RULES ON FILE A well-drafted employee manual trains and protects.

Your employees are among your facility's most valuable assets, but they can also be liabilities, and you're ultimately responsible for their actions. A comprehensive, up-to-date employee manual is the key to making sure they're aware of what you expect from them, and what they can expect from you. It can also provide legal protection in the event you're served with an employment claim. When's the last time you reviewed and revised your employee manual — that is, if you've drafted one at all? At a minimum, it should clearly cover the following 4 areas.

Probation and termination
Before you bring on a new hire, do your due diligence by conducting background checks, verifying licenses and checking referrals. Once a new employee is on board, though, we suggest a probation period of a few months, during which time she and your facility's leaders can evaluate the appropriateness of the employment. Probation period employees are generally not afforded benefits, but upon its successful completion you should offer them the full privileges of employment, as described in the employee manual.

"Employment at will" means that an employer has the right to discharge an employee at any time for any reason (except, of course, with respect to race, creed, national origin, age, handicap, gender, sexual orientation or marital status). If your state is among the many that recognize the concept, be sure your manual says so. Upon termination, all employees should undergo an exit interview with administration, in which you'll discuss the terms of the employment and discharge.

Hours and days
You can avoid disputes large and small if your manual classifies the types of employment on site (full-time, part-time and per-diem, for example) and the hours that each type of employee is expected to work. The manual should advise employees whom they should inform in the event they'll be late for their shift, spell out the facility's policy on taking time off during the day for personal matters, and explain if and when they are eligible for overtime pay.

Paid time off might be the most frequently discussed aspect of employment policy. Does your manual specify how many vacation days and sick days employees are entitled to, how they accumulate them and how they can use them? How much notice must be given in advance of vacation days? Whether a doctor's note is required following sick days? If employees can roll over a year's unused days into the following calendar year, or receive compensation for unused days?

On-the-job injuries are a serious matter. The manual should detail your policies and procedures regarding workers' compensation. It should also define the eligibility for the benefits offered to employees, including health insurance, retirement plans, and life and/or disability insurance. Although you should retain the right to fine-tune the details of your facility's benefits package, the manual is a good place to review what's offered.

Confidentiality
Recent changes that have strengthened HIPAA's privacy requirements — and its penalties for failing to comply with them — make the confidentiality of patient information a particularly urgent area for a manual to address. Now is the time to adhere to the federal regulations. The Department of Health and Human Services has announced that its Office of Civil Rights will be stepping up its HIPAA compliance audits of medical practices. It's expected to enforce compliance with fines. As such, make your employees aware that they may be subject to disciplinary action, up to and including termination, in the event that they inappropriately disclose protected health information.

You'll want to protect your facility's own business information, too. To ensure that your trade secrets, including billing, general processes and accounts receivables, remain secret, the manual should remind employees that all such proprietary information should be kept confidential during and after the terms of employment.

Rules of conduct
Since most of your employees will be in direct contact with patients, it's imperative that they comply with certain ethical guidelines, which the manual should carefully outline, from treating all patients with respect to not treating or diagnosing patients unless they're appropriately licensed. The manual should state that all employees are required to conduct themselves in a professional and courteous manner, or else face disciplinary action. Actionable infractions may include, but are not limited to, the following: failure to comply with reasonable requests made by a supervisor; sexual harassment; lack of personal cleanliness; disregarding safety regulations; substandard work performance; verbal or physical mistreatment of patients; falsification of time sheets; substance abuse in the workplace; theft or destruction of property; offering, soliciting or accepting bribes, gifts or gratuities from patients; or other disruptive or uncooperative behavior.

The manual should also set the tone for your facility's policies on smoking, appropriate dress, personal phone use, and e-mail and Internet usage.

The best defense
Unlike physician-owners, perioperative and business staff members aren't usually bound by contract to their terms of employment. But in an economically tight climate, former employees who were terminated or otherwise separated from their positions occasionally seek compensation through litigation or unfair practices claims. A comprehensive, up-to-date list of employee rules and responsibilities, signed by the employee herself, is a preemptive advantage that can blunt such attacks. The labor laws in today's workplace are extremely complex. Those employers who address the most contentious issues in a well-drafted employee manual, and train their employees to the policies described within it, will have taken an enormous step in avoiding labor law disputes in the future.