PERSONNEL HANDBOOK
HANDBOOK NUMBER: ____________
Contents
MISSION STATEMENT ............................................................................................................... 4
INTRODUCTION .......................................................................................................................... 5
WHY YOU ARE HERE ................................................................................................................. 5
CONFIDENTIALITY..................................................................................................................... 6
FUNCTIONS OF THE MANUAL ................................................................................................. 6
Definitions in the manual: ........................................................................................................... 6
HIRING........................................................................................................................................... 7
I-9 STATEMENT ........................................................................................................................... 7
EMPLOYEE CLASSIFICATION .................................................................................................. 7
Full time: ..................................................................................................................................... 7
Part time: ..................................................................................................................................... 7
Temporary/Limited Part time: .................................................................................................... 7
Exempt Employee: ...................................................................................................................... 7
New Employee: ........................................................................................................................... 8
WORKING HOURS AND OFFICE HOURS ................................................................................ 8
MAKING UP LOST TIME ............................................................................................................ 8
WORK WEEK ................................................................................................................................ 9
OVERTIME WORK ....................................................................................................................... 9
TERMINATION OF EMPLOYMENT .......................................................................................... 9
PAY PRACTICES ........................................................................................................................ 10
PERFORMANCE REVIEW ........................................................................................................ 10
INTER-DIVISIONAL EMPLOYEE TRANSFERS .................................................................... 10
MILEAGE REIMBURSEMENT ................................................................................................. 10
PAID TIME OFF POLICY (PTO) ............................................................................................... 11
PTO CREDIT CALCULATION .............................................................................................. 11
TOTAL MAXIMUM ALLOWED CREDITS ......................................................................... 12
MISCELLANEOUS PAID TIME OFF CREDIT INFORMATION ....................................... 12
SCHEDULING PTO ................................................................................................................ 12
PTO CASH OUT ...................................................................................................................... 13
SHORT-TERM ABSENCES - SICK/PERSONAL TIME........................................................... 13
EXTENDED ILLNESS BANK (EIB) .......................................................................................... 14
CONTRIBUTING PTO, EIB OR SICK/PERSONAL TIME ...................................................... 14
HOLIDAYS .................................................................................................................................. 14
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ATTENDANCE/NO FAULT POLICY ....................................................................................... 15
HEALTH INSURANCE ............................................................................................................... 15
LIFE INSURANCE ...................................................................................................................... 15
DISABILITY INSURANCE ........................................................................................................ 15
RETIREMENT BENEFITS.......................................................................................................... 16
CIVIC RESPONSIBILITIES........................................................................................................ 16
BEREAVEMENT POLICY ......................................................................................................... 16
INCLEMENT WEATHER ........................................................................................................... 17
FMLA POLICY ............................................................................................................................ 18
MILITARY LEAVE POLICY ..................................................................................................... 20
BEHAVIOR OF EMPLOYEES ................................................................................................... 22
NO HARASSMENT POLICY ..................................................................................................... 22
WORKPLACE RELATIONSHIPS .............................................................................................. 22
PERSONAL APPEARANCE/UNIFORM POLICY .................................................................... 25
PERSONAL ACTIVITIES ........................................................................................................... 26
PERSONAL CALLS .................................................................................................................... 27
SOLICITATION ........................................................................................................................... 27
VENDOR REBATES OR COMPS .............................................................................................. 27
DISCIPLINARY PROCEDURES ................................................................................................ 28
E-MAIL, INFORMATION SYSTEMS AND INTERNET/INTRANET POLICY ..................... 29
WEAPONS POLICY .................................................................................................................... 31
WORKPLACE VIOLENCE POLICY ......................................................................................... 31
SMOKING .................................................................................................................................... 34
DRUGS, NARCOTICS AND ALCOHOL POLICY ................................................................... 35
MEDICAL EMERGENCY PLAN ............................................................................................... 37
EMERGENCY PREPAREDNESS PLAN ................................................................................... 38
FIRE .............................................................................................................................................. 38
TORNADO/HIGH WIND ALERT .............................................................................................. 38
BOMB THREAT .......................................................................................................................... 39
GENERAL NOTE: ....................................................................................................................... 39
DESIGNATED ASSEMBLY AREAS ......................................................................................... 40
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TRI-STATE CENTERS FOR SIGHT, INC.
MISSION STATEMENT
Tri-State Centers for Sight, Inc. is an organization
of caring professionals dedicated to
providing superior, comprehensive and cost
effective eye care of the highest quality
at our Centers of Excellence.
The statements of policies in this manual are intended to be a general guideline for current
policies. We reserve the right to change these guidelines at any time without notice. This
manual should not be construed, nor is it intended to constitute a contract, expressed or implied.
It is the policy of this corporation to administer personnel policies and practices without
discrimination against anyone on the basis of race, color, religion, sex, age, national origin,
veteran status, marital status or disability. Every effort is made to make employment decisions
that utilize employees’ abilities so they may achieve both personal satisfaction and opportunity
for growth.
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PERSONNEL POLICIES
INTRODUCTION
In an organization such as ours, there is a need for rules governing working time and personal
conduct. For best results we depend upon the loyalty of the employees and their interest in, and
devotion to, their jobs rather than the strict discipline that prevails in many organizations. We
like to foster a spirit of friendliness and develop comfortable and enjoyable working conditions.
In order to avoid misunderstandings, it is advisable to set forth statements of policies as to
wages, benefits, work schedules and hours.
WHY YOU ARE HERE
The ultimate purpose of all work in this corporation can be summed up in these three words: to
help people. Our patients ask for our help and we must provide service to them when it is
needed. Our offices must have operating rules and policies to aid in reaching that objective.
Every staff member must understand that the objective is more important than the rules
themselves. If a rule interferes with the goal of helping people, then it must be questioned.
Perhaps an exception should be made; perhaps the rule should be changed. These changes and
exceptions are matters that should be brought to the attention of the management, who will then
discuss them with the doctors as appropriate.
Many policies of this corporation are intended to build the confidence that the patient feels in the
doctors and the other personnel who work in our offices. A strong doctor-patient relationship is
a must if the patient is to receive full benefit from the doctor’s services. Patients must perceive
the doctor to be knowledgeable, conscientious and approachable. Only if these attitudes prevail
will patients be likely to take the doctor’s advice, and do their part in following through with the
treatment plan. You play an important part in building this confidence by being cheerful,
friendly, tactful, neat, and industrious.
An extremely important principle governing the policies of each office is that the doctor’s time is
the most valuable resource in the office. This resource must be used carefully if sufficient health
care is to be made available to all that may need it. You must do everything possible to help the
doctor use his time effectively. If problems arise, you should take them to the office manager for
resolution, rather than interrupting the doctor’s schedule.
Working together as a team, we can provide the ultimate in service to the patient and have an
efficient and cheerful place to work. We hope you are ready to make your contribution to this
most worthwhile goal.
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CONFIDENTIALITY
The medical care we provide to our patients is personal and highly confidential. Employees are
never to disclose or distribute any information or documents regarding Tri-State Centers for
Sight, Inc. including, but not limited to, policies, practices and fees, its patients (including the
patient’s name, diagnosis, treatment, or any other information relating to the patient), the doctors,
or co-workers to anyone for whom the information is unauthorized or unnecessary. This
includes non-custodial parents of minors. Collectively, this information is referred to as
“Confidential Information”. Confidential information may not be discussed in hallways,
stairways, or other public places whether within or outside of Tri-State Centers for Sight, Inc.
