SUPREME CHOICE HEALTHCARE



SUPREME CHOICE HEALTHCARE

WHERE WE TAKE PERSONAL CARE…PERSONALLY!!

EMPLOYEE HANDBOOK

Corporate Office

1100 Hardee Road

Suite 115

Kinston, NC 28504-2429

1866-859-9271



AGENCY PHILOSPHY

Home care is a very important part of our community, and an agency must provide an irreplaceable service to that community in the regards that we, the very people that deliver that service, may and will become a consumer of that service in the future. SUPREME CHOICE HEALTHCARE, LLC. wants to make healthcare accessible, affordable, and propriety to all qualified members of this element.

It is the mission of Supreme Choice HealthCare to provide healthcare services that are effective in nature, presented with quality and carried out with class, respect and dignity. Our services are provided in a safe and productive environment with our consumers, stakeholders and affiliates in mind as our top priority.

AGENCY PURPOSE

1. SUPREME CHOICE HEALTHCARE, LLC. is an essential element with the delivery of health care. By providing continuing care to clients in their homes reduces the probability of injuries or accidents.

2. SUPREME CHOICE HEALTHCARE, LLC. understands the process of aging is inevitable, and it is a part of life that has to be cherished. SUPREME CHOICE HEALTHCARE, LLC. understands the struggles to longevity, and wants to make contributions back to these citizens who have made it possible for members of this organization and society to thrive and live a prosperous life.

3. SUPREME CHOICE HEALTHCARE, LLC. wants to educate staff, clients, family members, and all concern citizens about being health-wise. We want to teach the aged how to keep living, and give them something to live for in the future. We want to teach the young how to reach the plateau of their epoch; and teach them to learn integrity, and that their actions today will have an effect tomorrow.

4. SUPREME CHOICE HEALTHCARE, LLC. understands the fragility of most aged people, and We want to facilitate these individuals with simplicity – ADLs, medication, appointments, & etc. Our purpose is optimization of health and subsistence for our community and abroad.

5. SUPREME CHOICE HEALTHCARE, LLC. is committed to the rehabilitation of illness, diseased, aged, or disable members to fight for existence and possible independency again. When rehabilitation is not possible, then we are committed to the hospice care of that individual with respect and compassion for those individuals.

SUPREME CHOICE HEALTHCARE

Organizational Chart

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CONFLICT OF INTEREST

POLICY

No staff or governing body members shall place themselves in a position where a personal interest may influence decisions between Agency and other entities. All officers, directors, and management shall adhere to the policy regarding avoiding conflicts of interest to ensure the agency’s mission is not harmed by their relationships.

PURPOSE

To assure the mission of SUPREME CHOICE HEALTHCARE, LLC. is not harmed by relationships of staff or governing body members, and maintain a healthy environment for staff members and clients.

PROCEDURE

1. No member of management shall solicit or accept any gratuities, gift, favors, or significant monetary value from any person or party while representing SUPREME CHOICE HEALTHCARE, LLC. Significant monetary value shall be anything beyond the amount of $20 or gifts that cannot be consumed within 24 hours.

2. All members of management shall not place themselves in a vulnerable position that coincides with conflict of interest.

3. If a member notices a conflict of interest, it shall be report to higher authority immediately for appropriate actions.

4. If there are any situations that aren’t clearly defined as a conflict of interest, notify higher authority for extended guidance.

NOTE

A conflict of interest may occur when the home care agency officers, directors, or management staff enter into a relationship with another organization or person, which in its content or process, may result in a compromise of SUPREME CHOICE HEALTHCARE, LLC. obligation to act in the best interest of its clients.

EQUAL EMPLOYMENT OPPORTUNITY

POLICY

SUPREME CHOICE HEALTHCARE, LLC. provides equal employment opportunities for any and all whom apply for employment without regards to race, color, creed, sex, national origin, age, or handicap/disability.

PURPOSE

1. To ensure that every applicant has an equal opportunity for employment regardless of demographic disparities.

2. To ensure that there isn’t any harassment of any employee due to that employee’s race, color, creed, sex, national origin, age, or handicap/disability is strictly forbidden.

a. Any employee experiencing such harassment should report the incident immediately to his/her supervisor or any other member of management.

3. To ensure that SUPREME CHOICE HEALTHCARE, LLC. is in compliance with Federals laws pertaining to Medicaid providers

a. Title VI of the Civil Rights Act of 1964

I. “No person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation under any program or activity receiving federal financial assistance.”

b. Section 504 of the Rehabilitation Act of 1973

I. [amendment] “No otherwise qualified handicapped individual in the United Stated shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.”

c. Americans with Disabilities Act of 1990

I. Prohibits exclusion from participation in or denial of services because the agency’s facilities are not accessible to individuals with a disability.

