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					 New Employee
Orientation Manual




Restoring Quality of Life Through Rehabilitation




                                                   1
          Welcome to
Therapy Management Corporation

 Welcome to Therapy Management Corporation. We are
 happy that you have joined our staff. You have been
 carefully selected to join our dynamic organization and
 we very much want you to succeed.

 We have always emphasized that outstanding people
 are the key to our success. Through the efforts of our
 people, Therapy Management Corporation has become
 a leader in the therapy marketplace.          To ensure
 continued success, we feel it is important that all
 employees understand our policies and procedures.
 This orientation manual will familiarize you with various
 aspects of the company. We encourage you to use it as
 a valuable resource.

 At Therapy Management Corporation, we feel an open
 line of communication is essential for everyone’s
 success. If you have any questions, comments or
 concerns we invite you to speak with your supervisor or
 a member of Human Resources.

 Thank you for joining our team. We hope that you find
 this to be the first step in a challenging and rewarding
 career with our company.

 Welcome Aboard,
 Dreama Waldrop
 President




                                                             2
        Orientation Manual
      Purpose and Disclaimer


As part of the orientation process all new employees
are given a copy of the Therapy Management
Corporation Employee Orientation Manual, which
includes some of our Policies and Procedures. This
manual is designed to prepare you for a long and
rewarding career with Therapy Management
Corporation. This serves as a guide and career
resource for new employees to better understand the
company’s policies and procedures as well as the
company’s expectation of you as a team member. It
also provides an overview of the essential benefits
available to you, which we consider a very important
part of your total compensation package.

The Orientation Manual is intended to be an
overview of the company’s policies and benefits and
is not a contract, expressed or implied.        The
employment relationship is employment at will and
does not guarantee employment for any specific
duration.    Because we operate in a dynamic
industry, policies and procedures are subject to
review and may be changed any time at the
discretion of management. We will attempt to give
you written notification of any changes in policies
and procedures in a timely manner.

We want you to know that you are a valuable part of
our organization. Your ideas, cooperation, interest
and commitment that you have in your work will help
Therapy Management Corporation meet the
challenges and opportunities of today and tomorrow.

                                                       3
        Employee Relations
           Philosophy

We recognize that outstanding people are the key
to our success and we strive for a satisfied
workforce. Through the efforts of our people we’ve
become a leader in the Therapy Marketplace. To
ensure continued success it is important that all
our employees understand our policies and
procedures.

We are committed to providing our employees with
fair, competitive wages and benefits in a workplace
that is diverse, productive, professional and
customer focused. We operate all our facilities with
the health and safety of our employees and
patients in mind.

We recognize the need to comply with all laws and
regulations. We believe the fulfillment of this
positive employee relations philosophy creates an
environment of mutual respect and cooperation,
which allows us to achieve the objectives and
successes we all seek.




                                                       4
  Mission Statement
TMC’s Mission Statement is derived from the
Hedge Hog Concept as outlined in Jim Collins’
book “Good to Great.” TMC will strive to be
the best therapy arena throughout the Southern
states. We will be the best at customer service
for our clients, providing the best working
environment for our employees and ultimately
making a difference in the lives of everyone we
come in contact with. We will be the provider of
choice for the entire Southern states and the
employer of choice for contract and outpatient
therapy. We strive for excellence in customer
service and will not settle for less. We will build
our success on integrity, ethics and an
environment of innovation.

         Core Values
                    Respect
                    Integrity
                  Compassion
                   Innovation
              Fiscal Responsibility
                     Quality

                                                      5
         Hedge Hog Council


Each quarter the Hedge Hog Council meets to
discuss TMC’s journey from “Good to Great” and
the brutal facts facing our employees. The Hedge
Hog Council consists of representatives from all
disciplines and all states. To participate contact
your Hedge Hog representative with suggestions.




 An email is available for employees to use at any
                        time.
           hedgehog@therapymgmt.com



                                                     6
              HEDGEHOG COUNCIL MEMBERS
            (in alphabetical order by Last Name)
    Name         Location         Work #        Disc.              Email

Holli           Home Office     352-382-1141   OT        hbenthusen@therapymgmt.com
Benthusen

Trisha Bryant   Texas City,     409-949-9151   OT        tbryant@therapymgmt.com
                TX

Barry Denham    Home Office     352-382-1141   Finance   bdenham@therapymgmt.com


Shona Gann      Green Oaks,     903-675-1673   PTA       sgann@therapymgmt.com
                TX

Maggie Gierak   Sugarmill FL    352-382-7214   Billing   mtelekesi@therapymgmt.com



Betty Hampton   Flannery        225-274-3802   COTA      fbhampton@therapymgmt.com
                Oaks, LA

David           Mississippi –   601-788-2332   PTA       dharvison@tristarrehab.com
Harvison        PE

Lee Jacobson    Dunnellon,      352-465-5880   PT        ljacobson@therapymgmt.com
                FL

Jen             Lady Lake,      352-347-8877   PTA       jmarcinkiewicz@therapymgmt.c
Marcinkiewicz   FL                                       om


Michele         Home Office     352-382-1141   HR        mprzepasniak@therapymgmt.com
Przepasniak

Meagan Stone    Blountstown     850-674-1223   PT        mstone@therapymgmt.com
                FL

Dreama          Home Office     352-382-1141   PT        dwaldrop@therapymgmt.com
Waldrop
                                                                                   7
          CODE OF ETHICS

     The Therapy Management Corporation Code of
     Ethics is a public statement of the expected
     behaviors of our employees based on the value
     and principles we promote in our company.

