Eyes. If an exposure to the eye or mucous membrane occurs, immediately flush the area with clean water for at least 5 minutes.

b. Cuts. If an exposure occurs in a cut, open sore or lesion, abrasion, or damaged cuticle, wash the area with soap and water as soon as possible. Apply first aid.

c. Puncture wound. If exposure occurs by sharps, wash the area with soap and water as soon as possible. Apply first aid.

d. Clothing. Immediately clean all contaminated clothing with a 10% bleach solution. Change clothes as soon as possible. Carry an extra uniform in the car.

e. Respiratory. See the procedure for Implementing a Tuberculosis Control and Personal Respiratory Protection Program.

2. Report the exposure incident to your supervisor within 1 hour of occurrence.

3. Follow OSHA recommendations for testing, counseling, and seeking appropriate medical assistance. (All efforts should be made to ensure employee confidentiality.)

4. No further client contact should be made by the exposed personal assistance aide and field staff until approval is given by the Administrator.

5. Clean and replace any equipment used during the procedure. Discard any disposable items according to Standard Precautions.

AIDE CONSIDERATIONS

Consider a tetanus prophylaxis for cuts and deep wound punctures; consult with a physician as needed.

DOCUMENTATION GUIDELINES

The Administrator will complete an incident report within 24 hours of occurrence for follow-up, treatment, surveillance, and evaluation.

Please Sign Your Acknowledgement Page & Return To The Operations Manager

PHI & HIPAA

Information given by a customer, or a client may be privileged or confidential information. Such information is to be maintained with strict confidentiality. This may also be true for proprietary information within the company. You are encouraged to be careful in discussing with non-company people any information about the company where you work.

Any employee or contractor who reads a client’s medical, dental or client’s file or who has access to sensitive customer records, and discusses any material with another person, except for assigned duty, may be subject to immediate dismissal. Information about other employees or contractors is also private.

In 1996, Congress enacted the Health Insurance Portability and Accountability Act, also known as HIPAA. Among the primary purposes of HIPAA are (1) to protect people from losing their health insurance if they change jobs or have pre-existing health conditions, (2) to reduce the costs and administrative burdens of healthcare by creating standard electronic formats for many administrative transactions that are currently carried out on paper, and (3) to develop standards and requirements to protect the privacy and security of confidential healthcare information.

Recently, the Department of Health and Human Services issued new regulations referred to as the Privacy Rule and Security Rule. The regulations require healthcare organizations to adopt processes and procedures to ensure the highest degree of client confidentiality. These processes include administrative, physical and technical safeguards to ensure that medical information is stored, transmitted and received in a safe and secure manner.

As you can imagine, the HIPAA regulations impact virtually every department of every entity that has access to confidential health information. Hospitals, medical practices, insurance companies, medical-device manufacturers and other healthcare organizations are undergoing major changes in the way they handle client information.

The Privacy and Security Rules provide stiff penalties for those who fail to comply with the requirements or who improperly disclose or misuse protected health information (PHI). It is important that all who may come into contact with PHI understand and carry out their responsibilities under the Rules, as outlined in this training program.

HIPAA is a broad and far-reaching law. Entities covered by the Privacy and Security Rules include healthcare plans, providers and clearinghouses.

The Rule also extends to the business associates of covered entities, which include auditors, consultants, lawyers, data and billing firms, and others with whom the covered entities have agreements involving the use of protected health information. The covered entity must receive satisfactory assurances that the business associate will comply with the Privacy and Security Rules, though the covered entity need not monitor the business associate's work unless it learns of a problem with compliance. You do not need a business associate agreement for employees, cleaning services, and contracted employees such as a physical therapist who perform a substantial portion of their for this agency. The Privacy Rule requires the return or destruction of all protected health information (PHI) at the termination of a business associate agreement contract only where feasible or permitted by law.

In addition, the Rules apply to any company that offers healthcare and treatment to its employees on-site. Thus, if an employer or school operated an on-site clinic, the clinic would be a covered entity, and its client information would be subject to the Privacy and Security Rules.

Entities Covered by State Law

When covered entities use or transmit protected health information in any form, they must comply not only with the Privacy and Security Rules, but also with any state laws regarding privacy of medical records. In the event of a conflict between HIPAA and state law, HIPAA preempts state law unless the state law is stricter. (In other words, whichever provides greater protection to clients must be followed.)

HIPAA establishes a single set of transaction standards for electronic healthcare transactions, thus enabling healthcare providers and insurance companies to communicate more fluidly. The Privacy and Security Rules cover the following types of information transactions:

Healthcare claims (professional, institutional and dental);
Health plan eligibility inquiries and responses;
Enrollment and disenrollment in a health plan;
Healthcare payment and remittance advice;
Health plan premium payments;
Claim status inquiries and responses;

Referral certification and authorization; and Coordination of benefits.

The Rules also require covered entities to use special coding standards for all transactions involving electronic data interchange (EDI), including the use of "unique identifiers" for providers, health plans, employers and clients. These new coding standards are still being developed and refined by the Department of Health and Human Services.

The Privacy and Security Rules protect individually identifiable health information transmitted or maintained by a covered entity, no matter what form it takes.

That means that when a doctor takes notes in a medical chart, when a hospital data-entry clerk types health insurance information into a computer, or when healthcare providers discuss a client's condition, any identifiable health information becomes protected health information (PHI) under HIPAA. Medical records are protected health information. Clients and authorized client representatives are allowed access to their medical records. The client can authorize a person to receive PHI information at any time and may also revoke authorization at any time. The need to provide in writing the person(s) that they wish to allow access to PHI. If a client wants to request a restriction on the disclosure of his/her protected health information it must be in writing. However, the client may request to review their records in person and are not required to provide the request in writing.

When a client requests access to his/her medical records you can provide a summary if you think it is too difficult for the client to interpret. You must have the requestor agree on charges for the summary in advance. When a client requests copies of his/her medical records you can charge reasonable cost-based fees for providing the copies/summaries.

Note, however, that employment records held by a covered entity in its role as an employer are not considered PHI.

While many covered entities may seek to rely on practice-management software or healthcare clearinghouses as a means of ensuring HIPAA compliance for their healthcare transactions, software alone cannot provide a complete solution. Most of the work in complying with HIPAA for all covered entities is in developing and administering systems and policies that prevent the misuse of PHI in a comprehensive and consistent way. This agency has 60 days to respond to a request to amend a record. The agency can refuse to make amends in certain cases.

The Privacy Rule requires a covered entity to:

Provide clients with a Notice of Privacy Practices (NPP); and make a good-faith effort to obtain a client's written acknowledgment of receiving the NPP.

The NPP must inform clients of (1) the uses and disclosures of PHI that the entity may make, (2) the client's right to access and amend their medical information, and (3) the covered entity's responsibilities with respect to PHI. Notice of Privacy Practices (NPP) must be given to each client at the first visit after April 13, 2003, posted on the company Web site, if it has one, and posted in the office. If I forget to give a Notice of Privacy Practices (NPP) to a client, I have to mail it on the date of service and document my actions.

The agency can make changes to the NPP if it has reserved the right in the notice.

Once it has obtained the acknowledgment or has made a good-faith effort to do so, the entity may:

Use PHI for its own treatment, payment or healthcare operations; and disclose PHI to other covered entities for their treatment, payment or certain limited healthcare operations.
When using or disclosing PHI or when requesting PHI from another covered entity, a covered entity must make reasonable efforts to limit PHI to the minimum necessary to accomplish the intended purpose of the use or disclosure.

As a general rule, a covered entity may not use or disclose protected health information for purposes other than treatment, payment and healthcare operations without the client's written authorization. A copy of an authorization is acceptable if all elements are included.

A “breach” of PHI is any unauthorized access, use or disclosure of unsecured PHI, unless a risk assessment is performed that indicates there is a low probability that the PHI has been compromised. The risk assessment must be performed after both improper uses and disclosures, and include the nature and extent of the PHI involved, a list of unauthorized persons who used or received the PHI, if the PHI was in fact acquired or viewed, and the degree of mitigation. If the risk assessment determines the probability to low that PHI was compromised, it is not necessary to notify the client.

Marketing

The Privacy Rule prohibits a covered entity from disclosing PHI to others for marketing purposes without the client's written authorization. For example, a pharmacy may not provide a pharmaceutical company a list of clients with a particular disease or condition in order for the pharmaceutical company to market drugs to those clients without their authorization.

At the same time, communications regarding treatment, case management or the recommending of alternative therapies are excluded from the definition of "marketing," as are communications that promote health in a general manner. Thus, for example, a health-related newsletter that a covered entity distributes to clients to inform them about new healthcare developments would not be considered marketing under the Privacy Rule.

Incidental Disclosures

The Privacy Rule allows "incidental" disclosures of PHI, as long as the covered entity uses reasonable safeguards and adheres to the "minimum necessary" standard. For example, doctors' offices may use waiting-room sign-in sheets, hospitals may keep charts at bedside, doctors may talk to clients in semi-private rooms, and medical staff may confer at the nurse's station without violating the Privacy Rule.

Since many of us receive, store and transmit PHI as part of our day-to-day responsibilities, The Privacy Rule requires the following administrative safeguards to ensure that PHI is not compromised:

Designating a Privacy Officer to be responsible for the development and implementation of privacy policies;
Providing physical safeguards to protect our computer systems and related equipment from fire, other environmental hazards and intrusion;
Using technical safeguards like encryption software to transmit health information over the Internet;
Requiring business associates (lawyers, consultants, auditors, billing companies, pharmacists, etc.) to confirm that they will protect PHI
Developing a system to track who accessed what information; and
Implementing rules for addressing violations of privacy, security and transaction regulations, including establishing a process for making complaints and preventing retaliation against anyone who reports a HIPAA violation. The client may lodge a complaint to any staff member or the regulatory body.

If the Secretary of Health and Human Services (HSS) validates a complaint: It may result in a compliance review.

If a non-authorized disclosure of protected health information (PHI) is made: You must keep a record of this for six years and give the client a full accounting upon proper request.

Employees and contractors must receive an initial training on HIPAA and also requires those with access to PHI to undergo periodic training on these and other appropriate privacy procedures, and to keep documented proof that these trainings have been given. Everyone who works in my office, including unpaid volunteers, contract employees, and casual laborers, must be trained or show documentation of training about HIPAA

A privacy officer should conduct the following steps:

Identify the internal and external risks of disclosure of pprotected health information (PHI)
Create and implement a plan to reduce the risk of releasing PHI in those areas identified
Train all personnel on the practice’s privacy and security of PHI.
Monitor the implementation and enforce appropriately any breaches of policy.

The Security Rule also requires that administrative, physical and technical safeguards are in place to prevent the improper use or disclosure of PHI. The required administrative safeguards are as follows:

Certification Review: A technical evaluation to ensure that our computer environment is secure from intrusion.
Chain of Trust Agreements: Agreements with external recipients of PHI confirming that they will protect the confidentiality of data exchanged.
Contingency Plan: A plan for responding to system emergencies, including the performance of backups, emergency-mode operations, and disaster-recovery procedures.
Policies & Procedures: Policies and procedures for the proper use of healthcare information.
Access Controls: A plan for granting different levels of access to healthcare information, including policies that determine each individual's right to access the information.
Internal Audit Procedures: An in-house review of system activity records (such as log-ins, file accesses, and security incidents).
Personnel Security: Security checks and special training for all employees with access to sensitive information regarding the proper use and handling of PHI, and documentation to verify that the training has occurred.
Security Configuration Management: Procedures for the security of our computer systems, such as virus checking and security testing.
Security Incident Procedures: Instructions for reporting security breaches.
Security Management Process: A process to ensure that we have the proper infrastructure in place to prevent and detect security breaches.
Termination Procedures: Procedures to prevent a terminated employee from having access to confidential information.

HIPAA also requires those with access to PHI to undergo periodic training on these and other appropriate security procedures, and to keep documented proof that these trainings have been given.

