Advanced Pediatrics Practice, LLC

Employee Handbook

Last Update: 05/04/2016

Table of Contents

No. Policy Revised Page

INTRODUCTION 010 Welcome Message 8/1/2010 1 020 Purpose of 8/1/2010 1 Handbook 030 Organization 8/1/2010 1 Description 040 Employee 8/1/2010 3 Acknowledgement & Release Form

EMPLOYMENT 101 Nature of 5/1/2015 4 Employment 102 Employee Relations 5/1/2015 4 103 Equal Employment 5/1/2015 5 Opportunity 104 Outside Employment 5/1/2015 6 & Conflicts of Interest 105 Non-Disclosure 8/1/2010 6 106 Disability 8/1/2010 7 Accommodation

EMPLOYMENT STATUS & RECORDS 201 Employment 5/1/2015 7 Categories 202 Access to Personnel 5/1/2015 9 Files 203 Employment 5/1/2015 9 Reference Checks 204 Personnel Data 8/1/2010 9 Changes 205 Introductory Period 8/1/2010 10 206 Employment 8/1/2010 11 Applications 207 Performance 8/1/2010 11 Evaluation 208 Job Descriptions 8/1/2010 12 209 Salary 8/1/2010 12 Administration

EMPLOYEE BENEFIT PROGRAMS 301 Personal Time Off 5/4/2016 13 302 Holidays 5/1/2015 14 303 Workers' 8/1/2010 14 Compensation Insurance 304 Bereavement Leave 4/15/2012 15 305 Jury Duty 4/15/2012 15 306 Witness Duty 4/15/2012 16 307 Benefits 5/1/2015 16 Continuation (COBRA) 308 Health Insurance 4/15/2012 16 309 Continuing 8/1/2010 17 Education and Training 310 401(k) Plan 8/1/2010 18

TIMEKEEPING/P AYROLL 401 Timekeeping 4/15/2012 18 402 Paydays 4/15/2012 18 403 Employment 8/1/2010 19 Termination 404 Pay Advances 8/1/2010 19 405 Pay Deductions and 4/15/2012 20 Setoffs 406 Overtime Pay 5/1/2015 20 407 Salary Increases 8/1/2010 20

WORK CONDITIONS & HOURS 501 Safety 4/15/2012 21 502 Work Schedules 4/15/2012 22 503 Use of Phone and 4/15/2012 22 Mail Systems 504 Smoking 4/15/2012 23 505 Rest and Meal 5/1/2015 23 Periods 506 Overtime 8/1/2010 23 507 Emergency Closings 5/4/2016 24 & Inclement Weather 508 Business Travel 4/15/2012 24 Expenses 509 Visitors in the 4/15/2012 24 Workplace 510 Computer and Email 5/1/2015 25 Usage 511 Internet Usage 8/1/2010 26 512 Workplace 8/1/2010 27 Monitoring 513 Cell Phone Usage 8/1/2010 28

LEAVES OF ABSENCE 601 Medical Leave 04/15/2012 28 602 Military Leave 8/1/2010 29 603 Pregnancy Related 4/15/2012 30 Absences

EMPLOYEE CONDUCT & DISCIPLINARY ACTION 701 Employee Conduct 5/1/2015 30 and Work Rules 702 Drug and Alcohol 5/1/2015 31 Use 703 Sexual and Other 8/1/2010 31 Unlawful Harassment 704 Attendance and 4/15/2012 33 Punctuality 705 Personal Appearance 4/15/2012 34 706 Return of Property 8/1/2010 35 707 Resignation 8/1/2010 36 708 Security Inspections 8/1/2010 36 709 Disciplinary 8/1/2010 36 Procedures 710 Problem Resolution 8/1/2010 37 711 Workplace Etiquette 8/1/2010 38

INTERNAL COMMUNICATION 801 Meeting 8/1/2010 38 802 Federal and State 5/1/2015 39 Employment Law Posters 803 Memos, Letters, or 5/1/2015 39 Forms 804 Open Door Policy 8/1/2010 39 805 Staff Training 8/1/2010 39

APPENDIX 9-A Continuing 4/15/2012 40 Education and Training Form 9-B Time Clock 5/1/2015 41 Correction/Leave Request Form

INTRODUCTION

010 Welcome Message

Welcome to Advanced Pediatrics where it is our mission to maintain the feel of a small practice while continuing to deliver novel big ideas as a leader in healthcare. This handbook describes many of our policies. It outlines many of the programs and benefits available to eligible employees.

We hope that your experience here will be challenging, enjoyable, and rewarding.

020 Purpose of Employee Handbook

The Advanced Pediatrics Employee Handbook provides information and direction to ensure uniformity throughout our Practice. It serves as a reference and working guide in the equitable administration of our policies, procedures and practices.

The policies, procedures and practices in this manual are not intended to be contractual commitments by employees or Advanced Pediatrics. They are intended to be guidelines to management and a reference for policy and procedures. Advanced Pediatrics reserves the right to revoke, change or supplement any policy, procedure and/or practice at any time without notice. No policy, procedure or practice is a guarantee of continuity of benefits or rights.

When language such as owner is used, it is referring to the partners or owners of the practice. When language such as management is used it is referring to the Practice Manager or the Nurse Manager. When language such as practice, business or office is used, it is referring to Advanced Pediatrics.

Please understand that no one other than the owner(s) has the authority to enter into any agreement with you for employment for any specified period of time or to make any promises or commitments contrary to the foregoing. Further, any employment agreement entered into by the owner shall not be enforceable unless it is in a formal written agreement and signed by the employee and the owner(s).

030 Organization Description

Advanced Pediatrics was established in October of 2000 by Dr. Richard H Schwartz, to provide medical care and health services to infant, child and adolescent patients. In addition, the practice remains steadfast in a commitment to vaccine and pharmaceutical research studies and as active educators of future physicians, physician assistants, and nurse practitioners.

5 Our mission is to personalize the care we deliver to clients while providing an extensive array of services usually reserved for larger healthcare facilities. Advanced Pediatrics aims to balance exemplary service with competitive prices by assembling a dedicated and knowledgeable staff, and by participating in, supporting and serving the community with compassionate and quality pediatric care.

Our values are to maintain a high ethical standard in practicing evidence based pediatric medicine, give clients options so that they may make informed decisions regarding their children and deliver high quality customer service to our clients.

Advanced Pediatrics intends to build a strong clientele by providing the finest pediatric services available, while minimizing client and employee attrition by building strong partnering relationships with clients, their children, our employees and the community.

6 040 Acknowledgment and Release Form

The employee handbook describes important information about Advanced Pediatrics. I understand that I should consult the Practice Manager if I have any questions that are not answered in the handbook.

As an applicant for a position with Advanced Pediatrics, I hereby authorize inquiries regarding my past employment record including, but not limited to, attendance, job performance, disciplinary records and reason for termination. I hereby release Advanced Pediatrics and its representatives from any liability or damage which may result from furnishing the information requested. Advanced Pediatrics may contact me should there be any question as to the validity of this release.

I became an employee at Advanced Pediatrics voluntarily. I understand and acknowledge that there is no specified length to my employment at Advanced Pediatrics and that my employment is at will. I understand and acknowledge that "at will" means that I may terminate my employment at any time, with or without cause or advance notice. I also understand and acknowledge that "at will" means that Advanced Pediatrics may terminate my employment at any time, with or without cause or advance notice, as long as they do not violate federal or state laws.

I understand and acknowledge that there may be changes to the information, policies, and benefits in the handbook. The only exception is that Advanced Pediatrics will not change or cancel its employment-at-will policy. I understand that Advanced Pediatrics may add new policies to the handbook as well as replace, change, or cancel existing policies. I understand that I will be told about any handbook changes and I understand that handbook changes can only be authorized by the Owners of Advanced Pediatrics.

I understand and acknowledge that this handbook is not a contract of employment or a legal document. I have received the handbook and I understand that it is my responsibility to read and follow the policies contained in this handbook and any changes made to it.

EMPLOYEE'S NAME (printed): ______

EMPLOYEE'S SIGNATURE: ______

DATE: ______

7 SECTION 1 EMPLOYMENT

101 Nature of Employment

Effective Date: 08/01/2010 Revision Date: 05/01/2015

Advanced Pediatrics is an employment-at-will employer and has the right to terminate employment at any time with or without cause. No representative of Advanced Pediatrics has the authority to enter into any agreement for employment, or to make any agreement contrary to the foregoing, unless it is done in writing and is signed by the owner or appropriate manager under whom they will support and given authority to do so by the owner(s).

102 Employee Relations

It is our objective to implement fair and effective policies and to require all employees to serve the practice’s best interests. However, nothing in this handbook should be considered as altering the employment-at-will relationship or as creating an express or implied contract or promise concerning the policies, procedures or practices that Advanced Pediatrics has implemented or will implement in the future.

