Welcome to Lexington Medical Center
As you begin your exploration down a path of limitless career
potential, it is the goal of the hospital to ensure that you start
your journey smoothly. This New Hire Packet was designed
to help you navigate successfully as a new employee within
the Lexington County Health Services District. Your journey
as a new hire will be guided through the Human Resources
department, Staff Development and your department
manager. With proper guidance, continued training and
dedication, we know that your contributions to our team will
continue in the tradition of excellence that propels Lexington
Medical Center as the best within our region and state.
So, let’s begin your journey!
The New Hire Journey Part I ~ On-Boarding
New Hire Journey ~ Part 1 [ 1 ]
Your first step in the new hire journey is with the Human Resources department. The purpose of this packet is to provide you with vital information that is needed prior to your first day of employment. It is also important for us to gather information from you. Enclosed you will find the following forms:
• New Employee Orientation Date Date and time of your orientation (Mini- and/or General Hospital Orientation). You will also find vital information
about orientation and answers to commonly asked questions.
• Employee Personal Data Form
The Employee Personal Data Form contains information that will be used to start your electronic personnel record. To help us maintain the integrity of the data collected, please ensure that you complete each line of this form (front and back).
• LMC Policies and Procedures Disclaimer Form
You will find two copies of this form in your packet. Please ensure that you sign the disclaimer form designated
as Human Resources Copy. The Employee Copy located in this booklet is for your personal records.
• Form I-9, Employment Eligibility Verification* Please complete Section 1 – Employee Information and Verification. This is an official government form. It is important that you complete this form accurately and do not have any lines, scratches, etc. Once completed,
please review, sign and date (within section one) only.
• Acknowledgment of Receipt of Notice of Privacy Practices
• Breach of Confidentiality
• Post-Offer Medical Questionnaire
• Orientation Map
*Please ensure that you also bring identification to complete the I-9 form, as well as the original form/card of credentials.
These forms need to be completed and returned to the HR Representative during your initial Pre-employment/Employee Health appointment. If you have any questions regarding your paperwork, please contact the Human Resources office at (803) 791-2960.
New Employee Orientation Checklist
Mini-orientationYou are scheduled for a Mini-Hospital (HR) Orientation on ______________________________________________
Human Resources office on Monday from 8:00 a.m. – 9:30 a.m.
Attendance is mandatory. During the mini-orientation you will review all introductory payroll and safety information needed to begin employment. Please remember to park in Lot K (Employee Parking), located at the back of the hospital. If Lot K is full, please park in Lexington Medical Park 2 on Level 4, 5 or 6. It is important that you bring a voided check or deposit slip to your scheduled mini-orientation. Direct deposit is a requirement for employment at Lexington Medical Center.
General Hospital OrientationYou are scheduled for General Hospital Orientation on _______________________________________
Lexington Medical Park I Auditorium from 7:30 a.m. – 5:00 p.m.
All employees are expected to attend orientation for the entire day (even if you have completed a mini-orientation). Lunch is provided and breaks are built into the schedule for your convenience. Please remember to park in Lot K (Employee Parking), which is located at the back of the hospital. If Lot K is full, please park in Lexington Medical Park 2 on Level 4, 5 or 6. If you have not already completed a mini-orientation, you must bring a voided check or deposit slip. Direct deposit is a requirement for employment at Lexington Medical Center. If you have already completed a mini-orientation, you must bring your employee ID badge and clock in under “orientation” in the system.
SC Retirement SystemYour position may require you to join the SC Retirement System. If you do not have an active account with the SCRS and your position does not require that you join, you may choose to waive. Please note, if you choose to waive SCRS, your election is irrevocable. Please be prepared to make your decision during your new hire orientation and provide the following information for your designated beneficiary(ies) as this will be collected during the benefits portion of orientation: name, date of birth and social security number. If your beneficiary is under 18 years of age, you must have a trustee designated in your will. Please refer to the enclosed SCRS Member Handbook for information about SCRS.
