HIGH PEAKS HOSPICE

PERSONNEL POLICIES AND PROCEDURES

ALPHABETICAL INDEX
As of August 1, 2018

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

 

  Introduction HPH-100 (Upd 08/18)

      Form: Mission Statement Rev 11/18

  Annual Report-Hospice Program Evaluation HPH-102 (Upd 08/18)
  Attendance HPH-103  (Upd 08/18)

  Budget Process HPH-101 (Upd 08/18)

  Bulletin Boards HPH-106 (Upd 08/18)

  Compensation HPH-109 (Upd 08/18)

     Form - Change of Pay Rate or Bonus (Rev 07/18)

  Competency of Hospice Care Providers HPH-110 (Upd08/18)

  Compliance Program HPH-111  (Upd 08/18)

     Form- Compliance Reporting (Rev 07/18) 

  Computer Use and Information Technologies HPH112 (Upd 08/18)

     FormComputer Use Policy Agreement (Rev 07/18)

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

     Form - Laptop Computer Use Agreement (Rev 07/18)

  Conflicts of Interest HPH-147 (Upd 08/18)

    Form - Annual Conflict of Interest Statement (Rev 07/18)

    Form - Disclosure of Conflict of Interest (Rev 07/18)

  Criminal Background Checks HPH-159 (Upd 08/18)

     Form - Background Check Memo (Rev 07/18)
     Form - Background Check Permission (Rev 07/18)
     Form - Correction Law Article 23-A

 Development and Fundraising HPH-148 (Upd 08/18)

     Form - Release Form (Rev 07/18)

  Disability HPH-113 (Upd 08/18)

  Disciplinary Procedures HPH-114  (Upd 08/18)

  Disciplinary Procedures HPH-114 (Effective 11/01/2018)

     FormDisciplinary Counseling (Rev 07/18)

  Dress Code HPH-115 (Upd 08/18)

  Education Programs for Staff HPH-124 (Upd 10/18)

     Form - Mandatory In-Service for All Staff (Rev 10/18)

    Form - Sign In Sheet for In-Service (Rev 07/18)

    Form - Community Outreach In-Service Sign In Sheet (Rev 11/18)

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

   Employee Benefits HPH-116  (Upd 08/18)

     Form: Pre-Tax Premium Plan Enrollment Decline Form (Rev 07/18)

 Employee Problem Review- Grievance Process (Upd 08/18)

      FormEmployee Concern Problem Review (Rev 07/18)

  Employment Reference HPH-120  (Upd 08/18)

  Fax Policy HPH-122 (Upd 08/18)

      Form: Fax Cover Sheet (Rev 07/18)

     Form:  Fax  Internal Cover Sheet (Rev 07/18)

   Financial – Check Writing Limitation HPH-149  (Upd 08/18)
  Gift Acceptance HPH-151 (Upd 08/18)
  Gratuities HPH-161 (Upd 08/18)
  Health Commerce System (HCS) HPH160 (Upd 08/18)

  Health Rquirements for Staff HPH117 (Upd 08/18)

     Form - Annual Health Reassessment for Employee/Volunteer (Rev 10/18)
     Form - Flu Vaccine Release (Rev 07/18)
     Form - Flu Vaccine Waiver (Rev 07/18)
     Form - Hepatitis B Vaccine Consent (Rev 10/18)
     Form - Hepatitis B Vaccine Decline (Rev 07/18)

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

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

  Hiring Practices HPH-123  (Upd 08/18) 

  (See Administrative Office for Forms)

  Insurance for Transport of Patients HPH-146 (Upd 08/18)
   Job Descriptions HPH-163 (Upd 08/18)
   Job Posting HPH-125 (Upd 08/18)
   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 (Upd 08/18)

     Form - Bereavement Leave Request (Rev 07/18)
     Form - Leave Donation Form (Rev 07/18)
     Form -  Leave Request (Rev 07/18)

     Form - Year End Paid Leave Carry Over Request (Rev 07/18)

  Marketing Materials  HPH-129 (Upd 08/18)

      FormRelease Form (Rev 07/18)

  Performance Evaluation HPH-133 (Upd 08/18)

  Personnel File HPH-118 (Upd 08/18)

     Form - Emergency Contact Information (Rev 07/18)

     Form - Personnel File Requirements (Rev 07/18)

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

   Form: Clinical Policy Review by IDT Sign In Sheet (Rev 07/18)

  Productive Work Environment HPH-121 (Upd 08/18)

  Quality Assessment and Performance Improvement Program (QAPI) HPH-157 (Upd 08/18)

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

   Receipt of Income HPH-107 (Upd 08/18)

   Records Retention with Schedule HPH-150  (Upd 08/18)

  Reimbursements HPH-130 (Upd 08/18)

     Form - Mileage/Activity Log  (Rev 08/01/16)  USE T-SHEETS after 1 July 2018
    Form - Check Request Form (Rev 07/18)

  Sexual Abuse HPH-137  (Upd 08/18)

  Smoking HPH-138 (Upd 08/18)

   Social Media:Ethical Use HPH-155 (Upd 08/18)

  Staff Requests to be Excluded from Patient Care HPH-139 (Upd 08/18)
  Staffing Management HPH-140  (Upd 08/18)

  Standards of Conduct HPH-141(Upd 08/18)

     FormMission Statement Ethics Code (Rev 07/18)

  Termination of Employment HPH-142 (Upd 08/18)

     Termination of Employment HPH142 (Effective 11/01/18)

     Form - COBRA Continuation or Termination (Rev 07/18)

     Form - Consent to Release Information (Rev 07/18) 

    Form -  Exit Interview Quenstionnaire  (Rev 07/18)

    Form - Exit Processing Checklist (Rev 07/18)

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

     Form - Timesheet (USE T-SHEETS)

  Vehicle Use - Company Owned HPH-153 (Upd 08/18)

     Form - Vehicle Use Agreement (Rev 07/18)

  Verbal/Non-Verbal Abuse and Sexual Harassment HPH-144 (Upd 08/18)

   Volunteers HPH-145  (Upd 10/18)

     Form - Volunteer Activity Log (Rev 08/18)

     Form - Volunteer Application (Rev 07/18)

     Form - Volunteer Documentation (Rev 07/18) 

     Form - Volunteer File Requirements (Rev 11/18)  

     Form - Volunteer Job Descriptions (Rev 11/18)

     Form -  Volunteer Narrative Patient Visit (Rev 07/18)
     

    
    

   Whistleblower HPH158 (Upd 08/18)