UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING …

UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING December 17, 2018

Clinical Agency Affiliations and Locations

Agency Name

1st Operations Medical Group Hurlburt Field, Florida 2D Medical Group Barksdale AFB, Louisiana 3HC Home Health & Hospice Care Goldsboro, North Carolina 4th Medical Group Seymour Johnson AFB, North Carolina 5th Medical Group-Minot AFB Minot AFB, North Dakota 18th Medical Group, Kadena Air Base Japan 21st Medical Group, Peterson Air Force Base Colorado 35th Medical Group, Misawa AFB Japan 48th Medical Group, RAF Lakenhealth , UK

52nd Medical Group Spangdahlem AFB, Germany 99th Medical Group Nellis Air Force Base, Nevada 354th Medical Group, Eielson, AFB, AK Alaska (Pediatrics Department Only) 374th Medical Group Yokota Air Base, Japan

377th Medical Group, Kirtland AFB New Mexico

436th Medical Group Dover Air Force Base Dover, Delaware 509th Medical Group Whiteman AFB, Missouri

Programs Covered

MSN, DNP, Post Graduate Certificate,

MSN to DNP MSN

Undergraduate and Graduate Students

Agency Requirements

Student must complete Attachment 1

Student must complete the Trainee Agreement Addendum

MSN and DNP Nurse Practitioner

Student must complete Trainee Addendum. Student may utilize agreement for a period of no more than 2 years at a time. Student must complete the Trainee Agreement Addendum

Executive Nursing Executive Nursing Admin DNP ONLY Admin DNP ONLY

Student must complete Attachment 1

Advanced Practice

Executive Nsg Admin DNP ONY

Student must complete Trainee Agreement Addendum

Please contact the following for interest in this site.

ALANE C. GARLISI, Lt Col, USAF, NC Education and Training Flight Commander 48th Medical Group, RAF Lakenheath, UK alane.garlisi@us.af.mil

MSN and DNP Advanced Practice Nurse Practitioner

Student must complete the Trainee Agreement. Student will need to complete Attachments 1&2 from Agency.

Student must complete Trainee Agreement Addendum

Student: Must complete the Trainee Agreement Addendum, provided by the facility.

MSN and DNP

Women's Health Nurse Practitioner

ONLY RN-BSN, MSN,

DNP

Contact: Capt. SHENIQUA D. FORTUNE Director, Education & Training sheniqua.d.fortune.mil@mail.mil Student must complete TAA Student must complete and sign the Trainee Agreement Addendum. While utilizing this agreement, students are prohibited from engaging in off-duty employment at USAF MTF. Student must complete the Trainee Agreement Addendum

Student must complete Trainee Agreement Addendum

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UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING December 17, 2018

Clinical Agency Affiliations and Locations

Agency Name

673rd Medical Group, Join Base, Elmendorf-Richardson JBER, Alaska

Programs Covered

RN-BSN, MSN, DNP

Agency Requirements

Attachment 1 and 2 for Trainee Agreement Addendum

A

Agency Name

Abrom Kaplan Memorial Hospital Kaplan, Louisiana Access Community Health Network Chicago, IL (see Exhibit A for complete

lists of affiliates covered by agreement)

Programs Covered

Undergraduate and Graduate Nursing

Students Graduate Nursing

Programs

Agency Requirements

USA/Faculty: Please see Exhibit A for all Facility Sites. Student: Must obtain comprehensive health insurance. Shall provide to Agency evidence that they have met all requirements of CPR certification, hepatitis B vaccination, and OSHA compliance for prevention of transmission of blood borne pathogens and TB before being placed in the Program. A criminal background check and drug screen, as specified in Exhibit B, and as required by and acceptable to Agency, are required of each Participant prior to being placed in the Program.

Each student prior to his/her arrival at the Agency Site are required to:

(i) Follow the administrative policies, standards, and practices of Agency; and

(ii) Obtain medical care at his/her own expense for any injuries or illnesses sustained as a direct or indirect result of his/her participation in the Program; and

(iii) Provide his/her own transportation and living arrangements; and

(iv) Report to the assigned Agency Site on time and follow all established regulations of Agency during the regularly scheduled operating hours of the Agency Site; and

(v) Conform to the standards and practices established by USA while participating in the Program; and

(vi) Meet the personal, ethical and professional standards required of employees of Agency and conduct themselves at all times consistent with the applicable professional Code of Ethics and the applicable standards of the Joint Commission and/or other relevant accrediting or regulatory bodies; and

(vii) Obtain prior written approval of Agency and AFFILIATE before publishing any material relating to the Program.

