DESERT VIEW HOSPICE is an equal employment opportunity employer. We adhere to a policy of making employment decisions without race, color, religion, gender, sexual orientation, national origin, citizenships, age, disability. We assure you that you opportunity for employment with DESERT VIEW HOSPICE depends solely on you qualifications

I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired. I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for employment. I also authorize you to request and receive such information. In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted at any time, at the company's sole option and without prior notice to me. I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the company or myself.

As indication that you have read and understood each sentence, please write your initials in the spaces provided below. 

 In exchange for the consideration of my job application by DESERT VIEW HOSPICE,(hereafter called “the Company''), I agree that: 

The affairs of the organization by all personnel (including Governing Body and Professional Advisory Committee members) will be conducted in accordance with the highest standards of integrity. There can be no deviation from complete honesty in business transactions. Use of organization funds or internal business information for improper purposes and dishonest practices is absolutely forbidden. 

1. The Organization will ensure that: 

A. Ethical patient care issues will be referred to the ethics committee B. All marketing literature will be reviewed with the marketing/planning director or risk management Personnel to ensure that services promoted are provided. C. Billing practices will be monitored for accuracy to ensure that only services provided are billed. D. The Governing Body and senior management personnel will be accountable to the conflict of interest policy, related to disclosure of any benefit. E. If a patient requires transfer to another organization, he/she will be informed of any financial benefit to the organization, and provided the option to choose a provider of their choice. 

2. Member of the Governing Body and Executive Personnel will: 

A. Act in the course of their duties solely in the best interests if the Organization without consideration of interests of any other organization with which they are associated, and to refrain from taking part in any transaction where such person(s) do not believe in good faith that they can act with undivided loyalty to the organization. B. Disclose any material , financial, or other beneficial interest to any entity engaged in the delivery of goods or services to the organization or its members. C. Annually disclose any transactions with the organization that would result in any benefit to themselves, their immediate families, or any entity in which they hold significant financial ownership or other interests, and refrain from participation in any action on such matters except upon approval of the Governing Body after full and frank disclosure. D. Refrain from utilizing any inside information as to the business activities of the organization for the benefit of themselves, their immediate families or any entity with which they may be associated. 

3. During the orientation process, all personnel will be required to sign an employment agreement that includes statements related to:

 A. Confidentiality B. Noncompetition C. Return of records, papers, and equipment

4. All personnel will agree to devote his/her best efforts to the Company and not directly or indirectly be engaged in or connected with any other commercial pursuits whatsoever without written authorization of the organization. 

5. In the event that a situation arises whereby organization personnel could use confidential or privileged organization information for personal gain, they are obliged to report that potential to the Executive Director/Administrator. 

6. Disclosure of potential conflict and the Executive Director’s/Administrator’s decision regarding the actions will be noted in the log file kept by the Executive Director/Administrator. 

7. No full-time salaried organization staff member will engage in private practice of a service similar to that provided by the organization within the geographic area serviced by the organization, without the written permission of the Executive Director/Administrator. Persons violating this policy will be subject to probation or termination. 

8. In the event that a situation arises whereby a member of the Governing Body or senior management personnel could use confidential or privileged organization information for personal gain, he/she is obligated to report in writing that potential to the Governing Body. 

9. The Governing Body will render a decision of that member’s eligibility to be part of voting, if applicable.

10. Disclosure of potential conflict and the Governing Body’s decision regarding voting will be noted in the minutes of the meeting.

Attestation Statement: I have read the Conflict of Interest policy set forth above and agree to comply fully with its terms and conditions at all times during my service as an employee of the Governing Body. If at any time following the submission of this form, I become aware of any actual or potential conflicts of interests, or if the information provided below becomes inaccurate or incomplete, I will promptly notify the Executive Director/Administrator in writing.

All personnel will adhere to DESERT VIEW HOSPICE standards of conduct in their interactions with internal and external customers. These standards will apply to any individual working within the organization, including clinical, clerical, administrative, financial and marketing representatives. 

1. Personnel will comply with daily assignments as scheduled or assigned by the supervisor. If an emergency arises, personnel will notify their immediate supervisor as soon as possible during the workday. 

2. Personnel will not leave the field on their work area without completing the scheduled visits/shifts/deliveries for that day or their work assignments for the day. 

3. All paperwork or electronic documentation will be completed in a timely, accurate manner. Any falsifications of documentation in the clinical/service record and billing record may result in disciplinary action including termination. 

4. All representation of the organization in marketing literature or verbal presentations is to be accurate and truthful. Only care and services that the organization is capable of providing either directly or through written contracts is to be promised to potential referral sources. 

5. Whenever a patient is referred to another organization(i.e. hospital, skilled nursing facility, another organization) , the patient will receive an explanation of any relationship that receiving an organization has to this organization, if any including financial benefit to DESERT VIEW HOSPICE. 

6. All Personnel will follow organization policies, especially policies relating to appropriate admitting, transferring, referral, and discharging practices within the organization. Billing personnel will follow financial policies for assuring accuracy of bills and billing practices. 

7. Personnel must not allow their private interests to conflict with those of their patients. 

8. Personnel will not be permitted to ask for or accept a loan or gift of money or any object of material value from patients, their families, or caregiver. CLINICAL PERSONNEL ONLY 

9. Patient contact Personnel will adhere to the following guidelines: A. Do not give home/ phone numbers to patients, families or caregivers. B. Dress according to Organization policy. C. Avoid engaging in personal discussion with patients. families or caregivers. D. Avoid voicing personal opinions about patients, families and caregivers. E. Do not offer medical advice. F. Do not smoke during home visits. G. Do not expect or accept meals from patients, families, caregivers. H. Avoid abusing patient’s hospitality, use the telephone only in emergency situations or to call the office. I. Be punctual and responsible. J. Do not transport patients, families or caregivers in the car. K. Do not take anyone into the patients’ homes without administrative and patient approval. 

10. All patient contact personnel will communicate with the office to confirm itinerary and to give and receive reports according to organization policy. 

Confidential information is defined as any information found in a patient’s medical records, personal information and work-related information(including salary information). All information relating to a patient’s care, treatment, or condition constitutes confidential information. This confidentiality policy also encompasses any trade secret, scientific or technical information developed by the Practice or its personnel.

1. Employees shall never discuss a patient’s medical condition with any non-employee of the Practice, friends, or family members. Confidential matters involving patients will not be discussed in areas where they might be overheard by other patients or other non-employees of the Practice. Staff members are to be aware at all times that conversations regarding patients are not to be overheard by others and take appropriate steps to ensure this confidentiality. 
2. All salary information is confidential and may not be shared with others in the clinic or with patients. Only authorized individuals may relay salary information to employees or non-employees.
3. Any unauthorized disclosure of confidential information by employees could render the clinic liable for damages. Any employee who violates the confidentiality of clinic, medical or employee-related information is subject to disciplinary action up to including termination from employment. 

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If you change your bank account information with us, there is a processing fee of $5.00, and takes up to (2) two weeks to process. 

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