All Confidential Information must be properly secured at the end of each day. Absolutely no
information may be released to any unauthorized person, either orally or in writing, except in
accordance with a written authorization signed by a person with legal authority to do so. In
addition, an employee may only refer to a patient’s chart when it is essential to his or her work
responsibilities. Referring to medical information for other purposes or otherwise breaching this
duty may be a cause for immediate dismissal.
FUNCTIONS OF THE MANUAL
This Personnel Policy Manual embodies a compilation of policies, practices, and procedures that
were designed as a communication tool, offering a standardized approach for administration of
personnel policies. The basic intent is to reduce difficulties that might arise.
No representative of this practice has the authority to modify the terms of this manual either
orally or in writing, or to make any promises contrary to the policies contained herein. TriState’s Executive Board must approve all changes to this manual.
Each new employee will receive a copy of the Personnel Policy Manual on his/her first day of
employment. As new policies or revisions are issued, copies will be distributed to all employees.
The manuals are the property of the office and upon termination of employment it is the
responsibility of the employee to return the assigned manual to the Office Manager for
reassignment.
If there is a question concerning a policy contained in the Manual, the Office Manager will show
the employee the written policy involved and interpret the policy.
Definitions in the manual:
1.
2.
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The words shall and will are to be interpreted as mandatory and the word may as
permissive.
Supervisor or Immediate Supervisor is used interchangeably with Office
Manager and means an individual with authority to assign, direct and review the
work of one or more employees.
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HIRING
Tri-State shall not discriminate against any employee or applicant based upon race, color, creed,
religion, sex, ancestry, national origin, age, disability, genetic information, marital status, sexual
orientation, military or veteran status, or other protected group status. This policy applies to all
personnel actions such as recruiting, hiring, promotion, disciplinary actions, compensation,
benefits, and reductions in force. Applicants for open positions will be recruited and considered
on the basis of their achievement, performance, and ability..
I-9 STATEMENT
To qualify for employment, an individual must be able to prove his/her eligibility to work in the
United States as required by the Immigration and Control Act of 1986. Examples of acceptable
proof of eligibility to work include a valid driver’s license; US social security card; US passport.
This is handled by the office manager.
EMPLOYEE CLASSIFICATION
Full time:

an employee who is regularly scheduled to work 35 or more hours per week.
Part time:

an employee who is regularly scheduled to work more than 20 but less than 35 hours per
week.
Temporary/Limited Part time:

an employee who is regularly scheduled to work 20 hours or less per week, or for a
limited number of weeks (i.e., summer employment).

Hourly:
 an employee paid based on the number of hours worked; such an employee can qualify
for overtime pay. paid on the hours worked; such an employee can qualify for overtime
pay
Exempt Employee:

Salaried employee designated with managerial responsibilities. They do not qualify for
overtime pay.
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New Employee:

There is an introductory period of 90 days for each new employee during which new
employees determine whether or not the position meets his or her expectations and
Management determines whether the new employee meets performance expectations so
as to successfully perform his or her job. At any time during the initial 90 days or
thereafter, employment may be terminated with or without cause.
WORKING HOURS AND OFFICE HOURS
Each clerical and clinical employee will work the specific days and established hours discussed
at the time of employment unless this is changed to facilitate the office schedule or unusual
personnel circumstances. There may be times when employees are required to work past their
normal working hours. The Office Manager will schedule this so the appropriate areas are
covered. Lunch breaks are not counted as paid time. Excessive tardiness and/or absenteeism will
subject the employee to disciplinary action up to and including termination.
The normal lunch break is thirty (30) minutes. However, employees who need more time will
either be required to make up the difference during that work week; or it may be subtracted from
the total time worked. Lunch times are to be staggered so that all areas have sufficient coverage
at all times. Again, the Office Manager is responsible for work schedules to ensure the necessary
coverage.
If combining lunch with a business errand, so that it takes longer than the prescribed lunch break,
the employee must obtain prior approval from their immediate supervisor..
MAKING UP LOST TIME
The Wage and Hour Laws were instituted to protect employees. As usually happens, a gain in
security means a loss in freedom and flexibility. Frequently, employees who have had to take
time off for some reason have asked if they could stay to make it up. This may not be possible
because the Wage and Hour Law states that all time worked over forty hours per week must be
paid at overtime rates. The same must apply to employees who would like to take two days off
in one week and make up a day by working six days in the following week. The law states that
compensatory time cannot be taken by hourly employees in a subsequent or preceding work
week in lieu of overtime pay. The option to make up time is at the discretion of the employee’s
immediate supervisor dependent upon current business needs.
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WORK WEEK
Work week for Tri-State Centers for Sight, Inc. employees begins at 12:01am Sunday and ends
the following Saturday at midnight.
OVERTIME WORK
All overtime must be authorized by the employee’s immediate supervisor. Employees who work
overtime without prior authorization may be subject to disciplinary procedures up to and
including termination.
Overtime rates of time and a half are paid for all time worked in excess of forty hours per week.
Below is an example of how overtime is calculated:
If a person is on a pay rate of $400.00 for a 40-hour week:
Regular pay is $400.00/40 or $10.00 per hour.
Overtime rate is 150% of the hourly rate, or $15.00 per hour
If the employee worked 50 hours in a week, the earnings would be as follows:
Base pay
Overtime (10 hours)
Total Pay
$400.00
$150.00
$550.00
Overtime pay applies only to actual time worked; therefore, absences due to illness, holidays, or
vacations do not count as time worked. For example, a person is scheduled to work Monday
through Friday. If the employee is ill on Thursday, he/she is entitled to pay for that day
(provided the employee is eligible for paid absences). If the employee works Saturday of that
same week, he/she will receive regular pay for the sixth day because only 32 hours were actually
worked through Friday, and therefore the employee is not eligible for overtime pay for Saturday.
TERMINATION OF EMPLOYMENT
If dismissal is necessary on or before the first year anniversary, there will be no severance
pay. If the employer terminates the employee after one full year, two (2) weeks severance
pay is to be paid unless employee is discharged for gross misconduct. In the event of
voluntary resignation, two weeks notice is requested and the employee will not be eligible
for severance pay.
Employees are not generally eligible for rehire. Rehire will need an approval from the
physicians. If the rehire is through another division, the managers of both divisions must
communicate before a decision is made.
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PAY PRACTICES
Our policy is to provide equitable compensation to employees commensurate with their abilities
and experience, and in accordance with current economic conditions.
Salaries are reviewed on an annual basis. Increases are considered based on the employee’s
initiative and capabilities, as well as current economic conditions. Employees’ salaries are
considered confidential.
Payroll will be run on a bi-weekly basis on the Wednesday following the end of the payroll
period. Paychecks are mailed or direct deposited into the employee’s bank account. It is strongly
recommended employees utilize the convenience of direct deposit.
PERFORMANCE REVIEW
Management will carefully review the employee’s performance in the various areas of
responsibility included in the position on a periodic basis. Management will evaluate the
employee’s work and then discuss with that employee his/her strengths and areas that need
improvement. Goals will be set as necessary and followed up at a prescribed time.
INTER-DIVISIONAL EMPLOYEE TRANSFERS
Positions may become open within divisions of Tri-State Centers for Sight, Inc. that are not
“advertised” within other divisions of the Company.
When an employee applies for a job in another division, the hiring division’s Principal Physician
is asked to call the Principal Physician of the division the employee intends to leave, to discuss
and obtain approval. In addition the office managers will discuss the transfer, and if the transfer
takes place the employee’s personnel file follows the employee.
MILEAGE REIMBURSEMENT
Tri-State Centers for Sight, Inc. will reimburse employees who use their personal vehicle to
travel while conducting necessary business. The amount of the reimbursement is determined by
the Board of Directors, and may change periodically.