It is Advanced Pediatrics’ policy to provide equal employment opportunity and treatment regardless of race, color, gender, religion, national origin, sexual orientation, age, marital status, disability, veteran status or any other areas of discrimination prohibited by applicable law.

In addition, Advanced Pediatrics’ goals include the following:

 To monitor and comply with applicable Federal and State laws and regulations concerning each employee and the practice;  To be receptive to constructive suggestions relating to the job, working conditions or personnel policies; and  To provide an 'open-door' policy for employees to discuss matters of interest or concern.

Advanced Pediatrics expects all employees to:  Maintain and provide proof of current Licensure;  Protect the privacy of individually identifiable health information in accordance with the HIPAA Security Rule;  Interact with clients, visitors and vendors in a professional and friendly manner;  Perform assigned tasks in an efficient manner;

8  Demonstrate a considerate, professional and constructive attitude toward fellow employees;  Adhere to the policies, procedures and practices adopted by Advanced Pediatrics;  Perform lifesaving procedures and perform CPR (all employees who hold certification) if hired as a nurse or a medical provider;  Provide proof of vaccination for Hepatitis B, MMR, Varicella and TDAP (received within past 5 years). For employees without proof of vaccination or medically documented disease, vaccines will be provided or titers may be drawn at the expense of the employee. Hepatitis B will be offered at no charge to the employee if not vaccinated. Employees may decline Hepatitis B vaccination by signing a Hepatitis B Vaccine Declination Form.  Provide proof of negative PPD in past year or receive the 2 step PPD test at Advanced Pediatrics. If employee tests positive, proof of a negative Chest X-Ray or treatment is mandatory. These documents must be provided before starting employment.  Complete the Good Clinical Practices (GCP) for Research Studies within 15 days of employment.  Complete OSHA training within 2 weeks of employment and annually thereafter.  Attend 75% of department specific and quarterly staff meetings (or initial meeting minutes and demonstrate knowledge of current policies and procedures);  Read Advanced Pediatrics Employee Newsletters to maintain current knowledge of policies and procedures  Complete annual proficiency testing for all waived tests for COLA certification (clinical staff only).

The management or the owners of Advanced Pediatrics, retain the sole right to exercise all managerial functions including, but not limited to, the right to:

 Dismiss, supervise and discipline employees;  Determine and change the size and qualifications of the work force;  Establish, change or abolish policies, procedures or practices; compensation; employee benefits and rules and regulations;  Assign duties to employees in accordance with Advanced Pediatrics needs and requirements and to carry out all ordinary business-related functions.

103 Equal Employment Opportunity

To give equal employment and advancement opportunities to all people, we make employment decisions at Advanced Pediatrics based on each person's performance, qualifications, and abilities. Advanced Pediatrics does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, or any other characteristic protected by law.

9 Our Equal Employment Opportunity policy covers all employment practices, including selection, job assignment, compensation, discipline, termination, and access to benefits and training.

If you have a question about any type of discrimination at work, talk with your immediate supervisor or the Practice Manager. No punitive action may be taken for asking such questions. If an employee is found to have illegally discriminated against another person the offending employee will be subject to disciplinary action, up to and including termination of employment.

104 Outside Employment & Conflict of Interest

If an employee participates in outside employment, it must not diminish or interfere with their performance at Advanced Pediatrics and must not involve the use of confidential information from Advanced Pediatrics or its patients.

We hold all employees to the same performance standards and scheduling expectations regardless if they have other jobs. In order to remain employed at Advanced Pediatrics, we will ask you to terminate an outside job if we determine that it is impacting your performance or your ability to meet our requirements, which may change over time.

If your outside employment has an undesirable impact on Advanced Pediatrics, we will consider that it is a conflict of interest.

105 Non-Disclosure

Effective Date: 08/01/2010 Revision Date:

It is very important to Advanced Pediatrics that we protect our confidential business information and trade secrets. Confidential information includes, but is not limited to, the following examples:

 compensation data  computer processes  computer programs and codes  customer lists  customer preferences  financial information  labor relations strategies  marketing strategies  new materials research  proprietary production processes  technological data

10  technological prototypes

If you improperly use or disclose a trade secret or confidential business information, you will be subject to disciplinary action, up to and including termination of employment and legal action. This applies even if you do not get any benefit from releasing the information.

106 Disability Accommodation

Advanced Pediatrics is committed to complying fully with the Americans with Disabilities Act (ADA). We are also committed to ensuring equal opportunity in employment for qualified persons with disabilities. We conduct all our employment practices and activities on a non- discriminatory basis.

Our hiring procedures have been reviewed and they provide meaningful employment opportunities for persons with disabilities. We only make pre-employment inquiries regarding an applicant's ability to perform the duties of the job.

Reasonable accommodation is available to an employee with a disability when the disability affects the performance of job functions. We make our employment decisions based on the merits of the situation in accordance with defined criteria, not the disability of the individual.

Qualified individuals with disabilities are entitled to equal pay and other forms of compensation (or changes in compensation) as well as job assignments, classifications, organizational structures, position descriptions, lines of progression, and seniority lists.

Advanced Pediatrics is also committed to not discriminating against any qualified employee or applicant because the person is related to or associated with a person with a disability. Advanced Pediatrics will follow any state or local law that gives more protection to a person with a disability than the ADA gives.

Advanced Pediatrics is committed to taking all other actions that are necessary to ensure equal employment opportunity for persons with disabilities in accordance with the ADA and any other applicable federal, state, and local laws.

SECTION 2 EMPLOYMENT STATUS & RECORDS

201 Employment Categories

It is important that you understand the definitions of the employment classifications at Advanced

11 Pediatrics and know your classification. Your employment classification helps determine your employment status and benefits. If you have questions or are not sure what your employment classification is, see your supervisor.

These employment classifications do not guarantee employment with Advanced Pediatrics for any specific period of time. You became an employee at Advanced Pediatrics voluntarily and your employment is at will. "At will" means that you may terminate your employment at any time, with or without cause or advance notice. Likewise, "at will" means that Advanced Pediatrics may terminate your employment at any time, with or without cause or advance notice, as long as we do not violate federal or state laws.

Nonexempt & Exempt Status

Depending on your job, you are either a) NONEXEMPT or b) EXEMPT from federal and state wage and hour laws under the Fair Labor Standards Act (FLSA). Exempt Employees (Full- or Part-Time) are those employees who are exempt from the provisions of the FLSA and to whom the payment of overtime is not required. Exempt status usually includes positions of a professional or managerial nature and paid a salary. Exempt employees may be full or part-time.

If you are a NONEXEMPT employee, you are entitled to overtime pay under the specific provisions of federal and state laws. If you are an EXEMPT employee, you are excluded from specific provisions of federal and state wage and hour laws. Your EXEMPT or NONEXEMPT classification may be changed only with written notification by Advanced Pediatrics management.

Full and Part Time Status

You are a REGULAR FULL-TIME employee if you are not assigned to a temporary or introductory status AND you are regularly scheduled to work at Advanced Pediatrics more than 30 hours per week. In most cases, regular full-time employees are eligible for all Advanced Pediatrics benefit programs, subject to the terms, conditions, and limitations of each benefit program.

You are a PART-TIME employee if you are not in a temporary or introductory status AND you are regularly scheduled to work less than 30 hours per week. Part-time employees receive all legally mandated benefits, such as Social Security and workers' compensation insurance. Part- time employees are eligible for PTO (personal time off). You are also eligible for life insurance.

You are an INTRODUCTORY employee if your performance is being evaluated to determine whether further employment in a specific position with Advanced Pediatrics is appropriate. When you satisfactorily complete the introductory period, you will be told about your new employment classification.

You are a TEMPORARY (or Limited-Term) employee if you were hired as an interim replacement, or to temporarily increase our workforce, or to help finish a specific project. This status includes paid co-ops and interns. Employees are in the temporary category for a limited time. Even if you work at Advanced Pediatrics longer than the original time period agreed to when you were first hired, you will stay a temporary employee until you are officially notified that you have been assigned to a different category. Temporary employees receive all legally mandated benefits, such as Social Security and workers' compensation insurance. Temporary

12 employees are not eligible for other Advanced Pediatrics benefit programs.

INDEPENDENT CONTRACTOR, a non-employee classification, represents those who undertake a specific assignment on behalf of Advanced Pediatrics on a non-employee contractual basis. Independent contractors are not employees of Advanced Pediatrics and thus are ineligible for the benefits of employment described in this handbook. They are required to carry their own liability and health insurance, as well as pay their required payroll taxes. An example of an independent contractor is a relief Physician or a contract Agency Nurse.

202 Access to Personnel Files

Advanced Pediatrics keeps personnel files on all employees. Personnel files include job applications and related hiring documents, education and licensing documentation, training records, performance documentation, salary history, and other employment records.

Personnel files are the property of Advanced Pediatrics. Because they contain confidential information, the only people who can see them are people with a legitimate business reason. If you wish to review your own file, contact the Practice Manager. You will need to give advance notice if you wish to see your file. You may review your file only when a representative of Advanced Pediatrics is also present.