PROCEDURE

1) Applicants will be attrition through the use of evaluating qualifications, skills, and experience as being the primary attributes when targeting a specific job.

2) Once the criteria have been met, then the correlation of job specifics will be coordinated with selected applicants.

3) Selection of applicants for the position is usually no more than 3 qualified prospects that will be called in for an interview.

a. Interview will be conducted in accordance with federal regulations under the supervision of the HR team.

b. Selection of designated applicant will be the determination of the hiring official.

ORIENTATION

POLICY

All staff members of SUPREME CHOICE HEALTHCARE, LLC. will complete a basic orientation program.

PURPOSE

1. To orient new SUPREME CHOICE HEALTHCARE, LLC. staff members to the philosophy, services, policies, and procedures of SUPREME CHOICE HEALTHCARE, LLC.

2. To orient new SUPREME CHOICE HEALTHCARE, LLC. staff members to their respective roles.

PROCEDURE

1. The RN Supervisor and Agency Director ensures that all pre-requisites for employment have been met prior to scheduling a SUPREME CHOICE HEALTHCARE, LLC. staff member for orientation:

a. Nursing Staff – must be currently licensed in North Carolina and preferably have at least one year of nursing experience.

b. In-Home Aides – must have completed an approved training and competency evaluation program for the level of services to be provided or are enrolled in an agency sponsored training and competency or competency evaluation program.

2. The RN Supervisor ensures a basic individualized orientation program for each new SUPREME CHOICE HEALTHCARE, LLC. staff member, immediately prior to employment, and includes the following as a minimum:

a. Philosophy and objectives of the SUPREME CHOICE HEALTHCARE, LLC.

b. A review of pertinent personnel policies of the care agency.

c. A review of the individual’s job description and additional information concerning the duties of each staff member’s position.

d. A review of SUPREME CHOICE HEALTHCARE, LLC. organizational chart including other client care positions, how the positions relate to one another in the provision of client care and the supervisory chain of command.

e. A review of record keeping and reporting responsibilities.

f. Client’s rights, including confidentiality.

g. For licensed staff and all hand-on caregivers, Infection Control, including OSHA mandated training on airborne and blood borne pathogens, universal precaution, and SUPREME CHOICE HEALTHCARE, LLC. specific exposure control plan and post-exposure follow-up procedures.

3. Documentation of orientation is included in each employee’s personnel record.

EMPLOYMENT

POLICY

SUPREME CHOICE HEALTHCARE, LLC. strives to employ the most qualified individuals for all positions within the organization and to provide equal employment opportunities to all employees and applicants regardless of race, color, creed, sex, national origin, age, handicap, sexual orientation, marital status, and status with regard to public assistance or Veterans’ employment.

SUPREME CHOICE HEALTHCARE, LLC. will hire and develop employees basing judgment solely on job related qualifications. All vendors, independent contractors, subcontractors, referral sources, clients, and others doing business with SUPREME CHOICE HEALTHCARE, LLC. will be informed of the organization’s adherence to equal opportunity principles. Advertising for prospective staff members will identify the agency’s equal employment opportunity position.

For all professional positions, the agency will employ only individuals who meet the licensure or certification requirements for the particular professional position and are in good standing there under.

PURPOSE

To establish a control mechanism to hire qualified individuals while relinquishing liability against Fair Labor laws.

PROCEDURE

1. Staffing

• Part-time and on-call personnel may be utilized in instances when the type of work, working schedule, and duration of employment permit.

2. Minors

• State and federal legislation imposes certain limitations on the employment of persons under the age of 18. Therefore, applicants shall be required to furnish proof of age after an offer of employment has been made. Offers of employment shall be automatically revoked when applicants under 18 are not able to provide a work permit.

3. Interviews

• Pre-employment interviews are required for all positions. Interviews may be scheduled according to agency needs. Applicants who qualify for employment will be referred to the responsible supervisor for a second interview. The final decision to hire shall be made by the supervisor and approved by the Administrator. The job will be made by the immediate supervisor.

4. Tests

• Written skills tests and competency testing shall be administered to all Home Health Aides.

5. Human Immunodeficiency Virus

• Equal employment opportunities shall be provided to persons who test positive for HIV or related conditions.

6. Health Screening

• Health Screening is required by all employees for TB testing (refer to Health Screening Policy). The agency reserves the right to request any applicant (after and offer of employment is extended) or current employee, to undergo a physical examination where the position or physical condition of the individual may warrant.

