Posted at 21 Jul, 09:20h in Uncategorized by Kamaryn Allison 0 Comments 0 Likes Share Facility AgreementFacility AgreementWhich branch office is your facility closest to?(Required)Atlanta, GAAugusta, GAChattanooga, TNColumbia, SCFlorence, SCGreenville, SCJohnson City, TNKnoxville, TNLexington, KYMemphis, TNNashville, TNRaleigh, NCFACILITY NAME(Required)FACILITY PHYSICAL LOCATION(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Consolidated Medical StaffingThis Supplemental Staffing Agreement is between (the “facility”) and Consolidated Medical Staffing (the “agency”), for the best-efforts provision of nursing and other healthcare personnel with the following terms and conditions. This agreement shall commence following the day of the agreement completion and shall continue for one calendar year.Responsibilities of AgencyAgency agrees to use its best efforts to provide the facility with qualified medical staff as requested by facility. Agency agrees to comply with additional facility required credentials and/or code of conduct as provided in writing by facility. Credentials: Agency is responsible to provide current valid credentials on its employees at the request of the client. Credentials pertain to, but are not limited to, professional licenses and certifications, reference and background checks, drug test, CPR, and a clinical skills assessment for the classification and area of expertise. Insurance: Agency will provide at its sole cost and expense programs of insurance: Worker’s Compensation and Employer’s Liability Insurance. Wages: Agency assumes full responsibility for payment of wages and is responsible for withholding federal and state income taxes and withholding and paying FICA taxes.Responsibilities of FacilityDocumentation: Facility agrees to assist Consolidated Medical Staffing in or with providing clinical evaluations on all provided field staff. Facility also agrees to provide written documentation of any violations of State Practice Laws or filled criminal charges with 24 hrs of suspected event. Late – Call: Late-Call rates are at the regular rate and, if called back in, there is an additional minimum charge of two – hours. Weekends: Agency Weekend begins with the Friday 7pm shift and ends at the 7am shift on Monday. Overtime: Agency workweek begins with the Monday 7am- 3pm shift through the Sunday 11pm- 7am shifts. All work more than forty (40) hours per week worked by an employee will be billed at time and one-half of the regular rates. The facility will be informed of the overtime status and proper approval obtained prior to committing the employee and facility. Holidays: Holidays begin with the 7am shift on the actual holiday and ends at 7am on the day following the holiday. The following holidays will be invoiced at time and one-half: New Year’s Day, Easter Sunday, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day and New Year’s Eve. Orientation: If requested, the agency will provide 4 hours of orientation at the facility at no cost to the client. Daylight Savings Time: Spring: billed one hour less; Fall: billed one hour more Cancellations: The facility may change or cancel its requests for supplemental staff without incurring costs if CMS is notified at least two (2) hours prior to the start of the shift. With less than a two-hour notice, Agency may charge two (2) hours of the designated shift and classification hourly rate. Turn Away Pay: If a change in staffing requirements occurs in which the Agency employee services are no longer required, the facility will be invoiced for (4) hours turn away pay for all cancellations occurring after arrival to the facility for the scheduled shift. If the facility offers the employee an option to work a minimum of four hours and the employee refuses, no charge will be billed to the facility. Employment: Facility agrees not to recruit or hire any Agency employees for its per diem/float pool or any position for a period of 90 days from his/her last shift worked at the facility. If the facility decides to hire an Agency employee, the facility agrees to pay a placement fee of $3,000 for CNAs, $5,000.00 for LPNs, and $8,000.00 for RNs. Facility agrees not to allow CMS employees to work at the facility through another staffing company for a period of 90 days from his/ her last shift worked at facility through CMS. CMS will also not allow other outside agency staff to work at facility through CMS for a period of 90 days from his/ her last shift worked at facility through other outside agency. Invoices: Invoices are to be paid in full upon receipt of the invoice. After Thirty (30) days, all unpaid balances will accrue interest at the highest rate permitted by law. Mail payments to: Consolidated Staffing, Inc. 318 High St. Maryville, TN 37804 Governing Law; Construction: This Agreement shall be governed by and construed in accordance with the laws of the State of Tennessee, County of Shelby without regard to applicable conflict of law’s provisions. OSHA: To ensure compliance with all applicable OSHA Standards, including the Hazard Communication Standard, 29 CFR 1910.1030, Consolidated Medical Staffing will provide its employees with “Generic” safety training prior to placement with a “host-employer”. Consolidated Medical Staffing generic training will cover, among other things, the Hazard Communication Standard and the Occupational Exposure to Blood borne Pathogens Standard. It shall be the sole responsibility of the host-employer utilizing Consolidated Medical Staffing employees to provide these employees with the necessary “site Specific” safety training. It shall also be the sole responsibility of the host-employer to create and maintain training records, as required by OSHA, which evidence the fact that such “Site Specific” training has occurred. The host-employer hereby agrees that upon written request it shall provide free of charge a copy of these training records to Consolidated Medical Staffing. The host-employer further agrees that it will be liable for compliance with applicable OSHA regulations. Entire Agreement: This agreement constitutes the entire agreement of the parties. No amendment or modification of this Agreement shall be effective unless made in writing and signed by both parties. Collection: In the event of any action to collect unpaid invoices, the Facility shall be liable to the Agency or its assignee for all costs of collection, including but not limited to attorneys’ fees and costs. The Agency may collect from the facility a fee of $20.00 for any check that is returned by the financial institution as “dishonored” of for “insufficient funds”. Relationship of Parties: Agency is not the Facility’s legal partner, covertures, principal, agent, insurer or representative. Neither Agency nor assigned employees have any claim to Facility’s revenues. Assigned Employees have no authority to bind Agency legally. Confidentiality: At Facility’s request, Agency will inform Assigned Employees of their obligation to keep in confidence any confidential information they might receive or observe on assignment for Facility. The Agency will also require that all employees will be aware of and receive in-service information on all HIPPA requirements and will be fully bound by those requirements. In Witness whereof, the parties with requisite legal authority, intending to be bound to the terms of the agreement, have caused this agreement to be executed by their duly authorized representatives agree to said terms and rates.Consolidated Medical Staffing Per Diem Staffing Rates CNA / NURSE AIDE/ NURSE ASSISTANTS $32/ hr LPN/ PRACTICAL/ VOCATIONAL NURSES $50/ hr RN/ REGISTERED NURSES $62/ hr Contract Staffing Rates CNA / NURSE AIDE/ NURSE ASSISTANTS $45/ hr LPN/ PRACTICAL/ VOCATIONAL NURSES $65/ hr RN/ REGISTERED NURSES $75/ hr IMPORTANT: Any additional compensation (ie, Shift Bonus, Travel Pay, Hazard Pay) promised to the Client to employee, verbally or in writing, will be invoiced with a 20% markup. Authorized Facility Manager & Title(Required) First Last Suffix Please state your title as “Suffix”.Authorized Facility Manager Phone Number(Required)Authorized Facility Manager Email(Required) Invoices will also be sent to this email.Staffing Coordinator Name(Required) First Last Staffing Coordinator Phone Number(Required)Staffing Coordinator Email(Required) Accounts Payable Manager(Required) First Last Accounts Payable Phone Number(Required)Accounts Payable Email(Required) This is where invoices will be directed.Facility Authorized Signature:(Required)Facility Authorized Title:(Required)Date(Required) MM slash DD slash YYYY CMS Authorized SignatureCMS Authorized TitleDate MM slash DD slash YYYY Untitled(Required) By submitting this form you agree for us to contact you via SMS. View our Terms and Services and Privacy Policy.
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