The Security Rule also requires a number of physical steps to ensure that PHI contained in computers is properly protected from fire and environmental hazards, as well as from intrusion. Physical safeguards include the following:

Security Management: Assignment of responsibility for Security management.
Media Controls: A set of procedures that govern the receipt and removal of hardware and software (such as diskettes, tapes, and personal data assistants).
Physical Access Controls: Procedures that deter intruders from accessing environments where sensitive information resides.
Equipment Controls: Security policies for bringing hardware and software into and out of offices, including policies on how to dispose of hardware and other storage media.
Guidelines on Workstation Use: Procedures describing the proper functions to be performed on computers, and how to handle sensitive information that may be displayed on computer screens.

Finally, the Security Rule requires certain technical safeguards for PHI, including:

Access Controls: Controls to ensure that access to sensitive information is available on a need-to-know basis, based on roles and context.
Audit Controls: Controls to record and examine system activity, helping to eliminate unnecessary access to sensitive information.
Authorization Controls: Controls for obtaining consent for the use and disclosure of health information.
Data Authentication: Controls to help ensure that health data has not been altered in an unauthorized manner.
Entity Authentication: Controls to ensure that data is sent to the intended recipient and received by the intended party. These controls include the use of password protections, PIN numbers and, when sent over public networks, encryption.

Sending PHI via E-mail and Fax

According to the Security Rule, it is permissible to use the Internet to transmit PHI, as long as (1) an acceptable method of encryption is used to protect confidentiality, and (2) appropriate authentication procedures are followed to ensure correct identification of the sender and receiver. Although faxes are transmitted over telephone lines, they are not considered to be "covered transactions," so they may be sent without additional security precautions.

The HIPAA regulations take effect for covered entities on April 14, 2003, while various parts of the Security Rule go into action between now and April 2005. Failure to comply with the Privacy or Security Rule can lead to significant financial and other penalties:

Civil monetary penalties for each individual failure to comply with HIPAA provisions include a fine of $100 for each violation with a cap of $25,000 per year for multiple violations of the same provision.

Criminal penalties for a basic offense include fines of up to $50,000 and/or imprisonment for up to one year.

Criminal penalties for an offense committed under false pretenses include fines of up to $100,000 and/or imprisonment of up to five years.

Criminal penalties for an offense committed with the intent to use PHI for one's commercial advantage include fines of up to $250,000 and/or imprisonment of up to ten years.

Release of Company Information

In the course of employment or contract with Promise Senior Solutions, you may have access to confidential information regarding the company, its customers, clients, business, and/or vendors.

Though you may not be aware that information is sensitive or is of value to others, it is your responsibility to safeguard and maintain the confidentiality of all company information.

1. Only authorized company management personnel are permitted to give statements regarding the company to any member of the media including, without limitation, the press.

2. If you receive a request for information from anyone who is not an employee or a supervisor or manager must contact your immediate supervisor or manager and report the request. You may give the person requesting the information your supervisor or manager’s name and provide the person with information regarding how to contact their supervisor or manager.

3. No inquiries about the company are to be answered by unauthorized individuals electronically, in writing, on the telephone, in person, or by any other means. Some examples of people or entities that could conceivably contact you in an attempt to gain information are listed below, without limitation. You should refer these people to a supervisor or manager.

Media: Television, Radio, or Newspaper
Attorney’s Offices
United States Department of Labor (including, without limitation, its directorate of Civil Rights, its Wage and Hour Division, or the Solicitor’s Office)
Local, State, County, or Federal Courts
Local, State, or County Human Relations Commissions
United States Equal Employment Opportunity Commission
Prospective Employers seeking employment verifications and references
Credit Bureaus, Banks, Mortgage Companies, other Financial Institutions
Telephone Service, Copier Service and Other Vendors
Police Departments
Other similar agencies, companies, or individuals

4. If you have a question as to whether the information being requested applies under this policy must contact their supervisor or manager for instructions. DO NOT VOLUNTEER, PROVIDE, OR OTHERWISE DISCLOSE ANY INFORMATION TO THIRD PARTIES.

5. You should be polite and exhibit professionalism and refer the questions to their supervisor or manager.

6. Price information procedures, policies, and any other information regarding the company and its business is strictly confidential and proprietary and must not be shared with customers, competitors, vendors, their representatives, or other third parties. Discussing company information in an indiscreet or careless manner, inside or outside the company, displays poor judgment and undermines the confidence the company has.

7. Absent express company management approval, you may not discuss or otherwise disclose the company’s pricing policies, actual pricing, or any other company information with anyone outside the company. Talking about pricing or otherwise disclosing pricing information, especially with or to competitors, may result in damage to the company and/or a price fixing charge against the company and/or other liability.

8. Nothing in this policy should be construed to interfere with the right of appropriate law enforcement or government agencies to conduct investigations, or the cooperation of employees in investigations, within such agencies’ jurisdiction. Upon request, the company will reasonably cooperate in investigations subject to the company’s right to be represented by counsel in such circumstances. Employees or contractors who receive a subpoena or other form of compulsory process shall immediately notify their supervisor or manager.

PHI & HIPAA Acknowledgement

I understand and acknowledge that:

I shall respect and maintain the confidentiality of all discussions, deliberations, client care records and any other information generated in connection with individual client care, risk management and/or peer review activities.

It is my legal and ethical responsibility to protect the privacy, confidentiality and security of all medical records, proprietary information and other confidential information relating to Promise Senior Solutions and its affiliates, including business, employment, contractors, and medical information relating to our clients, members, and health care providers.

I shall only access or disseminate client care information in the performance of my assigned duties and where required by or permitted by law, and in a manner which is consistent with officially adopted policies of Promise Senior Solutions, or where no officially adopted policy exists, only with the express approval of my supervisor or designee. I shall make no voluntary disclosure of any discussion, deliberations, client care records or any other client care, peer review or risk management information, except to persons authorized to receive it in the conduct of Promise Senior Solutions affairs.

Promise Senior Solutions Administration performs audits and reviews client records in order to identify inappropriate access.
My user ID is recorded when I access electronic records and that I am the only one authorized to use my user ID. I will only access the minimum necessary information to satisfy my job role or the need of the request.
I agree to discuss confidential information only in the work place and only for job related purposes and to not discuss such information outside of the work place or within hearing of other people who do not have a need to know about the information.
I understand that any and all references to HIV testing, such as any clinical test or laboratory test used to identify HIV, a component of HIV, or antibodies or antigens to HIV, are specifically protected under law and unauthorized release of confidential information may make me subject to legal and/or disciplinary action.
My obligation to safeguard client confidentiality continues after my termination of employment with the Promise Senior Solutions.

Please Sign Your Acknowledgement Page & Return To The Operations Manager

Prohibited Harassment

Guiding Principles

As employees or contractors of Promise Senior Solutions, LLC we are collectively responsible for providing a work environment that is free of workplace violence, bullying, and harassment; and where individuals are treated with dignity and respect. Harassment and workplace violence undermine the integrity of the workplace and an individual’s wellbeing and will not be tolerated. Promise Senior Solutions, LLC is committed to building a work environment that is free of discrimination, harassment, and workplace violence by ensuring its policies are implemented in a fair and equitable manner and are free of discrimination and creating an environment which enables all to contribute to their full potential, thereby increasing our business effectiveness and competitive advantage and providing employees and contractors with a positive, engaging and supporting work environment.

The purpose of this policy is to communicate Promise Senior Solutions’ determination to:

Provide a working environment free of discriminatory intimidation and/or sexual harassment.
Identify complaint procedures available.
Outline disciplinary penalties that may be imposed for discriminatory or harassing conduct.

Harassment involves verbal or physical conduct that harms or shows hostility or aversion toward an individual because of his or her race, color, religion, sex, age, national origin, sexual orientation, marital or familial status, physical or mental disability, or that of his or her relatives, friends, or associates and that:

Has the purpose or effect of creating an intimidating, hostile, or offensive working environment.
Has the purpose or effect of unreasonably interfering with an individual’s work performance.
Otherwise adversely affects an individual’s employment opportunities.

Sexual harassment involves:

Making unwelcome sexual advances or requests for sexual favors or other verbal or physical conduct of a sexual nature a condition of employment.
Making submission to or rejection of such conduct the basis for employment decisions.
Creating an intimidating, offensive, or hostile working environment by such conduct.
Harassment Policy
It is against Promise Senior Solutions policy for any employee, independent contractor, or other visitor to harass any employee or contractor of Promise Senior Solutions through the use of disparaging or abusive words or phrases, slurs, negative stereotyping or threatening, intimidating, or hostile acts that relate to race, color, religion, sex, age, national origin, sexual orientation, marital or familial status, or physical or mental disability. This includes acts that are declared to be “jokes” or “pranks”, but that might reasonably be perceived as hostile or demeaning.
It is illegal and against Promise Senior Solutions’ policy for any employee or contractor to harass another by making unwelcome sexual advances or requests for sexual favors or other verbal or physical conduct of a sexual nature a condition of employment or contract; by using an employee or contractors submission to or rejection of such conduct as the basis for or a factor in any decision affecting the individual; or by creating an intimidating, hostile, or offensive work environment by engaging in such conduct.
Creation of an intimidating, hostile, or offensive work environment may include publishing or posting written or graphic material that criticizes or shows hostility or aversion toward an individual or group because of race, color, religion, sex, age, national origin, sexual orientation, marital or familial status, or physical or mental disability that is placed on walls, bulletin boards, or elsewhere on company property or circulated in the workplace. The creation of an intimidating, hostile, or offensive work environment may include such actions as persistent comments on an employee or contractors sexual preferences or the display of obscene or sexually-oriented photographs or drawings. An investigation will be conducted to determine whether certain conduct occurred and/or whether it constitutes sexual harassment based on a review of the facts and circumstances of each situation.
Unreasonable conduct will not be tolerated. This includes, but is not limited to, excluding employees or contractors from information regarding opportunities for advancement; denying access to information, people, or places; treating others as inferiors; or selecting one or a few members of a group for favorable treatment.
Promise Senior Solutions will not condone any harassment or sexual harassment of employees or contractors. Moreover, Promise Senior Solutions will not tolerate such conduct by independent contractors or other visitors. All employees, contractors, supervisors or managers, will be subject to severe disciplinary action up to and including termination for any sexually harassing behavior.
When harassment is alleged, Promise Senior Solutions will determine whether certain conduct occurred and/or whether it constitutes harassment or sexual harassment based on a review of the facts and circumstances of each situation.
Employees or contractors who feel victimized by harassment or sexual harassment should immediately report the alleged harassment to their supervisor or manager. If the supervisor or manager is the source of the alleged harassment, employees and contractors should report the problem to the supervisor or manager’s superior or at Promise Senior Solutions at (833) 479-6700.
Supervisors or managers who receive a complaint of harassment or sexual harassment must report the complaint to Promise Senior Solutions at (833) 479-6700.
A prompt and careful investigation of the matter will be conducted, questioning employees and contractors who may have knowledge of the alleged incidents or similar problems. Both the complaint and the investigative actions and findings will be documented as thoroughly as possible.
Employees or contractors who are dissatisfied with an investigating supervisor or manager’s resolution of a harassment or sexual harassment problem may file a complaint in accordance with Promise Senior Solutions’ grievance procedures by contacting their manager or Promise Senior Solutions at (833) 479-6700.
No employee or contractor will be subject to any form of retaliation or discipline for pursuing a claim of harassment or sexual harassment.
Promise Senior Solutions recognizes that the issue of whether harassment or sexual harassment has occurred requires a factual determination based on all the evidence received. All Staff also recognizes that false accusations of harassment or sexual harassment can have serious effects on the innocent. We trust that all employees and contractors will act in a responsible and professional manner to maintain a pleasant working environment free of harassment or sexual harassment.
Promise Senior Solutions reserves the right to remedy inappropriate harassing or sexual harassing conduct that falls short of conduct subjecting Promise Senior Solutions to legal liability, in a manner that is appropriate, fair, and legal, up to and including termination and to report illegal acts to the proper authorities.