Principles:

•    Conduct ourselves in a professional manner.
•    Respect the rights and dignity of all individuals
     we come in contact with.
•    Provide service in an equitable manner.
•    Comply with laws, rules, and regulations
     governing our services.



Commitment to Excellence


We are committed to a standard of excellence in
the quality of care that is provided to patients, and
in the quality of work expected of our employees.



                                                         8
  Introducing Our Family of
    Healthcare Companies!

           THERAPY MANAGEMENT
               CORPORATION




    TLC
                        AllIn One CompCare
   REHAB




QUALITY CARE
                         TRISTAR REHAB
   REHAB




                                             9
Our Diverse Worksites
            Florida
  31 Sites throughout the state
         Louisiana
  36 Sites throughout the state
        Mississippi
  18 Sites throughout the state
           Texas
  24 Sites throughout the state
       And growing!


                                  10
               Who’s Who
   Mark Waldrop - Owner
        Mark was a nursing home administrator and COO of
         55 nursing homes before his involvement with the
         TMC family of healthcare

   Dreama Waldrop - Owner
        Dreama has 20 + years experience as a licensed
         Physical Therapist. She has been an owner/manager
         for the last 18 years and has placed great focus on
         Regulatory Compliance


   Holli Benthusen – VP Clinical Education
   Barry Denham – VP Financial Services
   Nick Samarkos – VP Administration
   Sangita Lewis – VP Marketing/New Development
   VP Operations – Tristar, QCR
   Kent Edwards – Director of Clinical Services- TLC
   Michele Przepasniak – Director of HR
   Mike Fletcher – Director of Recruiting
   Brian McAuley - Director of IT




                                                            11
        Regional Directors
                    Tristar:
Mississippi       Louisiana            Texas
Joel Wright    Tiffany Victoriano      Billy Holmes
Lesa McCormick


                     QCR:
Florida           Texas
Danielle Pouti    Sr. - Billy Holmes




                 Regional Directors



                  Area Managers



                  Rehab Directors

                                                      12
      Human Resources
          Payroll/Benefits
         Michele Przepasniak, PHR                  Teana Williams
        Director of Human Resources             Payroll Administrator
           (352) 382-1141 ext. 113            (352) 382-1141 ext. 110
             (352) 382-8024 fax                  (352) 382-1161 fax




  Laura Garbiras           Arlene Pugner               Heather Lohrey
Human Resources Rep     Human Resources Rep              HR Coordinator
      (MS, LA)                (FL, TX)               Benefits, HR Orientation,
                                                        Safety, W/C
(352) 382-1141 x124     (352) 382-1141 x125           (352) 382-1141 x122
 (352) 382-1161 fax      (352) 382-1161 fax            (352) 382-1161 fax




                                                                                 13
Company Policies
   Equal Opportunity Employer
   Open Door
   Harassment & Offensive Behavior
   Introductory Period
   Credential & Licensure
   Pay Periods/Time Sheet Protocol
   Benefits
   PTO
   Holiday
   Employee Referral
   CEU
   Expense Reporting
   Attendance
   Leave of Absences
   Personnel Files
   Emergency Conditions
   Dress Code – Clinical Staff
   Dress Code – Business Staff
   Smoking
   Alcohol and Drug Free Work Environment
   Personal Calls, Cell Phones, Electronic Devices
   Electronic Communication policy
   Visitors
   Resident/Patient Relations
   Safety
   Performance
   Progressive Discipline
   Resignation
   HIPAA
   OSHA
   Corporate Compliance
   Policies and procedures are subject to review and may change anytime at the discretion of
    management.



                                                                                                14
    EEOC STATEMENT
Equal Employment Opportunity has been,
and will continue to be, a fundamental
principle at Therapy Management
Corporation where employment is based
upon personal capabilities and qualifications
without discrimination because of race,
color, religion, sex, age, national origin,
disability, or any other protected
characteristic as established by law.




This policy applies to all policies and
procedures relating to recruitment and
hiring, compensation, benefits, termination,
training, transfer, promotion, educational
assistance and all other terms and
conditions of employment.



                                                15
     Open Door Policy
     and Suggestions
TMC, Inc. promotes an atmosphere whereby employees
can talk freely with members of the management staff.
Employees are encouraged to openly discuss with their
supervisor any problems so that appropriate action may be
taken. Managers and supervisors are expected to listen to
employee concerns, to encourage their input and to seek
resolution to their problems/issues. If the supervisor cannot
be of assistance, Human Resources is available for
consultation and guidance. TMC, Inc. is interested in all of
our employees’ success and happiness with us. We,
therefore, welcome the opportunity to help employees
whenever possible.

If you have any suggestions or ideas that you feel would
benefit TMC, Inc., we would encourage you to tell us about
them. We are always looking for suggestions that improve
methods, procedures and working conditions, reduce costs
or errors, and benefit TMC, Inc. and it’s employees.




                                                            16
            NON-DISCRIMINATION &
         ANTI-HARASSMENT POLICY


   TMC is committed to a work environment in which all
   employees are treated with respect and dignity.
   Each person has the right to work in a professional
   atmosphere that promotes equal employment
   opportunities and prohibits discriminatory practices,
   including harassment. TMC expects all relationships
   among persons in the workplace will be business-like
   and free of bias, prejudice, and harassment.




                Reporting an Incident


TMC strongly urges the reporting of all incidents of
discrimination, harassment or retaliation, regardless of the
offender’s identity or position. If you have any questions
or concerns please contact the Director of Human
Resources.

                                                         17
      Introductory Period
   All employees are hired on a 90 calendar
    day introductory period.

   During this time, the new employee will
    be provided with training and guidance
    from his/her supervisor.