[ 2 ] Lexington Medical Center
During Orientation employees may dress “business casual.” Uniforms are not necessary. All clothing should be neat, clean and properly fitting with appropriate undergarments. In addition to wearing an identification badge at all times, Lexington Medical Center’s dress code policy states in part:
2.1 Appropriate female business attire includes: suits, dresses, skirts and split skirts no shorter than three
(3) inches above the knee, and slacks (not shorter than mid-calf).
2.2 Unacceptable female attire includes: shorts, all denim attire, see-through blouses, halter/sun dresses,
athletic attire (sweatshirts, sweatpants and jogging suits), tight clothing or leggings, imprinted t-shirts,
and any type of attire which is low cut or where the midriff is exposed. Extreme styles should be avoided.
2.3 Appropriate male business attire includes: slacks and a collared shirt. A tie and jacket may be required.
2.4 Unacceptable male attire includes: jeans, imprinted t-shirts, shorts and athletic attire (sweatshirts,
sweatpants and jogging suits).
4.1 All employees are required to wear dress shoes, dress sandals, athletic shoes or work shoes.
Closed toe shoes are required for patient care areas. All shoes must be kept clean and polished.
4.2 No “flip flops” or cowboy boots may be worn to work.
6.1 Makeup should be used in moderation. No perfume or cologne should be used. Many individuals and
especially patients may be sensitive or become nauseous when in contact with various fragrances.
6.3 Jewelry should be tastefully minimized and appropriate for all business and professional attire. Earrings
are acceptable if they are conservative. Limit two per ear. Other visible body piercing is not allowed
(includes but not limited to tongue, nose and eyebrow). Excessive jewelry should not be worn. Long
necklaces, bracelets, long earrings, etc. are not acceptable in a patient care area as they present a
safety hazard.
6.4 If an existing tattoo could be considered offensive by any person, it must be covered.
New Employee Orientation
New Hire Journey ~ Part 1 [ 3 ]
Employee Personal Data
Employee ID:_________________________________ Date of Hire:________________________________________________________
Name: (must match name on Social Security Card) ___________________________________________________________________________
Preferred Name:____________________________________ Social Security Number:__________________________________________
Address:__________________________________________________________________________________________________________
City:__________________________________________________ State:______ ZIP: ________________ County:___________________
MAIN TELEPHONE ALTERNATE TELEPHONE
Cellular Home Other: ( _______ ) ________________ Cellular Home Other: ( _______ ) ________________
DATE OF BIRTH (MM/DD/YYYY) REFERRAL SOURCE (Please select, if referred please list employee name)
TV Internet LMC Website SCHA Job Listing Monster Other:____________________________________________
Employee Referral:_________________________________________________________________________________________________
DRIVER’S LICENSE INFORMATION Driver License Number:_____________________________________________________________
State Issued By:________________________ Expiration Date:_______________________ Type of License:________________________
EMERGENCY CONTACT PRIMARY Name:________________________________________________________________________________________________
Address same as above Address: _________________________________________________________________________________
City:__________________________________________________ State:______ ZIP: ________________ County:___________________
Telephone: Cellular Home Other: ( _______ ) ________________
SECONDARY Name:_____________________________________________________________________________________________
Address same as above Address: _________________________________________________________________________________
City:__________________________________________________ State:______ ZIP: ________________ County:___________________
Telephone: Cellular Home Other: ( _______ ) ________________
Smoker: Yes NoMarital Status: Single Married Divorced Separated
Highest Level of Education: HS Diploma/GED Associate Degree
Bachelor’s Degree Master’s Degree PhD _____________
Full time Student: Yes No
Sex: Male Female
Military Status: N/A Active Reserve
Inactive Reserve Retired Vietnam Veteran
Non-Vietnam VeteranLanguage: (other than English)________________________
Speaking level: High Medium Low
Writing level: High Medium Low
Ethnic Identification (optional): Please identify your ethnic
status for demographic purposes by circling below. You may
indicate up to three selections. If you select more than one option,
please place the percentage amount in the space provided.