Inappropriate Behaviors

Inappropriate behavior can be any conduct by an individual that adversely affects an individuals psychological or physical wellbeing. Such behaviors can stem from a series of incidents or a single incident depending on its severity. It is comprised of acts that are;

Demeaning, belittling, or can cause personal humiliation or embarrassment;

Threatening, intimidating and generally produce harmful results such as endangering a person’s safety or negatively affecting their work performance or employment relationship;

Create a hostile, threatening, or coercive work environment;

Offensive or insulting including comments, jokes, slurs, name calling, gestures, innuendoes, threats, or taunting;

Displaying or distributing inappropriate posters, pictures, cartoons, graffiti, drawings, or other visual representations;

Yelling, use of profanity, making condescending or crude remarks at a person or persons;

Ostracizing or spreading gossip and spiteful rumors about a person or persons;

Coercion or intimidation tactics when managing and monitoring a person’s work.

Verbal bullying: Slandering, ridiculing, or maligning a person or his or her family

Persistent name calling that is hurtful, insulting or humiliating; using a person as butt of jokes; Abusive and offensive remarks;

Physical bullying: Pushing, shoving, kicking, poking, tripping, assault or threat of physical assault, damage to a person’s work area or property

Gesture bullying: Nonverbal threatening gestures; glances that can convey threatening messages.

Exclusion: Socially or physically excluding or disregarding a person in work-related activities.

The following examples may constitute or contribute to evidence of:

Bullying

Persistent singling out of one person.

Shouting or raising voice at an individual in public or in private.

Using verbal or obscene gestures.

Not allowing the person to speak or express himself of herself (i.e., ignoring or interrupting).

Personal insults and use of offensive nicknames.

Public humiliation in any form.

Constant criticism on matters unrelated or minimally related to the person’s job performance or description.

Ignoring or interrupting an individual at meetings.

Public reprimands.

Repeatedly accusing someone of errors that cannot be documented.

Deliberately interfering with mail and other communications.

Spreading rumors and gossip regarding individuals.

Encouraging others to disregard a supervisor’s instructions.

Manipulating the ability of someone to do his or her work (e.g., overloading, underloading, withholding information, assigning meaningless tasks, setting deadlines that cannot be met, giving deliberately ambiguous instructions).

Inflicting menial tasks not in keeping with the normal responsibilities of the job.

Taking credit for another person’s ideas.

Refusing reasonable requests for leave in the absence of work-related reasons not to grant leave.

Deliberately excluding an individual or isolating him or her from work-related activities, such as meetings.

Unwanted physical contact, physical abuse, or threats of abuse to an individual or an individual’s property (defacing or marking up property).

It is important that these behaviors are brought to the attention of the individual perpetrating the action and/or the next level manager so that appropriate measures can be taken.

Harassment

Harassment is any conduct that is directed at a person or persons and the individual knew or should have reasonably known, to be unwelcome, inappropriate, or offensive. Harassment can stem from a series of incidents or a single incident depending on its severity of the situation. There are two forms of harassment that violate human rights legislation, including:

A) Sexual harassment; and,

B) Discrimination based on protected grounds.

Disrespectful behaviors and harassment are not mutually exclusive in practice; the behaviors listed in the section above under Inappropriate Behaviors" are considered harassment if based on sexual or protected grounds and adversely impact the relationship, an employee or contractor work performance or their ability to advance through developmental opportunities.

Sexual Harassment

Unwelcome sexual attention, advances, or propositions, including sexually explicit or implicit comments about a person’s body, attire, or personal life; An implied or expressed promise of reward for complying with a sexually oriented request, or threat of reprisal or actual reprisal for refusing to comply with such a request; Displays and distribution of sexually suggestive photographs or materials in the workplace, especially those that cause insecurity, discomfort or humiliation or are offensive; Unwanted physical contact such as touching, patting, kissing or unnecessary closeness; Sexual jokes or obscene remarks or gestures that cause awkwardness or embarrassment; The defining characteristic of sexual harassment is that the conduct associated with it is unwelcome or unwanted

Discrimination based on Protected Grounds

This refers to harassment based on the following protected grounds identified under human rights legislation:

Race, Place of origin, Color, Mental or physical disability, Family or marital status, Age, Sexual orientation, Ancestry, Religious beliefs, Gender, Source of Income,

What is not Considered Disrespectful Behavior or Harassment

Harassment is a serious offense and must be distinguished from other forms of workplace behaviors that are entirely appropriate even though an individual or a group of individuals may find them annoying, stressful or cause them anxiety, frustration, or unhappiness. The following are not considered to be harassment or bullying:

The imposition of disciplinary measures in accordance with the Promise Senior Solutions, LLC policies and procedures;

The appropriate use of managerial authority in directing day to day activities that serve legitimate work-related purposes;

Workplace stress and organizational changes.

Workplace Violence

Workplace violence is the threatened, attempted, or actual conduct of a person that causes or may cause physical injury or a fatality in the workplace. Examples of violence can include, but are not limited to:

Physical attacks such as hitting, shoving, pushing, or kicking;

Verbal, written, or implied threats that express an intent to inflict harm;

Threatening behaviors such as shaking fists, destroying property or throwing objects;

Acts of domestic violence that evolve into the workplace;

Any other act that would arouse fear in a reasonable person in the same circumstances.

Any person who makes a threat, exhibits threatening behaviors, or engages in a violent act on company property or client property may be removed as quickly as possible taking into consideration the safety and legal aspects of the situation. Any person who is engaging in workplace violence may be suspended from entering company property or client property

pending the outcome of an incident investigation. People committing these acts outside of the workplace, but the results of which impact the workplace, are also violating this policy and will be dealt with accordingly. Threats, acts of violence and physical assault will be investigated. Possession and/or use of unauthorized personal firearms in the workplace is not tolerated. Roles and responsibilities maintaining a respectful, professional and harassment free workplace is everyone’s responsibility.

Responsibility

All employees and contractors are responsible for:

Familiarizing themselves with the policy; Creating and supporting a harassment free workplace through adherence to the policy; Bringing any incident of harassment or potential harassment observed or that they are aware of to their immediate supervisor, and/or the Administrator.

Please Sign Your Acknowledgement Page & Return To The Operations Manager

Vehicle Operations, Transportation, & Drivers

Drivers Licenses

Employees or contractors who use an automobile in the course of their work will have their driving record checked, and must provide proof of auto insurance.

Cell Phones and Driving

Employees or contractors whose job responsibilities include driving and who must use a cell phone for business purposes are expected to refrain from using their phone while driving. Allow voice mail to handle calls when possible. Safety must come before all other concerns. Regardless of the circumstances, including slow or stopped traffic, employees are strongly encouraged to pull off to the side of the road and safely stop the vehicle before placing or accepting a call.

If acceptance of a call is unavoidable and pulling over is not a safe option,

Use hands-free devices;
Use the voice-activated or “speed dial” feature;
Keep the call short;
Do not take notes, text message or e-mail while driving;
Refrain from discussion of complicated or emotional issues; and,
Keep eyes and attention on the road and both hands free to operate the vehicle.

Special care should be taken in situations;

When there is moderate to heavy traffic;
Inclement weather; or,
Driving in an unfamiliar area.

In situations where employees or contractors drive and accept phone calls, state law, as well as this policy, requires the use of “hands-free” equipment. Under no circumstances are employees allowed to place themselves at risk to fulfill business needs. Employees who are charged with traffic violations resulting from the use of their phone while driving will be solely responsible for all liabilities that result from such actions. Violations of this policy will be subject to discipline, including termination.

Driving

Any employee or contractor driving a Company vehicle or driving on Company business must observe all safety, traffic, and criminal laws of this state.

Drowsy Driving

Every driver has a responsibility to drive safely and follow the established rules of the road. If we receive serious or repeated reports of drowsy driving, the driver will be subject to disciplinary action.

What is drowsy driving?

Drowsy driving is driving when you are tired; here are some ways drivers and riders may notice that someone is driving drowsy:

Appearing tired, exhausted, or sleepy; Frequently blinking, having trouble keeping their head up and/or eyes on the road; Frequently yawning; Nodding off; Following other vehicles too closely; Unable to keep their vehicle in the lane or on the road.

Why is drowsy driving unsafe?

According to the Governors Highway Safety Association, a lack of sleep may lead to and may cause:

Slower reaction times; Impaired judgment, situational awareness, and vision; Increased levels of risk-taking; Frequent blinking or microsleep, where someone literally dozes off for a few seconds while driving; Problems with information processing; Memory impairment (for example, around how many hours they’ve driven); Attention failure (for example, not paying attention to traffic signs)

How can a driver prevent drowsy driving? Here are some tips from GHSA:

Be well rested before hitting the road. Several nights of fewer than 7-8 hours of sleep slows reaction time and results in a sleep debt. It may take several nights of being well rested to repay that debt and make someone ready for a long road trip.
Schedule frequent breaks on long trips. Stop every 2 hours or 100 miles.
Do not drink alcohol. Just one beer when someone is sleep-deprived mimics the effect of 2 or 3 when they’re well rested.
Do not rely on caffeine to stay awake. Sleep is the only proven remedy when someone is tired.

How does Promise Senior Solutions receive reports that a driver is driving drowsy?

Riders can contact the local branch and report instances when their driver drove drowsy.

What happens to the driver if a rider reports they were driving while drowsy?

A complaint of drowsy driving may temporarily affect a driver’s schedule while the complaint is being investigated. Serious or repeated claims of drowsy driving can result in disciplinary action.

Will a driver be affected by false rider reports?

We review each report for signs of fraud. We are continually implementing new processes and technology to identify and discourage user fraud. Any report we find to be related to fraud would not affect a driver’s schedule status. Riders who submit false information to Promise Senior Solutions or otherwise engage in fraudulent activity violate our User Agreement and risk losing access to Transportation Services.

Dangerous Driving

Every driver has a responsibility to drive safely and follow the established rules of the road and all applicable laws. If we receive serious or repeated reports of dangerous driving and/or violations of applicable driving laws, the driver will be subject to disciplinary action.

What is dangerous driving?

Examples include:

Distracted driving

According to our partners at the Governors Highway Safety Association, distraction can take many forms—from phone handling or texting to drinking a cup of coffee or adjusting your visor—and those behaviors may take a driver’s focus off the road.

Not following traffic laws

Aggressive driving

Examples of aggressive driving include:

Speeding; Braking suddenly; Tailgating; Abruptly accelerating or stopping; Swerving, including into pedestrian walkways or bike lanes

Driving under the influence

Using or being under the influence of alcohol or other drugs.
Promise Senior Solutions has a Zero Tolerance Policy on driving under the influence.

How does Promise Senior Solutions receive reports that a driver is driving dangerously?

Riders can contact the local branch and report instances when their driver drove dangerously. Unsafe driving reports include any complaint that mentions a specific issue with the driver’s operation of the vehicle that resulted in a perceived unsafe, high-risk, or dangerous experience.

What happens to the driver if a rider reports they were driving unsafely?

Every time a rider reports potentially dangerous driving, a driver will be contacted by their supervisor letting them know about the complaint. We also let them know that serious or repeated claims of unsafe driving can result in disciplinary action.

False rider reports?

Management will review each report for signs of fraud. We are continually implementing new processes and technology to identify and discourage fraud. Any report we find to be related to fraud would not affect a driver’s schedule status. Users who submit false information to Promise Senior Solutions or otherwise engage in fraudulent activity violate Promise Senior Solutions User Agreement.

No driver may consume alcohol or illegal drugs while driving a Company vehicle, while on Company business, while in a Company vehicle, or prior to the employee's shift if such consumption would result in a detectable amount of alcohol or illegal drugs being present in the employee's system while on duty.

In addition, no driver may consume or use any substance, regardless of legality or prescription status, if by so doing, the driver's ability to safely operate a motor vehicle and carry out other work-related duties would be impaired or diminished.

No driver may pick up or transport non-employees while in a Company vehicle or on Company business, unless there is a work-related need to do so.

Any illegal, dangerous, or other conduct while driving that would tend to place the lives or property of others at risk is prohibited.