203 Employment Reference Checks

To ensure that individuals who join Advanced Pediatrics are well qualified and have a strong potential to be productive and successful, it is the policy of Advanced Pediatrics to check the employment references of all applicants. Applicants will be asked to sign a release of information form.

The Practice Manager will respond in writing to those reference check inquiries that are submitted in writing. Responses to such inquiries will confirm dates of employment, wage rates, and positions held.

204 Personnel Data Changes

It is important that Advanced Pediatrics have certain personal information about you in our

13 records. You need to tell us as soon as there is a change to your mailing address, telephone numbers, marital status, dependents' information, educational accomplishments, and other possibly related information. We also need to have information about who to contact in case of an emergency. Contact the Practice Manager to change your personal information or if you have questions about what information is required.

205 Introductory Period

Advanced Pediatrics has an introductory period for new employees. During the introductory period, we will evaluate your work habits and abilities to make sure that you can perform your job satisfactorily. The introductory period also gives you time to decide if the new job meets your expectations.

During the first few days of the introductory period, an employee will participate in an orientation program. During this program, the employee will receive important information regarding the performance requirements of his/her position, basic practice policies, procedures and practices, compensation and benefits programs, plus other information necessary to acquaint the employee with his/her job at Advanced Pediatrics. Employees will also be asked to complete all necessary paperwork at this time, such as federal, state and local tax forms, new employee enrollment form, Immigration and Naturalization Form (I-9), Licensure and fidelity bond application, emergency contact form, HIPPA form, medical and dental insurance application or waiver. During the first two weeks of the introductory period, employees will provide proof of immunization, licensure and CPR certification and complete OSHA training.

Employees should use this orientation program to familiarize themselves with Advanced Pediatrics and our policies and benefits. We encourage employees to ask any questions they may have during this program so that they will understand all the guidelines that affect and govern their employment relationship with Advanced Pediatrics.

Since your employment with Advanced Pediatrics is voluntary and at will, you may terminate your employment at any time during or after the introductory period, with or without cause or advance notice. Likewise, Advanced Pediatrics also may terminate your employment at any time during or after the introductory period, with or without cause or advance notice.

The introductory period for all new and rehired employees is the first 90 days calendar days after their hire date.

If you are absent for a significant amount of time during your introductory period, the length of the absence will automatically extend the introductory period. We may also extend the introductory period if we decide it was not long enough to evaluate your performance. This could happen either during or at the end of the introductory period.

When employees satisfactorily complete the introductory period, they are assigned to the "regular" employment classification.

During the introductory period, new employees are eligible for those benefits that are required by

14 law, such as Social Security and workers' compensation insurance. After becoming regular employees, they may also be eligible for other Advanced Pediatrics benefit programs, subject to the terms and conditions of each benefit program. Be sure to review the information for each benefits program to see the exact requirements.

206 Employment Applications

In accordance with the Immigration Control and Reform Act of 1986, all new employees will be required to present, within the first three days of employment, appropriate documentation of their eligibility to work in the United States. Failure to present appropriate documentation within the first three days can result in immediate dismissal.

We rely on the accuracy of the information you put on your employment application. We also expect that you and your references give accurate and true information during the hiring process and employment. If we find that any information is misleading, false, or was left out on purpose, we may reject an applicant from further consideration. If the person was already hired, it could result in termination of employment.

When we process an employment application, we may obtain a consumer credit report for employment purposes only concerning the applicant's credit worthiness, credit standing, and credit capacity. If we take an adverse employment action based in whole or in part on the consumer credit report, a copy of the report and a summary of your rights under the Fair Credit Reporting Act will be provided as well as any other documents required by law.

207 Performance Evaluation

We encourage you and your supervisor to discuss job performance and goals on an informal, day- to-day basis. A formal written performance evaluation will be done at the end of the introductory period after you are first hired at Advanced Pediatrics. In addition, you and your supervisor will have formal performance evaluations to discuss your work and goals, to identify and correct weaknesses, and to encourage and recognize your strengths.

Performance evaluations are usually done every 12 months. Information derived from the performance evaluation may be considered when making decisions affecting an employee including, but not limited to, decisions concerning training/continuing education needs and opportunities, compensation and continued employment.

15 208 Job Descriptions

Our goal is to provide accurate job descriptions for all jobs at Advanced Pediatrics. A job description includes the following sections: job information; job summary (gives a general overview of the job's purpose); essential duties and responsibilities; supervisory responsibilities; qualifications (includes education and/or experience, language skills, mathematical skills, reasoning ability, and any certification required); physical demands; and work environment.

We use the job descriptions to help new employees understand their jobs and their responsibilities. We also use job descriptions to identify the requirements of a job, set up the hiring criteria, set standards for employee performance evaluations, and establish a basis for making reasonable accommodations for individuals with disabilities.

The Practice Manager and the hiring manager prepare a job description when a new job is created. We review existing job descriptions and change them when a job changes. You can help by making sure that your job description is accurate and describes your job duties.

Your job description does not necessarily cover every task or duty that you might be assigned. You may be assigned additional responsibilities as necessary. If you have questions or concerns about your job description, contact the Practice Manager.

209 Salary Administration

At Advanced Pediatrics we strive for consistent pay practices, comply with federal and state laws, support our commitment to Equal Employment Opportunity, and offer competitive salaries within our labor market.

We are committed to paying equitable wages that are based on the requirements and responsibilities of each job. We also try to pay wages that are comparable to the wages paid to employees in similar jobs in other organizations in the area.

Compensation for each job is based on several factors. The factors include job analysis and evaluation, the essential duties and responsibilities of the job, and salary survey data (how other employers pay their employees). Salaries are annually reviewed by the Practice Manager and by the owners of the practice.

If you have a question about compensation in your area or for your job or if you have a question

16 about your salary, contact the Practice Manager.

SECTION 3 EMPLOYEE BENEFIT PROGRAMS

301 Personal Time Off

Advanced Pediatrics offers personal time off to all regular full-time and part-time employees. Personal time off (PTO) may be used for sick leave, personal leave, or vacation time. Eligible employees accrue PTO every pay period. Leave hours are based on your regularly scheduled hours per week.

Years of Service Weeks Off (Hours to include your normally scheduled hours) 1-3 2 3-5 3 5+ 4

The calculation for PTO is a factor multiplied by the hours you work. The factor corresponds with the amount of paid time you are eligible. If you are normally scheduled for a 30 hour work week, your two week vacation time would be a total of 60 hours.

For example, an employee working only 6 months of the calendar year who is eligible for 2 weeks off will only receive 1 week of PTO. Military leaves are counted as time worked in calculations of PTO. See the leave of absence policies in this handbook for information on how each type of leave affects vacation accruals.

All employees hired after 3/1/16 will start accruing PTO on the 91st day of their employment. This will be the start point for their initial 2 week PTO accrual, for the first year of employment.

Before you can use PTO you must complete a waiting period of 90 calendar days. Any employee, who is discharged for any reason or resigns before one full year of employment, will only be paid for actual time accrued.

We encourage employees to use all PTO in a one-year period. Accrued PTO must be taken prior to taking unpaid leave. If an employee does not use all accrued PTO by the last day of the calendar year, only two weeks of leave may be carried over to the next year. Any accrued leave over two weeks will be forfeited if not used in the current calendar year.

PTO must be approved by management in advance unless for illness, and may be taken in one hour increments and a maximum of two weeks at a time. Every effort will be made to approve PTO as requested. However, if there are any conflicts the employee will be notified as soon as possible.

17 Please make sure to notify your supervisor as soon as possible when you know that you will be late or out sick. Please call the supervisor or practice directly. Do not text or email this information as it may only be checked periodically.

Beginning on January 1st of each year, starting with seniority, employees shall put in for PTO with the attached leave form. All employees have until March 1st to request time off by seniority. After March 1st leave will be granted on a first come, first serve basis. All employees are expected to rotate holidays as needed. Employees with accrued PTO will be granted time off prior to those taking unpaid leave. If you do not have accrued leave, you should attempt to find coverage for your leave of absence.

302 Holidays

Advanced Pediatrics will be closed on the following holidays:

 New Year's Day  Easter  Memorial Day  July 4th  Labor Day  Thanksgiving Day  Christmas Day

Christmas Eve and New Year's Eve are half days and those normally scheduled to work on these days in the afternoon will be compensated as holiday time for 4 hours.

Non-salaried full-time and part-time employees will receive holiday pay should a holiday fall within their normal work week of regularly scheduled hours. Holiday pay is calculated by multiplying an employees’ regular hourly rate by the number of hours they would have worked. Evening holiday hours are paid at normal hourly rate. The 15% evening differential is paid only when hours are actually worked not on holiday time. The dinner break will not be paid on holidays since no actual hours are worked.