   Under appropriate circumstances, the
    introductory period may be extended.

   At the end of the introductory period, the
    employee and his/her supervisor may
    discuss his/her performance and provide
    an informal work performance review.

   Provided job performance is “satisfactory”
    at the end of the introductory period the
    employee will continue in our
    employment as an at-will employee.

                                              18
Credential & Licensure
     Verification
For all staff requiring credentials,
employment is contingent upon providing
proof of professional license, registration
or diploma for their personnel file.

Staff members are responsible for
keeping their license and/or certification
renewed and in good standing. A dated
copy must be provided for the personnel
file.




                                             19
       Payroll Periods
         EZ Labor
          Protocol
Pay periods are two week periods from
Sunday to Saturday. Pay day is on
Friday following the end of the pay
period. A payroll schedule is attached
for your convenience.

Each employee is responsible for
accurately recording his or her timesheet
on a daily basis. Employees cannot
clock another employee in or out.

Falsification is grounds for immediate
termination.




                                        20
         Direct Deposit
All employees are eligible for direct deposit.




 Direct Deposit Forms are provided by the
                  HR Dept.


It may take up to 20 days for direct deposit
                to be in effect.

You have the option to designate funds to
  be deposited into 2 separate accounts
          and an HSA if eligible.


                                            21
  2008 Benefits



The company offers a variety
 of benefits for full time and
 part time employees. The
following is a short summary
        of the benefits.

Benefits are subject to review
    and may be revised,
suspended or eliminated due
   to business needs or
changing legal requirements.

                                 22
          Benefit Overview
         For Full Time Employees – 32+ hours/wk.

Eligibility: 1st of the month, after 30 days of employment

   Medical: BCBS

   Dental: Guardian

   Group Life Insurance: Sunlife
        Company paid basic life = 1 x salary or a minimum of $25,000
        Voluntary life for employee, spouse, and child

   Travel Assistance Program: Sunlife
        Company paid

   Voluntary Short Term Disability: Sunlife

   Voluntary Long Term Disability: Sunlife

   Voluntary Vision: Advantica

   Flexible Spending Account (FSA): Flexible Corporate
    Plans (Medical FSA & Dependant FSA available)

   EAP Program: Compsych
        Company paid

   Indemnity Plans such as Hospitalization, Cancer,
    Accident, etc: AFLAC
                                                                        23
 Employee Assistance
      Program
Free for all full-time
employee and
their dependents


       24 hour, 7 day a week assistance

       Confidential telephone consultations

       Advice and referrals

       Face to Face consultations
       – up to five in-person sessions available

       Educational resources
       Online resources
       Free online will preparation
       Financial calculators
       Retirement Planning
       Legal Matters
       Parenting & Child Care
       Emotional Well Being
                                                   24
                               Additional
                                Benefits
            For Full Time Employees – 32+ hours/wk.

401K
        Eligible to participate after 6 months of employment
        Company matches 33 cents on the dollar of employee contributions, up to 9% of the
        deferred amount
        Vesting Schedule

                  1 year of service          0%
                   2 years of service        25%
                   3 years of service        50%
                   4 years of service        75%
                   5 years of service       100%

Paid Time Off
        Per PTO Policy

        6 Paid Holidays (8 hours of pay)



Continuing Education
       For Clinical Employees Only

       Up to $1,000 per year for CEU purposes



Clinical Career Ladder Program (Per Policy)
       For Clinical Employees Only
       Optional Participation

Direct Deposit

Paid Bereavement Leave (Per Policy)

Mileage Reimbursement
       $.40 per mile



Workers Compensation
       Provided for all employees



Professional Liability Insurance

Employee Recognition Program: TEAM

Employee Discount Program: ticketsatwork.com




                                                                                             25
                  Company
                  Benefits
   For Part Time Employees – 20+ hours/wk.

Paid Time Off
       Per PTO Policy
       6 Paid Holidays (4 hours of pay)

Direct Deposit
Mileage Reimbursement
       $.40 per mile

Workers Compensation
       Provided for all employees

Employee Recognition Program

Employee Discount Program

Clinical Career Ladder Program
    •Per Policy
    •For Clinical Employees Only
    •Optional Participation



Professional Liability Insurance
       Provided for all clinical



                                             26
            Paid Time Off
Full-time & part-time employees start accruing PTO hours
immediately and are eligible to use PTO after they
successfully meet their 90-day introductory period.



Schedule of PTO Benefits
Full-time      0 -5 years       4 hr per pay    104 hrs per
                                period          calendar year



Part-time      Consistently     1.539 hrs per   Based on hours
               work 20 or       pay period      worked.
               more hours per
               week.




 Carry Over

 A maximum of 56 PTO hours can be carried over to
 the next calendar year full-time and a maximum of 20
 hours for part-time employees. Employees must
 designate PTO hours in excess of 56 hours into one of
 the following 3 options: Cash-out, Extended Illness
 Bank, or Group Benefit (COBRA) Retirement Account.

                                                                27
     PTO Carry Over Accounts
1.   Option 1: Cash-out

       Employees that elect the cash-out option may cash-out PTO hours in
       excess of the carry over maximum according to the following criteria:

     Years of Service at the Time           % of Benefit to be Cashed
              of Rollover                              Out
             0 thru 3 years                              25 %
             4 thru 6 years                              50 %
             7 thru 9 years                              75 %
            10 year and over                            100 %


2.   Extended Illness Bank

     EIB hours will be available to assist in covering the employee’s medical
     leave if the illness qualifies under a TMC medical leave policy and can be
     accessed after the 5th consecutive absence due to the same illness and
     with supporting medical documentation.