7. Reference Check

• Information supplied on the application form or during an interview will be subject to verification. Reference checks shall be made by the agency and may be conducted by phone or mail.

8. License Certification

• For professional positions, all applicants must be able to furnish for inspection their current license or certificate. A copy of the applicant’s original license or certificate shall be retained for the employment file. The agency shall obtain copies of updated licensure on an ongoing basis.

9. PCS Aide Qualifications

• Must meet the in-home aide qualifications in the Home Care Licensure Rules, Licensing of Home Care Agencies (10 NCAL3L. 1110).

Can not be the patient’s spouse, child, parent, sibling, grandparent or grandchild. This also includes any person with an equivalent step or in-law relationship to the patient.

EMPLOYEE RIGHTS

POLICY

Employees have the right not to participate in cares or treatments that are in conflict with their cultural values or religious beliefs.

PURPOSE

To identify an employee’s right to not participate in activities that are in conflict with his/her cultural values or religious beliefs.

PROCEDURE

1. Prospective employees and agency representatives shall discuss performance expectation during the interview process. This would include rotating work schedules, weekend assignments, etc. If a prospective employee is not available for such a schedule, the employment offer may be deferred on the basis of inability to meet expected job requirements.

2. After an employment offer has been made and accepted by the applicant, the agency representative may ask if there are any restrictions to type of care or client populations based on religious or cultural beliefs.

3. Employees with religious beliefs celebrated on nontraditional agency holidays will be instructed to request personal time off in such situations. Time may or may not be paid depending on employment status. Adequate notice must be given to allow the agency to arrange alternate staffing.

4. Specific care activities or procedures which are in conflict with religious belief or cultural practice may be refused by employees without fear of discrimination or reprisals.

5. Situations where employees request not to work in certain geographic areas or refuse to perform activities they do not feel qualified for will be addressed in competency assessment and staff safety policies and procedures. Employee concerns will be addressed with their immediate supervisor and/or RN Supervisor, as appropriate.

HOURS OF WORK

POLICY

Hours of work shall be determined by each area. All full-time salaried employees will work 40 hours each week. Hourly employees will be compensated for those hours reflected on his/her time sheets.

PURPOSE

To establish a uniform policy for employees and agency to adhere to, and to notify employees of their requirements to fulfill the position.

PROCEDURE

1. Regular Hours

• Normally, office hours are Monday through Thursday, from 9:00 a.m. to 4:30 p.m. Starting and quitting time for full-time employees may vary according to each area. Employees shall be entitled to an hour lunch.

• Normal Office employees work hours are from 8:30 a.m. to 4:30 p.m. and. Any time before the regular schedule work time is not considered pay rate hours, and any time beyond normal regular schedule work time is not considered pay rate hours, unless Administrator request employee to work over.

2. Overtime

• The U.S. Fair Labor Standards Act requires that all employees be paid overtime for hours worked beyond 40 hours in any one week except those employed as executive, professional, and administrative employees. By common usage, the “exceptions” are referred to as “exempt employees”, the others are referred to as “nonexempt”. Any nonexempt employee who works over 40 hours in any one week will be paid time and a half of their regular pay for the number of hours worked over the standard. Authorization of overtime and payment must be approved by the immediate supervisor.

3. Punctuality

• All employees will be expected to report to work on time. If an employee will be delayed, the employee shall call his/her supervisor and inform him/her of the reason for late arrival and the employee expected time of arrival.

4. Payday

• Supreme Choice Healthcare will reimburse staff members for all documented time work every other Friday. Pay Dates and times will be discussed upon hire.

ATTENDANCE AND REPORTING

POLICY

SUPREME CHOICE HEALTHCARE, LLC. employees shall have regular attendance and punctuality at scheduled work times.

PURPOSE

To ensure employees understand requirements for promotions, salary increases, and transfers.

PROCEDURE

1. Absence:

• Absence: The failure to report to work at the scheduled time and is defined as lost time (partial or full day) due to illness, injury, personal business, or other reasons for which the agency is not responsible.

• Calling in absent: Employees shall notify their supervisor as soon as the employee is aware of the need to be absent, no later than two hours before the scheduled starting time. If possible, the expected duration of the absence should be communicated to the supervisor in advance.

• Emergency Conditions: In the event an emergency or hospitalization occurs due to illness or accident, the immediate supervisor should be notified by the employee’s designated emergency contact as soon as possible. A doctor’s statement should be sent to the agency within three (3) working days. If the immediate supervisor is not available, the next level of supervision should be notified.

• Doctor’s Statement: A doctor’s statement may be required for any illness. The agency may request a corroborating statement from a consulting physician.