Anything a driver does in connection with the operation of motor vehicles can affect that driver's fitness for duty or insurability as a driver. Regardless of fault, circumstance, on- or off-duty status, time, or place, any driver who receives a traffic citation from or is arrested by a law enforcement officer, or who is involved in any kind of accident while driving, must inform an appropriate supervisor about the incident immediately or as soon as possible thereafter.

Any penalty, fine, imprisonment, fee, or other adverse action imposed by a court in connection with such an incident must be reported immediately to an appropriate supervisor. In both of the above situations, the matter will be reported to the Company's insurance carrier so that a prompt decision on continued coverage of the employee can be made.

The driver involved in an accident or cited by a law enforcement official for violating a motor vehicle law must turn over any documentation relating to such incident as soon as possible to the employer, and must cooperate fully with the employer in verifying the information with other parties involved and with law enforcement authorities.

While parking tickets will not affect a driver's insurability, any parking ticket issued on a vehicle that is being used for company business should be reported to an appropriate supervisor at the earliest possible opportunity.

Please Sign Your Acknowledgement Page & Return To The Operations Manager

General Information

Probationary Period

Except for transfers, employment and contracts may be considered to be on a probationary basis for the first 90 Days for purposes of establishing eligibility for benefits.

During this trial period, you and management will have an opportunity to observe and evaluate each other. You will be evaluated for such qualities as: the ability to interact with other people, attendance, professional conduct, willingness to learn, performance and skills. After the trial period of satisfactory performance you will normally be eligible for benefits.

Continuing Education

The company will arrange for position specific training and will provide reasonable notification of training dates and times.

Personal Information

Promise Senior Solutions maintains personnel records, which are important to you. If information on your paycheck stub is not correct, or problems arise concerning your taxes, benefits, or other matters please contact our office immediately. You should be sure that your records are always kept current. You are required to report changes in address, telephone number, number of dependents, or marital status to Promise Senior Solutions. It is your responsibility to inform Promise Senior Solutions immediately of any such changes.

Conflict of Interest

You must inform your supervisor or Promise Senior Solutions of any other job appointment that might interfere with your duties or assignments with the company.

Performance Reviews

Your supervisor will be observing your effectiveness in performing your work. These reviews are used to provide you with an opportunity to talk about the job and your personal goals. Performance reviews do not necessarily result in merit increases.

Resignation

If you find it necessary to resign, you are requested to give advance notice in writing to your supervisor indicating the last day that you will be working. A two-week notice is appreciated. If you resign without notice, you may forfeit your eligibility to be rehired. Final paychecks for may be picked up on regular payday or can be mailed to the most recent address listed on file on the regular payday.

Hours of work

Various factors, such as workloads, operational efficiency, staffing needs and client working schedules, may require variations in starting and quitting times. Your supervisor will give the beginning and ending of your standard workweek to you. Punctual and consistent attendance is an important measurement of your performance.

Time-Keeping

You are to report to work no earlier than five minutes before your work schedule begins and leave no later than five minutes after it ends. You are responsible for making sure your time is recorded accurately using your WellSky App. If you find any errors, contact Human Resources immediately. You must record your own time, never the time of another employee.

Overtime Pay

You are to work overtime only at the request and authorization of your supervisor. Employees who qualify as administrative, executive, or professional employees within the meaning of the state and federal wage and hour laws are exempt from overtime pay and are not subject to this policy. Only non-exempt employees qualify for overtime pay. Overtime pay is based on hours worked per workweek in accordance with state and federal requirements. Employees shall record all time worked, including time worked over their normal schedule. Time will be paid in hundredths of an hour. Overtime hours worked in excess of forty hours in a work week, (not in excess of 8 hours per day) and approved by your supervisor, will be paid one and one-half times your base rate of pay per hour. Hours worked means time actually spent on the job. It does not include hours away from work due to vacation, sickness, or holiday even when these days are compensated. Unpaid sick leave, personal leave or any other time away from work is also not considered hours worked.

Payroll Deductions

Promise Senior Solutions may be required by law to recognize certain court orders, liens, and wage assignments (child support). Promise Senior Solutions is required to make proper deductions from your earnings on your behalf. Amounts withheld vary according to how much you earn, your marital status, government employment regulations, and other factors. These mandatory deductions are made until the maximum amount is reached. Mandated withholding include some of the following:

Other deductions may be made from your paycheck with your permission, including:

· Federal Income Tax

· State Income Tax

· Social Security

· Dependent Health Insurance Coverage

· Voluntary Insurance Coverage

· Dental Care

· Retirement Fund Contribution

· Other Services Requested by the Employee

Payday

See the posted Pay Calendar in the Office or call your manager/supervisor for Payroll Days. Wages will be deposited directly into an account you specify on your Direct Deposit Authorization Form.

Paid Leaves

Promise Senior Solutions’ policy for vacation, sick leave, holiday, bereavement, or other paid leaves are described in greater detail as an addendum to this handbook. In order to be eligible for these benefits, you must complete a 90 Day trial period. You are encouraged to schedule vacations with your supervisor and use all PTO benefits accrued.

Unused PTO leave benefits when available do not accumulate from year to year. A notification from your doctor may be required before returning to work.

Attendance

Any employee that does not report for a scheduled work assignment, or is tardy for a scheduled work assignment must contact the supervisor a minimum of two hours prior to the start of the scheduled work assignment and inform the supervisor that the employee will not be able to report for the scheduled work assignment or will be tardy to the assignment. If the employee is unable to provide a valid reason or documentation of an illness, then the supervisor may consider the absence / tardy as unexcused, if it does not fall under the category of Gross Misconduct.

If the employee / contractor fails to contact the supervisor a minimum of two hours in advance, then the employee / contractor will be deemed to have an unexcused absence / tardy.
If an employee / contractor has more than two unexcused absences / tardy from work in a 30 day period, then a final written warning may be issued.
The third such unexcused absence / tardy within 30 days subjects the employee / contractor to termination.
A third unexcused absence / tardy within a 30 day period following a final warning the employee / contractor will be terminated.
Unexcused absences are reduced by 1 – every 30 days the employee / contractor has perfect attendance.

No Call / No Show

Any employee or contractor that does not report for a scheduled work assignment; and does not contact the supervisor a minimum two hours prior to the start of the scheduled work assignment to inform the supervisor; will be considered a No Call / No Show. If the employee or contractor is unable to provide a valid reason or documentation of an illness, then violation is considered Gross Misconduct. They will be removed immediately from future schedules until they can provide an acceptable excuse for such misconduct. If they can provide acceptable documentation for the absence, the supervisor may return them to their regular schedule following a final written warning. If they cannot provide acceptable documentation for the absence the employee or contractor is terminated immediately for Gross Misconduct. Any additional No Call / No Show within a rolling 12-month period is subject to immediate termination.

Leaves of Absence

We realize that leaves of absence due to prolonged illness, accidents, or other compelling reasons are sometimes necessary. Although leaves of absence are uncommon, a leave of absence from work should be properly arranged through your supervisor. Promise Senior Solutions has a formal request form for this purpose. The term “leave of absence” means an approved absence from work without pay for a period of time in excess of five working days. The granting of a leave of absence, especially an extended one, does not guarantee that there will be a position available to you after the end of your leave. Each case will be treated individually and upon your return, every effort will be made to give you the best available job for which you are qualified by experience, ability and seniority. Employees returning from a leave necessitated by medical reasons may be required to provide a doctor’s release. If you have any questions Promise Senior Solutions will be happy to provide you with information on how to request a leave. Pre-paid contributions to certain benefit plans for the first thirty-days of your leave of absence may be required in order to maintain continued coverage. If your leave extends more than one month you must make monthly payments for your insurance to continue. It is the employee’s responsibility to report to work at the end of an approved leave. Failure to do so may be considered a voluntary termination of employment.

Family and Medical Leave Act (FMLA)

FMLA Leave

Under the Family Medical Leave Act (FMLA) of 1993, you may be entitled to take up to 12-weeks of unpaid, job-protected leave for any of the following qualifying reasons:

A serious health condition that makes you unable to perform the functions of your job.

The birth of a child and to bond with the newborn child within one year of birth.

The placement of a child for adoption or foster care, and to bond with the newly placed child within one year of placement.

To care for your spouse, child (including biological, adopted, foster, step, legal wards, and children for whom you stand in loco parentis), or parent who has a serious health condition.

Any qualifying exigency arising out of the fact that your spouse, child, or parent is a military member on covered active duty.

To care for a service member with a a serious injury or illness if the employee is the spouse, child, parent, or next of kin of the service member.

Eligibility for FMLA Leave

In addition to having a qualifying reason, you must also meet the following eligibility criteria to take FMLA leave:

You must have worked at least 1,250 hours in the 12-month period immediately preceding the leave.

Duration of FMLA Leave

If eligible, you may take up to 12 weeks of FMLA leave (26 weeks for military caregiver leave) during a "rolling" 12-month period. Your 12-weeks will begin on the date that your Family and Medical Leave begins, and will exclude weekends and holidays.

Requesting FMLA Leave

To request FMLA, you must complete an Employee Request for Family and Medical Leave (Online) 30 to 45 days days prior to the date you need your leave to begin. If you are unable to complete your request at least 30 days prior, then please submit it as soon as is practicable. If you are unexpectedly absent for three or more days, then your department may also submit this request on your behalf.

Once the request is submitted, Human Resources - Benefits and Leave Management (Benefits and Leave) will send you a Notice of Eligibility and Rights and Responsibilities, and copy your supervisor and HR contact. Please be sure to read this notice in its entirety, and pay special attention to the section labeled Actions Required. The U.S. Department of Labor, Wage and Hour Division, mandates that employers designate time off as FMLA-qualifying if the employee is eligible, and the time off is for an FMLA qualifying reason. Completing the actions required will assist the university in complying with this mandate.

Once you receive your Notice of Eligibility and Rights and Responsibilities, please complete the following within 15 calendar days:

Ensure your timesheets are complete and up to date.

Review the list of FMLA qualifying reasons above.

If your need for time off is not for one of the qualifying reasons, then you do not need to complete the remainder of this process. You will receive an FMLA denial notice after 15 calendar days. This notice is to inform both you and your department that the FMLA does not apply to your time off.

If your need for time off is for one of the qualifying reasons, then please complete the remainder of this process.

If you have not already done so, submit an Employee Request for Time Off Under the Family and Medical Leave Act (FMLA).

For serious health conditions, ask your or your family member’s healthcare provider to complete the appropriate Certification of Healthcare Provider (CHP) form.

If your leave is for your own condition, ask your healthcare provider to complete a Certification of Healthcare Provider – Employee.

If your leave is for your family member’s condition, ask your family member’s healthcare provider to complete a Certification of Healthcare Provider – Care for Family Member.

The CHP should be faxed to Benefits.

For qualifying exigencies (when an immediate family member is called to military service), complete the Certification for Military Family Leave.

For Military Caregiver Leave, ask the servicemember or veteran's healthcare provider to complete the appropriate Certification for Military Caregiver Leave.

If your leave is to care for a current servicemember, ask the servicemember's healthcare provider to complete a Certification for Serious Injury or Illness of a Current Servicemember.

If your leave is to care for a veteran, ask the veteran's healthcare provider to complete a Certification for Serious Injury or Illness of a Veteran.

Review the Employee Rights notice.

If you have any questions, please feel free to contact the Benefits Specialist listed on the Notice of Eligibility.

If these steps are not completed within 15 calendar days, then absent any extenuating circumstances, your FMLA will be denied, and your time off will not be federally job protected. Benefits and Leave will notify you, your supervisor, and your HR contact of the denial in writing.

If these steps are completed within 15 calendar days, then Benefits and Leave will review the certification submitted by your healthcare provider, and send you, your supervisor, and your HR contact a written FMLA Designation Notice that specifies whether your FMLA is approved or denied. If your FMLA is approved, then the notice will also specify whether your award is continuous, intermittent, or reduced schedule.

Types of FMLA Leave

FMLA leave may be either continuous, intermittent, or on a reduced schedule basis. In most instances, your or your family member's healthcare provider will specify which type of leave is needed when completing the certification form.