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PAID TIME OFF POLICY (PTO)
Tri-State Centers for Sight Inc. recognizes the need for employees to have reasonable amounts of
time away from work for vacation. To compensate the employee for such time, eligible
employees are credited with paid time off (PTO) each pay period. It is the responsibility of each
employee to understand and budget their own PTO hours.
PTO credits may begin to be used during the first payroll period following 90 days of
employment. PTO is intended to be used as vacation, however, your PTO time must be used
after you have exhausted your sick/personal days and whenever you take time off work.
PTO CREDIT CALCULATION
The amount of PTO credited varies with the length of service and the number of hours the
employee is paid each pay period. PTO is credited by rounding to the nearest 1/10th hour
increment. For calculation purposes, the maximum allowable number of paid hours for purposes
of computing PTO credits is 40 hours for each work week or 80 per pay period.
The schedule below lists the annual PTO credits for an hourly employee who is paid for 40 hours
of work during each work week.
The amount of PTO which is credited each pay period for employees is the result of multiplying
the number of paid hours times the applicable PTO factors:
HOURLY
ALLOWED
CATEGORY
ANNUAL
CREDIT
PTO FACTOR
MAXIMUM PER
PAY PERIOD
TOTAL
MAXIMUM
ALLOWED
0 -23 Months
40 Hours
.01923
1.5 Hours
50 Hours
24-59 Months
80 Hours
.03846
3.1 Hours
100 Hours
60-119 Months 120 Hours
.05769
4.6 Hours
150 Hours
120+ Months
.07692
6.2 Hours
200 Hours
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160 Hours
Page 11
TOTAL MAXIMUM ALLOWED CREDITS
An hourly full-time employee who normally is scheduled to work 40 hours per week, may earn
and use PTO hours up to a maximum of 1.25 times the ANNUAL credit of the applicable
months-of-service category. Once the employee reaches the maximum hours earned, no further
PTO hours will be accrued until the maximum hours fall below the maximum for the applicable
months of service earned by the employee. Part-time employees working fewer than 40 hours per
week accumulate PTO at the same rate as a 40 hour per week employee but the maximum
accumulation amount is based on the percentage of hours scheduled as it relates to 40 hours. For
example: an employee that is scheduled to work 25 hours per week, qualifies for 62% (25
divided by 40) of the hours listed in the applicable category under ANNUAL CREDIT. To
calculate MAXIMUM PER PAY PERIOD, multiply the PTO factor times the actual hours paid in
the current pay period.
MISCELLANEOUS PAID TIME OFF CREDIT INFORMATION
Employees move from one month-of-service category to another on the PAYDAY following their
month-of-service anniversary of hire date.
An hourly employee may not utilize, at any time, more PTO hours than are in their PTO bank.
Negative balances will not be permitted for hourly employees.
Employees may only use PTO credits in minimum 1 hour increments.
PTO may not be used for tardiness.
PTO credits may not be exchanged for cash.
PTO should not be considered wages or a form of insurance.
Unused PTO is advanced to the following year, subject to the maximum allowed, based on
months-of-service.
SCHEDULING PTO
Scheduled use of PTO requires the employee to confer with his/her supervisor about the
feasibility of such use as far in advance as possible. Management reserves the right to refuse
scheduling of PTO on certain days or during certain periods, in order to ensure adequate staffing.
At the beginning of each calendar year, or as soon as is practical, it is requested that each
employee schedule major segments of PTO being requested (vacations). Management will
attempt to honor the employee’s personal preference, taking into consideration the employee’s
total length of service with Tri-State Centers for Sight Inc., fairness to others, and other staffing
considerations. PTO requests should be made at least 72 hours in advance. Management will
approve or deny requested time as soon as possible upon receipt.
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PTO CASH OUT
Upon separation of employment, employees will be paid for all unused PTO time two weeks
following their final pay check. An employee who is involuntarily terminated for gross
misconduct, or fails to give the requested two weeks notice of voluntary resignation, will not be
paid for unused PTO time.
SHORT-TERM ABSENCES - SICK/PERSONAL TIME
Regular full-time hourly employees are allowed five days per calendar year. An employee
becomes eligible for this benefit after 90 days of employment. During the first year of
employment, the number of sick days allowed is pro-rated as follows:
Month of hire
Sick days available
January - March
April - June
July - September
October - December
3.75
2.50
1.25
0.00
Part time employees will be allocated Sick/Personal time pro-rated based on the average number
of scheduled hours worked per week. For example, there are 2080 work hours per year. If an
employee is scheduled to work 1040 hours (20 hours per week), they would be allocated 50%
(1040 ÷ 2080 = .50) of what a full time employee would be allocated.
Sick/personal time is intended purely for illness and personal items that cannot be handled during
non-working hours. Sick/personal time is not to be used to extend PTO (vacation hours). The
first increment of time to be used for Sick/Personal time is 30 minutes. Time will be rounded up
to the nearest half of an hour thereafter.
If calling in late, the employee is required to notify their immediate supervisor as soon as
practical. Failure to notify in a timely manner may be cause for discipline.
Employees desiring time off from work (other than scheduled PTO time off) MUST use their
Sick/Personal days and then any available PTO time available unless the time off is due to a
circumstance precipitated by the Practice; ie: office is closed or your services are not needed due
to the doctor being out of the office.
At the end of each calendar year, all unused sick/personal days will be calculated. The employee
will be paid their normal hourly rate for any unused hours of sick/personal time. This payment
will be made on the second payroll processed in January of the following year. Unused
Sick/Personal time is not paid out at termination of employment.
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EXTENDED ILLNESS BANK (EIB)
The first three consecutive days of any absence from work as a result of an illness or injury are
provided for under the Short-Term Absences plan. On the fourth day of any absence, due to
injury or illness, employees can draw from their EIB. Employees will be paid from their EIB as
long as the necessary physician statement is received for the illness or injury on the day you
return to work and/or pay period that EIB is requested. All employees earn EIB hours at the rate
of .02 factor for each hour worked, resulting in a total yearly accumulation of hours of 40.6 hours
for all hourly employees who are paid for 40 hours per week. The maximum accumulation is up
to 160 hours. A part-time employee benefit is reduced based on total number of hours actually
worked. For example: a part time employee that is scheduled to work 25 hours per week,
qualifies for 62% (25 divided by 40) of the maximum amount allowed.
The use of EIB requires a statement from your attending physician as to the expected amount of
time you will be away from work.
Upon termination of employment, whether voluntary or involuntary, all EIB is forfeited without
payment.
CONTRIBUTING PTO, EIB OR SICK/PERSONAL TIME
Employees may not contribute any of their accrued PTO, EIB, or Sick/Personal Time to any
other employee for any reason.
HOLIDAYS
Tri-State Centers for Sight, Inc. designates New Year’s Day, Memorial Day, Independence Day,
Labor Day, Thanksgiving Day and Christmas Day as holidays. If the holiday falls on a Saturday,
the Friday before will be considered the day the holiday is observed. If the holiday falls on a
Sunday, the holiday will be observed on the Monday following the holiday.
In addition, the company will designate one additional floating holiday at the beginning of each
year.
When an hourly employee has a set day off during the week and the holiday falls on this
particular day they will not be paid for the holiday. For example: a full time or part time
employee’s regular day off is Wednesday and the holiday falls on Wednesday the employee will
not receive holiday pay because the day would be their regular day off.
To receive holiday pay, an eligible hourly employee must be at work, or on a scheduled absence,
on the work days immediately preceding and following the day on which the holiday is observed.
If an employee does not work their full schedule of hours, or is absent due to illness or injury, a
doctor’s verification (from the employee’s treating physician) will be required to verify the
absence to allow the employe to be paid for the holiday.