If Advanced Pediatrics remains open on a holiday listed above, those non-salaried employees working will receive 100% of their regular pay in addition to holiday pay (see above for definition). For salaried employees asked to work on a holiday, they will be compensated in equal number of hours in PTO. Employees may use Personal Time Off for bona fide religious holidays not listed above.

303 Worker’s Compensation

Effective Date: 08/01/2010

18 Revision Date:

All employees are protected under the state of Virginia’s Workers’ Compensation Law. This benefit covers accidental injuries or occupational illnesses that are caused by, arise out of, or occur in the course of employment at Advanced Pediatrics. Benefits continue uninterrupted until the employee has reached Maximum Medical Improvement and an assessment of ability to return to work has been made, as defined by the Worker’s Compensation laws of Virginia.

If an employee is injured, no matter how slightly, the injury must be reported immediately to management. If the accident occurs at work outside normal working hours, a voice mail message should be left immediately after the accident occurs.

If an employee is on a leave of absence due to a work related injury, it is the employee’s responsibility to keep management advised of any changes in his/her condition, treatment or expected return to work date.

304 Bereavement Leave

Advanced Pediatrics provides bereavement leave up to three days to employees who need to take time off because an immediate family member died. For bereavement leave, "immediate family" means your spouse, parent, child, brother, or sister; your spouse's parent, child, brother, or sister; your child's spouse; your grandparent or your grandchild.

To ask for bereavement leave, see your supervisor.

305 Jury Duty

Advanced Pediatrics encourages you to fulfill your civic responsibilities by serving jury duty if you receive a summons.

If you get a jury duty summons, show it to your supervisor as soon as possible. This will help us plan for your possible absence from work. We expect you to come to work whenever the court schedule permits.

Subject to the terms, conditions, and limitations of the applicable plans, Advanced Pediatrics will continue to provide health insurance benefits for the full period of jury duty leave. Advanced Pediatrics will compensate you for originally scheduled work hours, subject to documentation demonstrating hours served on jury duty.

19 Your Personal Time Off days and holiday benefits will continue to accrue during jury duty leave.

306 Witness Duty

If you get a subpoena to testify in court, Advanced Pediatrics will give you time off to be a witness and use your PTO time. If you are summoned to be a witness for Advanced Pediatrics or if we ask you to testify, we will give you time off with pay.

If you need time off to be a witness, show the subpoena to your supervisor as soon as you receive it. We expect you to report for work whenever you are not needed in court.

307 Benefits Continuation (COBRA)

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) helps employees and their dependents to continue their health insurance even if they are no longer eligible under our health plan.

There are strict rules about when you can use COBRA. COBRA lets an eligible employee and dependents choose to continue their health insurance when a "qualifying event" happens. Qualifying events include the employee's resignation, termination, leave of absence, shorter work hours, divorce, legal separation, or death. Another qualifying event is when a dependent child stops being eligible for coverage under your health insurance.

If you continue your insurance under COBRA, you will pay the full cost of the insurance at Advanced Pediatrics' group rates.. When you become eligible for our health insurance plan, we will give you a written notice describing your COBRA rights. Because the notice contains important information about your rights and what to do if you need COBRA, be sure to read it carefully. You must give the Practice Manager notification in writing if you choose COBRA prior to leaving the company.

308 Health Insurance

Our health insurance plan offers medical benefits to eligible employees and their dependents.

20 Employees in the following employment classifications are eligible to enroll in the health insurance plan:

 Regular full-time employees (working more than 30 hours per week).

The eligible employees can enroll in the health insurance plan subject to the terms and conditions of the agreement between Advanced Pediatrics and its insurance carrier.

If you are enrolled in the health insurance plan and change to an employment classification that would make you no longer eligible, you may be able to continue your health care benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA). See the Benefits Continuation (COBRA) Policy in this handbook for more information.

There are more details about our health insurance plan in the Summary Plan Description (SPD). When you become eligible for health insurance, you will receive the SPD and rate information. If you have questions about our health insurance plan, contact the Practice Manager for more information.

Health Insurance coverage is effective the 1st of the next month after hire date.

309 Continuing Education and Training

Advanced Pediatrics supports a continuous learning environment, and may provide financial assistance to selected employees who are willing to develop their skills and performance in order to grow both professionally and personally as an employee of Advanced Pediatrics.

Employees must complete a “Request for Training” application prior to the commencement of the seminar/course and submit it to management for approval if the employee wants Advanced Pediatrics to cover the expense. Continuing Education and Training must be related to pediatric medicine or practice management. Employees must work greater than 30 hours per week to qualify for this benefit unless otherwise approved by the owner(s) of the practice. Owner(s) and Managers of Advanced Pediatrics will determine the amounts, if any to be reimbursed.

Employees receiving Continuing Education and Training financial assistance must agree and sign the Continuing Education and Training Agreement (Appendix), which states the following:

1* If the employee voluntarily terminates his/her employment, or the employee’s employment is terminated for cause, the reimbursed amount received during the previous 12-month period will be deducted from the employee’s final paycheck with any balance immediately due.

2* If by Advanced Pediatrics action, an employee’s employment is terminated for reasons unrelated to performance, the employee will not be required to pay back the reimbursed amount.

21 310 401(K) Plan

Eligibility for the 401(k) plan includes being a full time employee at least 21 years of age with a minimum of 6 months of service with Advanced Pediatrics with an entry date of January 1 and July 1. Eligibility for Profit Sharing is being a full time employee at least 21 years of age with a minimum of 6 months of service with entry dates of January 1 and July 1.

SECTION 4 TIMEKEEPING & PAYROLL

401 Timekeeping

Nonexempt employees are responsible for accurately recording the hours they work. The law requires Advanced Pediatrics to keep accurate records of "time worked" in order to correctly calculate employee pay and benefits. "Time worked" means all the time that nonexempt employees spend performing their assigned work. Each employee is to only punch their own time clock. Employees are not to punch time clocks for any other employee. Corrections will be made by the bookkeeper, Nurse Manager, or the Practice Manager. Please see the attached Time Clock Correction Form. This is also the form to put the PTO you are taking.

If you are a nonexempt employee, you must accurately record the time you start and stop work, when you start and end any meal periods or split shifts, and when you leave the workplace for personal reasons. Before you work any overtime, you must always get advance approval.

Falsifying time records is a serious matter. You may not change time after it is already recorded, enter a false time on purpose, tamper with time records, or record other employees' time for them. If you do any of these actions, you may be subject to disciplinary action, including termination. In the event a correction to the times logged in for work hours is needed, please complete the correction form found at the end of the employee manual.

402 Paydays

All employees are paid biweekly on every other Thursday. Each paycheck includes pay for all

22 work performed through the end of the previous payroll period.

If a payday falls on a holiday, you will be paid on the last work day before that payday.

If you are on vacation on payday, you will get your paycheck when you return.

Advanced Pediatrics has a direct deposit program. Direct deposit means that we will deposit your pay directly into your bank account. On paydays, instead of a check, you will get a statement explaining how much you were paid and all the details.

403 Employment Termination

There can be many reasons why employment may terminate. The following are some of the most common reasons for termination of employment:

 Resignation - voluntary employment termination initiated by an employee.  Discharge - involuntary employment termination initiated by the organization.  Retirement - voluntary employment termination initiated by the employee meeting age, length of service, and any other criteria for retirement from the organization.

Employment with Advanced Pediatrics is voluntary and at will. You may terminate your employment at any time, with or without cause or advance notice. Likewise, Advanced Pediatrics may terminate your employment at any time, with or without cause or advance notice. At the time of departure, an exit interview will be offered with the employee. The importance of this interview is to help the management of Advanced Pediatrics make the practice a better working environment for everyone by soliciting feedback from departing employee.

Your benefits are affected by termination in several ways. All accrued, vested benefits that are due and payable at termination will be paid out. You may be allowed to continue some benefits by paying for them yourself. You will be notified in writing about which benefits you can continue and the limitations and details of how to continue them.

404 Pay Advances

Advanced Pediatrics does not give pay advances on unearned wages to employees.

23 405 Pay Deductions & Setoffs

Effective Date: 08/01/2010 Revision Date 04/15/2012

Advanced Pediatrics is required by Federal and State law to deduct the following from an employee’s paycheck (unless an exemption is claimed): Social Security, Medicare, Federal Income Tax and State Income Tax.

Advanced Pediatrics also offers programs and benefits to eligible employees that are not required by law. You may ask us to deduct money from your pay to cover your payment for these programs.

We may take a "pay setoff" from your paycheck. Pay setoffs mean that Advanced Pediatrics must deduct money from your paycheck to pay off a debt you owe us or by court order.

If you do not show up for your regular working hours and do not have PTO accrued you will not be paid.

If you want to know why money was deducted from your paycheck or how your pay is calculated, see the Practice Manager.

