LPN

Submission Documents

Resume

Must include candidate's education (Including month / year of graduation), & complete work history from the last seven (7) years. All work history should include facility worked at, not the agency name.

Skills Checklist

Completed within one (1) year of submittal for specialty where candidate is submitted

Two (2) References

Two (2) references from work history occurring within the past three (3) years. At least (1) one reference must be from a supervisor.

Online verification of professional license or certification

Verified within 30 days of submission. Nursys acceptable.

Placement Documents

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License or Certification Verification

Online verification of professional license completed within thirty (30) days of start and at time of extension. For RN / LPN verification must be through Nursys.

Drug Screen

10-panel drug screen collected within thirty (30) days of start date; required to be updated on an annual basis. The following drugs must be on the panel : Amphetamine to include Methamphetamine, Barbituates, Benzodiazipines, Cocaine, Marijuana, Methadone, Methaqualone, Propoxyphene, Opiates / Opioids, Phencyclidine

Physical

Completed within one (1) year of start date; required annually thereafter

MMR

Shown by proof of two (2) MMR vaccinations or positive IGG titers

Varicella

Shown by proof of two (2) vaccinations, positive IGG titer, or provider verified history

Hepatitis B

Shown by proof of vaccination series, positive surface antibody titer or declination

Influenza

Vaccination for Assignments occurring from 10 / 1-3 / 31. Decline form permitted but must follow location s policy for masking during active flu cases

Tdap

Administered within ten (10) years of start date. Decline form accepted.

TB

Documentation of TB skin test, TB QuantiFeron, or T-Spot completed within one (1) year of start date and annually thereafter. Chest X-Ray should only be completed for past positive PPD cases as a result of TB exposure. If providing Chest X-Ray, TB questionnaire is required at time of placement and annually thereafter.

Background Check

Completed within 30 days of start date and including National Criminal Check, FACIS Level III, National Sex Offender, all counties lived and worked within past 7 years, including for any alias. SSN Address trace is required.

OIG (Office of Inspector General)

OIG completed within thirty (30) days of start date, and at time of extension. Must be run for all alias names that appear on the SSN address trace.

SAM (System for Award Management)

SAM completed within thirty (30) days of start date, and at time of extension. Must be run for all alias names that appear on the SSN address trace.

Specialty Competency Exam

Completed within one (1) year of start date for the specialty corresponding to the CP s Assignment; required annually. An 80% or passing rate is required.

Joint Commission Modules

Core I, II and III modules completed within a year of start; required annually

Valid state issued Drivers License or ID card

State issued photo ID or state issued Drivers License required to be current at time of start. Photo ID must be submitted to clients for identification verification.

COVID-19

Proof of Covid vaccination or declination accepted.

Nebraska DHHS Registry Check

Nebraska DHHS Central Registry Check, to include Adult Protective Services and Child Abuse and Neglect Registries, completed within sixty (60) days of start date.

Smoke Free Campus Policy Form

Please have HCP sign.

Pager Policy

Please have HCP sign

BLS - Basic Life Support (American Heart Association)

Provided Documents

Healthcare Provider Timekeeping Instructions

Agency to download this document and provide to all HCP's prior to their start date. HCP / Affiliate Vendor responsible to enter time in Triage Plus no later than noon CST every Monday.

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