3.   Group Benefit (COBRA) Retirement Account

     At the age of 55 or older the hours can convert into a dollar amount at
     their current rate of pay to be used only to extend benefit coverage in
     TMC group benefit plans while on retirement.




                                                                           28
           Paid Time Off
Termination of Employment

  Employees who voluntarily resign, provide the required
  proper notice, and have successfully completed their
  90-day introductory period will receive their unused
  portion of PTO paid out to them in their final paycheck.

To Schedule PTO

  Employees are to schedule planned time off 30 days in
  advance by submitting a PTO request Form. Approval
  of PTO will be based on patient caseload and staffing
  needs as determined by their manager.




                                                         29
Time Off Request Form

       INSERT




                    30
              Holidays
Full-time employees, outside the 90-day
introductory period, are eligible for 8 hours of
holiday pay. Part-time employees, that work 20 to
31 hours per week, outside the 90-day
introductory period, are eligible for 4 hours of
holiday pay.


News Year’s Day                Memorial Day

July 4                         Labor Day

Thanksgiving Day               Christmas Day


Employees who do not work the day before, or
the day after the holiday, without prior approval,
will not be paid for the holiday.




                                                     31
     Employee Referral


The Employee Referral Program is designed to reward
our employees for referring qualified therapists. Refer
to policy for specifics.

Follow Employee Referral Procedures by submitting
candidates information prior to any Recruiter contact.



 Full-time positions                 $1500
 Part-time positions                 $750


After successful completion of 90 days of employment,
the referring employee will receive the first half of the
bonus.

After successful completion of 6 months of
employment, the referring employee will receive the
second half of the bonus.

*TMC has the right to change referral bonus criteria at
any time.


                                                          32
       Clinical Education
          Department
  As part of our mission to advance the professions of
  physical, occupational and speech therapy, the
  department participates in clinical education of students
  throughout the year and is an integral part in the clinical
  training of staff therapist. The Education Department is
  to provide a vehicle for increasing and improving
  communication among clinicians.

Department objectives:
      To increase the participation of clinical educators in the
       education session (we have a program to teach clinicians
       how to be clinical instructors and how to teach students
       for field work.
      To provide continuing education in area pertinent to
       clinicians.
      To provide training regarding documentation via live
       meetings and clinical documentation audits.
      To serve as resource involved in acquiring and
       disseminating information relating to changing trends in
       Medicare and other therapy related fields.




             The division consists of Clinical
         Documentation Consultants or (CDC’s)
          who visit the sites on a set rotation to
         review documentation and to serve as a
                  resource for all staff.
                                                               33
              TMC
Clinical Documentation
           Consultants
Director of Clinical Education/Training
   - Leslie Welch
        - Louisiana / Florida SNFs / TLC

Clinical Documentation Consultant
   - Rhonda Regouffre
        - Louisiana/ Florida SNFs / TLC

Clinical Documentation Consultant
   - Karen Fulton
        - Mississippi / FL SNFs / TLC

Clinical Documentation Consultant
   - Erin Wallace
         - Texas




                                           34
      Continuing Education
            Benefits
                For Licensed Clinical Staff
    Full-time eligible employees are eligible to accrue up to
     $1,000 per calendar year, which may be used for course
     tuition and travel.

    CEU benefits are accrued at a rate of $38.46 per pay period
     based on a 40 hour work week.

    3 additional PTO days are awarded to attend continue
     education courses that fall within an employees normal
     working hours.

    Courses must be relevant to an employee's current or
     expected job path.

    A minimum grade of a “B” must be maintained.


Required Procedures for Reimbursement:

1.   Education Request Form prior to course.

2.   Course Critique Form after course completion.

3.   Electronic expense report with receipts after course
     completion.




                                                                 35
Expense Reporting




                    36
Clinical Career Ladder
       Program
   Definition:

    A clinical career ladder will provide an avenue for
     recognition and additional compensation for the
      therapists that strive to give the extra effort to
      improve programming, education, and overall
         improved quality of care to our patients.


   Why Participate:

       Attainment of personal and professional goals.
       Develop hidden potentials and unrealized
        opportunities.
       Intended to “push” you personally and
        professionally.
       Enhance your earning.
       Leadership development.



                                                      37
 Clinical Career Ladder
        Program
Implementation:
      The ladder will be administered within each
       calendar year.

      The therapist decides whether to participate and at
       which level each year.

      Documentation is gathered during the current year
       and the differential is paid the following year.

      Levels are determined by the therapist based on
       their desired level of participation.

      Criteria is set for Clinical Levels 1, 2, & 3.

      Mandatory criteria is established for each level.

      A certain number of optional criteria must be met
       depending on the level the therapist is trying to
       obtain.




