General Employment Application
1st Hand Health Care Services
701 Yarnall St. Suite G, Chester, Pennsylvania 19013
11 North Broad Street, Middletown, Delaware 19709
Office Number: +1 (302) 765-8495
Office Fax: +1 (888) 817-8426
Email: info@1sthandhealthcare.com
APPLICATION FOR EMPLOYMENT
Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.
Position you're applying for:
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Current Address, City, State, Zip Code
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PLEASE INDICATE THE NUMBER OF YEARS EXPERIENCE IN THE FOLLOWING AREAS:
Are you looking for full-time employment?
If No, what hours are you available?
How did you hear about us?
Emergency Contact - In case of emergency, please notify:
Has your license ever been investigated or suspended?
Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis?
Have you ever been convicted of a felony?
Are you presently employed?
May we contact your present employer?
EDUCATION - High School Name, Location and Year Graduated
EDUCATION - College Name, Location and Year Graduated
REFERENCES - List three professional references not related to you, including name, position, facility and ref. phone number
Employment History, Facility Name, Supervisor Name, Phone Number, Start and Finish Month / Day / Year
CRIMINAL BACKGROUND CHECK
To ensures that all applicants meet the necessary legal, professional, and safety requirements to work within 1st Hand Health Care Services.
As part of the application process, all applicants are required to complete a Criminal Background Check.
Do you have a current criminal background check completed within the last 3–6 months?
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If No, you will need to complete a background check before moving forward.
Please select one of the following options and complete your payment.
Submit the $85 payment via Zelle to: 1sthandhealthcare@gmail.com.
After submitting, please take a screenshot of your payment confirmation and upload it with your application documents.
CONFIDENTIALITY AGREEMENT
The purpose of this Agreement is to protect the confidential and proprietary information of 1st Hand Health Care Services, including but not limited to patient information, business operations, policies, procedures, and any other sensitive data that may be accessed during the course of employment or contractual work.
📝 Definition of Confidential Information
For the purposes of this Agreement, "Confidential Information" includes, but is not limited to:
Medical records, treatment plans, personal health information (PHI), and any other details protected under HIPAA (Health Insurance Portability and Accountability Act).
Policies, procedures, financial data, marketing strategies, employee and contractor records, and any other proprietary information related to the Agency's operations.
• Third-Party Information
Any confidential data obtained from clients, healthcare providers, vendors, or business partners.
📝 Confidentiality Obligations
✅ Maintain the confidentiality of all information obtained through 1st Hand Health Care Services.
✅ Not disclose, share, copy, or use confidential information for personal gain or for any purpose outside of official duties.
✅ Comply with HIPAA regulations and all federal and state privacy laws regarding patient information.
✅ Immediately report any unauthorized access, loss, or disclosure of confidential information to Agency management.
Confidential Information may only be disclosed:
✅ To authorized personnel within 1st Hand Health Care Services who require access for legitimate business or patient care purposes.
✅ When required by law, subpoena, or court order, provided that the Applicant notifies the Agency before disclosing such information, unless prohibited by law.
📝 Return or Destruction of Information
Upon termination of employment or contract, the Applicant agrees to:
✅ Return all documents, records, and materials containing confidential information.
✅ Not retain any copies, notes, or extracts of confidential data.
✅ Ensure that all electronic files related to the Agency's business are deleted from personal devices.
Any violation of this Agreement may result in disciplinary action, including but not limited to termination of employment, legal action, and financial penalties. The Agency reserves the right to seek legal remedies for any unauthorized use or disclosure of confidential information.
Acknowledgment and Agreement
This Agreement remains in effect during and after the Applicant's employment or contract with 1st Hand Health Care Services. The obligation to maintain confidentiality continues indefinitely.
By signing below, I acknowledge that I have read, understood, and agreed to abide by the terms of this Confidentiality Agreement.