American Indian:______% Asian:______% Black:______%
Hispanic:______% Pacific Island:______% White:______%
Choose Not to Specify
Please note: This information will be placed in your personnel file. If you are unsure about any section, contact your HR Representative.
New Employees forms.indd 1
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Employee Personal Data Form
The Employee Personal Data Form contains information that will be used to start your electronic personnel record. To help us maintain the integrity of the data collected, please ensure that you complete each line of this form (front and back).
SAMPLE
[ 4 ] Lexington Medical Center
ALL EMPLOYEES OF THE LEXINGTON MEDICAL CENTER (LMC) ARE EMPLOYED AT-WILL AND MAY QUIT
OR BE TERMINATED WITHOUT NOTICE AND/OR WITHOUT A REASON AT ANY TIME AND FOR ANY REASON.
NOTHING IN ANY OF LMC RULES, POLICIES, HANDBOOKS, PROCEDURES OR OTHER DOCUMENTS RELATING
TO EMPLOYMENT CREATES ANY EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT. NO PAST PRACTICES
OR PROCEDURES, WHETHER ORAL OR WRITTEN, FORM ANY EXPRESS OR IMPLIED AGREEMENT TO
CONTINUE SUCH PRACTICES OR PROCEDURES. NO PROMISES OR ASSURANCES, WHETHER WRITTEN
OR ORAL, CREATE ANY CONTRACT OF EMPLOYMENT UNLESS: 1) THE TERMS ARE PUT IN WRITING; 2)
THE DOCUMENT IS LABELED A CONTRACT OR AN AGREEMENT; 3) THE DOCUMENT STATES THE TERM OF
EMPLOYMENT; AND 4) THE DOCUMENT IS SIGNED BY LMC’S CHIEF EXECUTIVE OFFICER.
I ACKNOWLEDGE THAT LMC’S POLICIES AND PROCEDURES INCLUDING THOSE ON THE INTRANET ARE NOT
A CONTRACT OF EMPLOYMENT.
____________________________________________________________ _______________________________ Signature Date
____________________________________________________________ Printed Name
____________________________________________________________ Social Security Number
Employee CopyPlease maintain this copy for your personal records.
Lexington Medical Center Policies and Procedures
New Hire Journey ~ Part 1 [ 5 ]
Lexington Medical Center is committed to the protection of your health information as it is used in the maintenance and administration of the hospital’s group medical benefit plan. Enclosed with your new hire paperwork you will find LMC’s Notice of Privacy Practices. The Notice of Privacy Practices informs you how your protected health information is used and disclosed when health insurance claims are filed. Other than reviewing the notice, no action is needed on your part, and this does not change your current level of benefits or the way in which you submit health care claims. The Notice of Privacy Practices will be available upon request at any time and is located in the Human Resources department. Please share this information with your spouse or any adult children who are covered by our health plan. If you should have any questions, please feel free to contact our Privacy Officer at (803) 936-8235.
Notice of Privacy Practices
Notice ofPrivacy PracticesNotificación de Prácticas Privadas
Special Note: The I-9, Employment Eligibility Verification Form is an important
government document that certifies your eligibility to work within the United States. Please ensure
that you carefully read the directions below prior to completing this form. In the event that you
do make an error on this form, please contact your Lexington Medical Center Human Resources
Representative immediately to get a clean form.
Please complete Section 1 – Employee Information and Verification. This is an official
government form. It is important that you complete this form accurately and do not have any lines,
scratch-outs, etc. Once completed, please review, sign and date (within section one) only.
• This form must be filled out in black or blue ink.
• Ensure that you completed each line in Section 1.
• Remember to sign and date on the same line that says “Employee’s Signature.” Do not sign above this line.
• The back of the I-9 Form lists acceptable documents that can be used for Human Resources to complete this form. Please remember that all documents must be unexpired.