406 Overtime Pay, Evening Pay and Dinner Pay

As a result of workload and approved in advance by management, an employee may be asked to work overtime. Overtime pay will be paid to all eligible employees in accordance with applicable tax laws, which generally means employees in hourly positions i.e. non-exempt. Overtime pay is considered to be 150% of regular pay unless otherwise established. Our pay week starts on Sunday and ends on Saturday.

Evening pay is 15% above usual documented hourly rate. It covers only shifts worked through the evening ,until closing. If an employee completes his or her afternoon shift beyond 5:30 pm, it is still considered the afternoon shift.

Dinner break is paid only to employees working 3 shifts for the day and will be put in by the bookkeeper for a total of ½ hour.

407 Salary Increases

24 Salary increases are based on market conditions, individual performance and contributions and the practices’ financial condition and objectives. Salary increases may occur any time throughout the year and is not guaranteed. It is the practice of Advanced Pediatrics to annually review salaries as part of performance evaluations. Salary rates of employees will reflect individual differences in experience, performance and contribution. Since there is no constructive purpose for discussing compensation with fellow employees, it is strictly against our policy. Management is responsible for establishing wages based on many objective and subjective factors; therefore, discussions are to be between the management and the employee only.

SECTION 5 WORK CONDITIONS & HOURS

501 Safety

Advanced Pediatrics is committed to providing a safe working environment. The practice will make every effort to comply with the Occupational Health and Safety Act (OSHA). Advanced Pediatrics’ objective is aimed at minimizing the exposure of our employees and customers in our facilities to health or safety risks. To accomplish this objective, all employees are expected to work diligently to maintain safe and healthful working conditions and to adhere to proper operating practices and procedures designed to prevent injuries and illnesses. Employees are expected to:

3* Participate in an annual training session on workplace safety and instruction on safe work practices and procedures;

4* Exercise maximum care and good judgment at all times to prevent accidents and injuries;

5* Report to management and seek first aid for all injuries, regardless of how minor;

6* Report unsafe conditions, equipment or practices to management;

7* Use equipment in accordance to manufacture’s guidelines at all times;

8* Observe conscientiously all safety rules and regulations at all time; and

9* Notify management before the beginning of the workday of any medication they are taking that may cause drowsiness or other side effects that could lead to injury to them, their coworkers and our customers.

Some of the best safety improvement ideas come from employees. If you have an idea, concern, or suggestion on how to improve safety in the workplace, tell your supervisor, another supervisor,

25 or the Nurse Manager. We want you to know that you can report any concerns about workplace safety anonymously and without fear of reprisal.

502 Work Schedules

Advanced Pediatrics normal office hours will be as follows:

Monday 7AM – 8:00 PM Tuesday 7AM – 8:00PM Wednesday 7AM - 8:00 PM Thursday 7 AM – 8:00 PM Friday 7AM - 5:15 PM Saturday 8AM - 1:00 PM Sunday As Needed

While the above listed are the normal work hours, employees are expected to stay until all expected work is completed even if this runs over the above listed hours.

Arriving early or staying late is not a usually a requirement. Employees should ask their supervisor for the hours they are required to work. Employees will not be paid for extra time unless it is approved. Please do not punch in more than 15 minutes prior to start time.

In the event an employee is going to be late to or absent from work, he/she must advise management as soon as possible (preferably before the practice opens that day). Excessive absenteeism or tardiness will not be tolerated and may be cause for termination.

503 Use of Phone and Mail Systems

Open lines of communication are critical to the success of Advanced Pediatrics’ business. As such, our telephones should be used for authorized practice business only. Of course, we recognize the occasional need to make telephone calls for personal matters, and ask that these calls be brief and held to a minimum. In the event a long distance telephone call is required, employees shall make note of the date, time and destination of the call or receive authorization from a supervisor. This information is to be given to the Practice Manager. The employee will be billed for such expense on a monthly basis.

The use of Advanced Pediatrics paid postage for personal correspondence is permitted. Before

26 use, please pay the billing office for our petty cash box.

504 Smoking

To maintain a safe and comfortable working environment and to ensure compliance with applicable laws, smoking in Advanced Pediatrics is not allowed at any time. Smoking is permitted on an employee’s off time.

505 Rest and Meal Periods

Employees working 8 consecutive hours will have one meal period of at least 30 minutes and up to 60 minutes in length each workday. Your supervisor will schedule your meal period to accommodate operating requirements. During meal periods, you are not subject to any work responsibilities or restrictions. You will not be paid for meal period time.

If an emergency arises and an employee is asked to cut his/her break short, the employee will either 1) take the remaining break at another time during the day; 2) have his or her schedule modified; or 3) be paid for the time worked. We ask that all employees be flexible to the time they take their break since it is often difficult to predict the daily flow of practice activities. Lunch hours are generally between 11:30 am to 1:45 pm and dinner hours between 5:00 pm and 6:00 pm. Please remember to be back from your break by your next scheduled shift.

506 Overtime

There may be times when Advanced Pediatrics cannot meet its operating requirements or other needs during regular working hours. If this happens, we may give employees the opportunity to work overtime.

It is our policy that no overtime can be worked without the approval and authorization of the supervisor. We try to distribute overtime assignments fairly among all employees who are qualified to perform the required work.

Nonexempt employees will receive overtime pay in accordance with the federal and state wage and hour laws. Overtime pay is based on the actual hours worked. For this reason, time off for sick leave, vacation, and other paid or unpaid leaves of absence is not counted as hours worked

27 when calculating overtime pay.

If you work overtime without first getting your supervisor's approval, you may be subject to disciplinary action, up to and including possible termination of employment.

507 Emergency Closings and Inclement Weather

Employees are expected to use their best judgment when determining whether or not they can/should report to work. It would be rare that the office would close due to inclement weather.

If the office closes due to inclement weather every attempt will be made to notify you. If Advanced Pediatrics must close the office for the entire day due to inclement weather, those employees scheduled to work that day will receive pay for their normally scheduled hours, up to 8 hours for the closure. This inclement weather pay will only pertain to the first two days of closure per year, beginning on January 1st of the current year.

Guidelines used to determine if Advanced Pediatrics is open during inclement weather:

When inclement weather is projected, early morning appointments will be called the prior day and told to call our office before their appointment to confirm that we are open. Additionally, patients should be told to check our Facebook page for closure information.

Employees will receive an email, call or text with closure or delayed opening information. Employees should feel free to contact supervisors with any questions.

Please remember if you feel it is unsafe to drive or you cannot come in due to road or weather conditions in your neighborhood, it is your responsibility to notify your supervisor. PTO may be used when the office is open and you cannot make it in due to road conditions.

508 Business Travel Expenses

We will reimburse you for reasonable business travel expenses if the Owners approve the travel in advance. After a trip is approved, you are responsible for making your own travel arrangements.

When a business trip is over, submit your completed travel expense report within 30 days. With your expense report, you must also submit receipts for every expense item.

28 509 Visitors in the Workplace

Only visitors who are properly authorized may be on Advanced Pediatrics premises. This helps to maintain safety standards, safeguard employee and customer welfare, protect our property and facilities, guard confidential information against theft, and reduce potential distractions and disturbances.

Because of safety and security reasons, we ask that you discourage family and friends from visiting you at work. If you do have a visitor, we will ask you to meet that person outside of your work area.

All visitors should enter Advanced Pediatrics at the reception area. If you have visitors, you are responsible for their conduct and to watch out for their safety.

If you see an unauthorized person at work, notify your supervisor immediately or direct the person to the reception area.

If a visitor has access to patient records they will be required to complete a personal information form and a HIPAA Business Partner form.

510 Computer and Email Usage

To help you do your job, Advanced Pediatrics may give you access to computers, digital files, email, and software. You should not use a password, access a file, or retrieve any stored communication without authorization. To make sure that all employees follow this policy, we may monitor computer and email usage. Software from home may not be installed on office equipment without prior approval including screen savers. All employees should protect health information as outlined by the Health Insurance Portability and Accountability Act . We try hard to have a workplace that is free of harassment and sensitive to the diversity of our employees. Therefore, we do not allow employees to use computers and email in ways that are disruptive, offensive to others, or harmful to morale.

At Advanced Pediatrics you may not display, download, or email sexually explicit images, messages, and cartoons. You also may not use computers and email for ethnic slurs, racial comments, off-color jokes, or anything that another person might take as harassment or disrespect.

You may not use email to ask other people to contribute to or to tell them about businesses outside of Advanced Pediatrics, religious or political causes, outside organizations, or any other non-business matters.

29 You may only use software on local area networks or on multiple machines according to the software license agreement. Advanced Pediatrics prohibits the illegal duplication of software and its documentation.

If you know about any violations to this policy, notify the Practice Manager. Employees who violate this policy are subject to disciplinary action, up to and including termination of employment.

511 Internet Usage

Advanced Pediatrics may provide you with Internet access to help you do your job. This policy explains our guidelines for using the Internet. You may only use the Internet usage for job-related activities. We do not allow personal use of the Internet.

