This document will illustrate horiv
America (RCA) facility located a
and is responsible for putting at 'i
and under their care.

The irresponsible and unprofess'
signi?cant stress, putting my sol:

Boston Center for Addiction Treatment (BCAT) a Recovery Centers of

75 Lindall Street, Danvers, Massachusetts mistreats employees and patients

sk the sobriety and the wellbeing of employees and patients in their employ

nal actions taken by members of the BCAT administration have caused
iety at risk and causing a signi?cant ?nancial burden to my family.

I believe that Boston Center for Addiction Treatment (BCAT) a franchise of Recovery Centers of America

.has and continues to engage in 1
possible danger.

ethical behavior that could potentially put an already at risk population in

- Patient reported having been addressed by senior staff members and asked "admit to being ?irtatious" after

as sexually assaulted by

ousekeeping employee.

- No employee handbook outlini 1g policies or protocol is available.

- Training is minimal. Generally



ew hires are scheduled for ?Jll shifts with less than one day of training.

0 Senior sta?" routinely makes kn awn to patients and staff that six months of sober time and a GED area?

1

that?s required to work at 

as an RSS.

- routinely falsify rounds sheets. 'In some cases patients have been marked as either being in their
room or in common areas several hours after they have been discharged from the facility. also fill Out
rounds sheets for certain time slots 2-3Ihours after the speci?ed times had passed. While a policy was put
in place and distributed during the week of June 18, prior to the BSAS visit, the policy is not followed. See

Rounds Policy? on page

25. .



- RSS staff request that patients order food from the caf? and bring it to the RSS of?ce for a staff member in

order to avoid paying for meals,

in de?ance of the orders that no food leave the caf?.

 

  
   
 

. Untrained and unquali?ed staff
subjects on which they are neit

- RSS and nurses have verbally a
patient as 

0ple? and wa

brought to attention wh

for a reason to get rid of.?

- RSS staff absent from ?Unit for

Employees arriving to work visi
0 Employees potentially abusing
0 Patients are rOutinely drinking

Patient removed a bottle of me

- Staff to patient ratio: Average st
In many instances it?s far less.
nurse assigned to the unit.

Incorrect room assignments on

0 Patients complaining of being or

members leading patient groups by reading from Power Point slides on
er trained in nor have any pro?ciency. 

used patients. In one Such instance, involving a nurse who referred to a
seen screaming at a patient who knowingl suffered from PT SD. This was
uickly it to? i; . ?I?ve been looking

aid. The nurse is still employed with 

  

veral hours, leaving the ?oor unattended or short staffed.
ly under the in?uence.

bstances while on break.

urell from the nurses station.

cation from the nurses cart for personal. use.

per unit is two RSS staff members and two nurses for a 30 person unit.
times one RSS is on the floor alone to monitor 30 patients with only one

he nurses board.

er medicated or having been given the wrong 

- Seizures in the common areas 01 the are met with slow responses due to faulty equipment such as

1.

 

 

 

walkie-talkies- Shortly after the?
familiar with the incident.

facility opened a patient died due to a lack of response, according to staff

- Pay is routinely miscalculated dud can take weeks to rectify.

- are routinely taken off of
the building from that location

- Patient?s family visits are disorg
drugs during these visits.

A Brief History

After over a decade of sobriety, in
accepted a position with Bridgew
call recovery coaching for patient
on the recovery process, and res
called and respond in person to 
program coordinator/clinicai cas

the floor to ?guard the back door? due to the CEO suspecting drugs entering
There are multiple unsecured areas by which contraband can enter.

,anized, unattended, and chaotic. Visitors routinely pass contraband and

Febmary of 2017, I was certi?ed as [a Recovery Coach from CCAR and
all on February 27, 2017. My job entailed, among other things, providing on
and family members; providing education to patients and family members

hospital within 30 minutes of the call; and communicating with the
manager regarding the status of the call and the disposition of the patient.

pfnding in communication With on dull service within 5 minutes of being

 

In April of 20171 attended a job

ir at Recovery Centers of America?s (RCA) Danvers, MA facility, Boston

Center for Addiction Treatment CAT), during which I was immediately offered a ?full time? position as a

Recovery Support Specialist. Des
date of April 24, 2017. 