Continuous

Continuous FMLA leave is taken in one continuous block of time. While on continuous FMLA leave, you will not be expected to return to work until you no longer have a qualifying reason, or your FMLA leave has been exhausted, whichever comes first.

Intermittent

Intermittent FMLA leave is taken in separate, nonconsecutive blocks of time. If your need for FMLA leave is intermittent, then the certification form will usually specify the frequency and duration (i.e. two hours per day, three days per week), and that need will be communicated to you, your supervisor, and your department's HR contact. If you are absent more than the certification allows, your department will notify HR - Benefits and Leave Management, and we may ask you to provide an updated certification. While on intermittent FMLA leave, please keep the following in mind:

You must provide advanced notice of foreseeable absences, and make a reasonable effort to schedule those absences so that they do not disrupt your department's operations.

If your need for leave is not foreseeable, then you must follow your department's normal call in procedures. If you are unable to do so, then you must notify your department as soon as is practicable.

Barring any restrictions from your healthcare provider, while at work, you will be expected to perform the essential functions of your position. If you will not be able to do so, talk to your or your family member's healthcare provider about the possibility of additional work restrictions, increasing the frequency and duration of your intermittent FMLA leave, or transitioning to reduced schedule or continuous FMLA leave.

Reduced Schedule

While on reduced schedule FMLA, your daily and weekly work hours may be reduced (i.e. you may only work 6 hours per day, 4 days per week).

Pay During FMLA Leave

If you are on FMLA for any reason other than a work related illness or injury, then you will be required to use your available paid time off accruals, including sick, vacation, holiday, and compensatory time, concurrently with your FMLA leave. Please keep in mind that sick time off may only be used concurrently with FMLA leave if your need for leave is due to pregnancy, your own serious health condition, or the serious health condition of a spouse, child, or parent. For pregnancy, the ability to use sick time off is further constrained to the time necessary to attend prenatal appointments, for bed rest, and for the period of incapacity following birth. Generally, the period of incapacity is six weeks following a vaginal birth or eight weeks following a cesarean, but it may be longer if complications arise.

Work Related Illness or Injury

If you are on FMLA leave due to a work related illness or injury, then you may choose whether to use your available paid time off accruals. If you do, then you will be required to exhaust your available sick time, as well as any other time you elected to use before receiving income benefits.

Once you have exhausted your available paid time off accruals, you will be placed on unpaid time off for the remainder of your FMLA leave.

Short-Term and Long-Term Disability

If you have short and long-term disability Insurance, then you may file for disability benefits at any time prior to or during your FMLA leave. If your claim is approved, then your short-term disability payments will begin 7 days after your date of disability, or once all of your available sick leave has been exhausted, whichever is longer. Long-term disability benefits will begin 90 days after your date of disability or once your available sick leave has been exhausted, whichever is longer.

Once your disability claim is approved, you may choose to freeze your remaining available paid time off, use it to supplement your disability and receive 100% of your pay, or use it in conjunction with your disability to receive 160% of your pay. You must choose within 10 days from the date your disability claim is approved, and notify both your supervisor and your department's HR Contact of your decision. Choose carefully because you will not be able to change your election for the remainder of your disability.

Insurance During FMLA Leave

While you are on paid FMLA leave, the university will continue to pay its portion of your health insurance, and you will continue to be responsible for paying your portion of your health insurance premiums. If you transition to unpaid time off for a full calendar month or more, then you will have the option to continue all of your current insurance coverages; continue some of your optional coverages and suspend others; or suspend all of your optional insurance coverages. You should receive a letter detailing your insurance options within ten days of beginning your unpaid time off. If you do not, then please reach out to your respective Benefits Specialist or departmental human resources contact.

Returning to Work

The FMLA guarantees that you will be able to return to work in the same position or an equivalent position as determined by the university. To return to work from continuous FMLA due to your own serious health condition, you must provide a written return to work release to your supervisor. If you do not, then your department will send you home and you will not be able to return to work until you have done so.

If you will not be able to return to work at the end of your designated FMLA leave, then you must coordinate additional time off with your supervisor, Benefits and Leave, or the campus' Americans with Disabilities Act (ADA) Coordinator prior to the end of your designated FMLA leave. Failure to do so may result in termination due to your inability to work. Additional time off options may include the use of available paid time off accruals, sick leave donation, sick leave pool, additional FMLA, and unpaid time off.

If your return to work will require any work related restrictions or limitations, you must notify your supervisor prior to your anticipated return to work date so that they may partner with your departmental human resources contact, Benefits and Leave, and the campus' ADA Coordinator, if necessary, to discuss accommodations. If your department, in consultation with HR, Benefits and Leave, and the ADA Coordinator, determines that it cannot reasonably accommodate your restrictions or limitations, then you may be required to remain on leave for the duration of your limitations, or until your FMLA exhausts, whichever is sooner.

Jury and Witness Duty

You may be granted time off to serve as a juror or witness. If you are required by law to appear in court as a witness, you may take unpaid time off provided you arrange this with your supervisor in advance.

Voting Time

You are encouraged to vote in local, state and federal elections. In most instances you can vote before or after working hours. When hardships makes this impractical, you may be granted time off with prior approval from your supervisor.

Military and The National Guard

As a member of the United States Military Reserve or National Guard, you may be required to take time off to meet annual minimum active training requirements. Contact your supervisor to determine how or if you will be paid for this time off.

Medical and Dental Appointments

Medical and dental appointments should be scheduled around your assigned work schedule. If this is impossible, talk to your supervisor about making special arrangements. You will not be paid for these absences.

Benefit Programs

Group Medical and Dental Insurance may be provided based on your employment category and status. Each employee and contractor will accrue PTO based on company policy.

Appearance

Management / Marketing / Office Staff: Professional attire or scrubs should be consistent with the normal business environment. Company issued I.D. badge to be worn when in the community representing the company or in-house event.

Supervisory / Field Staff: May wear any color scrubs as long as they are in good condition; wrinkle free, no stains, no fading, and clean. Company issued I.D. badges are to be worn at all times while on duty. Uniform/Scrubs are purchased by the employee or contractor. Appropriate clothing must be worn to work.

The following are the requirements for uniforms/scrubs:

All clothing should be non-see through.
Casual attire such as blue jeans, stretch or stirrup pants, sweatpants / sweatshirts, jogging clothes or shorts are not to be worn.
Tight form-fitting or low cut attire is not acceptable.
Clothing must fit appropriately without horizontal pull lines or gaps between closures.
No midriff should be showing, even when reaching or bending.
Tops:
Appropriate color uniform or scrub top, top with collar, mock turtleneck or turtleneck may be worn.
Non-scrub tops worn alone must be non-fitted
A shirt that is the same color of the scrubs, or white solid color mock turtleneck, turtleneck or tee shirt, (long or short sleeves) may be worn under the scrub top. No tee shirt writing may be visible under scrub top.
Sleeveless, cap sleeves and low cut tops are prohibited.
Pants:
Appropriate color uniform or scrub ankle length pants may be worn.
Scrub pans or lose khaki pants preferred, otherwise a casual dress pants can be an alternate but should not be tight.
Hair must be clean, neatly groomed and controlled
1. Long hair must be secured away from the face.
2. Hair decorations must be kept plain and simple.
3. Extreme styles and colors are not permitted.
4. Facial hair must be kept neat and well-trimmed
Nails must be neat, clean, and support the functional use of hands and fingers.
Jewelry must be plain and inconspicuous. Jewelry must not interfere with patient care or present a hazard to the employee.
Earrings are permitted with the following criteria:
Should not be dangling.
Only 2 earrings per lobe.
A single plain necklace of neck length may be worn
Only one ring or ring set per hand is allowed.
A form fitting wrist watch is permitted.
Fragrances must be minimally evident. With some client care populations, fragrances may not be permitted.
Tattoos must be inconspicuous or covered.
Footwear should be clean, appropriate for clothing, protective and fit securely.
1. Canvas shoes or “crocs” with holes are not permitted in patient care areas.
2. Clogs may be worn if they have a closed heel or strap.
Buttons, hats, pins (or other types of insignia), which could be offensive to patients / visitors / staff during working hours are not permitted.

Courtesy

Courtesy and your attitude toward the people you come in contact with will influence the image people have of Promise Senior Solutions – either positively or negatively. You are encouraged to develop an attitude of helpfulness toward your clients, fellow workers, and supervisors. Courtesy is the key to good human relations.

Equipment, Medical Supplies, or Uniforms on Loan

You are responsible for safekeeping of equipment, medical supplies or uniforms that are furnished to you. You must return medical supplies or equipment that were loaned to you before picking up your final paycheck. This policy permits Promise Senior Solutions to recover the cost of such items where they are furnished without a deposit and not returned upon termination.

Phone Calls, Personal Mail and Visitors

The use of business phones is limited to official company business. Local personal calls are to be kept to emergencies only. Friends and relatives should be discouraged from calling during working hours unless there is an emergency. Under no circumstance should you make or charge a long-distance call unless it is work-related and approved by your supervisor. Good telephone etiquette is important when dealing with the public. Be courteous and confine the conversations to the subject at hand. The first representation that many people have with an office or business is through the telephone. Do not use company stationary, stamps, postage meters or other company supplies for your personal mail. Have all of your personal correspondence sent to your home address, unless you have permission from your supervisor. Personal visits by visitors (individuals not employed by the company) to your work area may be restricted by your supervisor. You may not bring your children to work or to a client home while on company time, or without prior permission from your supervisor.

Electronic Communication Policies

With the different opportunities offered through the internet it has become necessary for companies to monitor use. An employee or contractor should never use the internet for personal business while at work without the consent of their supervisor. An employee or contractor should never transmit, download or receive inappropriate material, messages, jokes, pictures, etc. over the internet for any reason while on company time. Inappropriate material may consist of but is not limited to; the use of disparaging or abusive words or phrases, slurs, negative stereotyping; pornographic pictures, cartoons, or websites. No graphic or written material that criticizes or shows hostility or aversion toward an individual or group because of race, color, religion, sex, age, national origin, sexual orientation, marital or familial status, or physical or mental disability.

An employee or contractor should hold no expectation of privacy with e-mail, Internet usage, company paid cellular phones or pagers, content on computer hard drives, etc. because such tools are company property. It is also necessary to respect copyright laws by not downloading software. An employee or contractor should always use caution when opening email from an unknown source. Check with your supervisor prior to opening links or downloading files from any unknown sources. Abuse of the internet (e-mail included) may result in disciplinary actions up to and including termination.

Endorsements and Tips

Selling of merchandise or distribution of endorsement materials during working time is strictly forbidden. You may not endorse or imply endorsement of a product or service by Promise Senior Solutions. You are not to solicit or accept tips or gratuities for any related service in the course of your work duties. Acceptance of tips or gratuities from current or former clients of Promise Senior Solutions may result in disciplinary action. Including but not limited to termination.

Travel Authorization

If you are traveling on company business you must have authorization from your supervisor prior to making any travel arrangements. When using your personal vehicle on company business you must have a valid driver’s license and carry adequate insurance. The company is not responsible for damage to your car while on company business. Reimbursement for travel will be according to the mileage allowance schedule, which is given to you by your supervisor.

Smoking

Smoking is prohibited at work except at designated smoking areas outside the building. Do not smoke in any “No Smoking” areas. You should exercise extreme care regarding the fire hazards associated with smoking at all times. Under no circumstances should you smoke in a client’s home.

Dishonesty

Promise Senior Solutions considers thefts or dishonesty a serious offense. If you take company property or merchandise, it is stealing, and stealing in any form will not be tolerated.

Non-Solicitation of Clients

Promise Senior Solutions employee / contractor agree not to solicit Promise Senior Solutions, LLC current or former clients directly or indirectly, overtly, or covertly, to provide similar services while actively employed / contracted. This includes accepting solicitation from Promise Senior Solutions, LLC clients that you are currently or formerly scheduled to provide services while actively employed / contracted. Violation of this policy constitutes Gross Misconduct and the employee / contractor will be subject to immediate termination.