All Internet data that is written, sent, or received through our computer systems is part of official Advanced Pediatrics records. That means that we can be legally required to show that information to law enforcement or other parties. Therefore, you should always make sure that the business information contained in Internet email messages and other transmissions is accurate, appropriate, ethical, and legal.

The equipment, services, and technology that you use to access the Internet are the property of Advanced Pediatrics. Therefore, we reserve the right to monitor how you use the Internet. We also reserve the right to find and read any data that you write, send, or receive through our online connections or is stored in our computer systems.

You may not write, send, read, or receive data through the Internet that contains content that could be considered discriminatory, offensive, obscene, threatening, harassing, intimidating, or disruptive to any employee or other person.

Examples of unacceptable content include (but are not limited to) sexual comments or images, racial slurs, gender-specific comments, or other comments or images that could reasonably offend someone on the basis of race, age, sex, religious or political beliefs, national origin, disability, sexual orientation, or any other characteristic protected by law.

Advanced Pediatrics does not allow the unauthorized use, installation, copying, or distribution of copyrighted, trademarked, or patented material on the Internet. As a general rule, if you did not create the material, do not own the rights to it, or have not received authorization for its use, you may not put the material on the Internet. You are also responsible for making sure that anyone who sends you material over the Internet has the appropriate distribution rights.

To protect against computer viruses, you may not download a file from the Internet without getting authorization in advance.

If you use the Internet in a way that violates the law or Advanced Pediatrics policies, you will be subject to disciplinary action, up to and including termination of employment. You may also be

30 held personally liable for violating this policy.

The following are some examples of prohibited activities that violate this Internet policy:

 Sending or posting discriminatory, harassing, or threatening messages or images  Using the organization's time and resources for personal gain  Stealing, using, or disclosing someone else's code or password without authorization  Copying, pirating, or downloading software and electronic files without permission  Sending or posting confidential material, trade secrets, or proprietary information outside of the organization  Violating copyright law  Failing to observe licensing agreements  Engaging in unauthorized transactions that may incur a cost to the organization or initiate unwanted Internet services and transmissions  Sending or posting messages or material that could damage the organization's image or reputation  Participating in the viewing or exchange of pornography or obscene materials  Sending or posting messages that defame or slander other individuals  Attempting to break into the computer system of another organization or person  Refusing to cooperate with a security investigation  Sending or posting chain letters, solicitations, or advertisements not related to business purposes or activities  Using the Internet for political causes or activities, religious activities, or any sort of gambling  Jeopardizing the security of the organization's electronic communications systems  Sending or posting messages that disparage another organization's products or services  Passing off personal views as representing those of the organization  Sending anonymous email messages  Engaging in any other illegal activities

512 Workplace Monitoring

Advanced Pediatrics may conduct workplace monitoring to help ensure quality control, employee safety, security, and customer satisfaction.

All computer equipment, services, or technology that we furnish you are the property of Advanced Pediatrics. We reserve the right to monitor computer activities and data that is stored in our computer systems. We also reserve the right to find and read any data that you write, send, or receive by computer.

We may perform video surveillance of non-private workplace areas. We may use video monitoring to identify safety concerns, maintain quality control, detect theft and misconduct, and

31 discourage and prevent harassment and workplace violence.

Because we are sensitive to employees' legitimate privacy rights, we will make every effort to guarantee that workplace monitoring is always done ethically and with respect.

513 Cell Phone Usage

Advanced Pediatrics discourages the use of personal cell phones and text messaging during your work day.

In an emergency, please remember to keep your conversations private and quiet. Please keep all cell phones in silent mode in the office and out of sight.

SECTION 6 LEAVES OF ABSENCE

601 Medical Leave

Advanced Pediatrics grants unpaid medical leaves of absence to eligible employees who become temporarily unable to work due to a serious health condition or disability. For medical leave purposes, a serious health condition or disability includes inpatient care in a hospital, hospice, or residential medical care facility. It also includes continuing treatment by a health care provider. It also includes temporary disabilities associated with pregnancy, childbirth, and related medical conditions.

Employees in the following employment classifications are eligible to request medical leave:

 Regular full-time employees

If you think you will need a medical leave, give your request to your supervisor at least 30 days before the leave would start. This will help us plan for your possible absence. If it is an unexpected situation, make your request as soon as possible.

We require a health care provider's statement verifying that you need a medical leave, when the leave would start and the expected end dates. You are responsible for telling us if that information changes later. Before you can return to work, we will require verification from a health care

32 provider that says you are fit to return.

If you sustain a work-related injury, you are eligible for a medical leave for the period of disability in accordance with the laws covering occupational disabilities. Subject to the terms, conditions, and limitations of the applicable plans, Advanced Pediatrics will continue to provide your health insurance benefits for the full period of an approved medical leave.

Your benefits, such as PTO or holiday benefits, will not accrue during a medical leave. When you return from leave, the benefits will start accruing again.

Please give us at least two weeks advance notice before you plan to return. When you return from medical leave, you will go back to the same job if it is still available. If that job is no longer available, we will place you in an equivalent job that you are qualified for, although hours worked may vary.

If you do not come back to work promptly at the end of a medical leave, we will assume that you have resigned.

602 Military Leave

Advanced Pediatrics will grant a military leave of absence if you are absent from work because you are serving in the U.S. uniformed services in accordance with the Uniformed Services Employment and Reemployment Rights Act (USERRA). You must give your supervisor advance notice of upcoming military service, unless military necessity prevents advance notice or it is otherwise impossible or unreasonable.

You will not be paid for military leave. However, you may use any available accrued personal time off (PTO), to help pay for the leave.

Continuation of health insurance benefits is available as required by USERRA based on the length of the leave and subject to the terms, conditions and limitations of the applicable plans for which you are otherwise eligible.

Your benefits, such as PTO or holiday benefits, will not accrue during a military leave. When you return from leave, the benefits will start accruing again.

If you are on military leave for up to 30 days, you must return to work on the first regularly scheduled work period after your service ends (allowing for reasonable travel time). If you are on military leave for more than 30 days, you must apply for reinstatement in accordance with USERRA and applicable state laws.

When you return from military leave (depending on the length of your military service in accordance with USERRA), you will be placed either in the position you would have attained if you had stayed continuously employed or in a comparable position. For the purpose of determining benefits that are based on length of service, you will be treated as if you had been continuously employed.

33 If you have questions about military leave, contact the Practice Manager for more information.

603 Pregnancy Related Absences

Advanced Pediatrics will not discriminate against an employee who asks for an excused absence for medical disabilities associated with pregnancy. If you ask for leave because of a pregnancy- related condition, we will treat your request the same as a medical leave request. Read the Medical Leave policy in this handbook for more information.

SECTION 7 EMPLOYEE CONDUCT/DISCIPLINARY ACTION

701 Employee Conduct and Work Rules

Employees are expected to work together efficiently and effectively. By accepting employment with Advanced Pediatrics, each employee has a responsibility to the practice and to his/her fellow colleagues to adhere to certain policies and procedures and behavior and conduct. The purpose of these policies and procedures is not to restrict an employee’s rights, but rather to be certain that each employee understands what conduct is expected and necessary. When each person is aware that he or she can fully depend upon fellow workers to follow standards of conduct, then our practice will be a better place to work for everyone.

While it is impossible to list every action that is unacceptable conduct, the following lists some examples. Employees who break work rules such as these may be subject to disciplinary action, up to and including termination of employment:

 Theft or inappropriate removal or possession of property  Falsification of timekeeping records  Working under the influence of alcohol or illegal drugs  Possession, distribution, sale, transfer, or use of alcohol or illegal drugs in the workplace, while on duty, or while operating employer-owned vehicles or equipment  Fighting or threatening violence in the workplace  Boisterous or disruptive activity in the workplace  Negligence or improper conduct leading to damage of employer-owned or customer-

34 owned property  Insubordination or other disrespectful conduct  Violation of safety or health rules  Smoking in prohibited areas  Sexual or other unlawful or unwelcome harassment  Possession of dangerous or unauthorized materials, such as explosives or firearms, in the workplace  Excessive absenteeism or any absence without notice  Unauthorized absence from work station during the workday  Unauthorized use of telephones, mail system, or other employer-owned equipment  Unauthorized disclosure of business "secrets" or confidential information  Violation of personnel policies  Unsatisfactory performance or conduct

All employees are responsible for maintaining their work areas in a clean and orderly fashion according to OSHA rules, at all times. Patient files must be kept in neat order to make access easier. Care must be taken to ensure that all information, faxes, lab reports and letters go into the proper patient chart.

All employees are expected to complete a Fidelity Bond insurance application to protect the practice against employee theft/fraud. Advanced Pediatrics will pay for all premiums for this bond.