                                                           38
              CCL Mandatory
                Category
Mandatory Category       Level I        Level II      Level III


                       (Proficient)   (Advanced)      (Expert)

                         1040           1040           1664
1. Hrs Worked/Yr       (part time)    (part time)   (full time)

2. Organization                        State &       State &
     Memberships         State          National      National
3. In House In-
      Services              1              2             3
4. Community
     Service Hrs            4              6             8
5. Absence of DAP w/
     App Yr                 0              0             0


6. Meet Job              Meet           Meet         Meet
    Performance          Standards      Standards    Standards
 (DOCs, CDC score)
7. Years of
     Experience            1+             2+            3+
8. CEU                     20             25            30
                                                                  39
CCL Optional Category
  Optional Categories           1 Optional            2 Optionals             3 Optionals

1. Clinical Instructor          1 Student              2 Students           2 Students plus

                                                                             CI Certification


2. Specialty Certification   Beneficial to SNF     Beneficial to SNF        Beneficial to SNF


3. Attend Professional         1 x per year           1 x per year            1 x per year


Organization Conference

4. Presentation at RD
      Mtg                      1 x per year           2 x per year             3x per year

or present CEU course
      for TMC

                                                  Eval a research article
5. Research                     In-service                  and present        Participation in

                                                                                   clinical trial
                                                                                          /data


                                                                            collection -present
6. Participation in           In-service for
      School                       students      In-service for students      Teach a class

    related activities
      that support             1 x per year           2 x per year
       employee’s
        discipline


7. Employee Referrals          1 Employee             2 Employees             3 Employees

                                                                                    15 hr with
8. Committee                       9 hrs                 12 hrs                     leadership
                                                                               responsibilities

                                                                                          40
        CCL Hour Verification
    Criteria Categories that require hour verification:
        In-House in-services
        Community service
        Research in-service
        Participation in school related activities
        Committee hours


      Criteria Pre-Approval
 If a candidate has a question regarding the validity of
a presentation, in-service, specialty certification,
community hours, etc. as it applies to the
mandatory/optional criteria the “Criteria Pre-Approval”
form can be submitted to the designated state
committee person for approval.

This form is not mandatory however it is the
employee’s responsibility to get any courses/hours pre-
approved if there is any doubt of the validity as it
applies to the CCL program.

                                                           41
     Application Process
   The therapist will assemble evidence throughout
    the year as the criteria are met in a portfolio.

   The portfolio will be submitted to the supervisor by
    the pre-determined due date to be evaluated for
    completion.

   Approval of the application and promotion on the
    ladder is then awarded by a committee who will
    oversee the ladder.

   The differential will be paid based on the level
    obtained by the therapist.



          Pay Differentials
•Level 1 - $1/hour
•Level 2 - $2/hour
•Level 3 - $3/hour

•Differentials are to be paid in addition to the regular
salary for one calendar year.

•The employee’s annual increase will be calculated
on the base rate, not including the differential pay. 42
         Ladder Committee
             Members
   Billy Holmes (TX contact person)
        wholmes@therapymgmt.com
        Cell (318) 364-6741

   Tiffany Victoriano (LA contact person)
        tvictoriano@therapymgmt.com
        Cell (225) 229-3036

   Jackie Fagan (MS contact person)
        jfagan@therapymgmt.com
        Cell (601) 606-6531

   Kent Edwards (FL contact person)
        kedwards@tlcrehabinc.com
        Cell (352) 422-4825

   Committee members will be available to answer
    questions regarding candidate portfolios and the
    program via phone/email.




                                                       43
       Attendance Policy
TMC depends heavily upon its employees to provide quality and
    timely rehab services to our patients. It is important that
              employees attend work as scheduled.

   In the event an employee expects to be late or
    absent, they must notify his/her supervisor as far in
    advance as possible, but no later than one hour
    before his/her scheduled start time.

   An employee themselves should call to notify their
    immediate supervisor. A spouse or any other
    individual is not to call in for the employee.

   An employee will be allowed 3 occurrences of
    absences (including illness) an any annual period.
    On the fourth occurrence the employee will be
    subject to the progressive disciplinary policy.

   Employees who fail to contact his/her immediate
    supervisor may be considered as having voluntarily
    resigned or will be subject to the progressive
    disciplinary policy.



                                                              44
     Leave of Absence
TMC has many leave of absence policies available for
  its employees. Please see each policy to determine
                      eligibility.

 Personal Leave
 Family & Medical Leave
 Maternity
 Disability
 Military
 Jury & Witness Duty
 Bereavement Leave


    Those requiring a leave of absence
       should contact their immediate
    supervisor and the HR Department to
     discuss benefit continuation and to
            determine eligibility.

                                                  45
             Human
           Resources
         Personnel Files
The Human Resources Department is responsible for the
maintenance of employee records. Your personnel file
contains your personal information, emergency notifications,
performance appraisals, disciplinary actions.

Except where legally required, no information will be
released about you unless there is a signed authorization
from you. You may review the information contained in your
file at any time by contacting your supervisor. A mutual time
and date will be arranger through your supervisor and HR.

Your benefit information is contained in a separate medical
file. Since this information is used for benefit administration,
it is important that you inform Human Resources
immediately if you have any changes in your personal
information such as: name change, address change, marital
status, etc.

 Changes in personal information should be faxed into
  the HR department using the Personal Information
                   Update Form.




                                                               46
    Emergency Conditions
    In cases of extreme weather conditions, such as
        hurricane, flood, or tornado the management
         team may declare a weather emergency.

   Unless advised to the contrary, employees should
    make every reasonable effort to report to work on
    time.

   Those unable to report to work because of the
    extreme weather will not receive pay for the day,
    but has the option to:

        Use their PTO
        Take time without pay
        Receive prior approval from supervisor to
         make up lost time on the weekend, if it meets
         patient care needs. This is at
         the discretion of management.




                                                        47
Dress Code




             48
       Smoking Policy

 Smoking    is permitted only in
  designated area per host
  facility policy.

 Itis not permitted in the
  treatment area or within patient
  view.

 Questions  regarding the
  smoking policy should be direct
  to your supervisor or the HR
  Department.

                                    49
Use of Drugs & Alcohol

 TMC is a drug and alcohol free
 workplace.

 Employees   reporting for work
 who appear to be under the
 influence of alcohol or drugs
 will be subject to immediate
 discharge.