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In order to promote an environment of fairness, employees who schedule time off immediately
before or after a scheduled holiday will not be granted that same time off the following year
unless no other employee requests that time off or business conditions allow. Management will
have the final decision making authority on this issue.
ATTENDANCE/NO FAULT POLICY
You are expected to be at work as scheduled whenever possible. Absenteeism interferes with the
ability of our practice to meet our commitments/care for our patients and is, therefore, considered
a very serious issue. Should it become necessary for you to be absent from work, you are
expected to notify your supervisor of this fact as soon as possible, preferably before the start of
your shift. A phone call to another employee does not qualify as notifying your supervisor.
Your supervisor will tell you how he or she expects to be notified. Tri-State’s Short Term
Absences – Sick Personal Benefit with a limit of 5 days per year is designed to allow for these
types of occurrences.
You are held accountable for all unscheduled absences. Unscheduled means time lost from
work regardless of the reason, including sick time. It does not mean time off which is preapproved at least seventy-two hours before the scheduled day off.
HEALTH INSURANCE
Health insurance will be offered under the practice’s group plan. Each year Tri-State will
determine the amount of premium subsidy provided to employees who elect to participate. Each
full time employee will be given the opportunity to participate in the practice’s group medical
insurance plan at the first of the month following their date of employment. Full description of
the plan benefits are available on the company’s website, www.tristatesight.com.
LIFE INSURANCE
Each full time employee will be enrolled in the Group Life Insurance plan after one year of
continuous employment providing the employee is considered eligible by the insurance
company. Coverage will be equal to one times the employee’s previous annual income, up to a
maximum of $50,000.00.
Note: The actual Life Insurance Plan Document, not this manual, governs the terms of the
Plan.
DISABILITY INSURANCE
Each full time employee will be enrolled in the Group Disability Insurance plan after one year of
continuous employment providing the employee is considered eligible by the insurance
company.
Note: The actual Disability Insurance Plan Document, not this manual, governs the terms of
the Plan.
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RETIREMENT BENEFITS
At the present time Tri-State has two Retirement Plans. A 401-K Profit Sharing Plan and a
Defined Benefit Plan. See the Plan Summaries in separate documents. (Available on the
Company’s website www.tristatesight.com).
CIVIC RESPONSIBILITIES
When an employee is called for Jury Duty, his/her full salary will be paid for a maximum of four
weeks during the time of jury service. An amount will be subtracted, however, for all fees
received from the government for jury duty. All payments received for transportation in
connection with jury duty are the employee’s to keep.
Employees summoned to jury duty and released early should return to complete their normal
shift if time permits. Management reserves the right to limit the number of paid days in the
event of a lengthy grand jury trial.
BEREAVEMENT POLICY
All full time employees will receive three (3) paid days off associated with the death of a
member of his/her immediate family or immediate step family - spouse, mother, father, (or legal
guardians), daughter, son, sister, brother, mother-in-law, father-in-law, or grandparents.
Bereavement leave applies to all full time employees after 90 days of employment. If an
employee requires additional time, he/she may charge those hours against unused sick/personal
time benefits or PTO. If all benefits have been exhausted, the employee may request additional
time away from the office for bereavement up to a maximum of 10 days. No additional financial
compensation will be offered.
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INCLEMENT WEATHER
It is the policy of Tri-State Centers for Sight Inc. to remain open during most periods of
inclement weather; however where extraordinary circumstances warrant, the division reserves
the right (as determined by the physician) to close their offices. The office should be presumed
open unless otherwise communicated. The employees will be notified by Management as soon as
possible whether the office will be closed.
If the office is open, you are expected to be at work; however it is each employee’s decision as to
whether you will attempt to report during such weather. If an employee elects not to work on a
given day, we request that you notify your manager or supervisor as soon as possible, advising as
to your status for the day. Our Sick/Personal Day allotment is designed to accommodate these
types of events.
If the facility is announced to be closed on a given day, hourly employees may use sick time. If
sick time is exhausted, the employee may use PTO in increments sufficient to cover the absence.
If you work for a Division which utilizes the office space of another Division your Supervisor
will be responsible for telling you if you are required to report to that location. Due to the fact
our offices are in several states, the level of declared state of emergency due to inclement
weather may vary from state to state.
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FMLA POLICY
LEAVES OF ABSENCE
POLICY:
It is the policy of the Company to grant employees extended leaves of absence under certain
circumstances. Except as stated below, employees will not receive compensation during a leave
of absence.
PROCEDURES
1) The Company will comply with the provisions of the federal Family and Medical Leave Act
(FMLA). Under this act, an employee is entitled to 12 weeks of unpaid leave, within a 12
month period to:
a) care for the employee’s child after birth, or placement for adoption or foster care;
b) care for the employee’s spouse, son or daughter, or parent, who has a serious health
condition;
c) treat a serious health condition that makes the employee unable to perform the
employee’s job; or
d) because of any qualifying exigency (as the Secretary of Labor shall by regulation,
determine) due to an employee’s spouse, child, or parent being on active duty or
receiving a call to active duty in the Armed Forces in support of a contingency
operation.
2) Also in compliance with the provisions of FMLA, the Company will provide Service
member Family Leave of up to 26 weeks of leave in a single 12-month period to eligible
employees to care for a spouse, child, parent, or next of kin of a covered service member
who has become ill or injured during the course of active duty. This leave is not granted in
addition to 12 weeks of FMLA leave and total leave taken in a year may not exceed 26
weeks.
The 12 month period is defined as a 12-month period measured on an individual basis from
the date the employee’s first FMLA leave begins.
3) Requests for a leave of absence should be submitted in writing to the employee’s office
manager thirty days prior to commencement of the leave period, or as soon as possible in an
emergency situation. A medical certification form will be required to support a request for
leave because of a serious health condition or to care for an ill or injured service member.
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Management may require second or third opinions (at the company’s expense) and a fitness
for duty report to return to work.
4) The granting and duration of each leave of absence and the compensation received by the
employee, if any, during the leave is outlined below under each type of leave. If receiving
compensation for a leave of absence, all requirements of that policy must be followed as
outlined in the policy.
a) Sick leave of absence: Employees who are unable to work because of their own serious
health condition or disability. This type of leave covers any serious health condition
including those caused by pregnancy, childbirth, or any other medical conditions.
Compensation during a sick leave of absence would be paid in the following order:
(x)
(x)
(x)
Personal/Sick Days
Extended Illness Bank (EIB)
Paid Time Off (PTO)
The Company requires certification of an employee’s need for sick leave (both before the
leave begins and during the leave should circumstances change) by the employee’s health
care provider.
b) Parental leave of absence: Female employees, when not disabled by pregnancy or
childbirth (see above), and male employees may be granted a parental leave of absence to
care for a child upon birth or upon placement for adoption or foster care. Compensation
during a parental leave of absence would be:
(x)
(x)
(x)
Personal/Sick Days
Extended Illness Bank (EIB)
Paid Time Off (PTO)
Benefits outlined in this policy will not be paid for abortion except where life of the mother
is endangered if the fetus is carried to term, or when medical complications have arisen from
abortion.
c) Family care leave of absence: Employees may be granted a family care leave of
absence for the purpose of caring for a child, spouse, or parent who has a serious health
condition. Compensation during such leave would be the same as listed under (b) Parental
leave of absence. The Company requires certification of the family member’s serious health
condition, both before the leave begins and on a periodic basis, by the family member’s
health care provider.
