Personnel File Audit Form (081109) - Home Rehabilitation Services
Personnel File Audit Form (081109) - Home Rehabilitation Services
Personnel File Audit Form (081109) - Home Rehabilitation Services
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<strong>Home</strong> <strong>Rehabilitation</strong> <strong>Services</strong> of Michigan<br />
<strong>Personnel</strong> <strong>File</strong> <strong>Audit</strong> <strong>Form</strong><br />
Employee: ___________________________________<br />
Status: __________<br />
Hire Date: __________________________<br />
<strong>File</strong> Prep<br />
New<br />
Hire<br />
Final<br />
<strong>Audit</strong><br />
90-Day<br />
<strong>Audit</strong><br />
To BHC<br />
Section 1: Offer Letter, <strong>Personnel</strong> Change <strong>Form</strong>s and Emergency Contacts<br />
Offer Letter<br />
<strong>Personnel</strong> Change <strong>Form</strong><br />
Emergency Contact <strong>Form</strong><br />
How did you hear about our company?<br />
Referral?<br />
Driver's License<br />
Auto Insurance<br />
Social Security card<br />
Work authorization (if applicable)<br />
Second Language<br />
Application for employment completed and signed<br />
including “Background Check Application <strong>Form</strong>.”<br />
Resume<br />
Fingerprint: Appointment scheduled<br />
Fingerprint: Appointment verification and receipt<br />
Fingerprint: Verification of eligibility for employment<br />
Fingerprint: Director notification<br />
Fingerprint: HRSM Training Coordinator notification<br />
Application for Conditional Employment<br />
“Agreement to Notify Employer of Arraignment or<br />
Conviction” form.<br />
Professional license/certification<br />
card/registration<br />
Section 2: Identification and Credentials<br />
Page 1 of 4 08-11-09
<strong>Home</strong> <strong>Rehabilitation</strong> <strong>Services</strong> of Michigan<br />
<strong>Personnel</strong> <strong>File</strong> <strong>Audit</strong> <strong>Form</strong><br />
SLP Certificate of Clinical Competence<br />
<strong>File</strong> Prep<br />
New<br />
Hire<br />
Final<br />
<strong>Audit</strong><br />
90-Day<br />
<strong>Audit</strong><br />
To BHC<br />
Diploma<br />
CPR Certification (Adult & Child)<br />
Reference check<br />
ICHAT Criminal Records Check<br />
OIG<br />
PSOR: Sex offender check<br />
Driver's Record Check<br />
On-line License Verification<br />
Section 3: Payroll and Benefits<br />
I 9<br />
MI W-4<br />
Federal W-4<br />
Direct deposit<br />
Badge: # assignment<br />
Badge: $10 replacement fee acknowledgment<br />
Badge: Photo Taken<br />
Badge: Photo sent to Premier<br />
Badge: Given to employee<br />
Medical Benefit/Vision Enrollment form<br />
Met Life Dental Enrollment form<br />
Life Insurance/STD Enrollment form<br />
Page 2 of 4 08-11-09
<strong>Home</strong> <strong>Rehabilitation</strong> <strong>Services</strong> of Michigan<br />
<strong>Personnel</strong> <strong>File</strong> <strong>Audit</strong> <strong>Form</strong><br />
<strong>File</strong> Prep<br />
New<br />
Hire<br />
Final<br />
<strong>Audit</strong><br />
90-Day<br />
<strong>Audit</strong><br />
To BHC<br />
Service Excellence: Date scheduled _____/_____/_____<br />
Current TB test/chest x-ray/ positive symptom<br />
review<br />
Hep. B vaccine: _____ Accept _____Decline<br />
Section 4: Company Requirements & Policies<br />
Hep. B Titer: _____ Accept<br />
_____Decline<br />
Flu Shot _____Accept<br />
_____Decline<br />
Job Description: Signed and dated<br />
Set-Up HRSM Website access<br />