I have worked there until July 14,
on unpaid "Administrative Leave?

an incident invol

ite the signi?cant reduction in pay, I accepted the job and received a start

2017 when my employment was abru

   
      

Itl terminated after having been put
- '1 directly following
to have ingested a liter

 

sinceJune 28,2017 by .. 
June 27, 2017 on Unit 5 netox 0 was

   

vin a patient on .
of hand sanitizer. noti?ed me of this by leaving me a voicemail less than an hour before i was to report?

for work that day. Despite
matter on' Fridayjune 30th.

It?s important to note that I never
or access to any of these the entir
most recent request was made on
I could

 
  
 

documentatio
provided. 3 . 3 and
The requested documents were 

but wher

I received one day of training on

assurances to me via email that I would be noti?ed by-regarding this

received an employee handbook, guide, policies or procedures manual

3 time I?ve been employed at BCAT, despite my repeated requests. The
June 15th during a staff meeting when I asked not only for the relevant

nd it on the company portal or within Sharepoint. This was never

were among the many employees in attendances at that meeting.
ded.

 

 

 
 
 

ver provi

pril 28th and was subsequently put on the floor as an RSS the following

day. The majority of the skills I ac uired at BCAT were self-taught and without the oversight of another

employee or trainer. The docume
Bureau of Substance Abuse Servi

I ?nd it hard to believe that I was

t! had me sign during the week of June 18th, prior to the visit by
BSAS), should re?ect that.

problem employee? as - purports.

    
 

It de?es logic and reason that I terminated for the reasons stated in the letter postmarked July 14, 2017,

stating that I my employment wa
Trial Period," (see Letter 0

offered not only more hours, but
terminated) and I had ?the best 1'
before completing treatment (als

   
    
   

being terminated ?due to unsatisfactory completion of the 90 Day Work
Termination? on page 66), since prior to the June 27th incident I was

shifts of my choice. I was also told by that (also
eave acr ity

ults? when retaining patients who were attempting to
known as We were both asked by 0 train other RSS staff

members on our technique. Neith of these actionswould indicate an employee who has been a problem.

I have also recently been invited 
area. Again, not something a ?pro lem employee? would be considered for.

have told me verbally on numero

present my views 'of recovery and treatment to several hospitals in the
and therapists at the facility
occasions thatl was "doing a good job? an was ?really good with the

patients.?

I attended staff meetings as requ red, completed the Mandatory Relias Training and CPR classes, as well

as having compieted compulsory training that was mandated on scheduled days off prior to the BSAS visit
mentioned above.

 

While both and Human Resources Business Partner, stated in several incidents
that I, along Wit anot er RS re on eave pending an investigation into the-incident, neither
of us were questioned or given opportunity to recount the events of that evening. Plainly put; We .were
accused of doing something, tha would be considered by most the right thing to do, that we technically

did not do; then put on leave Wh an investigation about our actions took place, in which we had no part

or ability to offer testimony; and :hen let go for no apparent reason following a siew of unsubstantiated
acmsations.

  
 

I have documented the events on the foilowing pages, to the best of my knowledge and recollectiOn,
beginning with the incident on? involving a patient on Unit 5 (Detox) who was believed to have
ingested a liter of hand sanitizer.

 

 

BCAT Incident june 27, 2 I7-

6-27- 17 18: 00/18: 30

Shortly after the BCAT- ati nt? 5 scheduled dinner break a patient from Unit 6 

reported to RSS

a Unit 5 patient smelled of alcohol. Both and I agreed that

we would monitor the patient? 5 ehavior.

We observed the iatient walking across the common area with a bowl of cereal, spilling milk as-made-

way to a seat.

con onted the patient about the spill and asked that he clean it up. The patient

proceeded to gather some paper owels and clean up the spill. The patient became belligerent and referred to
both of us in a profane manner.
that

as slurring his words.

  

51: spoke to the patier

We questioned the nurses and 
counter of the nurse?s station.

Nurse - 

 

The patient moved towards one 
Patient lost-footing or lunged

from a bottle at the nurse?s statidn.

th?nursesand was stopped by 5 
as had become increasingly belligerent.

this point we noticed that the patient was having dif?culty walking and

t. The patient admitted to that-had ingested hand sanitizer

Ire told that nearly half of a 2?liter bottle of Purell was missing from the

breathalyzed the patient and returned with a result 148 mg/dL.

 
 

It is unclear whether

 

 

6-27-?17 approx.19:30

The nursin sta?" informed both
?Stated, ?I?m not m.

made by the nursing staff at app

I noti?ed the front desk by walki -

be noti?ed upon their arrival.