❖ The doctor’s statement must indicate:

The nature of the illness

The expected duration of the illness

The anticipated return date

2. Excessive Tardiness/Absenteeism

• When determining whether an employee should be disciplined for excessive tardiness or absenteeism, the supervisor should apply sound judgment based on knowledge of the circumstances.

• Any disciplinary action taken must be consistently applied in like situations.

• An administrative team (RN Sup, Office Manager, and Director) shall make the final decision in any situation.

1. Each disciplinary action will not reflect exactly what is entailed in this manual mainly to include, but not limited to: the nature of offense, severity of offense, frequency, and past employee performance.

CODE OF ETHICS

POLICY

SUPREME CHOICE HEALTHCARE, LLC. has an established code of ethics which addresses SUPREME CHOICE HEALTHCARE, LLC. practice guidelines for management of internal and external customers.

PURPOSE

To articulate the guidelines for ethical conduct of the SUPREME CHOICE HEALTHCARE, LLC. and its employees in a written code. These guidelines shall include, but are not limited to:

□ Client rights

□ Client/family responsibility

□ Agency rights/responsibilities

□ Interagency relationships

□ Fiscal responsibilities

□ Agency marketing and public relations

□ Personnel

□ Ethical issue review process

□ Staff rights

PROCEDURE

1. Client Rights, as outlined in the Home Care Bill of Rights, are protected and promoted by SUPREME CHOICE HEALTHCARE, LLC. A copy of these rights is provided to individuals at time of admission. Also provided are the address and phone number of the Office of Health Facility Complaints and a brief explanation of how to file a complaint.

2. Client/Family Responsibilities

At the time of admission, clients are informed of their responsibilities related to the care or service to be provided.

3. SUPREME CHOICE HEALTHCARE, LLC. reserves the Rights to:

a. Refuse admission based on admission criteria.

b. Be assured of a safe work environment for its employees.

c. Expect the client/family to participate in the development of plans for care and subsequent changes.

d. Discontinue services based on SUPREME CHOICE HEALTHCARE, LLC. policies.

4. Agency Responsibilities

Once a client is admitted for care, the agency has a responsibility to provide services that are within the agency capabilities, mission, and applicable laws and regulation. If a conflict arises that might results in denial of care, services, or payment, the client’s specific needs will dictate the decision regarding discharge/transfer.

5. Inter-Agency Responsibilities

All referral sources shall honestly and conscientiously cooperate in providing adequate information about referrals and cooperate to assure comprehensive services.

6. Fiscal Responsibilities

a. The amount of service billed is consistent with the amount and type of service provided. Invoices reflect current published rates.

b. Accepted accounting practices are used in determining charges for service, supplies, and equipment.

c. SUPREME CHOICE HEALTHCARE, LLC. will not engage in activities or be in situations or relationships which might indicate “kickback”/”payoffs” or other inappropriate practice.

7. Marketing and Public Relations

a. Oral and written statements will fairly represent available services, benefits, costs, and agency capabilities.

b. Services promoted to the public media include information descriptive of home care in general, as well as specific SUPREME CHOICE HEALTHCARE, LLC. information.

8. Personnel

a. SUPREME CHOICE HEALTHCARE, LLC. is an equal opportunity employer and complies with all applicable laws, rules, and regulations.

b. Written personnel policies is available and uniformly applied to all employees.

c. An adequate number of qualified employees are available and utilized at the level of their competency.

d. All employees are supervised.

e. All employees receive an ongoing performance review.

f. Orientation and in-service training are available to all employees.

g. Continuing education is promoted and encouraged.

h. SUPREME CHOICE HEALTHCARE, LLC. has a responsibility to ensure that employees promote ethical and professional values in the delivery of home care.

i. Reasonable compensation is awarded to the employee for services rendered.

9. Ethical Concerns Review Process

It is the responsibility of the physician, SUPREME CHOICE HEALTHCARE, LLC. management, care giving staff, including those providing services through contract, and the client to report unethical concerns to SUPREME CHOICE HEALTHCARE, LLC. Ethical Review Committee.

10. Staff Rights

a. An employee has the right to refuse to participate in aspects of care or treatment that are in conflict with his/her cultural or religious beliefs.

b. Care is not interrupted when an individual employee refuses to participate. Rather, care is reassigned to qualified personnel. In the event employee refusal to participate in care of treatment because of religious or cultural beliefs limits client access to qualified care delivery, the client will be informed and assisted to obtain alternate services.

c. Individual performance evaluations will reflect motivation of refusal of care.