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d) Military qualifying exigency leave of absence: An employee may be granted leave
due to a qualifying exigency arising out of the fact that an immediate family member is on
active duty or has been ordered to active duty in the Armed Forces. The Company requires
a copy of the military member’s active duty orders or certification be submitted to support
the need for leave. Compensation during such leave would be the same as listed under (b)
Parental leave of absence.
e) Service member Family Leave: Employees may be granted a service member family
leave to care for an immediate family member or next of kin who has become injured or ill
during the course of active duty. To obtain leave to care for an injured or ill family member,
the Company requires certification of the servicemember’s injury or illness. Compensation
during such leave would be the same as listed under (b) Parental leave of absence.
5) Employees on an approved leave of absence may not perform work for any other employer
during that leave.
6) The Company will continue to provide health insurance and other benefits to employees on
leave as required by law. The timing and specifics of premium payments will be outlined by
the Central Business Office (CBO) prior to commencement of leave or as soon as possible
after leave begins. Benefits that accrue according to length of service, such as paid vacation,
personal and sick days, do not accrue during periods of leave.
7) An employee returning to work at the conclusion of a leave of absence will be restored to
his/her former or comparable position at the same rate of pay unless circumstances have
changed so that it is unreasonable to reinstate the employee. A returning employee shall
retain credit for prior service and accumulated seniority, except in cases where law prohibits
it.
8) If an employee fails to return to work at the conclusion of his/her leave of absence, the leave
will be terminated and employment terminated. The effective date of the termination will be
the last day worked.
MILITARY LEAVE POLICY
Employees who are inducted into the U.S. Armed Forces or who are reserve members of the U.S.
Armed Forces or state militia groups will be granted leaves of absence for military service,
training, or other obligations in the compliance with state and federal laws.
These employees may use accrued PTO benefits but are not required to do so. Medical coverage
during Military leave can be extended under USERRA (Uniformed Services Employment and
Reemployment Act) and/or work in conjunction with COBRA benefits for dependants, if
applicable.
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Based on length of the concluded leave, the employee generally has the right to return to the
same position and benefit level, he/she held prior to the leave or to a position and benefit level,
the employee would have had, as long as the person is qualified, if the employee had been
continuously employed. The employee (or the appropriate officer of the branch of military in
which the employee will be serving) is requested to notify Tri-State Centers for Sight Inc. with
his/her orders to his/her immediate supervisor as soon as they are aware of the military
obligation.
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BEHAVIOR OF EMPLOYEES
All employees are expected to behave in a manner conducive to the efficient operation of the
office. Conduct that interferes with operations, brings discredit to the office, or is offensive to
patients or fellow employees will not be tolerated.
NO HARASSMENT POLICY
Tri-State Centers for Sight, Inc. does not tolerate harassment of our employees. The term
harassment includes but is not limited to slurs, jokes, and other verbal graphic or physical
conduct relating to an individual’s race, color, sex, religion, national origin, marital status,
genetic information, citizenship, age or disability. Harassment also includes unwelcome sexual
advances, requests for sexual favors, unwelcome or offensive touching, and other verbal, graphic
or physical conduct of a sexual nature.
VIOLATION OF THIS POLICY WILL SUBJECT AN EMPLOYEE TO DISCIPLINARY
ACTION UP TO AND INCLUDING IMMEDIATE TERMINATION.
Procedures:
1)
If you feel that you are being harassed by another co-worker, manager, physician, client,
or vendor, you must make your feelings known immediately to your Manager or
Administrator. You may also call the Quality Assurance Hotline at 859-581-7120
Extension 605. Leave a confidential message and it will be reviewed by the Physician
Chairperson of Tri-State’s Quality Assurance Committee.
2)
Your complaint will be kept as confidential as possible consistent with a thorough
investigation.
3)
Please do not assume that Tri-State Centers for Sight, Inc. is aware of your problem. It is
your responsibility to bring your complaints and concerns to our attention so that we can
help resolve them. You will not be penalized in any way for truthfully reporting such
conduct.
4)
Any employee who is made aware of harassment and fails to report it will be subject to
disciplinary action up to and including termination of employment
WORKPLACE RELATIONSHIPS
Positive employee morale and good team-working relationships are important components to
Tri-State Centers for Sight, Inc.’s success. We recognize that sometimes romantic relationships
can develop between people who work together. But unfortunately, sometimes attractions are
not mutual or relationships do not remain mutual, and these situations can develop into problems.
In addition, such relationships can cause morale problems, unhappy complications, and
difficulties for all concerned. For these reasons, the Corporation has developed the policy set
forth below concerning romantic relationships. This policy is not intended to inhibit the social
interaction (such as lunches or dinners or attendance at entertainment events) that are or should
be an important part or extension of the working environment.
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1. Physicians and other company employees who have any type of supervisory authority
(“supervisor”) may not evaluate, nor make a recommendation concerning performance
and/or salary, of any employee with whom the partner or supervisor is involved with
romantically or sexually. If such a relationship develops during the course of
employment, it shall be the responsibility and mandatory obligation of the supervisor
promptly to disclose the existence of the relationship to the company’s Executive Board.
The employee may make the disclosure as well, but the burden of doing so shall be upon
the supervisor. The Corporation, in its sole discretion, will take whatever action deemed
necessary to accommodate the best interest of the Corporation.
2. In all instances, the Corporation will enforce its policy against sexual harassment. If at
any time, requests for dates or romantic pursuit become unwelcome or interfere with an
individual’s work or the work environment of others, such conduct should be reported to
the Corporation’s Administrator, the employee’s immediate supervisor or a member of
the Company’s Quality Assurance Committee and thereafter to be subject to investigation
and disciplinary action as set forth below.
3. Employees who believe there may be a violation of the Workplace Relationships policy
or who have any concerns about an issue the Workplace Relationships policy intends to
address must report the matter in accordance with the reporting procedures described
below. Your complaint will be kept as confidential as possible consistent with a
thorough investigation.
Reporting a Problem
Using and insisting upon good manners, behavior and the exercise of good sense will go a long
way in avoiding and preventing the inappropriate conduct prohibited by this policy. It is every
employee’s responsibility to help maintain a work environment free from harassment.
Employees who believe they have experienced or observed harassment must report the
harassment immediately to the Corporation’s Administrator, or the employee’s immediate
supervisor or a member of the Corporation’s Quality Assurance Committee. Both male and
female members of the Committee are available to investigate complaints and serve as an
alternative means through which a report of an incident or incidents can be communicated for
corporate action.
Retaliation Prohibited
The Corporation encourages employees to raise questions or concerns regarding harassment and
will not permit any form of retaliation against any employee who has made a claim or report of
harassment, or against any employee who has provided information to the Corporation during the
investigation of a claim or report of harassment. Employees who believe that they have been
retaliated against should immediately contact the Corporation’s Administrator, the employee’s
immediate supervisor or a member of the Corporation’s Quality Assurance Committee.
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Investigation & Disciplinary Action
Each matter that is reported will be the subject of a timely investigation that shall be conducted
by or under the direct supervision of the Corporation’s Administrator or the designee of the
Executive Board. After the investigation has been completed, a determination will be made by
the Corporation regarding the resolution of the matter. Appropriate action, including disciplinary
action up to and including separation from the Corporation will be taken if that is deemed the
proper resolution of the matter.
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PERSONAL APPEARANCE/UNIFORM POLICY
1. Professional Image: As a Tri-State Centers for Sight, Inc. employee, you are a
representative of our corporation. Good taste, neatness and good personal hygiene are
basic to our standards of dress and grooming. At Tri-State Centers for Sight, Inc. we
want to maintain high standards that reflect a professional, business-like atmosphere to
our patients and the community.