6-27?17 approx. 1 9:45

  

at the front desk noti?es?
ey wanted to talk to someone

Of?cers

the 911 was rescm I stat
ingested hand sanitizer and state
re-uested via police radio that th

I . ntered the lobby escorti

  

The patient was helped onto the 

ambulance.

Upon returning to the Unitl se
patient?s roommate was also test
roommate to a Styrofoamcup th:
me that the patient had been drir

At this time I was made aware by

of BCAT had called 911 to cancel the ambu ance in I

Out of concern for the well-being

the
on the unit a ingested hand sai

  
    
      
  
  
  
  
  
 
 
  
  

and me that the patient required hospitalization for- safety.
i 'ng any oec1sions 0 You guys make a decision.? The 911 call was
uximately 19:30. 

   
 

-talkie that the police and ambulance had been called and requested that we

me via walkie- talkie that the olice had arrived were in the lobby, and that
went downstairs. Nurse 3's ollowed soon after.

  

were in the BCAT lobby. The of?cers questioned us as to why

at I was unaware of the call and informed them that the patient had
my concern for the safety and well-being of the patient Of?cer 
ambulance be returned to BCAT. Shortly after the call was made
the patient. The ambulance arrived soon after

   

ey and escorted by police and members of the BCAT staff to the

  
 

ched the patient? 3 room, and with the of nurse
:d with a breathalyzer- the result was negative. I was direct a 

was half full of Purell on the patient? 5 night table. The roommate informed
king from it.

  
 

p01ce,w 1et ey were on eir way.

and I made a request to -
rea yze to determine whether anions se

the nursing staff that both

   
  

of the rest of the patients,
of Unit 5 be examined and
1itizer and/or were intoxicated - the request was denied by

 

4

 

 

 
 
 
 

 
 

 

 

Danvers Police Report if

 

 

 

 

 

I 70 I 2609

Page I of 2

 

 

Main Form
POLICE DEPARTMENT
MA
IN 1 0mm My; Mm
17012509} 1 OFFICER REVIEWED
INCIDENT 1701260{ DATA
,As Goa/2712017 23:43:34
1 BASIC Mnmnon - 
CASE Tnus Iocn'mN Anamfr 
MEDICALAID 75 LINDAIL ST .
DWHQ 
06/27/2017 19 32.20 011 or about 06/27/2017 19:momma]

OFFICER REPORT: 11
DATE 5 on? man:
06/27/2017 19:32:20


On 06-27?2017 I 1

 

 



INCIDENT

.- 

esponded to Recovery} Centers of America at 75 Lindall St for a

 

?zeport of a client vda:
arrival with 
was calm and no 
'3poka to several stat
stated was unsure

needed to be seen at

squashed 

 

was cut of control after drinking hand sanitizer. Upon my

we were advised that we were cancelled as the party

at. the facility. then arrixred on scene and we 
members about what he .appened. Staff member 
0 had. cancelled the 911 call but he did feel that the client 
a Energency room after ingesting the hand sanitizer. -
ambulance return to the tacility. and several other i

-
-rs then escorted out of the facility and into the
was intcx cate an . 19erent. - was transported to the

whale-?Ce. 

I 6/3 0001 7

23

 

- 

Termination

July 17th, 2017

Received the following letter Tom BCAT signed by .

i in .via USPS.

 

El-
5-

The Boston Center

 

 

 

CALL i 

 

for Addiction Treatment

A 2;?ch OF WCOHPANY

75 LINDALL STREET. DANVERS. MA 01923

 
 

,Please be advised hat. your employment. with Recovery Centers of America, Danvere is

terminated, effectii 9. immediately due to unsatisfactory completion of 90 Day Work Trial
Period -

 

   
 
 
     

orkcd from the start of this pay period along with your accrued
1e will be included in your ?nal paycheck which you will receive today.

Payment for time 
vacation, if applica

You can expect a 3-1 arate bene?ts stat?us letter?that will outline the status of your bene?ts
upon termination. he letter will include information about. your eligibility for Consolidated
Omnibus Budget 1 conciliation Act (COBRA) continuation of group health coverage.

We wilJ need your ID card alang with any keys or other eq uipnient issued to you.
You will need to ke -p the company informed of your contact information so that we can
provide the inform tion you may need in the future such as your W-2 form.

Please con (sac; i} Human Resources Business Partner with any questions.

CC: Personnel ?le

 

l8

 

 

 

 
   
  
    

Compliance and lnfractio 

In addition to the unprofessional and 'rresponsible way they have acted in regards to the incident of june 27, 201 7, -
has been noti?ed by me and her staff members about the following potentially dangerous and negligent behaviors. To
my howledge these have not been ressed.