EMPLOYEE INCIDENT AND INJURY

POLICY

All employees suffering a work-related injury or illness must report it immediately to their supervisor so they may be referred for necessary medical attention.

PURPOSE

To establish a standard procedure for ensuring proper care of those employees suffering work-related injuries or illness.

To assist in identifying work hazards in need of immediate attention.

To protect the agency against unwarranted claims for illness or injury and reduce absenteeism.

PROCEDURE

1. All employees must fill out an incident/injury report, regardless of the severity of the injury.

2. All incidents must be reported immediately upon the incident, if able, if unable to report the incident immediately, then within 24 hours to the agency with a notification of the reason it could not be reported at the time of the incident.

3. Refer to Post-Exposure Evaluation and Follow-Up policy for employee exposure to AIDS or Hepatitis B.

4. All incidents are summarized and are a component of the Quality Improvement Plan.

influenza vaccination

POLICY: SCHC staff, shall be offered and provided the influenza vaccination during the annual influenza vaccination campaign. Staff will be required to obtain the vaccination by December 15, 2016 of each year or sign a declination form. The vaccination will be offered and provided free of charge to staff who consent to the vaccination. Locations of vaccination may be at the main office at 1100 Hardee Road Kinston, NC 28504 or any Walgreens location. Records will be maintained documenting vaccinations and declinations. If vaccination shortages occur or if CDC recommendations are altered the agency RN, or agency director may suspend or revoke all or part of this policy.

PURPOSE: The purpose of this policy is to minimize transmission of the influenza virus within the agency by providing occupational protection to staff and thus preventing transmission to members of the community, which we serve.

Annual influenza vaccinations have been found to be both safe and effective in reducing the risk of influenza and health care related transmission. The Centers for Disease Control and Prevention (CDC) recommended vaccination of all workers in health care settings. Research, however has shown that vaccination programs restricted to those who actively seek the vaccination have limited penetration, and thus effectiveness in protecting clients and staff. This policy is intended to maximize the protection offered to our staff.

Definitions:

1. Staff- any person that receives financial compensation for work performed with Supreme Investments, LLC dba Supreme Choice Health Care

2. Influenza (flu)- a mild to severe contagious illness caused by viruses that infect the respiratory tract

3. Influenza Vaccine- a preparation of influenza antigens (live or killed virus) , which stimulate the production of specific antibodies when introduced to the body. These antibodies provide protection against influenza virus infection.

a. TIV- also known as the Trivalent Inactivated Influenza Vaccine, is made with killed virus and is administered through the muscle

b. LAIV- also known as the Live Attenuated Influenza Vaccine, is made with live weakened viruses that do not cause the flu and is administered through nasal spray

4. Annual influenza vaccination campaign- Each year during the month when the maximum benefit is provided by the influenza vaccination, SCHC along with Walgreens pharmacy will conduct a major vaccination campaign including vaccination clinics, staff and client outreach. The campaign will start on November 1 of each year and end on December 15 unless for some reason the campaign should extend longer.

PROCEDURE:

A. All staff will be required to obtain the influenza vaccine or sign the declination on the Influenza Vaccination Employee Statement each year

IMPLEMENTATION:

B. Supreme Choice Health Care will offer and Walgreens pharmacy will provide the influenza vaccination to Supreme Choice Health Care staff at no cost to the staff

C. The Live Attenuated Influenza Vaccine (LAIV) or the Trivalent Inactivated Influenza ( TIV) will be administered to employees based on vaccine availability and published CDC guidelines

D. SCHC Registered Nurses will educate staff about or at a minimum:

a. The Influenza Vaccine

b. Non Vaccine control measures

c. Prevention Measures

d. Diagnosis, Transmission

e. Impact of Influenza

RESPONSIBILTIES:

E. All staff of SCHC shall familiarize themselves with this policy and procedure by signing the Acknowledgment of Receipt form to the agency director, or office manager

F. This documentation shall be included in the staff chart

G. Annually each employee should complete and sign the Influenza Vaccination Employee Statement, whether consenting to or declining vaccination by the established deadline

H. Taking one of the above actions by December 15 or if hired during the annual influenza vaccination campaign, within 1 month of employment