Performance Expectations

You are expected to be at work and ready to work at the established starting time and are expected to remain at these positions and perform their assignments until the end of their shift.
You are not to gather on Promise Senior Solutions’ premises or conduct personal business during working hours.
Certain protective equipment, when provided by the supervisor, must be properly utilized as directed.
You must report all injuries or accidents to your supervisor at once.
You must be physically and mentally capable of performing your work assignment.
You must perform all assigned duties and fulfill your responsibilities to Promise Senior Solutions.
You must be available for work as scheduled or requested.
You will be responsible for all property that has been placed in your custody.
You shall not neglect your job duties or responsibilities, nor refuse any work assigned to you.

Prohibited Conduct

Bringing firearms, weapons or ammunition of any kind, intoxicating liquors or illegal drugs, inhalants, drug paraphernalia or chemicals into the office or onto the premises of work or clients home.

Being on the job while under the influence of alcohol, drugs, inhalants or intoxicants of any type.

Falsifying information or client forms, reports, records, including personal absence, sickness, time cards and production records.

Falsely stating or making claims of injury.

Removing or using, without authority, property, records or other materials of Promise Senior Solutions or other persons.

Fighting or threatening, intimidating or coercing any visitor or employee.

Damaging or destroying property or wasting of materials.

Loitering or sleeping while on duty.

Refusing to follow supervisor’s directions or instructions or other insubordinate conduct.

Violating safety or health rules or practices, or engaging in conduct which creates a safety hazard.

Engaging in unlawful or improper conduct off the work premises or during non-working hours which affects an employee’s relationship to work, fellow employees, supervisors or Promise Senior Solutions products, property, reputation or goodwill in the community.

Leaving work before the end of the shift without the authorization of your supervisor.

Using Promise Senior Solutions facilities and time for personal business, or unauthorized possession or use of Promise Senior Solutions keys.

Soliciting or accepting tips from visitors, clients, or other employees.

Smoking in client homes, or other restricted, posted no smoking areas.

Addressing Grievances

If you have a work related problem it should first be discussed with your immediate supervisor so that it can be resolved quickly. If the problem can not be solved by your immediate supervisor, you may contact your administrator for assistance.

Client Complaints and Grievances

The client may report a complaint or grievance at any time without reprisal or disruption of services. Any staff member may receive a complaint or grievance about services or care that is or is not furnished or about the lack of respect for the client’s person or property by anyone furnishing services on behalf of the agency. All client complaints are to be reported to your immediate supervisor as quickly as possible.

Anti-Discrimination

This agency welcomes caring for individuals of all cultures and background but realizes that sometimes staff and client cultural differences may conflict. Staff is encouraged to discuss with their supervisor any cultural/belief conflicts they believe may interfere with caring for a client. If a problem is perceived the supervisor will attempt to change the staffing assignment.

Reporting Suspected Client Abuse, Neglect, or Exploitation

If you suspect abuse, neglect, exploitation, or family violence of a client, contact your supervisor right away, stating clearly that you are reporting a suspected case of abuse, neglect, or exploitation, and reporting at least the following:

Name, age, and address of client
Name and address of responsible person
The client’s condition
The basis of your knowledge
Any other relevant information

The Administrator / Operations Manager / Alt. Administrator must:

Fill out the Case Information Form completely and accurately.
Decide if a joint visit is indicated and, if so, who should participate.
Incidents related to Family Violence shall be reported to the local law enforcement Agency and APS.
Decide on appropriate follow-up action(s).
Notify the Administrator regarding the incident and follow-up status.
Offer to provide referrals to the victim for care.

Safety is an Agency Wide Priority

We pride ourselves on doing for others what they can no longer do for themselves. You are the eyes, ears, arms and legs of our clients. When it comes to client safety it is up to you to ensure that the potential for accidents is recognized and addressed before it happens. The importance of your role in protecting our clients can not be understated. Your clients are counting on you to be there when it counts.

All personnel will be alert to safety factors in the home environment. Client safety and comfort is the agency number one goal. Please report any findings to your supervisor that may improve safety or quality of care. The client and family should be encouraged to:

Have grab bars installed in the bathroom.
Use non-skid mats or emery strips in the tub.
Use a shower stool or transfer bath bench.
Remove throw rugs or other hazards such as loose extension cords, small mats.
Use assistive equipment such as toilet handrails, gait belt, Walker, wheelchair, shower / tub bench.
Always lock any wheeled equipment before transferring a client.
Utilize a medication sheet to ensure proper administration of prescribed medications.
Apply distinct and complete labeling of medications, good illumination of the medication cabinet in order to avoid errors in self-administered medications.
Refrain from smoking or being near open flames while using oxygen. Post no smoking signs in visible location

Fall Prevention

Falls are the second leading cause of accidental death in the United States. Seventy-Five percent of these falls occur in older adults. Falls not only affect the quality of life of the client but also significantly influence the caregiver and family. The agency shall protect all clients from preventable injuries and illnesses.

Employees and contractors with access should routinely perform a home safety checks when servicing a client.

Educate clients or family members on the following Fall Prevention Tips:

Have your vision checked at least once a year by an eye doctor. Poor vision can increase your risk of falling.
Get up slowly after you sit or lie down.
Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.
Improve the lighting in your home. Put in brighter light bulbs. Add lighting to dark areas.
Paint a contrasting color on the top edge of all steps so you can see the stairs better. use a light color paint on dark wood.
Think about wearing an medical alert device that will bring help in case you fall and can’t get up.

Equipment Malfunction

Employees and contractors are required to report any client medical equipment malfunction to management immediately. Management will create a communication record and notify the client or family of the risks associated with the issue. An incident Report will be completed if injury has occurred as a result of the malfunction. If a piece of equipment is or you suspect that a piece of equipment is malfunctioning contact the supervisor immediately. Do not attempt to unplug/Unhook or correct the issue without consulting with a supervisor first. Prior to using equipment it should be checked for obvious damage or frayed electrical lines. if damage is apparent do not use the equipment. proper instruction on equipment to the client is important in reducing equipment accidents. You are encouraged to educate clients on proper use and are required to document their teaching in the client journal.

Fire Safety

The most important thing that can be done to protect people from a fire is to prevent it from occurring. By preventing the outbreak of fire, you not only save lives, but also avoid property damage. Everyone has a responsibility to protect those that they support from fire. Assuring adherence to common fire safety practices; regarding the use of appliances and other dangerous items, and assuring that all fire protection systems are operating properly all promote good fire safety. Practicing the Fire Plan is also an integrated component of a well-rounded fire prevention program.

It is important to have appropriate planning, training and skill to be ready and able to react effectively. The training and information you receive is designed to help prepare you so that if an incident does occur, your response should be immediate, intelligent and most importantly, effective.

These instructions need to be followed agency wide for all Fire Emergencies (e.g., fire, smoke, odor of smoke or burning, crackling noises, unusual heat conditions, and any automatic detector activation). Although specifically geared to “fire” emergencies, much of these instructions would apply in any generalized emergency situation.

Safety is a vital concern of Promise Senior Solutions. The ultimate responsibility for safety lies with you. We need your help promoting safety and the prevention of accidents by observing the following common sense rules.

GENERAL INFORMATION:

ALL AUTOMATIC ALARMS shall be treated as TRUE EMERGENCIES. Everyone should immediately implement the Fire Plan and begin an evacuation as outlined in your evacuation plan, regardless of the cause of the automatic alarm.

ANY Staff members and any other occupants in the building(s) at the time of an alarm or other emergency shall render such assistance as directed.

Beds, mattresses and other bulky equipment should NEVER be used to evacuate occupants unless absolutely necessary. (Use blanket drags, carries, etc.)

STAY LOW. Keep yourself and all occupants low if in a smoke involved area. The fire generated smoke and gases are potentially more dangerous than the actual flames.

Elevators shall not be used during a fire or emergency situation, other than by firefighters.

NO ONE other than firefighters shall enter or re-enter a fire or smoke involved structure.

Based on your training and/or your obligation, you may need to re-enter areas that are not involved with fire or smoke to assist others. Use your training and use extreme caution at all times. If re-Entry is attempted, make someone aware of your actions, to provide accountability for arriving emergency responders.

REPORT ALL FIRES TO THE FIRE DEPARTMENT IMMEDIATELY, EVEN IF IT APPEARS TO BE OUT, OR IS CONSIDERED INSIGNIFICANT!

If your local fire department is responding to assist, DO NOT reset your alarm until they arrive and evaluate the situation.

Plan Of Action:

REMOVE

ALERT

CONFINE

EXTINGUISH

The following general instructions explain these fundamental steps and provide guidance in the event of an emergency. It must be understood and stressed that each emergency will present itself in a unique way and with a different set of circumstances each time. Therefore, staff must be creative and confident to implement these steps in various situations.

In addition, it is important to note, that although these “steps” are presented in an organized manner in order to provide guidance on the importance and general sequence of these events, in the case of a true emergency, it could happen that many of the functions of this Guideline will be conducted at the same time or in an order appropriate to that specific situation. In all cases sound practical judgment, experience and training will prevail.

Pending the arrival of the fire department or other back up and responding personnel, YOU ARE THE FIRST LINE OF DEFENSE. The lives of those entrusted to your care, and possibly your very own, may well depend upon your reactions.

TO SUMMON HELP IN ANY EMERGENCY SITUATION...

IMMEDIATELY CALL .... 911

REMOVE

DO NOT PANIC - REMAIN CALM - DO NOT SHOUT OR YELL.

YOUR FIRST CONCERN IS FOR LIFE SAFETY - SAFETY OF THE OCCUPANTS, OTHER STAFF AND YOURSELF IS OF PARAMOUNT IMPORTANCE.

EVACUATE EVERYONE TO A POINT OF SAFETY. All occupants in the building must be evacuated as quickly and as orderly as possible to a pre-Designated POINT OF SAFETY, using the following guidelines:

1. ORDER OF REMOVAL OF OCCUPANTS:

Remove anyone in immediate danger (i.e., in the room of origin).

Evacuate occupants who can walk on their own. (This is done first to facilitate evacuating the most, the fastest)

Evacuate occupants who cannot walk, require additional assistance, use walkers, etc.

Evacuate occupants who are connected to life sustaining devices or medical management devices.

2. HOW TO EVACUATE THE OCCUPANTS:

Movement of any occupant shall be done as planned in advanced. As a general rule, the method that is used during non-emergency situations is going to be the best method for movement under emergency situations.

3. WHERE TO EVACUATE:

ANYONE IN IMMEDIATE DANGER should utilize the nearest and most immediate EXIT. If you have to escape through smoke, crawl on your hands and knees where air will be cleaner. Test all doors in your escape path for heat prior to opening them. Always test doors with the back of your hand. Remember to practice your escape plan several times annually.

ACCOUNTABILITY: As soon as all occupants are gathered in a safe place (either within the building, in an area of refuge, or outside), someone (i.e. staff in charge) shall take a roll call, using a checklist roster. If anyone is missing, immediately report this to the first arriving fire personnel. If staff and/or occupants are trapped by smoke, close doors, stay low, block openings to room and open a window to attract attention of rescuers.

ALERT

ALERT ALL NEARBY STAFF – By voice or use of code phrase. (This may be accomplished simultaneously with the Remove step)

PULL THE NEAREST ALARM BOX IF PROVIDED. This will automatically notify the occupants, and possibly the Fire Department and additional help. In addition this may initiate automatic fire protection features of the building.

CALL 911- If no fire alarm is available, immediately call 911. If there is an alarm system available, make a back-up call to 911 as soon as everyone is in a point of safety. Although redundant, this assures response and provides additional information to the responders.

Give the dispatcher the following information:

NAME, LOCATION, BRIEF DESCRIPTION OF THE INCIDENT, ANSWER ALL QUESTIONS. DO NOT HANG UP UNTIL DIRECTED BY THE DISPATCHER.

CONFINE

CONFINE THE FIRE BY CLOSING ANY DOORS, FIRE DOORS AND OTHER OPENINGS INTO THE ROOM OR AREA OF ORIGIN. Closing a door can be a very simple and effective method of containing the fire, buying time for evacuation.