2. Basic Dress Standard Guidelines: The following are the basic dress guidelines to be
followed by hourly employees, both clinical and those working in the Central Business
Office.






Only uniform jackets, tops, pants, shoes and name tags approved by the Board
may be worn.
Full time employees will be issued 3 pair pants (black) and 3 short sleeve scrub
tops in the style/color designated by the physician(s) and/or manager of their
division.
Part-time employees will be issued the appropriate number of uniforms according
to the days scheduled to work per week but not to exceed 2 pair pants (black) and
2 scrubs tops in the style/color designated by the physician(s) and/or manager of
their division.
Employees who wish to wear uniform jackets in the color designated by the
physician(s) and/or manager of their division will be required to pay for these
without subsidy from the Corporation. White sweatshirts with the Tri-State logo
previously approved by the Board may also be worn and again the employee will
pay for these without subsidy from the Corporation.
Male employees that do not wish to wear scrubs will be permitted to wear white
jacket with dress slacks, dress shirt and tie and appropriate business shoes.
The Corporation will subsidize every two calendar years, the appropriate number
of uniforms according to full time or part time employee.
3. Employees wearing clinical attire will have the option to wear short or long sleeve
round neck or turtleneck knit shirts in white or black (no sheer fabric). Male employees
will be permitted to wear Polo style shirt in white or black. Only these styles of knit
shirts in black or white are acceptable. The employee will pay for these without subsidy
from the Corporation.
4. Shoes are an important part of both the clinical and business attire for Tri-State
Centers for Sight, Inc. employees. Employees wearing the approved clinical attire are
permitted to wear white shoes with white socks/hose or black shoes with black
socks/hose. Socks or hose must be worn at all times. Male employees wearing the
business uniform of white jacket, dress slacks, dress shirt and tie, will wear appropriate
business shoes in black or brown. The employee will also pay for shoes/socks without
subsidy from the Corporation.
9/13/2010
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5. All fabrics are to present a professional appearance (follow manufacturer instructions
for washing, remove from dryer promptly, iron when necessary and use color safe
bleach only) and be tucked in where appropriate.
6. Hair should be worn in a professional manner (clean, well groomed and does not
interfere with patient care).
7. Jewelry which includes earrings should be kept to a minimum. Not to include more
than 2 earrings per ear. No other piercing (including, tongue, eyebrow, nose, or other
facial locations) may be worn. Perfume should be kept at a minimum. Nails should be
well kept; polish should be a neutral shade.
8. Name badges are supplied and paid by the Corporation and must be worn while working.
If the employee loses his/her name badge, they must replace at their own expense. (Due
to the leasing arrangement between Tri-State Centers for Sight, Inc. and Anderson
Hills Eye, Inc., employees of the Anderson Division will not wear our company logo
name badges.)
9. Tattoos – it is the practice to present a professional image at all times and therefore
tattoos should not be visible at any time.
Non-compliance: Employees not adhering to the personal appearance policy will be given a
dress violation notice and may be asked to return home to correct the violation. The violation is
equivalent to a verbal warning. If an employee has any questions about the appropriateness of a
particular item of clothing, discuss it with his/her office manager before you wear it to work.
PERSONAL ACTIVITIES
The standards of efficiency are very high for our organization. There is seldom a moment when
all of the work is done. Employees, therefore, are expected to postpone personal tasks until after
work or during lunch period.
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PERSONAL CALLS
Occasionally, personal phone calls may have to be received or made during the business hours.
A small number of such calls are permitted, provided they are local and handled in such a way
(e.g., during breaks and lunch period) as not to interfere with the assigned job responsibilities.
1. Company Phones: Employees are asked to keep such calls brief, and be ready to
interrupt them instantly to handle incoming calls or other office business.
2. Cellular Phones are not permitted unless prior approval is received from the office
manager. When permitted cellular phones will remain on vibrate and exercise the same
discretion with phone lines belonging to the Practice.Texting is also prohited while at
work and clocked in.
SOLICITATION
Employees are not permitted to solicit memberships, contributions, sell merchandise or
subscriptions, or conduct similar personal business or distribute printed matter for any purpose
during his/her working time or the working time of other employees. No distribution of any kind
is permitted in any work area at any time.
VENDOR REBATES OR COMPS
All vendor rebates or promotional materials are the property of Tri-State Centers for Sight, Inc.
Rebates received are allocated to the respective division and utilized as that division sees fit.
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DISCIPLINARY PROCEDURES
It is the policy of this office that any employee who violates any of the office rules and
regulations or standard of employee conduct and behavior will be subject to disciplinary action
up to and including immediate discharge. Generally, the Practice’s disciplinary procedure will
be administered in steps, with each step being more severe. However, the Practice does have the
right, consistent with employment at will, to take any disciplinary action it deems necessary,
including immediate termination of employment, depending on the circumstances as determined
by the Practice.
Procedures
1) On the occasion of the first violation, management will take the following action:
a. Meet with the employee to discuss the matter;
b. Inform employee of the nature of the problem and action necessary to correct it;
and,
c. Prepare a memorandum for management’s own records indicating that the
meeting was held, the nature of the violation, and the action the employee was
instructed to take to remedy the problem.
2) Should a second violation occur, management will hold a second meeting with the
employee at which time the following action will be taken:
a. Issue a written reprimand to employee with a copy placed in the employee’s file;
b. Warn the employee that a third violation will result in more severe disciplinary
action;
and,
c. Prepare and forward to the appropriate doctor and Practice Administrator a
written report describing the first and second violations summarizing the action
taken during the meetings with the employee.
3) Should additional violations occur, management will take progressive disciplinary action
by using any or all procedures listed below:
a. Issue a warning or reprimand including signature of management and employee
with a copy forwarded to employee’s file;
b. Suspend the employee without pay for up to five (5) working days; or,
c. Recommend termination. All documentation leading up to the termination will be
forwarded to the employee’s personnel file.
4) In cases of serious misconduct, as determined at the sole discretion of the Doctor,
employment may be immediately terminated.
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5) Employees who believe they have been disciplined too severely should be encouraged to
take the matter to the doctors for a hearing on the situation.
6) A period of one year during which an employee has no disciplinary problems may nullify
any previous violations for purposes of implementing the disciplinary procedures
contained in this policy.
E-MAIL, INFORMATION SYSTEMS AND INTERNET/INTRANET POLICY
The purpose of this policy is to establish a consistent policy with regard to use and disclosure of,
as well as access to, electronic mail messages and information from the Internet/Intranet, which
are created, sent, received, or downloaded by Tri-State Centers for Sight, Inc. employees. This
policy also applies to Tri-State Centers for Sight, Inc. contractors, vendors, consultants, and any
other individuals expressly authorized by Tri-State Centers for Sight, Inc. to use Tri-State
Centers for Sight, Inc.’s electronic mail system or Internet/Intranet capability. These information
systems are business tools provided by Tri-State Centers for Sight, Inc. to assist in conducting its
business. The electronic mail system hardware and Internet/Intranet access are considered
company property. Additionally, all messages composed, sent, received, or downloaded on the
electronic mail system or Internet/Intranet are and remains the property of Tri-State Centers for
Sight, Inc. They are not private or personal property of any employee or any other individual
authorized to access such Tri-state Centers for Sight, Inc. information systems.
Acceptable Use of the Internet
The Internet/Intranet is to be used by employees in conducting company business and is not for
employee’s personal use. Tri-state Centers for Sight, Inc. understands that on occasion there may
be a need to communicate with other persons for appropriate personal reasons, and Tri-state
Centers for Sight, Inc. is willing to accommodate such personal use of the systems to a limited
degree. However, personal use of the systems, which interferes with an employee’s work
performance or the systems, will not be tolerated.