Verify employee information in <strong>Home</strong>Works:<br />
demographic info. in HR Module, intials, Rolodex<br />
Add employee to HRSM group in <strong>Home</strong>Works<br />
Add employee BlackBerry number and GW email<br />
address to HR module in <strong>Home</strong>Works<br />
Criminal Records Consent <strong>Form</strong><br />
Acknowledgment of Disclosure of <strong>Personnel</strong> Information<br />
Photography Release <strong>Form</strong><br />
Section 5: Agreements and Release <strong>Form</strong>s<br />
HR Rep Preparing <strong>File</strong>:<br />
HR Rep Completing Orientation:<br />
HR Coordinator <strong>Audit</strong>ing <strong>Personnel</strong> <strong>File</strong>:<br />
HR Coordinator <strong>Audit</strong>ing HR Database:<br />
Date:<br />
Date:<br />
Date:<br />
Date:<br />
Page 3 of 4 08-11-09
<strong>Home</strong> <strong>Rehabilitation</strong> <strong>Services</strong> of Michigan<br />
<strong>Personnel</strong> <strong>File</strong> <strong>Audit</strong> <strong>Form</strong><br />
<strong>File</strong> Prep<br />
New<br />
Hire<br />
Final<br />
<strong>Audit</strong><br />
90-Day<br />
<strong>Audit</strong><br />
To BHC<br />
Section 6: Clinical Orientation<br />
On-Line Mandatories Transcript<br />
Service Excellence: Date of completion<br />
Service Excellence: Copy of certificate received/copy<br />
filed/original sent to employee<br />
Clinical Skills Checklist<br />
Written Skills Competency<br />
JCAHO Post-Test<br />
<strong>Home</strong>bound Status Scenario Review<br />
Falls Protocol Post-Test<br />
Infection Control Post-Test<br />
Safety & Security Sign-off<br />
BHC Organizational Improvement Sign-off<br />
Blackberry Agreement <strong>Form</strong><br />
Laptop Agreement <strong>Form</strong><br />
Acknowledgment of Receipt of <strong>Personnel</strong> Manual<br />
Section 7: Performance Reviews and Reports<br />
Field Evaluation<br />
Annual Performance Reviews<br />
Performance Corrections<br />
Adjusted Anniversary Date Memos<br />
Training Coordinator <strong>Audit</strong>:<br />
HR Coordinator <strong>Audit</strong>:<br />
Date:<br />
Date:<br />
Page 4 of 4 08-11-09
HRSM New Hire Training<br />
HRSM General Orientation<br />
Employee: ____________________________________________<br />
_____ HRSM Office Staff Introductions<br />
EVERYTHING ON THIS LIST MUST BE COMPLETED PRIOR<br />
TO EMPLOYEE GOING OUT INTO THE FIELD<br />
_____ Review of <strong>Personnel</strong> Policy Manual<br />
_____ BHC Addendums<br />
_____ Acknowledgement of Receipt<br />
_____ Acknowledgement of Sexual Harrassment Info<br />
_____ Acknowledgement of Receipt Policy Updates 04/09<br />
_____ CPR Policy and Procedure<br />
_____ Overall Image/Appearance/Guidelines<br />
_____ Review of Administrative Procedure Manual<br />
_____ Request for Time Off/Vacation form & policy<br />
_____ Vacation Coverage<br />
_____ Expense Report<br />
_____ Mileage Policy<br />
_____ Conference Request<br />
_____ Office Listing<br />
_____ Incident Report, Patient & Staff<br />
_____ Fire, disaster, and safety policy and procedure<br />
_____ Safety rules<br />
_____ Michigan Right-to-Know<br />
_____ Infection Control<br />
_____ Hand washing handouts<br />
_____ Supplies<br />
08/05/09
HRSM New Hire Training<br />
HRSM General Orientation<br />
_____ Hazardous chemicals<br />
_____ Cultural Diversity Handbook<br />
_____ Arabic-English Translations booklet<br />
_____ BHC Code of Business Conduct<br />
_____ Woe to Wow<br />
_____ BHC/HRSM Communication Process<br />
_____ R.A.R.E.<br />
_____ Beaumont Embraces Customer Service Standards<br />
_____ SOAR<br />
_____ BHC Pain Scale<br />
08/05/09