EXTINGUISH

EXTINGUISH THE FIRE. Attempt to extinguish the fire only after all occupants are in a point of safety (unless extinguishment of the fire is needed to evacuate, i.e., fire is between you and the door). Any attempts to extinguish the fire should be considered a “Last-Resort”. Evacuation should always be your first priority.

Fire Prevention is potentially the most powerful strategy for reducing both life and property fire hazards.

A FIRE THAT NEVER HAPPENS CAUSES NO LOSS OR DAMAGE !!!!

Emergency Preparedness

Disaster Planning

The Agency will review the Emergency Preparedness and Response Plan Policy with all staff.

The Agency will review the Emergency Preparedness Plan and Procedure checklist to ensure all staff understand the procedures. Preparing for the potential of a disaster includes, but is not limited to: identification and assessment of risks, integration with community resources, developing plans for mitigation, disaster response and recovery activities, education and training, and conducting exercises. The Agency Disaster Coordinator is your local Branch Administrator and the Operations Director will act as the Alternate Disaster Coordinator.

Identification and Assessment of Risks

The Agency will review all potential hazards to ensure all staff understand each emergency type that pose a risk for the Agency or the community. The Agency maintains a current list of names and contact information for patients' / clients', and Federal, State, tribal, regional, or local emergency preparedness staff.

Mitigation

A process in which sustained actions are taken to reduce or eliminate long-term risk from natural and man-made hazards or disasters. The Agency maintains a current list of staff, contract staff, patients' /clients', and Federal, State, tribal, regional, or local emergency preparedness staff, and all applicable contact numbers. This communication / disaster calling tree will be reviewed on a regular basis. The Agency maintains and keeps current a classification system/triage of all patients/clients. The Disaster Coordinator and Alternate Disaster Coordinator keep updated copies with them at all times. Upon admission clients condition and needs will be assessed for triage prioritization codes. The Agency will provide the client and family with information on what to do in emergencies. Local radio stations will be contacted by the Agency as a method of communicating with the client population or staff, if necessary. Public information systems will be monitored for disaster related news and information that could affect the Agency operations. Staff will communicate by telephone, texting, walkie talkies, email, or social media, as approved by management, or other designated method that has been provided, as needs arise.

Staff will know when to meet at the office, when to meet at a designated alternate site and any other important means of communication.

Response

Actions taken immediately before or during and after a disaster to address the immediate and short-term effects. These are the details of the plan given for others to follow for the Emergency Preparedness and Response plan to be successful.

The disaster calling tree will be activated. All staff will be responsible for having a copy or having access to procedures.
The Agency will contact local emergency medical services and other state agencies as appropriate.
All clients will be triaged according to classification, services and individual needs.
Clients requiring transportation will be coordinated with the Disaster Command.
Client referrals will be made as required.
Disaster Command and Administrative and Operations staff will provide 24/7 service and on call service to meet client needs.
If communication is limited, all staff will be required to report to the office or alternate site as available for further instruction.
To ensure accuracy and continuity of information, all questions from the media will be directed to the Governing Body.
The Agency will follow procedures to release patient information in the event of a disaster, in accordance with the agency's written policies and state regulations.

Recovery

Activities implemented during and after a disaster designed to return an agency to its normal operations as quickly as possible. All incidents will be documented. Support counselors may be offered to staff, and contractors. Clients who moved from the area will be reviewed and clients that remain will be placed back on the schedule for continuity. All patient/client transfers/discharges will be reviewed. If the office must be relocated, staff will be informed of locations and access. Clients and staff, or their families will be contacted to check on their status and offer support. Routine client visits will be resumed. The Agency will provide training at least once per year on emergency preparedness policies and procedures to all new and existing staff, contract staff. All training, exercises and education will be documented.

Conducting Exercises

Fire drills will be conducted at least annually. Staff will be responsible for knowing where fire extinguishers and exits are located.

The Agency will conduct exercises to test the emergency plan annually. The Agency will conduct a tabletop exercise or workshop that includes a group discussion led by a facilitator, using a narrated, clinically relevant emergency scenario, and a set of problem statements, directed messages, or prepared questions designed to challenge an emergency plan. The Agency will analyze the Agency's response to and maintain documentation of all drills, and revise the emergency plan, as needed.

Disaster Specific Recommendations:

Floods

If a flood is likely in your area, you should:

Listen to the radio or television for information.

Be aware that flash flooding can occur.

If there is any possibility of a flash flood, move immediately to higher ground.

Be aware of streams, drainage channels, canyons, and other areas known to flood suddenly. Flash floods can occur in these areas with or without warning.

Do not walk through moving water. Six inches of moving water can make you fall. If you must walk in water, walk where the water is not moving. Use a stick to check the firmness of the ground in front of you.

Do not drive into flooded areas. If flood waters rise around your car, abandon the car and move to higher ground if you can do so safely. You and the vehicle can be quickly swept away.

Hurricanes

If a hurricane is likely in your area, you should:

Listen to the radio or TV for information.

Secure your home, close storm shutters, and secure outdoor objects or bring them indoors.

Turn off utilities if instructed to do so. Otherwise, turn the refrigerator thermostat to its coldest setting and keep its doors closed.

Tum off propane tanks.

Avoid using the phone, except for serious emergencies.

Moor your boat if time permits.

Ensure a supply of water for sanitary purposes such as cleaning and flushing toilets. Fill the bathtub and or other large containers with water.

You should evacuate under the following conditions:

If you are directed by local authorities to do so. Be sure to follow their instructions.

If you live in a mobile home or temporary structure - such shelters are particularly hazardous during hurricanes no matter how well fastened to the ground.

If you live in a high-rise building - hurricane winds are stronger at higher elevations.

If you live on the coast, on a floodplain, near a river, or on an inland waterway.

If you feel you are in danger.

If you are unable to evacuate, go to your wind-safe room. If you do not have one, follow these guidelines:

Stay indoors during the hurricane and away from windows and glass doors.

Close all interior doors - secure and brace external doors.

Keep curtains and blinds closed. Do not be fooled if there is a lull; it could be the eye of the storm - winds will pick up again.

Take refuge in a small interior room, closet, or hallway on the lowest level.

Lie on the floor under a table or another sturdy object.

Tornados

Listen to NOAA Weather Radio or to commercial radio or television newscasts for the latest information.

Look for approaching storms.

Look for the following danger signs:

Dark, often greenish sky

Large hail

A large, dark, low-lying cloud (particularly if rotating) Loud roar, like a freight train.

If you see approaching storms or any of the danger signs, be prepared to take shelter immediately.

If you are under a tornado WARNING, seek shelter immediately!

Take refuge in a small interior room, closet, or hallway on the lowest level.

Lie on the floor under a table or another sturdy object.

High Temperatures and Heat

Stay indoors as much as possible and limit exposure to the sun.

Stay on the lowest floor out of the sunshine if air conditioning is not available.

Consider spending the warmest part of the day in public buildings such as work, libraries, schools, and other community facilities. Circulating air can cool the body by increasing the perspiration rate of evaporation.

Eat well-balanced, light, and regular meals. Avoid using salt tablets unless directed to do so by a physician.

Drink plenty of water. Persons who have epilepsy or heart, kidney, or liver disease; are on fluid-restricted diets; or have a problem with fluid retention should consult a doctor before increasing liquid intake.

Limit intake of alcoholic beverages.

Dress in loose-fitting, lightweight, and light-colored clothes that cover as much skin as possible.

Protect face and head by wearing a wide-brimmed hat.

Check on family, friends, and neighbors who do not have air conditioning and who spend much of their time alone.

Never leave children or pets alone in closed vehicles.

Avoid strenuous work during the warmest part of the day. Use a buddy system when working in extreme heat and take frequent breaks.

Winter Storms and Cold

Listen to your radio, television, or NOAA Weather Radio for weather reports and emergency information.

Eat regularly and drink ample fluids but avoid caffeine and alcohol.

Avoid overexertion when shoveling snow. Overexertion can bring on a heart attack, a major cause of death in the winter. If you must shovel snow, stretch before going outside.

Watch for signs of frostbite. These include loss of feeling and white or pale appearance in extremities such as fingers, toes, ear lobes, and the tip of the nose. If symptoms are detected, get medical help immediately.

Watch for signs of hypothermia. These include uncontrollable shivering, memory loss, disorientation, incoherence, slurred speech, drowsiness, and apparent exhaustion. If symptoms of hypothermia are detected, get the victim to a warm location, remove wet clothing, warm the center of the body first, and give warm, non-alcoholic beverages if the victim is conscious. Get medical help as soon as possible.

Conserve fuel, if necessary, by keeping your residence cooler than normal. Temporarily close off heat to some rooms.

Maintain ventilation when using kerosene heaters to avoid build-up of toxic fumes. Refuel kerosene heaters outside and keep them at least three feet from flammable objects.

To winterize your car, attend to the following:

Battery and ignition system should be in top condition and battery terminals clean. Ensure antifreeze levels are sufficient to avoid freezing. Ensure the heater and defroster work properly.

Check and repair windshield wiper equipment; ensure proper washer fluid level. Ensure the thermostat works properly. Check lights and flashing hazard lights for serviceability.

Check for leaks and crimped pipes in the exhaust system; repair or replace as necessary.

Carbon monoxide is deadly and usually gives no warning. Drive only if it is necessary. If you must drive. Travel in the day, don't travel alone, and keep others informed of your schedule.

Stay on main roads; avoid back road shortcuts.

Landslides

Mudslides usually start on steep slopes and can be activated by natural disasters. Areas where wildfires or human modification of the land have destroyed vegetation on slopes are particularly vulnerable after heavy rains.

Listen to the radio or watch TV for warnings about intense rainfall or for information and instructions from local officials.

Be aware of any sudden increase or decrease in water level on a stream or creek that might indicate debris flow upstream. A trickle of flowing mud may precede a larger flow.

Look for tilted trees, telephone poles, fences, or walls, and for new holes or bare spots on hillsides.

Listen for rumbling sounds that might indicate an approaching landslide.

Be alert when driving. Roads may become blocked or closed due to collapsed pavement or debris.

If landslide or debris flow danger is imminent, quickly move away from the path of the slide. Getting out of the path of a debris flow is your best protection. Move to the nearest high ground in a direction away from the path. If rocks and debris are approaching, run for the nearest shelter and take cover (if possible, under a desk, table, or other piece of sturdy furniture).

Volcanos

Volcanoes can produce ash, toxic gases, flash floods of hot water and debris, lava flows, and fast-moving flows of hot gases and debris. Some dangers from volcanoes can be predicted ahead of time while others may occur with little or no notice. Pay attention to warnings from local authorities for the best advice available on specific actions you can take to stay safe.

Be prepared either to shelter or to evacuate.

You should leave the area immediately. If you are warned to evacuate because an eruption is imminent, evacuate.

If you can drive rather than walk, use your vehicle to evacuate. When driving keep doors and windows closed, drive across the path of danger if you can or away from the danger if you cannot, and watch for unusual hazards in the road.

If you are indoors close all windows, doors, and fireplace or woodstove dampers. Turn off all fans and heating and air conditioning systems. Bring pets and livestock into closed shelters.

If you are outdoors seek shelter indoors. If caught in a rockfall, roll into a ball to protect your head.

If near a stream or river, be aware of rising water and possible mudflows in low-lying areas. Move up-slope as quickly as possible.

Seek care for burns right away. Immediate care can be lifesaving.

If your eyes, nose, and throat become irritated from volcanic gases and fumes, move away from the area immediately. Your symptoms should go away when you are no longer in contact with the gases or fumes. If the symptoms continue, consult your doctor.

Tsunami

A tsunami consists of a series of waves. Often the first wave may not be the largest. The danger from a tsunami can last for several hours after the arrival of the first wave. Tsunamis can move faster than a person can run. Sometimes a tsunami causes the water near the shore to recede, exposing the ocean floor.

Tsunamis can occur at any time, day or night. Tsunamis can travel up rivers and streams that lead to the ocean.

If you hear there is a warning, tell your relatives and friends, and move quickly to higher ground. Move in an orderly, calm and safe manner to the evacuation site or to any safe place outside your evacuation zone. Follow the advice of local emergency and law enforcement authorities.