Unacceptable Use of the Internet
The electronic mail system and the Internet/Intranet are not to be used in any manner that would
be offensive, disruptive, or harmful to morale. For example, the creation, display or transmission
of sexually explicit images, messages, or cartoons, any use of ethnic slurs, racial epithets, or any
conduct which violates Tri-State Centers for Sight, Inc. policies prohibiting discrimination
and/or harassment, is strictly prohibited. This prohibition would also extend, for example, to the
creation, display, or transmission of images that make reference to an individual’s age, sexual
orientation, religious or political beliefs, national origin or disability.
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Communications
Tri-State Centers for Sight, Inc. reserves the right to investigate, search, review, audit, access and
disclose any messages created, received, retained or sent over the Internet/Intranet without
permission of the employee. Accordingly, none of our employees, or any other individual
authorized to access Tri-State Centers for Sight, Inc.’s information systems, should have any
expectation of privacy in Tri-State Centers for Sight, Inc. provided computer systems or the
Internet/Intranet. For purposes of inspecting, investigation, or searching e-mail and/or
Internet/Intranet used by employees or other authorized personnel, Tri-State Centers for Sight,
Inc. may override any applicable passwords or codes in accordance with the best interests of TriState Centers for Sight, Inc., or it’s employees, it’s clients, customers, or visitors.
Software
Any unauthorized downloading of any software is prohibited to prevent computer viruses from
being transmitted through the system.
Copyright Issues
Tri-State Centers for Sight, Inc. purchases and/or licenses the use of copyrighted material for
business purposes. We do not own the copyright to such software applications or related
documents. Staff users are not permitted to copy, transfer, rename, add or delete information or
programs belonging to other entities unless given permission to do so by the owner. Failure to
comply with copyright or license agreements may result in disciplinary action from the Practice
or legal action by the copyright owner.
Security
Tri-State Centers for Sight, Inc. employees and individuals authorized by Tri-State Centers for
Sight, Inc. to access the company’s information systems, including e-mail and the
Internet/Intranet, may have access to sensitive, confidential and proprietary Tri-State Centers for
Sight, Inc. information. Unauthorized review, duplication, dissemination, removal, damage or
alteration of files, passwords, electronic mail messages, computer systems or programs, or other
confidential material proprietary to Tri-State Centers for Sight, Inc. or any improper use of such
information obtained by unauthorized means, may be grounds for disciplinary action up to and
including immediate termination of employment. Notwithstanding Tri-State Centers for Sight,
Inc. management’s right under this policy to review, inspect and retrieve any electronic mail
messages, such information and material should generally be treated as private by other
employees and accessed only by the intended recipient(s). Employees should not use code,
access a file, or retrieve any stored information of another employee unless first authorized to do
so, nor should employees attempt to gain access to another employee’s messages without
obtaining the latter’s permission.
Violations
Any employee or individual authorized to access Tri-State Centers for Sight, Inc. computer
systems including e-mail and/or Internet/Intranet, who violates this policy in any manner shall be
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subject to disciplinary action, up to and including immediate termination of employment and, if
applicable, legal prosecution.
Any employee or individual authorized to access the Company’s computer systems including the
e-mail system and/or Internet/Intranet, who discovers a violation of this policy shall promptly
notify the appropriate supervisor/manager, or the Practice Administrator.
Instant Messaging
Office usage of instant messaging should be limited to work related issues and not for personal
use. To avoid HIPAA violation, any identifying patient or employee information must to be sent
using a secured instant messaging, such as; X-IM.
WEAPONS POLICY
Employees are prohibited from bringing or possessing firearms, illegal knives or other weapons
(whether visible or concealed) onto company property or premises or at company-sponsored
events.
Employees with concealed carry licenses are prohibited from carrying concealed handguns on
company premises. This prohibition includes concealed weapons of any kind, regardless of
whether the individual is licensed to carry the weapon. Additionally, employees are prohibited
from carrying a concealed weapon while operating any motor vehicle owned or leased by the
company or from concealing a firearm in their own vehicle that is parked on company property
or premises.
Prohibited items include, but are not limited to, all firearms, knives with blades over 4”,
explosive devices or any other weapon that could be used to threaten, harass, intimidate, injure or
cause harm to another individual.
An employee found to have used a weapon or be in possession of a weapon while on company
property or company business will be subject to disciplinary action up to and including
termination. The company may also report the incident to the local law enforcement authorities.
WORKPLACE VIOLENCE POLICY
Workplace violence is defined by the National Institute for Occupational Safety and Health
(NIOSH) as “violent acts (including physical assaults and threats of assaults) directed towards
persons at work or on duty.” Outpatient (physician office) settings are affected to a lesser extent.
Some of the risk factors or greatest hazard(s) that contribute to the potential for workplace
violence within our organization are: long waits that cause frustration, billing and co-payment
related issues and drug seekers.
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Tri-State Centers for Sight, Inc. is committed to protecting employees from potential workplace
violence to the extent possible. We will not tolerate any violence or threats of violence by or
against anyone associated with this practice, whether employee, patient, family member, or
business associate. All employees are encouraged to report any potential triggers for workplace
violence and any incidents that were observed or experienced. Our organization will provide
first aid, medical treatment, and/or counseling for any employee who is harmed while
performing their job. There will be no reprisals against any employees who report problems.
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Workplace Violence Incident Report
A reportable violent incident should be defined as any threatening remark or overt act of physical
violence against a person(s) or property whether reported or observed
1. Date:
Time:
2. Assailant: Male
Name:
Female
Unarmed
Armed
3. Description of Incident: Physical/Verbal Abuse or Both
Explain:
4. Extent of injuries:
5. Office Location:
6. Violence Directed Toward:
7. Present at Time of Incident:
8. Need to Call:
9. Disposition of Assailant: Remained on premises
Escorted off premises
Left on own
Other
10. Report completed by:
11. Supervisor notified:
12. Additional Comments:
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SMOKING
Tri-State Centers for Sight is committed to protecting the safety and welfare of its employees
and patients. To that end, Tri-State Centers for Sight is declaring its premises to be a totally
smoke-free environment. No Smoking of any kind will be permitted in the buildings,
lavatories, or premises beginning October 1, 2010. Additionally, no smoking is allowed
within a minimum of twenty (20) feet or that distance which insures smoke will not enter
any ingress or egress from any Tri-State Centers for Sight location. Any employee who fails
to comply with this policy will be subject to disciplinary action, including written warnings,
suspension, and possible termination for continued violations.
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DRUGS, NARCOTICS AND ALCOHOL POLICY
Procedures:
1)
Employees are prohibited from the use, sale, dispensing, distribution, possession, and
manufacture of illegal drugs and narcotics or alcoholic beverages on Tri-State Centers for
Sight, Inc. premises or work sites.
2)
Tri-State Centers for Sight, Inc. will not hire, unless state or local law provides otherwise,
alcoholics or drug abusers whose current use of such substances prevents them from
performing their jobs or who would constitute a direct threat to the property or safety of
others. All applicants for employment may be tested for the presence of such substances;
they are to be informed of the test in advance writing.
3)
Employees will be subject to disciplinary action up to and including termination for
violations of this policy. Such violations include, but are not limited to, possessing
illegal or non-prescribed drugs and narcotics or alcoholic beverages at work, being under
the influence of such substances while working; using such substances while working, or
dispensing, distributing, or illegally manufacturing or selling them on Tri-State Centers
for Sight, Inc. premises or work sites. Employees may be required to take a drug test at
any time to determine the presence of drugs, narcotics, or alcohol, unless such tests are
prohibited by law. Testing positive for illegal drugs or alcohol is a violation of this
policy.