I. Annually staff should submit the signed form to the agency director or office manager by the established deadline

J. The agency director, RN, office coordinators and managers will be responsible for:

a. Allowing staff time to attend vaccination clinics

b. Assuring that staff comply with this policy and procedure

c. Maintaining copies of the Acknowledgement of receipt and Vaccination statement for each year and put in the staff chart

d. Provide new employees with information about the annual influenza vaccination policy during orientation and where to obtain the vaccine if employment begins during the campaign

e. Take corrective actions against staff who is not in compliance with this policy

f. Offering staff locations and times for vaccinations

g. Providing the vaccinations

h. Paying for the vaccinations

i. Maintaining records for staff who have consented or declined the vaccination

j. Review annual influenza vaccination rates

k. Develop and recommend strategies including revisions to this policy and enhance and improve vaccination rates

l. Evaluates the reasons given by staff for declining the influenza vaccination once annually

m. Provide influenza vaccination rate data to key stakeholders, staff, clients at least annually

Goals for Influenza Vaccination

A. Achieve a 90% vaccination rate as established in the national influenza initiatives for 2020 (Method used: )

B. Improve access for the Influenza Vaccination

C. Inform staff at least two weeks prior to the campaign kick off

D. Educate staff on the benefit of vaccination

E. Incorporate the Influenza Vaccination in all infection control policies and procedures

F. Improve the rates amongst clients and staff accepting vaccinations yearly

G. Evaluate at least annually the reasons given for declination, and any issues or concerns that occur during the campaign

INFECTION CONTROL

POLICY

Supreme Choice Health Care, LLC. implements policies and procedures for the care of clients with infections and/or contagious diseases and for infection control practices as appropriate.

PURPOSE

1. To control the spread of infection.

2. To protect individuals from transmission of communicable/infectious diseases.

PROCEDURE

1. Supreme Choice Health Care, LLC. implements infection control procedures with regard to clients, staff, and their environment.

2. Supreme Choice Health Care shall improve influenza vaccination rates

3. In order to serve the client with a communicable disease; there must be adequate facilities in the home to provide care while protecting staff and the client’s family.

4. Supreme Choice Health Care, LLC. will provide employees with appropriate protective face shields, consistent with Occupational Health and Safety requirements.

5. Staff will report immediately all exposures to the immediate supervisor

6. Infection control activities shall apply to all geographic areas and clients served

7. Infection control activities shall be verbally communicated and or included in print form

8. SCHC shall report infections to local, state, and federal public health authorities in accordance with law and regulation

Universal Precautions

All hands-on care employees must follow the “Universal Blood and Body Fluid Precautions” developed by the Centers for Disease Control (CDC) and published in 29 CFR Part 1910.1030, Occupational Exposure to Blood borne Pathogens. The Universal Precautions concept assumes that all blood and blood contaminated body fluids are potentially infectious.

CDC and the Occupational Safety and Health Administration (OSHA) have also identified other body fluids that are considered potentially infectious and to which Universal Precautions also apply. These are: semen, vaginal secretions, cerebrospinal fluid (CSF), synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and any fluids in which differentiation of body fluid types is difficult or impossible.

Infection control procedures include, but are not limited to the following:

1) Frequent hand-washing by caregiver:

2) Before and after the provision of direct client care

3) Before working in the kitchen

4) After handling soiled or contaminated materials

5) After going to the toilet

6) After removing gloves

7) Covering nose and mouth when coughing.

8) Covering open sores or cuts on fingers or hand with clean bandages.

9) Avoiding needle sticks and injuries from sharp objects. Not recapping, breaking or bending needles.

10) Placing disposable needles and sharps in puncture-resistant containers for disposal.

11) Wearing appropriate personal protective gear when contact with blood/body fluids is anticipated:

✓ Gloves: when touching blood/body fluids, mucous membranes or non-intact skin of consumers or when handling items OR surfaces soiled with blood/body fluids.

✓ Gowns: when splashes or soiling with blood/body fluids is likely.

✓ Masks, glasses, goggles: during procedures that are likely to generate splashes of blood/body fluids into the mouth, nose and ears.

❖ By using the same measures for anticipated contact with other body fluids not listed specifically by the CDC as potentially infectious for blood-borne pathogens (i.e., sputum, feces, urine, saliva, vomits, sweat, and tears), transmission of most infectious diseases can be avoided.

❖ Offering staff members at risk of exposure to blood or blood contaminated body fluids the Hepatitis B Vaccine series.

Precautions for Consumers/Caregivers

The spread of infectious diseases to the family or other caregivers can be limited by good personal hygiene principles. Some caregivers may need more information regarding mode of transmission of the causative infectious agent, the infectious material requiring special handling and the proper use of protective clothing if needed.