I-9 Employment Eligibility Verification Form
[ 6 ] Lexington Medical Center
New Hire Journey ~ Part 1 [ 7 ]
TO: All Employees
FROM: Tod Augsburger, President/CEO
SUBJECT: Breach of Confidentiality
Please read and be aware of the penalties for breach of confidentiality.
Lexington Medical Center (“LMC”) is committed to maintaining the confidentiality of all LMC information [and this requirement is further described in our compliance program and privacy policies]. The purpose of this Memorandum is to affirm your understanding of LMC’s expectation that you will maintain the confidentiality of all LMC information, including patient and employee information (“LMC Information”), and the possible penalties for breach of confidentiality of such information. Please read the statements below and indicate your understanding by signing at the bottom of this form.
I agree to hold in strict confidence LMC Information obtained during the course of my employment, including but not limited to information related to patients and employees. I understand that confidential treatment of all communication and records pertaining to a patient’s care are described in LMC’s patient’s bill of rights.
I acknowledge that breach of confidentiality of LMC Information is grounds for immediate termination of my employment, internship or other relationship with LMC, and that I may be held liable for damages in the event that the interests of LMC, a patient, or an employee are harmed because of a breach of confidentiality on my part.
I also understand that under 42 U.S.C. Section 1320d-6 of the Health Insurance Portability and Accountability Act, improper use or disclosure of individually identifiable health information by an employee or other individual could result in penalties up to $50,000 and one year in prison per offense, up to $100,000 and five years in prison per offense if committed under false pretenses, and up to $250,000 and ten years in prison per offense if committed with intent to sell, transfer, or use the information for commercial advantage, personal gain, or malicious harm. A person (including an employee or other individual) is considered to have obtained or disclosed individually identifiable health information in violation 42 U.S.C. Section 1320d-6 if the information is maintained by LMC and the individual obtained or disclosed such information without written authorization or under other permissible circumstances.
In addition, I acknowledge that the findings of any patient medical record reviews are for the sole use of Lexington Medical Center pursuant to the quality assurance program within the hospital and subject to the confidentiality provision of Section 40-71-20 of the Code of Laws of South Carolina.
I hereby acknowledge that I have read and understood the breach and confidentiality provisions described above, and will abide by the terms of these provisions. If there is any provision that I do not understand, I acknowledge that it is my responsibility to obtain clarification prior to signing below. I further understand and agree to promptly report any suspected breaches of confidentiality to the LMC Privacy Officer (803-936-8235).
___________________________________________________________ ______________________________ Printed Name Employee ID Number
___________________________________________________________ ______________________________ Employee Signature Date
Employee Copy
Breach of Confidentiality
Post Offer Medical Questionnaire
The purpose of this evaluation is to screen you for communicable diseases and to determine whether you have any physical, mental, or emotional
condition that could affect your ability to perform the job you have been offered. Whenever such condition is identified, we will evaluate, with your
input and consideration, reasonable accommodations that may allow you to perform the essential functions of your job safely. This interview is not
a comprehensive medical examination to identify hidden disease or to offer medical treatment. Once you have begun your job, we encourage you
to establish a relationship with a medical provider in accordance with your specific needs.
Name: __________________________________________________________________________________________________________
Address:__________________________________________________________________________________________________________
City:__________________________________________________ State:______ ZIP: ________________ County:___________________
MAIN TELEPHONE
ALTERNATE TELEPHONE
Cellular Home Other: ( _______ ) ________________ Cellular Home Other: ( _______ ) ________________
DATE OF BIRTH (MM/DD/YYYY) ___________________ AGE __________ SEX Male Female
Name:________________________________________________________________ Relationship:________________________________
Address same as above Address: _________________________________________________________________________________
City:__________________________________________ State:______ ZIP: ______________ Telephone: ( _______ ) ________________
Name:_______________________________________________________________________ Telephone:( _______ ) ________________
Title of job you have been offered:_____________________________________________________________________________________
Department Manager:______________________________________________________________________________________________
Anticipated Start Date:________________________ Human Resources Recruiter:______________________________________________
The purpose of this evaluation is to screen you for communicable diseases and to determine whether you have any physical, mental or emotional
condition that could affect your ability to perform the job you have been offered. Whenever such condition is identified, we will evaluate, with your
input and consideration, reasonable accommodations that may allow you to perform the essential functions of your job safely. This interview is not a
comprehensive medical examination to identify hidden disease or to offer medical treatment. Once you have begun your job, we encourage
you to establish a relationship with a medical provider in accordance with your specific needs.
