As of May 8, 2018

Policies are listed in alphabetical order regardless of policy number; revision date is indicated after the title.  

  Introduction HPH-100 (Rev 10/13/16)
  Annual Report-Hospice Program Evaluation HPH-102 (Rev 10/13/16)
  Attendance HPH-103  (Rev 10/13/16)

  Budget Process HPH-101 (Rev 10/13/16)

  Bulletin Boards HPH-106 (Rev 10/13/16)

  Compensation HPH-109 (Rev 10/13/16)
  Competency of Hospice Care Providers HPH-110 (Rev 10/13/16)

  Compliance Program HPH-111  (Rev 10/13/16)

     Form- Compliance Reporting (Rev08/14) 

  Computer Use and Information Technologies HPH112 (Rev 03/21/17)

     FormComputer Use Policy Agreement (Rev 10/16)
    Form - Email Communication Premission (New 1/12)

  Computers – Laptops and Other Portable Devices HPH-156 (Rev 03/21/17)

     Form - Laptop Computer Use Agreement (Rev 10/16)

  Conflict of Interest HPH-147 (Rev 10/13/16)

    Form - Annual Conflict of Interest Statement (Rev 01/18)

    Form - Disclosure of Conflict of Interest (Rev 03/15)

  Criminal Background Checks HPH-159 (Rev 03/21/17)

     Form - Background Check Memo (Rev 03/18)
     Form - Background Check Permission (Rev 03/18)
     Form - Correction Law Article 23-A

 Development and Fundraising HPH-148 (Rev 10/13/16)

     Form - Release Form (R03/15)

  Disability HPH-113 (Rev 10/13/16)

  Disciplinary Procedures HPH-114  (Rev 10/13/16)

     FormDisciplinary Counseling (Rev 03/15)

  Dress Code HPH-115 (Rev 10/13/16)

  Education Programs for Staff HPH-124 (Rev 10/13/16)

     Form - Inservice sign in sheet (Rev 9/11)

    Form - Copyright Agreement for Suncoast (R0112)

  Electronic Signatures AD.E30 (New 1/25/12) Moved to Clinical Policies

  Employee Benefits HPH-116  (Rev 10/13/16)

     Form: Pre-Tax Premium Plan Enrollment Decline Form (Rev 05/15)

 Employee Problem Review- Grievance Process (Rev 10/13/16)

      Form - Employee Concern Problem Review (Rev 02/17)

  Employment Reference HPH-120  (Rev 10/13/16)

  Fax Policy HPH-122 (Rev 10/13/16)

      Form: Fax Cover Sheet (Rev 05/18)

     Form:  Fax  Internal Cover Sheet (Rev 05/18)

   Financial – Check Writing Limitation HPH-149  (Rev 10/13/16)
  Gift Acceptance HPH-151 (Rev 10/13/16)
  Gratuities HPH-161 (Rev 10/13/16)
  Health Commerce System (HCS) HPH160 (Rev 05/08/18)

  Health Rquirements for Staff HPH117 (Rev 05/08/18)

     Form - Annual Health Reassessment (R01/18)
     Form - Flu Vaccine Release (R08/14)
     Form - Flu Vaccine Waiver (R08/14)
     Form - Hepatitis B Vaccine Consent (R04/15)
     Form - Hepatitis B Vaccine Decline (R04/15)

     Form - Incident Report Employee/Volunteer (Rev 07/18)

     Form - Initial Employee/Volunteer Physical (New 07/18)

  Hiring Practices HPH-123  (Rev 05/08/18) 

Contact the Administrative Office for these forms

   Form - Application for Employment (Rev 08/16) (For Interviews Only) 
   Form - New Employee 30 Day Checklist (Rev 4/12)
   Form - Orientation Plan General All Employees (Rev 08/16)
   Form - Reference Check (U04/12)
   Form - Survey for Orientation 90 Day HPH123 (R0412)

  Insurance for Transport of Patients HPH-146 (Rev 10/13/16)
   Job Descriptions HPH-163 (Rev 10/13/16)
   Job Posting HPH-125 (Rev 10/13/16)
   Jury Duty HPH-126  (Rev 10/13/16) added to Leave, Holiday, and Other Absences HPH 132 05/08/18

  Leave, Holiday, and Other Absences HPH-132 (Rev 05/08/18)

     Form - Bereavement Leave Request (R03/16)
     Form - Leave Donation Form (R03/12)
     Form -  Leave Request (R03/16)

     Form - Year End Paid Leave Carry Over Request (R03/16)

  Marketing Materials  HPH-129 (Rev 05/08/18)

      FormRelease Form (R03/15)

  Performance Evaluation HPH-133 (Rev 05/08/18)

  Personnel File HPH-118 (Rev 05/08/18)

     Form - Emergency Contact Information (Rev 5/15)

     Form - Personnel File Requirements (Rev 05/16)

  Policies: Review and Approval HPH 136 (Revised 05/08/18)

   Form: Clinical Policy Review by IDT Sign In Sheet (Rev 03/16)

  Productive Work Environment HPH-121 (Rev 10/13/16)

  Quality Assessment and Performance Improvement Program (QAPI) HPH-157 (Rev 10/13/16)

Form: Patient Satisfaction Questionaire 2 and 8 Week (Rev 01/2018)  

  Receipt of Income HPH-107 (Rev 10/13/16)

  Records Retention HPH-150  (Rev 03/21/17)

   Attachment: Records Retention Reference List (Rev 10/13/16)

  Reimbursements HPH-130 (Rev 10/13/16)

     Form - Mileage/Activity Log  (Rev 08/01/16)  USE T-SHEETS after 1 July 2018
    Form - Check Request (Rev 08/16)

  Sexual Abuse HPH-137  (Rev 10/13/16)

  Smoking HPH-138 (Rev 10/13/16)

  Social Media:Ethical Use HPH-155 (Rev 10/13/16) 

  Staff Requests to be Excluded from Patient Care HPH-139 (Rev 10/13/16)
  Staffing Management HPH-140  (Rev 10/13/16)

  Standards of Conduct HPH-141(Rev 05/08/18)

     Form - Mission Statement Ethics Code (U0412)

  Termination of Employment HPH-142 (Rev 10/13/16)

    Form - Exit Processing Checklist (R04/12)

   Timekeeping Records and Pay Process HPH-143 (Rev 05/08/18)

     Form - Timesheet (USE T-SHEETS)

  Vehicle Use - Company Owned HPH-153 (Rev 10/13/16)

     Form - Vehicle Use Agreement (New 11/11)

  Verbal/Non-Verbal Abuse and Sexual Harassment HPH-144 (Rev10/13/16)

   Volunteers HPH-145  (Rev 10/13/16)

     Form - Volunteer Activity Log (Rev 04/16)
     Form - Volunteer Documentation (Rev0212)
     Form - Volunteer File Requirements (R05/16)
     Form - Volunteer Application (R0212)
     Form - Volunteer Narrative Patient Visit (Rev 04/16)

   Whistleblower HPH158 (Rev 10/13/16)