Enterics

A client who has diarrhea or who has been diagnosed with an enteric pathogen (salmonella, hepatitis A, etc.) should pay strict attention to hand washing after each bowel movement. Likewise, that client’s caregiver should be instructed in the importance of hand-washing after cleaning the client and particularly, before eating or preparing food. It may be helpful for the caregiver to wear gloves if cleaning up the stool of the client or soiled clothes and linen, but not completely necessary if proper hand washing is performed when these tasks are finished. Soiled linens may be washed as usual laundry, but before washing, they should be placed in a plastic bag or separate laundry basket. Decontaminate shared bathrooms with routine hygiene measures. If soiled with stool, the caregiver must take care to clean the spill promptly with soap and water, as well as a disinfectant product. Hand-washing must again occur after cleaning.

Respiratory diseases (tuberculosis, chickenpox, influenza)

A client with tuberculosis will generally have already begun antimicrobial treatment. The caregiver must help ensure that the client takes his or her anti-tuberculosis medications as prescribed. To prevent the spread in the household, the client should cover his/her mouth if coughing. The client should wear a mask if still coughing and has been on treatment for less than two weeks. Caregivers and close contacts should be screened for possible infection by skin testing through their doctor or health department. Masks should be worn for direct care of the client who is coughing extensively and producing secretions. The use of a mask is usually only needed for a short period of time, when the client is on treatment. Hand washing must occur after contact.

Respiratory diseases such as measles, mumps, and chickenpox are spread by viruses. Caregiver for these consumers should check their immunization status or their history of the disease. Those who are not immune or are not sure should, if possible, the caregiver should wear a mask while performing direct care or when entering the client’s room. Visitors should use the same precautions. A client with a respiratory infection, purulent sputum or frequent coughing should be taught to cover the mouth and nose with a tissue when sneezing or coughing and to promptly dispose of the tissue in a plastic trash bag and handle as general trash.

Many respiratory diseases may also be transmitted by direct contact of respiratory secretions with hand and then transmitted to the mouth, nose and eyes. Therefore, hand-washing in conjunction with “Universal Precautions” must be emphasized for respiratory precautions as well.

Sexually transmitted disease (gonorrhea, syphilis, herpes)

Caregivers must use gloves if touching herpetic or syphilitic lesions or if in contact with any infectious secretions.

Infected wounds, scabies

Caregivers of consumers with infected or draining wounds or decubitis must be reminded of stringent hand-washing practices. Caregivers may use gloves when handling potentially infectious material, although this is not absolutely necessary if good hand-washing is performed. An over-gown or apron should be worn by a caregiver if in direct contact with a patient diagnosed with scabies. Good hygiene measures are sufficient for environmental decontamination and handling of laundry. Be sure client is receiving treatment for scabies and following protocol as ordered.

Blood-borne infections (hepatitis B, HIV/HBV)

Consumers with blood-borne pathogens should be handled with the same “Universal Precautions” used by staff members and instruction should be given for these precautions. They should receive instruction regarding t he following:

✓ Needles or sharps generated by the client must be placed in puncture resistant containers (coffee cans, bleach bottles)

✓ Use gloves when handling any blood or other body secretions, open wounds, or when handling soiled clothing or linens especially if the caregiver has cuts or abraded skin. Gloves must be removed when contaminated, followed by good hand-washing. Use aprons w hen changing grossly soiled linens or cleaning up large spills. Avoid splashes to the face of blood or other body fluids from the infected patient. Gloves must be worn when cleaning up blood spills.

✓ Clean spills with soap and water and a disinfectant product.

✓ Soiled linens may be washed as routine laundry but should be stored in a leak-proof container such as a plastic bag or separate laundry basket. Gloves should be worn when handling soiled linens.

Environmental infection control procedures include, but are not limited to the following:

□ maintaining a clean work environment, for example by maintaining clean counters, tables and shelves

□ covering food by closing cartons and replacing covers

□ refrigerating food promptly as appropriate

□ rinsing cans and bottles before disposal in the garbage

□ washing garbage cans, dirty pails and trash cans with hot soapy water

□ disposing of garbage properly (closed bags, impermeable bags)

□ cleaning all areas of bathroom, especially around toilet base

□ keeping clean and dirty items separate

□ using sterile items that are not outdated

□ keeping the patient environment clean, neat and orderly

□ regularly cleaning patient supplies, such as commodes, bedpans, urinals, suction machines and measuring containers

FAMILY AND MEDICAL LEAVE ACT

POLICY

A family and/or medical leave of absence is available to eligible employees for up to twelve (12) weeks per year. This leave is unpaid.

PURPOSE

To provide employees the ability to request and take leave of absence for family medical situations without jeopardizing job security.

PROCEDURE

1. Employee eligibility is determined as:

• Any employee who has been employed for a minimum of twelve (12) months by employer from whom request is being made.

• Employee has worked at least 1250 hours during the past twelve (12) month period.