Title II of the Genetic Information Nondiscrimination Act (GINA) prohibits employers from asking questions pertaining to genetic testing or
family medical history. Please do not disclose any health condition or potential health condition based on genetic testing or family history.
Applicant Consent
I understand my offer of employment is contingent upon the successful completion of the Lexington Medical Center’s pre-placement process. I understand
that drug testing is a part of the pre-placement process. If the results of my drug test are positive I understand the Human Resources Department will
be notified and my application for employment will be withdrawn. An exception will be made for the use of legally prescribed medication, taken under
and consistent with the direction of a physician, which I have listed on this form.
I certify that the following information is true to the best of my knowledge. I understand this information will become a part of my confidential medical
records in the office of Employee Health Services. I understand and agree that any false statement, omission or misrepresentation on the following
questionnaire will be cause for dismissal.
__________________________________________________________________________________ __________________________________
Signature
Date
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Congratulations! You have made it through the first half of pre-employment paperwork. You are headed in the right direction!
The next step on your journey includes your Employee Health screening which will include a tuberculin skin test and a drug screen urinalysis. The next form should be completed and given to the Employee Health Team:
• Post-Offer Medical QuestionnaireThe information from the questionnaire will be used to start your employee health file within the hospital. All information is confidential. Please complete the entire questionnaire to the best of your ability. Don’t forget to sign and date both the first and last pages.
Post-Offer Medical Questionnaire
[ 8 ] Lexington Medical Center
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103 .............. Administration Annex
107 .............. Marketing
109 .............. Sleep Solutions
112 .............. Data Center
115 .............. Community Relations
120 West ..... Lexington Heart
120 East ...... Lexington Medical Associates
123 .............. Rehabilitation and Sports Medicine
130 .............. Audit & Fiscal Services
134 North .... Epic Center
Main Campus
Lexington Medical OfficeBuilding
EmployeeParking
East Entrance
North Entrance
North TowerPatientPick-up
VisitorParking
120 East
123
115
111
112
109
105
103
107
120West
CDC
130
134 North
110
VendorParking
VisitorParking
VisitorParking
VisitorParking
VisitorParking
VisitorParking
M
Visitor Parking
Visitor ParkingN
Visitor Parking
VisitorParking
Employee/VendorParking
O EmployeeParking
134 East
EmployeeParking
Employee Parking
H
EmployeeParking
L
VisitorParking
PARKING GARAGE 1Level A & B – VisitorLevel C, D & E – Employee
PARKING GARAGE 2Level 1, 2 & 3 – VisitorLevel 4, 5 & 6 – Employee
103 .............. Administration Annex
107 .............. Marketing
109 .............. Sleep Solutions
112 .............. Data Center
115 .............. Community Relations
120 West ..... Lexington Heart
120 East ...... Lexington Medical Associates
123 .............. Rehabilitation and Sports Medicine
130 .............. Audit & Fiscal Services
134 North .... Epic Center
Main Campus
Lexington Medical OfficeBuilding
EmployeeParking
East Entrance
North Entrance
North TowerPatientPick-up
VisitorParking
120 East
123
115
111
112
109
105
103
107
120West
CDC
130
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110
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Visitor ParkingN
Visitor Parking
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O EmployeeParking
134 East
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H
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PARKING GARAGE 1Level A & B – VisitorLevel C, D & E – Employee
PARKING GARAGE 2Level 1, 2 & 3 – VisitorLevel 4, 5 & 6 – Employee
8371-078-C (10/15)
Employee parking is assigned by Public Safety. Please contact your department director for your designated parking assignment.
6-2015/200/LMC