Earthquakes

Minimize your movements during an earthquake to a few steps to a nearby safe place. Stay indoors until the shaking has stopped and exiting is safe.

If you are indoors take cover under a sturdy desk, table, or bench or against an inside wall, and hold on. If there isn't a table or desk, cover your face and head with your arms and crouch in an inside corner of the building.

Stay away from glass, windows, outside doors and walls, and anything that could fall, such as lighting fixtures or furniture.

Stay in bed, if you are there when the earthquake strikes. Hold on and protect your head with a pillow, unless you are under a heavy light fixture that could fall.

Use a doorway for shelter only if it is in close proximity to you and if you know it

is a strongly supported, loadbearing doorway.

Stay inside until the shaking stops and it is safe to go outside. Most injuries during earthquakes occur when people are hit by falling objects.

Be aware that the electricity may go out or the sprinkler systems or fire alarms may turn on.

DO NOT use the elevators.

If you are Outdoors stay there. Move away from buildings, streetlights, and utility wires.

Thunderstorms and Lightning

Postpone outdoor activities.

Get inside a home, building, or hard top automobile (not a convertible).

Although you may be injured if lightning strikes your car, you are much safer inside a vehicle than outside.

Remember, rubber-soled shoes and rubber tires provide NO protection from lightning. However, the steel frame of a hard-topped vehicle provides increased protection if you are not touching metal.

Secure outdoor objects that could blow away or cause damage.

Shutter windows and secure outside doors. If shutters are not available, close window blinds, shades, or curtains.

Avoid showering or bathing. Plumbing and bathroom fixtures can conduct electricity.

Use a corded telephone only for emergencies. Cordless and cellular telephones are safe to use.

Unplug appliances and other electrical items such as computers and turn off air conditioners. Power surges from lightning can cause serious damage.

Use a battery-operated NOAA Weather Radio for updates from local officials.

Chemical Attack

While potentially lethal, chemical agents are difficult to deliver in lethal concentrations. Outdoors, the agents often dissipate rapidly. Chemical agents also are difficult to produce.

A chemical attack could come without warning. Signs of a chemical release include people having difficulty breathing; experiencing eye irritation; losing coordination; becoming nauseated; or having a burning sensation in the nose, throat, and lungs. Also, the presence of many dead insects or birds may indicate a chemical agent release.

Listen to your radio for instructions from authorities.

If you are instructed to remain in your home or office building, you should close doors and windows and turn off all ventilation, including furnaces, air conditioners, vents, and fans.

Seek shelter in an internal room and take your disaster supplies kit.

Seal the room with duct tape and plastic sheeting.

If you are asked to evacuate do so immediately.

If you are caught outside, stay upstream, uphill, and upwind!

General, try to go at least one-half mile (usually 8-10 city blocks) from the danger area.

Do not walk into or touch any spilled liquids, airborne mists, or condensed solid chemical deposits.

In a motor vehicle. Stop and seek shelter in a permanent building. If you must remain in your car, keep car windows and vents closed and shut off the air conditioner and heater.

If you are requested to stay indoors:

Close and lock all exterior doors and windows.

Close vents, fireplace dampers, and as many interior doors as possible.

Turn off air conditioners and ventilation systems. In large buildings, set ventilation systems to 100 percent recirculation so that no outside air is drawn into the building. If this is not possible, ventilation systems should be turned off.

Go into the pre-selected shelter room. This room should be above ground and have the fewest openings to the outside.

Seal the room by covering each window, door, and vent using plastic sheeting and duct tape.

Use material to fill cracks and holes in the room, such as those around pipes.

Nuclear Power Plant Emergency

The following are guidelines for what you should do if a nuclear power plant emergency occurs.

Always keep a battery-powered radio with you and listen to the radio for specific instructions.

Close and lock doors and windows.

Turn off the air conditioner, ventilation fans, furnace, and other air intakes.

Go to a basement or other underground area, if possible.

Do not use the telephone unless necessary.

If you expect you have been exposed to nuclear radiation:

Change clothes and shoes.

Put exposed clothing in a plastic bag. Seal the bag and place it out of the way.

Take a thorough shower.

Keep food in covered containers or in the refrigerator. Food not previously covered should be washed before being put into containers.

After a Nuclear Power Plant Emergency Seek medical treatment for any unusual symptoms, such as nausea, that may be related to radiation exposure.

Epidemic or Pandemic

An epidemic occurs when an infectious disease spreads rapidly to many people. By their very nature, disease outbreaks can occur at unexpected times and places and may grow rapidly in scale.

A pandemic causes economic and social disntption due to high rates of illness and worker absenteeism. This is especially tnte if absenteeism affects key services such as transportation, communication, or power.

For any given outbreak, guidance should be obtained through the local, state, and/or federal health department.

Here are a few things you can do:

Follow the Agency's standard precautions

When possible, practice physical distancing (maintaining appropriate distance between people according to local, state, and federal guidelines) as much as possible.

Plan, in case services are disrupted. This is especially important if someone in your family has special needs. For example, make sure to have a way to fill needed prescriptions.

Store extra water, food, and supplies.

Stay as healthy as you can by getting adequate rest, managing stress, eating right, and continuing to exercise.

Foreign and Domestic Terror Attack

Move or leave if you feel uncomfortable or if something does not seem right.

Take precautions when traveling, Be aware of conspicuous or unusual behavior.

Do not accept packages from strangers. Do not leave luggage unattended.

You should promptly report unusual behavior, suspicious or unattended packages, and strange devices to the police or security personnel.

Learn where emergency exits are in buildings you frequent. Plan how to get out in the event of an emergency.

Be prepared to do without services you normally depend on - electricity, telephone, natural gas, gasoline pumps, cash registers, ATMs, and Internet.

If there is an explosion, you should get under a sturdy table or desk if things are falling around you. When they stop falling, leave quickly, watching for obviously weakened floors and stairways. As you exit from the building, be especially watchful of falling debris.

Leave the building as quickly as possible. Do not stop to retrieve personal possessions or make phone calls. Do not use elevators. Once you are out do not stand in front of windows, glass doors, or other potentially hazardous areas.

Move away from sidewalks or streets to be used by emergency officials or others still exiting the building.

Active Shooter

Upon discovery of an active shooter situation, as soon as possible and when safe to do so, notify law enforcement (911) and provide overhead announcement of an Active Shooter and location.

Response to an active shooter in the agency:

Evacuate - If there is an accessible escape path, attempt to evacuate the premises.

Hide Out - If evacuation is not possible, find a place to hide where the active shooter is less likely to be. To prevent an active shooter from entering your hiding place, lock the door and blockade the door with heavy furniture, if possible.

Hide behind large items (i.e., cabinets, desks). Silence your cell phone and remain quiet.

If evacuation and hiding out are not possible, remain calm, dial 911, if possible, to alert police to the active shooter's location. If you cannot speak, leave the line open and allow the dispatcher to listen.

As a last resort, and only when your life is in imminent danger, act against the active shooter - attempt to disrupt and/or incapacitate the active shooter by:

Acting as aggressively as possible against him/her; Throwing items and improvising weapons; Yelling; and Committing to your actions.

Safety & Security Officers1 Disaster Coordinator/ Alternate and/or the Administrator/Person in Charge will guide law enforcement officers if possible and as appropriate. The goal of law enforcement is to locate, isolate, and neutralize the shooter as quickly as possible to prevent additional deaths or injuries.

Agency Accident / Incident Reporting & Investigation

An accident or incident must be reported to your supervisor immediately. The employee or contractor may be required to write down all they remember regarding the accident or incident immediately following the occurrence, or as soon as they return from treatment for any injury. if you are a witness to an accident or incident, you will be required to provide information in order for the supervisor to complete the appropriate report. Please be aware of the importance of immediate action in reporting all details of the accident.

Reporting Emergencies

What constitutes an emergency & What do you do

An EXTREME EMERGENCY may be, but is not limited to:

1) Unresponsiveness (except in a known comatose client).

2) Severe chest pain with sweating, nausea, radiation of pain to neck or arm or cardiac arrest.

3) Signs and symptoms of hemorrhage or acute bleeding (G.I.), vomiting or diarrhea.

4) Extreme respiratory distress.

5) Fall with obvious fracture.

In the event of an EXTREME EMERGENCY:

1. Call 911 for emergency services responder to transfer to hospital immediately.

2. Call your supervisor or administrator to advise of the situation.

3. Stay with the client until emergency medical personnel arrive.

4. Document exactly what happened in the client journal.

A MODERATE EMERGENCY may be, but is not limited to:

1) Change in pulse, such as irregularity, tachycardia or bradycardia

2) Blood pressure with systolic less than 90 or diastolic greater than 110

3) Shortness of breath with shallow breath, rapid breath, or change in breath sounds

4) Decreased urinary output over twenty-four (24) hours

5) Blood sugar via glucometer greater than 250 or less than 60 (or anything abnormal for given client)

6) Vomiting or diarrhea with potential for dehydration

7) Temperature greater than 101 degree

8) Signs/symptoms of infection of wound

9) Fall with suspicion of injury

10) Medication irregularities (questionable dosages or potential interactions)

In the event of a MODERATE EMERGENCY:

1. Stay with the client until help arrives or you are satisfied that follow-up has been initiated.

2. Call the office and report to the supervisor or administrator that this is a moderate emergency

3. Call the physician, hospice nurse, or home health agency if directed to do so.

4. Document exactly what happened in the client journal all steps and actions taken.

A MINOR EMERGENCY may be, but is not limited to:

1) Fluctuation in vital signs, which are not life-threatening

2) Medication irregularities (questionable dosages or potential interactions between medications)

3) Complaints of pain, weakness, sweating, upset stomach, unexpected weight loss, UTI, GI symptoms indicating impending illness.

4) Falls without apparent injury

5) Change in wound size

In the event of a MINOR EMERGENCY:

1. Call the office and report the emergency to your supervisor

2. Document exactly what happened in the client journal all steps and actions taken.

3. It is not necessary to stay with the client until resolved (except see below).

NOTE: As with all written guidelines, certain situations do not fit the criteria listed. When unusual situations occur, DO NOT HESITATE to call the supervisor for advice. Field staff can tell the emergency services, hospice, family, or home health directly when it would cause a delay to call the office first. If you call, report the conversation and any change to the service plan to the supervisor as soon as possible. Also, remember to document the situation thoroughly as soon as possible in the client journal. Be aware that clients living alone or those without responsible family/caregivers present may need to be attended to until resolution is met.

Personal Injury

If you are injured on the job, Promise Senior Solutions’ prime concern is to provide you with the best medical care available. You must notify your supervisor or administrator immediately for instructions. If the injury is very serious or if it occurs when the closest medical provider is closed or unavailable, you need to go to the nearest emergency room. If you are not satisfied with your treatment at the clinic or hospital, report it as soon as possible to your supervisor or administrator so corrective action can be taken.

Follow-Up Treatment: All injured employees or contractors must follow the doctor’s order of treatment. Failure to do so may result in the loss of benefits.

Company Notification: If the doctor orders you to take time off from work due to an on-the-job injury, you must contact your supervisor immediately. You should advise them of your progress and expected date of return.

Modified Duty: Promise Senior Solutions wants you back to work as soon as possible. If you are not able to return to your regular duty, Promise Senior Solutions may create a modified duty position for you until you are released to regular duty by your doctor. You need to inform the treating doctor that Promise Senior Solutions offers modified duty work that can accommodate any restrictions or limitations the doctor may suggest. By working the modified duty position you are can continue to collect your regular average hourly pay amount.

This guide cannot anticipate every situation about your employment or contract. Promise Senior Solutions will do its best to recognize all rights and privileges extended in this handbook - unless doing so would harm our clients or expose our company to legal liability or financial loss. Promise Senior Solutions may need to supplement, modify, or eliminate one or more benefits, work rules, or guidelines described in this Handbook. The Company reserves the right to exercise its discretion to unilaterally make deletions from or additions to this Handbook. Promise Senior Solutions must authorize all such changes in writing.

Handbook Acknowledgement