                                   50
     Telephone Use &
    Cellular Phone Policy
   Personal use of the telephone should be
    limited to emergencies and unusual
    circumstances.

   Personal calls should be brief and within
    the local calling area. Long distance calls
    are prohibited.

   Cell phones are to be turned off during
    working hours and are not permitted
    during the treatment day to assure quality
    patient care.

   Excessive personal calls during the
    workday or violation of the policy may
    result in disciplinary action up to and
    including termination.



                                              51
    Electronic
Communications Policy
   All electronic communication
 systems and technology, including
 but not limited to the list below are
 to be used for business purposes
                 only.

    Computers
    Hardware & software
    Voice mail
    Email
    Internet access

       Passwords are designed to be
          confidentially maintained.

                                       52
        Visitor Policy

 To ensure the safety of our
  employees and to ensure
  security of patient privacy
  employee visitors are
  discouraged during working
  hours.

 Ifa family member must visit
  an employee during a workday,
  the visitor must register with
  the front office staff and remain
  in the reception area.


                                 53
Patient Relations Policy

All patients should be treated as
  individuals with consideration,
    caring, respect, and dignity.
All forms of abuse is prohibited.

  All alleged violations of this
  policy will be investigated by
           management.




                                   54
      Be Safety
       Smart
It is the responsible of each employee to
conduct all tasks in a safe and efficient
manner complying will all local, state and
federal safety and health regulations.

It is the responsibility of each employee to
know the Emergency Plan for his/her work
area.

If an employee or a patient is involved in or
witnesses a safety or health infraction, he/she
must complete an Accident/Incident Report
within 24 hours of the occurrence and fax it to
352-382-1161 or 352-382-8024.




                                                  55
Accident Report




                  56
           Safety Committee
                  The safety committee includes equal
                 representation from management & non-
                         management personnel.

    Purpose
       Promote safety & health awareness &
        participation.
       Identify trends & patterns to formulate training
        material.
       Recommend improvements & corrective
        measures for workplace safety hazards.

                       Safety Committee Members

      Employee                 Location           Position
                                              Regional Training
       Nia Baker                  TLC              Coordinator
    Stephanie Breaux             TRI-LS             OT
      Jason Brown               QCR-BT             COTA
      Sally Cottrell            TLC-CR             RD, PT
                                             Director of Support
    Chris Della Torre          Home Office           Services

     Stephanie Dunn             TRI-BC               RT

      Julie Lafferty            TRI-TB            RD, COTA

     Heather Lohrey            Home Office    HR Coordinator

    Rhonda Regouffre              CDC               CDC
     Amy Rodriguez              TLC-BR              PTA
    Stephanie Troyer            QCR-BM               RT
                                                                   57
Performance Appraisal
   Performance appraisals provide a means
    for discussing, planning, and reviewing
    the performance of each employee.

   Newly hired employees may receive a
    performance review after 90 days. Formal
    documented appraisals are conducted
    annually.

   Performance appraisals do not always
    result in an automatic salary increase.
    The employee’s overall performance and
    salary level relative to the positions
    responsibilities are taken into
    consideration.




                                          58
Progressive Disciplinary
    Action System
     The primary objective of any disciplinary
     action shall be to improve performance
         and efficiency of the employee.

     The system includes all or part of the
                following steps:
   Oral warnings
   Written warnings
   Written notice or performance deficiencies
   Suspension
   Reduction in pay
   Demotion
   Discharge

    Some infractions are very serious and may result in
        immediate discharge. For example: abuse of a
      resident, falsification of documentation, no call, no
                            show, etc…




                                                              59
            Resignation
     We hope to retain good employees.
           Employment is at-will.

To be eligible for rehire an employee must
            provide proper notice.

                Proper notice:
     Positions requiring licensure and/or
        certification, and administrative
      management staff employed at the
     corporate office, are required to give 4
              weeks written notice.

   All other staff, such as Rehab Tech’s and
     office staff are required to give 2 weeks
                    written notice.


                                                60
        HIPAA
Health Insurance Portability
  and Accountability Act


   “ The companies of
  Therapy Management
     Corporation are
 committed and required
 by law to protect health
      information. ”



                               61
Use and Disclosure for
        PHI
The following categories describe reasons we
may use and disclose health information:
    •   For treatment
    •   For payment
    •   For health care operations
    •   To caregivers directly involved
    •   As required by law
    •   For public health activities
    •   Health oversight activities
    •   Judicial and administrative proceedings
    •   Law enforcement
    •   To avert a serious threat to health or safety
    •   Workers compensation




                   Authorizations
                   We require a patient to authorize
                   disclosure of PHI. Contact your
                   designated Manager.



                                                        62
           Patient Rights
   To access, inspect, and copy

   To amend

   To an accounting disclosure

   To request restrictions

   To request confidential communications

   To have a paper copy of privacy notice

   To file a complaint




                                             63
               REQUESTS
          FORMS                     What It Does
Authorization to Use and    Authorizing PHI disclosures.
Disclose PHI


Accounting Disclosure       Requests for accounting
Form                        information disclosure.
Authorization for Release   Request access to their
of Information Form         medical records and billing
                            records.


Amendment to Health         A patient who believes there
Information                 is an error in information in
                            their medical or billing
                            records.
Request for Restrictions    Requesting restrictions on
                            use and disclosure.


Request Confidential        Request for confidential
Handling of Information     handling of information.