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UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING December 17, 2018

Clinical Agency Affiliations and Locations

Agency Name

Access Health Care Physicians, LLC Spring Hill, Florida

Adams Compassionate HealthcareACHN Chantilly, Virginia Adena Health System Chillicothe, Ohio

Programs Covered

Nursing

Agency Requirements

USA/Faculty: See Exhibit A-Teacher/Learner Expectations.

Undergraduate and Graduate Nursing

Students

Students must maintain health insurance and provide proof of health insurance to USA. Agency may request copy of proof.

MSN, DNP

Agency contact: Monica Climer, Coordinator Graduate Clinical Student-mclimer@- 740779-8821 USA/Faculty: Complete Attestation (Exhibit A). Inform facility of curriculum and sequence and of all courses and clinical experiences for each student. Notify facility of proposed schedule of student assignments to facility, including dates, number and names of students, their level of academic preparation.

Student: Complete Exhibit B. Obtain health insurance coverage for the period of the clinical experience.

Florida Hospital (Adventist Health

System/Sunbelt, Inc.) (to include: ?

Florida Hospital Altamonte -

601 E. Altamonte Drive, Altamonte

Springs, FL

?

Florida Hospital Apopka ?

201 N. Park Avenue, Apopka, FL

?

Florida Hospital Celebration

? 400 Celebration Place,

Celebration, FL

?

Florida Hospital East

Orlando ? 7727 Lake Underhill

Road, Orlando, FL

?

Florida Hospital Kissimmee ?

2450 N. Orange Blossom Trail,

Kissimmee, FL

?

Florida Hospital Orlando &

Childrens ? 601 E. Rollins Street,

Orlando, FL

?

Florida Hospital Winter

Garden ? 2000 Fowler Grove, Blvd,

Winter Garden, FL

?

Winter Park Memorial

Hospital ? 200 N. Lakemont

Avenue, Winter Park, FL

Maitland, Florida

Nursing Undergraduate

NON APRN

Agreement covers NURSING Student must be N-95 respirator fit tested prior to attending clinical. Testing can be done for $25 at the Agency clinic. Nursing Students please see Exhibit C ?Criminal Background Disqualifications Guidelines. Exhibit D- Physical and Mental Requirements. USA must provide a letter of good standing indicating that a background check and drug screen has been conducted. Provide in writing the names of students.

Agency Contacts:

Non Clinical Rotation- Debbie Stunkarddebrastunkard@

Clinical Rotation-heather.hernandez@ (graduate students please go to for application.

Student's research projects with additional requirements: Each student will need to obtain approval from the Principal Investigator on the research study. The research must be approved in advance by and subject to the review of Hospital's Institutional Review Board or receive a determination of non-human subjects research. If research involves the use of animals, the research must be subject to the oversight by an Institutional Animal Care and Use Committee. Student may not serve as Principal Investigators, but may assist as staff personnel, provided they have appropriate supervision. Students must obtain written approval of both parties before publishing any articles, and will submit all completed articles, etc., to Hospital for review and approval no less than 60 days prior to the date of submission for publication, disclosure or presentation.

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UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING December 17, 2018

Clinical Agency Affiliations and Locations

Agency Name

Florida Hospital (Adventist Health

System/Sunbelt, Inc.) (to include: ?

Florida Hospital Altamonte -

601 E. Altamonte Drive, Altamonte

Springs, FL

?

Florida Hospital Apopka ?

201 N. Park Avenue, Apopka, FL

?

Florida Hospital Celebration

? 400 Celebration Place,

Celebration, FL

?

Florida Hospital East

Orlando ? 7727 Lake Underhill

Road, Orlando, FL

?

Florida Hospital Kissimmee ?

2450 N. Orange Blossom Trail,

Kissimmee, FL

?

Florida Hospital Orlando &

Childrens ? 601 E. Rollins Street,

Orlando, FL

?

Florida Hospital Winter

Garden ? 2000 Fowler Grove, Blvd,

Winter Garden, FL

?