HRSM New Hire Training<br />
HRSM General Orientation<br />
BlackBerry<br />
_____ Cell Phone Agreement (Signed and Collected). This five (5) page document<br />
includes the following. Each sheet must be signed by employee.<br />
• Blackberry Equipment Agreement<br />
• Receipt of Blackberry Equipment<br />
• Policy on Use of Cell Phone while Driving<br />
• Cell Phone Usage in the Nursing <strong>Home</strong>s<br />
• E-HIPAA and Blackberry Use<br />
• Blackberry Personal Password Agreement<br />
_____ Voicemail<br />
_____ Customized Greeting<br />
_____ Password Set-up<br />
_____ Voicemail Messages<br />
_____ Accessing<br />
_____ Deleting<br />
_____ Demo Phone (See “Getting Started Guide”)<br />
_____ Icons<br />
_____ Review<br />
_____ Messages<br />
_____ Hot Sync<br />
_____ Phone<br />
_____ Address Book<br />
_____ Adding a Contact<br />
_____ Deleting a Contact<br />
_____ Editing a Contact<br />
_____ Profiles<br />
_____ Keyboard<br />
_____ Screensaver/Password<br />
_____ Security Timeout<br />
_____ Hide Sent Messages<br />
_____ Prompt Delete<br />
_____ Set-up Wizard: Display Info<br />
_____ Accessing MapQuest<br />
_____ HRSM Guidelines and Procedures<br />
_____Lost or stolen Blackberry Incident form & Communication Tree<br />
_____ Charging the Battery<br />
08/05/09
HRSM New Hire Training<br />
HRSM General Orientation<br />
_____ Scheduling<br />
_____ Scheduling Profile Entered in DB<br />
_____ Scheduling Database Set-up<br />
_____ Scheduling Procedures<br />
_____ Review new patient assign e-mail<br />
_____ Scheduling Back-up process (VZW)<br />
_____ Skills Checklist<br />
_____ Blood Pressure/Pulse competency<br />
_____ Reviewed & Assessed all Self-Study Sign-offs<br />
_____ Pathlores Transcript Printed & sent to HR<br />
08/05/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
THESE ITEMS MUST BE COMPLETED PRIOR TO EMPLOYEE<br />
GOING OUT INTO THE FIELD<br />
_____<br />
_____<br />
_____<br />
_____<br />
Review of Clinical Guidelines Manual*<br />
Job Description/Performance Expectations*<br />
Shadowing in field (1/2 day with another therapist)<br />
Pathlores Transcript (~3.5 hours)<br />
Self-Study Modules<br />
JCAHO _____ Post-test<br />
<strong>Home</strong>bound Status _____ Scenario Review<br />
Falls Protocol _____ Post-test<br />
Infection Control _____ Post-test<br />
Skills Competency _____ Post-test<br />
Safety & Security _____ Sign-Off<br />
BHC Organizational Improvement _____ Sign-Off<br />
Service Excellence Certificate to HR _____ Certificate<br />
_____ Ultrasound (OTs only)<br />
_____ TKA (PTs Only)<br />
_____ Oasis In-service (PT/OT/SLP)<br />
Date to be completed: ________<br />
Date to be completed: ________<br />
Date to be completed: ________<br />
Last updated 08/12/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
ROAD NOTES TRAINING<br />
Module 1:<br />
Laptop Basics<br />
_____ Laptop Do’s and Don’ts<br />
_____ Dell D400 Field Staff Manual<br />
_____ Laptop Basics<br />
_____ How to Copy and Paste Text<br />
_____ HRSM Synchronization Protocol<br />
_____ BHC Office Synching Sites<br />
_____ How to Synch Your Laptop<br />
_____ Tethering Laptop to Blackberry<br />
_____ How to Change Passwords<br />
_____ Lost/Stolen laptop protocol<br />
_____ Laptop Agreement<br />
_____ Laptop Receipt Agreement<br />
_____ Password Code Agreement<br />
_____ What to do when on vacation<br />
Last updated 08/12/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