4)
Employees subject to the Drug Free Workplace who are convicted of any criminal drug
violation occurring in the workplace must report such convictions to the Office Manager
within five days and the Office Manager is then to take appropriate action as required by
law. Co-workers should report immediately to the Office Manager any action by an
employee who demonstrates an unusual behavior pattern. The Office Manager must
document clearly the employee’s conduct and actions. The Office Manager will
determine whether the employee should be examined by a physician (NOT A PHYSICIAN
OF TRI-STATE CENTERS FOR SIGHT, INC.) or clinic and/or tested for drugs and
alcohol. Employees believed to be under the influence of drugs, narcotics, or alcohol will
need to be transported to the nearest testing facility by the office manager. A third person
is also needed for transportation if the manager is not the same sex. An employee that
tests positive for drug and/or alcohol use, appropriate action will be determined upon the
level and incident as defined in Items 6. In the event that the Office Manager is unable to
perform these responsibilities, it is required that only a shareholder physician or
Administrator may complete these tasks.
5)
Any employee who uses legal drugs or narcotics during work, and have any reason to
expect such use may affect their ability to perform their work, must report this fact to the
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6)
Office Manager. A determination will then be made as to whether the employee should
be able to perform the essential functions of the job safely and properly.
Employees who are experiencing work-related or personal problems resulting from
drugs, narcotic, or alcohol abuse or dependency may request, or be required to seek
counseling help. Tri-State Centers for Sight, Inc. required counseling should be kept
confidential and should not have any influence on performance reviews. Job
performance alone, not the fact that an employee seeks counseling, is to be the basis of all
performance appraisals.
Any employee who is abusing drugs and alcohol may be granted a leave of absence to undertake
rehabilitation treatment. The length of the leave absence is defined as follows:
For positive breath alcohol tests: .02 0 - .0399
First incident allows two days suspension without pay or use of any time off
benefits.
Second incident is immediate termination.
(Note: Levels of alcohol at the second incident is inconsequential, only that the
test results are positive)
For positive drug tests:
First incident allows formal drug rehabilitation program.
Second incident is immediate termination.
The employee will not be permitted to return to work until certification is
presented to the Office Manager that the employee is capable of performing
his/her job. Failure to co-operate with an agreed-upon treatment program will
result in discipline, up to and including termination.
Participation in a treatment program does not exclude an employee from the
imposition of discipline for violations of this or other Tri-State Centers for Sight,
Inc. policies.
Tri-State Centers for Sight, Inc. will, to the extent feasible, provide continuing
awareness programs for the work force about the harmful effects of drug, and
alcohol abuse.
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MEDICAL EMERGENCY PLAN
I
A medical emergency is defined by:
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
II.
Upon identifying a medical emergency in the office, the following procedure will be
followed:
a)
b)
c)
III
Trouble breathing or stopped breathing
Rapid pulse – tachycardia or no pulse
Severe chest pain or pressure in the chest – possible heart attack, pulmonary
embolism, asthma, etc.
Unconsciousness or fainting
Severe bleeding with loss of blood pressure
Allergic reaction to drugs or other outside agents
Low blood pressure with mental confusion
Severe or intense pain
Possible stroke with onset of paralysis, slurred speech, confusion, or collapse
Combative/highly disruptive patient
Attend patient for appropriate care:
1.
Clear airway
2.
Control any bleeding
3.
Check circulation – pulse and blood pressure
Notify the doctor and alert staff
Call 911 when needed
Responsibilities of office staff during the medical emergency:
a)
b)
c)
First responder:
1.
Calls for help
2.
Initiates resuscitation with basic CPR (if necessary)
Second responder:
1.
Notifies all others, including EMS/911
2.
Gathers resuscitation kit
Physician assigns tasks if on-site. If physician is not in, the most appropriate staff
member assigns tasks in lieu of Physician.
Note: At least one CPR-certified staff member must be available during office hours.
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IV.
Duties of staff during the medical emergency:
a)
Physician institutes treatment, e.g., CPR, supervises office staff
b)
Nurse (or most appropriate staff member)
1.
Helps with treatment and staff supervision
2.
Aids in CPR, if needed
3.
Clears other patients from treatment area
4.
Calls 911, if needed
c)
Medical Assistant and Receptionist
1.
Pages physician, if not present
2.
Contacts patient’s family
3.
Keeps other patients calm
4.
Keeps family members calm
EMERGENCY PREPAREDNESS PLAN
FIRE
1)
Confine fire: Close door(s)
2)
Report fire:
1)
Pull alarm, if appropriate
2)
Call 911
3)
Evacuate:
4)
Use fire extinguisher as appropriate
1.
2.
3.
4.
Follow your evacuation plan.
Pull the pin between the two handles
Aim at the base of the fire
Squeeze the handles together while holding the extinguisher upright
Sweep from side to side, evenly coating the entire area of the fire
TORNADO/HIGH WIND ALERT
1)
Office staff should assign specific areas in the facility to shelter people. The best
protection is an underground area.
2)
In buildings without basements, designate interior hallways on the lowest floor as shelter
areas. Shelter high-rise building occupants in small interior rooms or hallways.
3)
When a tornado warning is issued, direct staff and patients to take shelter immediately,
and to crouch down and cover their heads with their arms.
Close and latch all doors to outside rooms.
4)
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BOMB THREAT
1)
Keep talking: Keep the caller talking; have another person listen with you if possible.
Do not answer any other calls until directed.
2)
Notify Authorities: Delegate another person to contact 911
3)
Document:
Document all information
4)
Evacuate:
Evacuate as directed. Do not touch any suspicious-looking packages,
equipment or devices
GENERAL NOTE:
DURING ANY EMERGENCY, IF EVACUATION IS NECESSARY, DO NOT RETURN TO
THE BUILDING UNTIL THE EMERGENCY CO-ORDINATOR ISSUES AN “ALL
CLEAR”
Emergency Coordinator:
The Emergency Coordinator will verify if a call to 911 has been placed. If not, the Emergency
Coordinator will call 911 immediately.
 The Emergency Coordinator will be responsible for a specific area within a building.
The Emergency Coordinator’s responsibilities are:
1. When an alarm is activated, assign clerical staff to assist in the orderly evacuation
of the building.
2. Proceed to notify all occupants within their assigned area. Message to include
“Your attention please – as a precautionary measure please exit the building
and gather at the (designated area)”.
3. Coordinate the relocation and safeguarding of occupants that remain (persons-inplace) within the fire alert area. Person-in-place is: Sedated patients, patients
undergoing surgery or invasive procedures that prohibit immediate transport. Exit
the building and proceed to an assembly area.
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Clerical Staff:

Clerical staff, by direction of the Emergency Coordinator, will direct the occupants in
non-clinical areas to the appropriate fire exit and to a predetermined location outside
of the building. Physically challenged occupants may be evacuated to the outside, an
adjacent building, or to the nearest stairwell.

Message to include “Your attention please – as a precautionary measure please
exit the building and move toward the (designated area).” Repeat.
Care Providers:

Care-providers will direct the occupants in clinical areas to the appropriate fire exit
and to the predetermined location outside of the building. When required, careproviders will reassure patients and assist in relocating persons-in-place who are in
clinical areas to a designated safe area or to a predetermined location outside of the
building. Physically challenged occupants may be evacuated to the outside, an
adjacent building, or to the nearest stairwell.
DESIGNATED ASSEMBLY AREAS
Evacuation – When alarms are activated, occupants must exit the building via the nearest exit
and assemble at any of the location designated by each individual office.
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