PERSONNEL POLICIES REVIEW
As an RN, LPN, or CNA with our agency, you play a vital role in delivering high-quality home health care services to our patients. This Personnel Policies Review outlines the key policies, expectations, and responsibilities that guide our professional practice. Compliance with these policies ensures the safety, integrity, and excellence of patient care.
• Equal Opportunity Employer
1st Hand Health Care Services is an Equal Opportunity Employer and prohibits discrimination or harassment of any kind based on race, color, religion, sex, national origin, age, disability, genetic information, marital status, or any other protected status.
Employment with 1st Hand Health Care Services is at-will, meaning either the employee or the employer may terminate employment at any time, with or without cause or notice, unless otherwise stated in a written contract.
📝 Professional Conduct & Ethics
All RNs, LPNs, and CNAs must adhere to the highest professional and ethical standards, including:
✅ Upholding patient confidentiality in accordance with HIPAA regulations.
✅ Providing compassionate, respectful, and non-discriminatory care.
✅ Maintaining professional boundaries with patients and their families.
Reporting any suspicious activity, abuse, neglect, or non-compliance with care plans.
• Confidentiality & HIPAA Compliance
All patient information must be kept strictly confidential in compliance with HIPAA (Health Insurance Portability and Accountability Act). Unauthorized disclosure or misuse of patient information will result in disciplinary action, up to and including termination.
• Drug-Free Workplace & Substance Abuse Policy
1st Hand Health Care Services maintains a drug-free workplace. RNs are strictly prohibited from reporting to work under the influence of alcohol, illegal drugs, or controlled substances. Violations will result in immediate disciplinary action.
📝 Work Expectations & Responsibilities
• Work Assignments & Scheduling
✅ RNs, LPNs, and CNAs are expected to adhere to their assigned schedules and be punctual for all patient visits.
✅ Any scheduling conflicts or requests for time off must be communicated at least 48 hours in advance, except in emergencies.
✅ Staff may be required to work weekends, holidays, or on-call shifts, as needed.
• Patient Care Responsibilities
👩🏻⚕️ Registered Nurses (RNs)
✅ Conduct thorough patient assessments and document findings accurately.
✅ Administer medications, treatments, and IV therapy per physician orders.
✅ Provide patient education on medications, disease management, and home care.
✅ Coordinate with physicians, therapists, and other healthcare providers for patient care.
✅ Maintain accurate and timely documentation in compliance with agency policies.
👩🏻⚕️ Licensed Practical Nurses (LPNs)
✅ Assist with patient assessments and report changes in condition to the RN.
✅ Administer medications and treatments within scope of practice and under RN/physician supervision.
✅ Provide wound care, catheter care, and other skilled nursing tasks as assigned.
✅ Support patient and family education as directed by the RN.
✅ Accurately document all care provided in compliance with agency policies.
👩🏻⚕️ Certified Nursing Assistants (CNAs)
✅ Assist patients with activities of daily living (ADLs), such as bathing, grooming, dressing, and mobility.
✅ Take and record vital signs, weight, and intake/output as assigned.
✅ Report any patient changes or concerns promptly to the supervising nurse.
✅ Maintain a safe, clean, and supportive environment for patients.
✅ Provide emotional support and companionship to patients and families.
• Documentation and Record Keeping
✅ All patient care activities must be documented accurately and in real time.
✅ Records must be maintained in accordance with state and federal regulations.
Falsification, omission, or misrepresentation of records is strictly prohibited.
📝 Compensation & Benefits
• Pay Structure & Overtime
✅ Compensation is based on the agreed pay rate outlined in the employment agreement.
✅ RNs are paid as per agency policy.
✅ Overtime (beyond 40 hours per week) is compensated according to state and federal wage laws.
✅ Mileage reimbursement may be provided for approved travel between patient locations.
✅ RNs, LPNs, and CNAs must submit travel logs and documentation for reimbursement, if applicable.
• Drug-Free Workplace & Substance Abuse Policy
1st Hand Health Care Services maintains a drug-free workplace. RNs, LPNs, and CNAs are strictly prohibited from reporting to work under the influence of alcohol, illegal drugs, or controlled substances. Violations will result in immediate disciplinary action.
