Policy Manual sample

MDT Home Health Care Agency, Inc. Categories Very Dissatisfied Dissatisfied Neutral Satisfied Very Satisfied Amount and quality of information received re: employee benefits (vacation, sick leave, mileage reimbursement, educational opportunities, health insurance, retirement plan) Working Conditions and Benefits Mileage reimbursement Number of Agency in-services Physical working conditions within your work area Number of educational opportunities outside the Agency Quality of educational opportunities outside the Agency Employee suggestion/concerns procedure On Call System Scheduling procedure Pager system Backup system Timeframe for being on call (length) Compensation for accepting “call” Available of other staff to make visits Would you be interested in additional health insurance coverage for dental/vision/disability? Yes No Would you be interested if the premiums for this additional coverage were your responsibility? Yes No Do you feel that an employee Suggestion Box would be beneficial for the Agency? Yes No Additional Comments: _______________________________________________________________________________________ _______________________________________________________________________________________ Signature (optional) __________________________________ Date ___________________ Home Health Agency - - Skilled Professional Services D-72