2. Leave eligibility is determined:

• Family leave request is for care of employee’s child (birth, adopted, or foster care.)

• Employee request is made at least thirty (30) days in advance of anticipated leave.

• Medical leave request by employee to care for spouse, son, daughter, or parent who has a serious medical condition.

• Medical leave request by employee due to his/her serious health condition which prevents the employee from performing the functions of his/her position.

3. If both an employee and his/her spouse are employed by SUPREME CHOICE HEALTHCARE, LLC., a total of twelve (12) weeks of leave will be granted for care of a sick parent, rather than twelve weeks each.

4. If both an employee and his/her spouse are employed by SUPREME CHOICE HEALTHCARE, LLC., twelve (12) weeks leave will be granted to each individual for care of their spouse, child, or self.

5. Leaves will be granted at the discretion of the agency management staff for medical leave requested to care for in-laws or common law situations.

6. Intermittent or reduced leave will be granted for serious health conditions of an employee or an employee’s spouse, child, or parent.

7. Intermittent leave will be granted at the discretion of the agency for requests related to family leave.

8. If intermittent leave is requested, SUPREME CHOICE HEALTHCARE, LLC. may use discretion regarding placement of employee in an alternative position provided the salary and benefits remain the same. Once the leave is terminated, the employee will have the right to return to the same or equivalent position.

9. The employee will be required to use any accrued vacation or sick leave time prior to using the leave of absence.

10. Any disability benefits accrued by the employee for illness or disability will be paid during any portion of the medical leave.

11. Any employee benefits that normally accrue related to hours worked, i.e. vacation, sick leave, will accrue only during the paid portion of leave from work.

12. Any individual employee contributions required for participation in an employee plan will continue to be the responsibility of the employee while on leave.

13. At the end of the leave, the employee will be reinstated to his/her former position, if available, or to a position for which he/she is qualified and which has equivalent benefits, pay and conditions of employment. All employment benefits which had accrued prior to leave will be retained by the employee.

14. Contract personnel must comply with Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, the Title VI of the Civil Rights Act of 1964, as well as all other agency rule. Contract personnel shall be responsible to the RN Supervisor or other such designee.

15. Contract personnel utilized by the agency shall be periodically evaluated by a qualified supervisor. In the event that the contract for services is with a professional group, rather than an individual, proof of an annual performance evaluation from the practicing supervisor shall be submitted to the agency and will be accepted to meet the requirements of this policy.

16. The Contractual Agreement shall continue and be binding upon the parties from year to year unless terminated by either party with 30 days written notice. If the contractor fails to perform according to the agreement, services will be terminated with 24 hours notice by SUPREME CHOICE HEALTHCARE, LLC.

VACATION, BENEFITS AND HOLIDAYS

SUPREME CHOICE HEALTHCARE . recognizes the following paid holidays:

❖ Independence Day

❖ Labor Day

❖ 1 Days at Thanksgiving

❖ 1 Days at Christmas

If you desire to work these days you will be paid for working with your consumer. If you do not plan to work on these holidays the call out procedure remains in effect.

Currently SUPREME CHOICE HEALTHCARE, LLC provides AFLAC insurance, Medical- Blue Options (Blue Cross Blue Shield ) and Individual Retirement account options to all employees. See your local coordinator for detail on benefits.

TERMINATION

POLICY

SUPREME CHOICE HEALTHCARE, LLC. shall reserve the right to terminate the employment relationship with an employee at any time. The termination may be with or without cause. If it is found that an employee has failed to truthfully disclose information about his/her past, including felony convictions, termination may be immediate. Termination of an employee must have the prior authorization of the Director.

PURPOSE

To set a mechanism for determining termination, without regards to cause and effect.

PROCEDURE

1. Upon the resignation or termination of an employee, the immediate supervisor must:

• Document the reason(s), if available, for termination and document the exit interview, if applicable.

• Secure the return of all agency property, records, and keys.

• Notify appropriate agency personnel of the termination, including the payroll department.

2. All terminated SUPREME CHOICE HEALTHCARE, LLC. employees will be paid any unpaid benefits within 30 days of termination; unless the employee is holding agency properties then that employee will be reimbursed accordingly.

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AGENCY DIRECTOR

Home Care RN

S. Potter

Qualified Professional-MH/DD

N. Williams

Administrative Assistant/Office Manager-

NC Innovations and Home Care Consumers

MCO (Managed Care Organizations)- ECBH and Eastpointe

Habilitation Technicians

Clients Rights Committee

Office Manager

QUALIFIED PROFESSIONAL MH/DD

DIRECTOR-

Nikisha Williams

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