✅ Eligible employees may receive Paid Time Off (PTO) based on tenure and employment status.
✅ Health insurance and other benefits will be detailed in the employment contract, if applicable.
✅ RNs, LPNs, and CNAs must follow OSHA guidelines and infection control protocols to maintain a safe work environment.
✅ Proper hand hygiene, appropriate PPE use, and safe patient handling techniques must always be followed.
✅ Any workplace injury must be reported immediately to the supervisor.
• Mandatory Training & Certifications
✅ Registered Nurses (RNs) must maintain an active and valid state license. Certifications such as BLS (Basic Life Support), ACLS (if applicable), and IV Therapy Certification must be kept up to date.
✅ Licensed Practical Nurses (LPNs) must maintain an active and valid state license. Certifications such as BLS and IV Therapy Certification (if required by the state or facility) must be current.
✅ Certified Nursing Assistants (CNAs) must maintain active and valid state certification/registration. BLS/CPR certification is required and must remain current.
✅ Attendance at all mandatory training sessions, in-services, and continuing education is required for continued employment.
• Compliance with State & Federal Regulations
✅ RNs, LPNs, and CNAs must adhere to all applicable state licensure regulations, nursing board requirements, facility policies, and Medicare/Medicaid compliance standards.
✅ Any failure to comply may result in corrective action, suspension, or termination.
📝 Disciplinary Action & Termination
• Grounds for Disciplinary Action
Disciplinary actions may include verbal warnings, written warnings, suspension, or termination for violations such as:
❌ Breach of confidentiality or HIPAA violations.
❌ Failure to follow patient care protocols.
❌ Repeated tardiness or absenteeism.
❌ Substance abuse or impaired performance on duty.
❌ Falsification of records or misrepresentation of care provided.
❌ Unprofessional conduct or inappropriate interactions with patients or staff.
✅ Employment may be terminated at any time with or without cause as per the at-will employment policy.
✅ Employees who wish to resign must provide a written notice of at least 14 days.
✅ Upon termination, all company property (badges, records, equipment, etc.) must be returned.
Acknowledgment and Agreement
By signing below, I acknowledge that I have read, understood, and agree to comply with the personnel policies outlined above. I understand that failure to adhere to these policies may result in disciplinary action, up to and including termination.
For security and identification purposes, all staff are required to wear a name badge with a photo ID while working at any facility under 1st Hand Health Care Services. Please provide the information below as you would like it to appear on your badge.
Example: John Smith, RN or John L. Smith, RN, BSN
APPLICANT'S CERTIFICATE AND RELEASE
I certify that all information I have provided in order to apply for employment with 1st Hand Health Care Services is true, correct, and complete, including the information in this application. I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect may result in (a) no further consideration of this application or (b) my immediate discharge by 1st Hand Health Care Services when it is discovered.
I expressly authorize, without reservation, 1st Hand Health Care Services to conduct any reference or background checks that it, in its sole discretion, deems appropriate and authorize it to obtain information from employers, public agencies, licensing authorities, educational institutions, organizations, or individuals, and to otherwise verify the accuracy of all information provided by me in this application, my resume, or during the interviewing process.
I hereby release 1st Hand Health Care Services and its employees, agents, and affiliates from any and all liability relating to conducting or obtaining any reference or background checks, including my criminal background history, and the use of such information. I further release all employers, public agencies, licensing authorities, educational institutions, organizations, and persons from all liability in responding to any reference checking or criminal background inquiries by or on behalf of 1st Hand Health Care Services.
If I am hired by 1st Hand Health Care Services, I acknowledge that 1st Hand Health Care Services reserves the right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an employment agreement or contract for any specified period or duration. I understand that no employee, agent, or representative of 1st Hand Health Care Services is authorized to make any assurances to the contrary and that no implied, oral, or written agreements contracting to the forgoing express language are valid unless they are in writing and signed by 1st Hand Health Care Services' staffing coordinator.