                                                         64
     Office Role Directory
     Use minimum amount of information necessary.




DirectHealthcare                Access to full health information
Providers:                       with clear understanding that
                                 access & reading is limited to
    Physical Therapist
                                 need for treatment,
    Physical Therapy Assistant   reimbursement or operations.
    Occupational Therapist
    Occupational Therapist
    Assistant
    Speech and Language
    Pathologist
    Billing Staff
Technical   Staff:              Access to summary data with
    Rehab Tech                   clear understanding that access
                                 & reading is limited to need for
    Front Office Manager
                                 treatment, reimbursement or
                                 operations.




Observed violations of these rules should be reported to the
                   designated Manager.



                                                               65
     Privacy Complaints
   Our patients have the right to file
    complaints, have complaints
    investigated and, if appropriate,
    receive the disposition of the
    complaint.

   Under no circumstances will the
    fact that an individual has filed a
    complaint affect the services
    provided to the individual.

   File complaints within 180 days of
    when they became aware of the
    act, in writing.

                                          66
        HIPAA Recap

 Allpolicies are in your facilities
  operations manual.

 Allpatients will receive a
  “Notice of Privacy Practices”
  describing their rights.

 Ifyou have questions or are
  unsure what action to take
  please ask your designated
  Manager.


                                   67
    OSHA Compliance



 Abuse Prohibition
 Access to Exposure & Medical Records
 Bloodborne Pathogens
 Occupational Exposure to TB
 Control of Hazardous Energy “Lockout
  Tagout”
 Electrical Safety
 Fire Safety
 Hazard Communication
 Safe Patient Movement & Handling




                                         68
Abuse Prohibition
    *Abuse: the willful infliction of
 injury, unreasonable confinement,
   intimidation, or punishment with
     resulting harm, pain or mental
                anguish.

   *Neglect: Failure to provide
 goods and services necessary to
   avoid physical harm, mental
    anguish or mental illness.




                                        69
    Abuse Prohibition
*Involuntary seclusion: separation
   of patient from other patients outside
  her/his room or confinement to her/his
    room (with or without roommates)
  against the patient’s will, or the will of
   the customer’s legal representative.




  *Misappropriation of patient
      property: the deliberate
     misplacement, exploitation , or
  wrongful, temporary or permanent use
   of a patient’s belongings or money
      without the patient’s consent.

                                               70
        Hazard Communication

   Determine the hazards.

       2 Types: Physical and Health
         • Physical: chemicals that are flammable,
           reactive or corrosive.
         • Health: chemicals can poison you
           immediately or have long term damage.

              Avoid these hazards by:
   Labeling: must show the name of
    products, identify hazard warnings,
    name and address of the
    manufacturer.

   MSDS: include emergency phone
    #’s, list of hazardous ingredients
    and emergency and 1st aid
    procedures.

                                                     71
     Access to Exposure and
        Medical Records
You are permitted access to:

    exposure records of your past or present exposure to toxic
     and biohazardous substances, or other records that are
     related to your job and MSDS.

    and medical records containing your medical history,
     examination, test results.




    You may request to review or receive a copy of your

 exposure records by submitting a written request to the

      center location administrator through your Rehab

Director or Area Manager. A request should include your

    name, signature, date, and a general description of the

                 medical information desired.



                                                                  72
        Bloodborne Pathogens

You can be safe by employing simple and
  effective barriers against these disease.




   Bloodborne diseases include: Hepatitis B Virus
    (HBV), Hepatitis C Virus (HCV), HIV, and
    Syphilis.

       Hepatitis B: inflammation that can severely
        damage and lead to cirrhosis of the liver.
         • With prompt and proper treatment most cases can
           be treated successfully.
         • The Hepatitis B vaccine can help protect you from
           contracting HBV.

       Hepatitis C: inflammation of the liver which leads
        to chronic liver disease and death.
         • Currently no vaccines exists to prevent HCV
           infection, but with prompt and proper treatment,
           most cases can be treated successfully.


                                                               73
      Bloodborne Pathogens

   Human Immunodeficiency Virus: attacks
    the body’s immune system, causing the
    disease known as Acquired
    Immunodeficiency Syndrome (AIDS.)
     • Currently there is no vaccine to prevent the
       infection. A person can carry the virus
       without developing symptoms for several
       years, eventually develops AIDS. It is
       transmitted through contact with blood and
       some body fluids. It is not transmitted by
       touching, feeding or caring for customers
       who carry the disease.

   Workplace Transmission: HBV, HIV, and
    other pathogens may be present in blood
    and other materials like saliva, semen,
    vaginal secretions, cerebrospinal fluid,
    synovial fluid, pleural fluid, peritoneal fluid,
    pericardial fluid, and others.
     • HBV can survive on environmental surfaces,
       dried, at room temperature, for at least a
       week.
     • It can infect you by a cut on your skins,
       mucous membranes, or indirect transmission
       by touching contaminated surfaces and
       transferring to a cut or mucous membrane.


                                                       74
         Bloodborne Pathogens

   Exposure Control Plan: identifies the effective
    barriers that can minimize the risks in the
    workplace.

   Standard Precautions: outline a system of
    safeguards to barriers designed to protect you.
    These include: engineering controls, personal
    protective equipment, work practice controls,
    housekeeping and the Hepatitis B vaccine which
    must work together for a protective barrier against
    infection.

   Engineering Controls: the 1st protective barrier
    against contact with blood or other infectious
    materials. Eliminate hazards at their source with
    self-sheathing needles, retractable needles and
    lancets, IV access systems, and sharp disposal
    containers. But they must be used properly.




                                                      75
              Bloodborne Pathogens

   Personal Protective Equipment: protects you from
    contact with blood or other potentially infectious
    materials when worn properly. PPE includes:
    gloves, masks, gowns, aprons, lab coats, face
    shields, protective eyewear, mouth pieces an
    resuscitation bags.