Module 2:<br />
GroupWise<br />
_____ Logging in<br />
_____ Reading a message<br />
_____ Creating a message<br />
_____ Using address book<br />
_____ Replying to a message<br />
_____ Forwarding a message<br />
_____ Deleting a message<br />
_____ Emptying trash<br />
_____ Managing e-mail<br />
_____ E-mail etiquette<br />
_____ Retrieving via AT&T<br />
_____ Routine maintenance<br />
_____ <strong>File</strong> Cabinet<br />
_____ Text messages<br />
_____ Address Book Groups<br />
_____ Out of office – Set up<br />
_____ Out of office – Turn off<br />
_____ Editing a rule<br />
_____ Access via Internet<br />
_____ Use of GW Calendar<br />
Last updated 08/12/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
Module 3: Tree View Overview<br />
_____ Log into RoadNotes<br />
_____ Search for patient chart<br />
_____ Review of tree view<br />
Module 4: Before You See a Patient<br />
_____ Check-off: Before You See a Patient<br />
_____ Directions to Address for Care<br />
_____ Insurance authorization<br />
_____ Referral Profile<br />
_____ Visit Orders<br />
_____ Cert period<br />
_____ Patient Summary<br />
_____ PHI Restrictions<br />
Last updated 08/12/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
Module 6: Day to Day<br />
_____ Contacts: An Overview<br />
_____ Entering a Routine Visit Profile<br />
_____ Updating the Care Plan<br />
_____ Addendum<br />
_____ Non-Billable Visits<br />
_____ Memos<br />
_____ Fall Report<br />
_____ Refused Visit Protocol<br />
_____ Case Conference<br />
_____ Scheduling Module<br />
_____ Daily payroll tasks<br />
_____ Hospitalizations<br />
_____ PTA/COTA Supervision<br />
_____ Recertification Process<br />
_____ Discipline Specific Documentation Review<br />
Last updated 08/12/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
Module 7: Discharge<br />
_____ Check Off: Discharge<br />
_____ Planned versus Unplanned Discharges<br />
_____ Completing a Planned Discharge<br />
_____ Unplanned Discharge: Completing a Discipline Discharge Note<br />
_____ Discharge Oasis Survey<br />
_____ Discharging the Care Plan<br />
_____ Discipline Specific Documentation Review<br />
Module 8: Payroll<br />
_____ Payroll Orientation Overview<br />
_____ Pay Date Schedule<br />
_____ How to Enter Payroll Codes into the Scheduling Module<br />
_____ TOTA Time<br />
_____ How to Add a Reminder into the Scheduling Module<br />
Last updated 08/12/09
HRSM New Hire Training<br />
Clinical & RoadNotes Training<br />
Module 9:<br />
Resource Guide<br />
_____ BHC Contacts<br />
_____ Conference Call Schedule<br />
_____ HRSM On-Call Schedule<br />
_____ Interim Order fax sheet<br />
_____ BHC Drop-off Sites<br />
_____ CPR Resources<br />
_____ HRSM Web-Site instructions<br />
_____ RoadNotes Cheat Sheet<br />
_____ BHC Outpatient Therapy Locations<br />
_____ HRSM Therapy Supply Locations<br />
_____ DME Resources<br />
_____ Guardian Medical <strong>Services</strong><br />
_____ CSO Senior <strong>Services</strong><br />
_____ Communication Tool<br />
_____ BHC Care Management Resource Guide<br />
Module 10:<br />
Time Management<br />
_____ Tips & Tricks<br />
Quick Reference Tools<br />
Final Sign-off<br />
Employee: ______________________________________ Date: ____________<br />
HRSM Training Coord: ______________________________________ Date: ____________<br />
HRSM Training Coordinator Forward to HR Department<br />
Date: ____________<br />
Last updated 08/12/09
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