702 Drug and Alcohol Use

Advanced Pediatrics is committed to being a drug-free, healthy, and safe workplace. You are required to come to work in a mental and physical condition that will allow you to perform your job satisfactorily. Employees are prohibited from unlawfully manufacturing; distributing, dispensing, possessing or using controlled substances or possessing related paraphernalia in or outside of the workplace. Because we are a practice and have certain controlled substances on the premises, any employee authorized to handle these controlled substances must follow the guidelines as outlined in the OSHA and DEA Regulations pertaining to the handling, dispensing and disposal of controlled substances.

Advanced Pediatrics will not tolerate the illegal use of drugs. Employees will be subject to disciplinary action, up to and including termination, for violations of this policy. All employees are subject to random urine drug screening and refusal by the employee may be cause for termination. If an employee tests positive for illegal drug use, all patient contact will cease immediately and disciplinary action and or termination will be taken. Licensing/ Certification Boards may be notified according to Professional Board Criteria.

The possession, use or dispensing of alcohol on the practice premises is prohibited unless there is an Advanced Pediatrics approved event. In such events, employees are reminded to be

35 responsible and consume alcohol in moderation and to not operate motor vehicles if under the influence of alcohol.

703 Sexual and Other Unlawful Harassment

Advanced Pediatrics is committed to providing a work environment that is free from all forms of discrimination and conduct that can be considered harassing, coercive, or disruptive, including sexual harassment. Advanced Pediatrics will not tolerate any actions, words, jokes, or comments based on a person's sex, race, color, national origin, age, religion, disability, or any other legally protected characteristic.

In keeping with its legal and social responsibilities as an employer, the management at Advanced Pediatrics will treat any complaint of harassment as a serious matter.

Definitions

Workplace harassment may include comments or conduct by any individual towards another, which is intimidating, annoying, hurtful or malicious. Any person who persists in such behavior, which he/she knows or should know, is unwelcome, may be guilty of harassment.

Sexual Harassment

Sexual harassment is defined as unwanted sexual advances, or visual, verbal, or physical conduct of a sexual nature. This definition includes many forms of offensive behavior and includes gender-based harassment of a person of the same sex as the harasser. The following is a partial list of sexual harassment examples:

 Unwanted sexual advances.

 Offering employment benefits in exchange for sexual favors.

 Making or threatening reprisals after a negative response to sexual advances.

 Visual conduct that includes leering, making sexual gestures, or displaying of sexually suggestive objects or pictures, cartoons or posters.

 Verbal conduct that includes making or using derogatory comments, epithets, slurs, or jokes.

 Verbal sexual advances or propositions.

 Verbal abuse of a sexual nature, graphic verbal commentaries about an individual's body, sexually degrading words used to describe an individual, or suggestive or

36 obscene letters, notes, or invitations.

 Physical conduct that includes touching, assaulting, or impeding or blocking movements.

Unwelcome sexual advances (either verbal or physical), requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when: (1) submission to such conduct is made either explicitly or implicitly a term or condition of employment; (2) submission or rejection of the conduct is used as a basis for making employment decisions; or, (3) the conduct has the purpose or effect of interfering with work performance or creating an intimidating, hostile, or offensive work environment.

Report it immediately to your supervisor if you experience or witness sexual or other unlawful harassment at work. If your supervisor is unavailable or you believe it would be inappropriate to discuss it with your supervisor, you should immediately contact the Practice Manager or any other member of management. There will not be punishment or reprisal if you report sexual harassment or ask questions or raise concerns about it.

All allegations of sexual harassment will be quickly and discreetly investigated. To the extent possible, your confidentiality and the confidentiality of any witnesses and the alleged harasser will be protected against unnecessary disclosure. When the investigation is completed, you will be informed of the outcome of the investigation.

Any supervisor or manager who becomes aware of possible sexual or other unlawful harassment must immediately advise the Practice Manager or any member of management so it can be investigated in a timely and confidential manner. Any employee who engages in sexual or other unlawful harassment will be subject to disciplinary action, up to and including termination of employment.

Steps To Take If You Are Harassed

Workplace harassment is unpleasant and intimidating. Fear of retaliation, embarrassment or feelings of guilt may persuade you to fail to report an incident. However it is essential that you do voice your complaints, in order for action to be taken against it.

Step #1: Ask the harasser to stop. It is important to do this at such a time when you have the harasser’s full attention. Inform the harasser that his/her behavior is unwelcome. The person may not realize that he/she is being offensive. A simple reminder may resolve the problem. If the person refuses to cooperate, indicate that such behavior is against practice policy and that a report will be made.

Step #2: Keep a record of the harassment. When did the occurrence start (date, time and location)? What happened? Did anyone witness the incident? Were there any threats of reprisal? What was your response? Failure to keep a record of the events will not invalidate the complaint; a record, however, will reinforce it.

Step #3: Issue a complaint. If the harassment continues, the problems should be reported to management.

37 Resolution of the Complaint

All reports of harassment will be thoroughly investigated. If there is evidence of harassment, the appropriate disciplinary action will be taken. This may include immediate termination.

704 Attendance and Punctuality

We expect Advanced Pediatrics employees to be present to work when scheduled and on time.. If you cannot come to work or you will be late for any reason, you must call your supervisor as soon as possible in advance of the anticipated tardiness or absence.

All employees are required to call in or notify their supervisor of impending absence from duty or anticipated tardiness as far in advance as possible, at 6:00 AM or 2 hours prior to your shift of that particular day.

Note: It is the employee's responsibility to ensure that the proper notification is given. Asking another employee, friend, or relative to give this notification is not considered proper notification except under emergency conditions. Failure by the employee to give proper notification to their supervisor will result in progressive disciplinary action, up to any including termination.

Absence for one day without notifying your supervisor subjects the employee to disciplinary action, up to and including termination.

It is expected that all personnel are responsible as well as courteous to other employees and will be in attendance for working hours. Any deviation from this schedule must have approval from your supervisor.

Employees should clock in when ready to begin work in the AM. (Please attend to things such as breakfast and restroom before you clock in). Employees need to be at their work station fifteen (15) minutes prior to the start of scheduled work day. Employees are to clock out and back in for their lunch and dinner breaks and clock out when leaving work, unless it is work related.

Poor attendance and excessive tardiness are disruptive. Either may lead to disciplinary action, up to and including termination of employment.

Unplanned absences can disrupt work, inconvenience other employees, and affect productivity. If you have a poor attendance record or excessive lateness, you may be subject to disciplinary action, up to and including termination of employment.

705 Personal Appearance

38 Personal appearance means how you dress, how neat you are, and your personal cleanliness standards. Your personal appearance can influence what patients, parents, and visitors think about Advanced Pediatrics. Personal appearance can also impact the morale of your co-workers.

During business hours or whenever you represent Advanced Pediatrics, you should be clean, well groomed, and wear appropriate clothes. This is particularly important if your job involves dealing with patients, parents, or visitors in person.

If your supervisor finds that your personal appearance is inappropriate, you will be asked to leave work and return properly dressed and groomed. If you are asked to leave, you will not be paid for the time you are away from work. See your supervisor if you are not sure about the correct clothing standards for your job.

Where necessary, Advanced Pediatrics may make a reasonable accommodation to this policy for a person with a disability.

The following examples should help you understand the Advanced Pediatrics personal appearance guidelines:

 Shoes must provide safe, secure footing, and offer protection against hazards.  Blue jeans, slogan tee shirts, slogan sweat shirts, tank tops, tube or halter tops, or shorts may not be worn under any circumstances. Nursing uniform/scrubs are appropriate for nursing staff  Offensive body odor and poor personal hygiene is not professionally acceptable.  Perfume, cologne, and aftershave lotion should be used moderately or avoided altogether, as some individuals may be sensitive to strong fragrances.  Jewelry should not be functionally restrictive, dangerous to job performance, or excessive.  Facial jewelry, such as eyebrow rings, nose rings, lip rings, and tongue studs, is not professionally appropriate and must not be worn during business hours.  Multiple ear piercings (more than two rings in each ear) are not professionally appropriate and must not be worn during business hours.  Torso body piercings with visible jewelry or jewelry that can be seen through or under clothing must not be worn during business hours.  Visible excessive tattoos and similar body art must be covered during business hours.  Artificial or excessively long fingernails may harbor bacteria. Nails should be trimmed to reasonable length to avoid spreading infection.

706 Return of Property

Advanced Pediatrics may loan you property, materials or written information to help you do your job. You are responsible for protecting and controlling any property we loan you.

39 You must also return it promptly if we ask. If you stop working at Advanced Pediatrics, you must return to the practice all equipment, materials, records, keys, books, manuals and all other similar material issued to you during the period of employment.

Upon termination, an employee will pay any outstanding obligations owed to the practice or the owner. Amounts due may be, but are not limited to, such items as employee advances, unpaid personal charges and the balance on the employee’s practice account. Any expenses not paid by the employee’s last day will be deducted from the final paycheck.