        Gloves must be worn when you anticipate hand
         contact with blood, potentially infectious materials,
         mucous membranes, or non-intact skin. Make sure
         that gloves fit properly.

        Work practice controls are safety practices that
         decrease your risk of infection. Most are based on
         common sense and good hygiene.

        Hand washing keeps you from transferring
         contamination from your hands to other areas. Every
         time you remove your gloves, wash your hands or if
         you come in contact with blood or mucous
         membranes.




                                                                 76
    Bloodborne Pathogens

   Handling sharps: do not bend, recap, shear or
    break contaminated needles or other sharps.
    Do not point a used syringe toward any part of
    your body. Dispose of contaminated syringes
    immediately after use in an appropriate
    puncture-resistant an leak proof sharp
    container.

   Good housekeeping is everyone’s
    responsibility. Clean equipment and working
    surfaces ASAP. Never pick up contaminated
    broken glass with hands. Place contaminated
    sharps in Biohazardous waste containers.

   Hepatitis B Vaccination: since your job is at
    risk of exposure to HBV, the vaccination is
    available to you at no costs. You must
    complete a series of 3 shots within a 6 month
    period. It is 85 to 97% effective and prevents
    disease for at least 9 years.




                                               77
       Bloodborne Pathogens

 Post   Exposure:

     When accidents happen,
        immediately wash exposed skin
        with soap and water.
        flush exposed membranes with
        water.
        then report to your supervisor.
        If you consent, the employer will
        provide you with a confidential
        medical evaluation, blood test, post
        exposure preventive treatment and
        follow-up counseling.




                                           78
        Occupational Exposure to
             Tuberculosis


   TB is spread by tiny germs that
    float through the air when the
    person coughs, shouts, or sneezes.

       Live in the body without making you
        sick.
       You can get TB from someone’s
        clothes, drinking glass, handshake, or
        toilet.




   A skin test is the only way to tell if
    you have a TB infection.
                                             79
          Electronic Safety


 Electronic Hazards: burns,
  shock, fire, explosions, and
  equipment damage.

 Staffshould inspect all
  pieces of equipment before
  each use for a hazard such
  as broken or damaged
  plugs, frayed line cords,
  abnormal operation, or
  overheating.


                                 80
                    Fire Safety


   Controlling Fire Hazards
       Smoking: smoking is prohibited in all facilities,
        except in designated smoking area.
       Electricity: never use equipment that shows
        signs of being unsafe.
         • Keep paper products and linens away from all
           heat producing devices.
         • Keep all exit doors clear.
         • Know your evacuation plan.


   In case a fire starts:
       Act calmly. Your example can prevent
        dangerous confusion.
       Move patients who are in immediate danger
        from smoke and flames.
       If the fire is small and confined to the area
        where it started, use a portable fire
        extinguisher to fight it-but only after reporting
        the fire, and only if you know how to use the
        extinguisher.


                                                            81
Fire Procedures




                  82
             Corporate
            Compliance
Implementation of The Company’s commitment to legal and
ethical standards of business conduct must begin with each
employee. Accordingly, all employees are required to strictly
observe all applicable legal and regulatory requirements and
The Company’s Compliance Program, and are responsible in the
first instance for ensuring that their conduct conforms to such
standards. Adherence to the Compliance Program is a condition
of continued employment with the company and will be taken
into consideration in connection with periodic performance
reviews and other evaluations.
Each employee is responsible for reviewing the Compliance
Program. If you should have any questions or have the need to
report an incident, you should contact your supervisor or the
company compliance officer. Employees may report violations
anonymously if preferred. No employee will suffer retaliation or
embarrassment as a result of any report of suspected violation.


Compliance Officer
    Michele Przepasniak, Director of HR
    352-382-1141 ext. 113
    352-382-8024 (fax)
    mprzepasniak@therapymgmt.com

Mailing Address
    Corporate Compliance Committee
    Attn: Compliance Officer
    8477 S. Suncoast Blvd.
    Homosassa, FL 34446

                                                                   83
Compliance Review
 What is the purpose and objective of Corporate
Compliance?
    It is our objective to maintain the highest reputation for the
    integrity of the company and it’s employees.


 Who is responsible for ensuring compliance? Why?
    All employees are responsible for ensuring compliance. All
    employees are required to observe all legal and ethical regulatory
    requirements. Failure to report any illegal or unethical conduct by
    fellow employees may result in disciplinary action up to and
    including termination.


 How do I handle questionable situations?
    Do not immediately act on a questionable situation. You should
    immediately contact your Regional Director or the Compliance
    Officer and ask questions.


 How do I report a compliance issue?
    There are several avenues available to you to report compliance
    issues. You may contact your immediate supervisor, your Regional
    Director or the Compliance Officer directly via telephone, fax or US
    mail. All reports are held in the highest confidentiality, however, if
    you wish you may also report and issue anonymously via fax or US
    mail.


 Emergency Circumstances
    In the event that the issue or violation is due to fraud, abuse,
    accreditation, survey, licensing status, Medicare, Medicaid or Third
    Party issues the compliance committee will meet within 24 hours.



                                                                             84
          Conclusion

We are all responsible for creating a
professional, safe, customer focused work
environment which fosters teamwork. As a
high     performance,      service    oriented
organization we provide quality patient care in
a timely, cost effective manner. We recognize
we will be successful in creating this
environment through the efforts of all our
employees working together to achieve our
mutual goals and objectives.




                                                  85

				
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