Winter Park Memorial

Hospital ? 200 N. Lakemont

Avenue, Winter Park, FL

Maitland, Florida

Programs Covered

APRN

Adventist Florida Hospital Ocala (previously Munroe Regional Medical Center) Ocala, Florida

BSN, MSN, DNP

Adventist Health System Georgia, Inc. d/b/a Gordon Hospital

RN-BSN, MSN, DNP

Agency Requirements

Agreement covers NURSING Student must be N-95 respirator fit tested prior to attending clinical. Testing can be done for $25 at the Agency clinic. Nursing Students please see Exhibit C ?Criminal Background Disqualifications Guidelines. Exhibit D- Physical and Mental Requirements. USA must provide a letter of good standing indicating that a background check and drug screen has been conducted. Provide in writing the names of students.

Agency Contacts:

Non Clinical Rotation- Debbie Stunkarddebrastunkard@

Clinical Rotation-heather.hernandez@ (graduate students please go to for application.

Student's research projects with additional requirements: Each student will need to obtain approval from the Principal Investigator on the research study. The research must be approved in advance by and subject to the review of Hospital's Institutional Review Board or receive a determination of non-human subjects research. If research involves the use of animals, the research must be subject to the oversight by an Institutional Animal Care and Use Committee. Student may not serve as Principal Investigators, but may assist as staff personnel, provided they have appropriate supervision. Students must obtain written approval of both parties before publishing any articles, and will submit all completed articles, etc., to Hospital for review and approval no less than 60 days prior to the date of submission for publication, disclosure or presentation. USA/Faculty: Must provide student name, residence address, phone number to agency at least ten days prior to placement at facility. Prior to commencing performance per the agreement, the COLLEGE shall ensure health status of student and faculty entering premises is compliant with the following requirements of the AGENCY and shall produce documentation upon request: Statement by a healthcare provider that student is medically capable of performing internship related duties and is free of any communicable diseases. Documentation of a negative ppd within the last year (two ? step ppd if more than one year) or Chest XRay if past positive ppd. Documentation of active or passive immunity to Measles, Mumps, Rubella, Rubeola, Diphtheria, Pertussis, Tetanus, Hepatitis B and Varicella.

Student must contact Workforce Development Coordinator with Munroe to complete orientation packet prior to beginning clinicals. Students may be required to undergo a health examination.

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UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING December 17, 2018

Clinical Agency Affiliations and Locations

Agency Name

Affiliated Physicians Group Needham, Massachusetts

Programs Covered

MSN and DNP

Agency Requirements

USA Faculty please contact the following person for placement.

Jill Boyd 617-754-0733 jaboyd@caregroup.harvard.edu

USA/Faculty: At least 15 working days prior to clinicals provide written evidence of requirements set forth in Appendix A and provide a course description including objectives, a description of the evaluation system. Submit Appendix B for each clinical rotation. Student must be appropriate under the guidelines promulgated by the Massachusetts Executive Office of Health and Human Services (EOHHS). See below for Background check Requirements: Background Checks. The School shall check the Criminal Offender Record Information ("CORI") for each Participant who may be present on APG's premises as part of the Program. The School shall disqualify Participants as appropriate under the guidelines promulgated by the Massachusetts Executive Office of Health and Human Service ("EOHHS") and the Department of Mental Health ("DMH"). These guidelines may be found in the EOHHS Human Resource Policy Manual. No Participant will be permitted to participate in the Program without a satisfactory CORI check. The School shall also notify each Participant that a CORI check will be performed and that the Participant's participation in the Program is contingent on the outcome of the CORI check. The School shall comply with all requirements relating to dissemination of information related to the CORI check. CORI checks and disqualification decisions must be made at least 10 business days prior to the date on which the Participant is scheduled to begin. The School may comply with these CORI obligations independently, or it may request that APG conduct CORI checks and disqualify Participants as appropriate on the School's behalf, at a cost to the School. If the School opts to perform the CORI checks and make determinations regarding disqualification independently, the School will represent and warrant that it has performed a CORI check for each Participant and disqualified ineligible Participants consistent with EOHHS and DMH guidelines, and will provide documentation of these facts upon request. If the School delegates its CORI obligations to APG, APG will initiate checks only after it has received a release from the School for each Participant and all decisions by APG shall be final.

Affinity Health Group, LLC Monroe, Louisiana

AHS Hillcrest Healthcare System, LLC (Includes the following sites: Bailey Medical Center, Hillcrest Hospital Claremore, Hillcrest Hospital Cushing, Hillcrest Hospital

Undergraduate and Graduate Students

MSN, DNP

See Exhibit A for covered facilities. See Exhibit C for Background Requirements. Student must complete and sign Exhibit D.

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