707 Resignation

Resignation means that you voluntarily terminate your employment at Advanced Pediatrics. If you decide to resign, Advanced Pediatrics requires that you give at least 2 weeks' notice in writing before the date you will leave.

If you do not give 2 weeks advance notice before leaving, any accrued personal time off (PTO) will be forfeited at the time of your termination and such action could result in poor references for potential future references.

708 Security Inspections

Advanced Pediatrics wants to have a work environment that is free of illegal drugs, alcohol, firearms, explosives, or other improper materials. We prohibit the possession, transfer, sale, or use of these materials on our premises.

We may provide you with desks, lockers, and other storage devices for your convenience but these are always the sole property of Advanced Pediatrics. Because they are our property, we may allow our representative or authorized agents to inspect them at any time, either with or without advanced notice to you. We may also inspect any items that we find inside them.

We also want to discourage theft and the unauthorized possession of property that belongs to our employees, Advanced Pediatrics, visitors, and customers. To help enforce this policy, we may require inspection of employees and other persons who enter or exit our premises as well as any packages or other belongings they carry with them. To avoid having your belongings inspected, the best policy would be not to bring them to work.

40 709 Disciplinary Procedures

This policy describes the policy for administering fair and consistent discipline for unsatisfactory conduct at Advanced Pediatrics that may interfere with or adversely affect employment.

We believe it is important to make sure that all employees are treated fairly and that disciplinary actions are prompt, consistent, and impartial. The major purpose of a disciplinary action is to correct the problem, prevent it from happening again, and prepare the employee for satisfactory performance in the future.

Disciplinary action may be any of the following four steps: 1) verbal warning, 2) written warning, 3) suspension with or without pay, or 4) termination of employment. We will look at the severity of the problem and the frequency of occurrence when deciding which step to take. There may be circumstances when one or more steps are bypassed. Factors that may be considered in ascertaining the appropriate steps include, but are not limited to: (1) seriousness of conduct; (2) employment record; (3) employee’s ability to correct conduct; (4) action taken with respect to similar conduct by other employees; (5) effect on clients and (6) surrounding circumstances.

Some conduct may result in immediate dismissal. Some examples of behaviors that may result in immediate dismissal include, but are not limited to: (1) chronic absenteeism; (2) theft; (3) coming to work under the influence of an intoxicant or possessing the same on practice property; (4) arguing or fighting; (5) false statements; (6) insubordination; (7) unauthorized disclosure of any confidential practice information; (8) unlawful discrimination or harassment; (9) failure to cooperate with an investigation; (10) deliberate destruction or damage to practice property and (11) violation of any practice rules or regulations of which the employee has been notified.

These are only examples and as Advanced Pediatrics offers Employment at Will, an employee may terminate his/her employment at any time, with or without cause, and the practice retains the same right, as long as, the reasons are not specifically prohibited by law. Further, Advanced Pediatrics continually updates and reviews its policies and accordingly, its Disciplinary Action is subject to change.

710 Problem Resolution

Advanced Pediatrics encourages an open and frank atmosphere in which any problem, complaint, suggestion, or question receives a timely response from Advanced Pediatrics supervisors and management.

41 Advanced Pediatrics tries hard to ensure fair and honest treatment of all employees. We expect supervisors, managers, and employees to treat each other with mutual respect. We encourage employees to give positive and constructive criticism to each other.

If you disagree with Advanced Pediatrics rules of conduct, policies, or practices, you can state your concerns through the problem resolution procedure described in this policy. You will not be penalized, formally or informally, for making a complaint as long as you do it in a reasonable, business-like manner. You will also not be penalized for using this problem resolution procedure.

If a situation occurs when you believe that a condition of employment or a decision that affects you is not fair, you are encouraged to use the following problem resolution steps. You may stop the procedure at any step.

1. You present the problem to your supervisor after the incident occurs. If your supervisor is unavailable or you believe it would be inappropriate to discuss it with your supervisor, you may present the problem to the Practice Manager.

2. Your supervisor responds to the problem during discussion or after consulting with appropriate management, when necessary. Your supervisor documents the discussion and a written response will be put in your file.

3. You present the problem to the Practice Manager if the problem is not resolved.

4. The Practice Manager counsels and advises you, helps you to put the problem in writing, visits with your manager, if necessary, for a review of the problem.

5. The Practice Manager informs you of the decision, and a copy of the written response will be put in your file. The Practice Manager has full authority to make any adjustment that is determined to be appropriate to resolve the problem.

Not every problem can be resolved to everyone's total satisfaction. However, we believe that honest discussion and listening to each other will build confidence between employees and management and help make Advanced Pediatrics a better place to work.

711 Work Etiquette

Employees are to keep in mind that the success of Advanced Pediatrics depends on customer satisfaction. All customers should be treated in a kind, courteous and professional manner, regardless of the situation. In the event of any specific problems with the customer, management should be contacted immediately. If you are uncomfortable dealing with certain customers, please inform the management. It is our goal to avoid conflict. Please remember to present yourself in a friendly manner at all times.

42 SECTION 8 INTERNAL COMMUNICATION

801 Meetings

In an effort to maintain two-way communication with employees, Advanced Pediatrics is committed to holding staff meetings periodically. These staff meetings provide an avenue for employees to share ideas or issues with other employees and management. Employees are expected to present ideas or issues in a constructive manner. For example, don’t just protest a process or procedure, share ideas on how to improve the process or procedure in question

802 Federal and State Employment Law Posters

Official federal and state information on equal employment opportunity, wage and hour, health and safety, workers compensation and other issues is posted on the wall of the kitchen nearest to the nurse’s station.

803 Memos, Letters or Forms

The door in triage is also used to communicate information regarding the practice’s policy and business announcements, including, but not limited to, job postings, safety rules, health items, benefit programs and notices announcing special events.

For a more formal communication medium, Advanced Pediatrics will disseminate information via written employee newsletters, memorandum, letter or form. Topics needing this type of style include, but are not limited to, changes in policies, procedures or processes, salary rate increases and performance evaluations.

804 Open Door Policy

The need to communicate with other employees or with management occurs frequently, especially in small businesses. Management is committed to providing an open door policy for

43 employees who wish to communicate one on one or amongst other employees. Employees are expected to provide the same open door policy to fellow employees.

805 Staff Training

To constantly improve both the medical knowledge of employees as well as part of quality improvement, training sessions will be held regularly throughout the year. These sessions will include both OSHA training as well as maintaining office emergency preparedness.

44 SECTION 9 APPENDIX

Continuing Education & Training Request Form

Please Tab through selections or use your Mouse NAME: TRAINING OR CONFERENCE:

NUMBER OF DAYS: DATES REQUESTED: TO

TRAINING/CONFERENCE REQUESTED (NAME):

JUSTIFICATION:

TRAINING / CONFERENCE COST: $ EMPLOYEE MUST SUBMIT PROOF OF REGISTRATION NAME OF APPROVING OWNER______AND PAID RECEIPT

Continuing Education & Training Agreement (Please read carefully before signing)

The information on this request is submitted in application for Continuing Education & Training assistance under the terms of the Advanced Pediatrics Continuing Education & Training policy. In conformance with this policy, my signature below certifies that I have read, understand and agree to the following:

1. If I voluntarily terminate my employment, or if my employment is terminated for cause, the reimbursed amount I received during the previous 12-month period will be deducted from my paycheck with any balance immediately due.

1. If by Advanced Pediatrics action, my employment is terminated for reasons unrelated to my performance, I will not be required to pay back the reimbursed amount.

I have read and understand the agreement described herein. By signing this Request Form, I authorize Advanced Pediatrics to deduct any monies owing to them for the reimbursement of my Continuing Education & Training if I voluntarily terminate my employment, or if my employment is terminated for cause during the three-month period after I have received my reimbursement.

______Employee's Signature Date

______

45 Print Name Date

Management Approval ______

Time Clock Correction and Leave Request Form

Advanced Pediatrics

Once signed please make 3 copies, original to Lisa, copy to Lori, place copy in Aprill’s box & keep one

Time clock correction or Leave request (Circle One)

Employee Name: ______ID #______Date______

Date Day Correct Correct Correct Correct Normally Total hours IN OUT IN OUT Scheduled Hours PTO or LWOP Mon to Tues to Wed to Thurs to Friday to Sat to Sun to Mon to Tues to Wed to Thurs to Friday to Sat to Sun to PTO must be used prior to requesting leave without pay. Do you have accrued leave? ___Yes ___No

TOTAL HOURS OF LEAVE ON YOUR LAST PAYSTUB: ______

Dates requested off 1. Date ______to ______or partial days off 2. Coming in late on ______at ______am/pm 3. Leaving early on ______at ______am/pm Total Number of Hours you are Total Hours PTO______Total Hours LWOP______requesting off PTO______Holiday ______Other______Type of Leave LWOP______(only to be used when PTO is exhausted) Overstaffing LWOP______

46 ______Employee’s Signature Date

______Supervisor’s Signature Date