A patient reported having beer addressed by senior staff members to ?admit to being ?irtatious? after-
was sexually assaulted by a housekeeping employee.

RSS's falsifying rounds sheets. In some cases patients have been marked as either being in their room or
in common areas several hour after they have been discharged from the facility. ?lling out rounds
sheets for certain time slots 2- hours after the speci?ed times had passed.

0 RSS staff requesting that patie ts order food the caf? and bring it to the RSS of?ce for a staff member
in order to avoid paying for is.

- Untrained and unquali?ed st members leading patient groups by reading Power Point slides.
RSS and nurses verbally abusi patients. In one such instance, involving a nurse who referred to a patient

reaming at another atient who suffered from PTSD, this was brought to
ought it huh ?I?ve been looking for a

as ou people" and was seen
intention who uickl 
d. The nurse is still employed with BCAT.

reason to get rid of is

RSS staff absent from Unit for several hours leaving the floor unattended or short staffed.
Employees arriving to work vialbly under the in?uence.

Employees potentially abusing substances while on break.

- Patients are routinely drinkinglPurell from the nurses station.

- Patient removed a bottle of me iication from the nurses cart for personal use.

- Staff to patient ratio: Average staff per unit is two RSS staff members and two nurses for a 30 person unit.
In many instances it?s far less. personally can attest that I have been on the ?oor alone with 30 patients
and there was only one nurse assigned to the unit.

Names and testimonies available upon request.

22

 

Nicolosi, Tracey (DPH)

From: Hogan, James (DPH)

Sent: ursda Jul 20 2017 6:48 AM
Cc: Nicolosi, Tracey Liburdi, Anthony Lubega, Agnes (DPH)
Subject: . FW: BSAS Program License Submit Dco Notice

The Commonwealth of Massachusetts

Executive Of?ce ot?I?lealth and Iluman Services
Department of Public Health

250 Washington Street, Boston, MA 02108?4619

De?ciency Correction Order

Message From The Bureau of Substance Abuse Treatment Services

Dear?-

Thank you for your assistance in the investigation process that was conducted July 11, 2017.

Below' is the De?ciency Corrective Order (DCO) based on the site visit review of program documents
and interviews with staff members.

Please submit to_at the Department of Public Health, Bureau of Substance Abuse
Services, 250 Washington Street 3rd Floor, Boston, Ma 02108. A written plan for correction of each
violation cited in the de?CIenc correction order (DCO) within 10 days. Your response should be
received not later than*

Should you have any questions, please do not hesitate to contact me.

Sincereli, 

DCO Information

License No: 0396
Program Name: New England Center of Addiction Medicine
Program Address: 2701 Renaissance Fourth Floor King oi Prussia, PA 19406

DCO Issue DateDCO Line Items
Due Date: Aug 03 2017

Regulation Not in Compliance:
164.03 5: Required Noti?cations to the Department

(A) Change of Name, Ownership.'0r Location: at least 90 days prior to a change in location, name, ownership
or control of the facility, the licensee shall notify the Department in writing of the proposed change, and shall
comply with applicable provisions of 105 CMR thrOugh (H).

(B) Legal Proceedings: The licensee shall report in writing to the Department any civil action or criminal charge
that is brought against the licensee or any person employed by the licensee that relates to the delivery of the
service or may affect the continued operation of the facility. The report shall be given to the Department as soon
as the licensee is aware of the action and no later than 24 hours of the initiation of any legal action or within 24
hours of service of notice upon the licensee or its agent, whichever occurs ?rst.

(C) Closure: When a licensee plans to cease operation the licensee shall:

(1) notify the Department in writing at least 90 days prior to cessation of operations and closure. Such
noti?cation shall specify the date of closure and shall include the licensee?s plan for clOsure as required by 105
CMR 164.087: Closure. Voluntary closure shall include foreclosure or bankruptcy proceedings.

(2) In the case of involuntary closure not due to an action of the Department, notify the Department as soon as
the licensee is aware of the pending closure and prior to cessation of operations and closure.

(D) Interruption or Suspension of Service: If a licensee determines that the health, safety or well-being of clients
is in imminent danger as a result of conditions existing within the service, program or facility, the licensee shall
notify the Department immediately upon becoming aware of the danger to "clients. The Department shall
consult with the licensee regarding the need to interrupt or suspend services as provided for in 105 CMR
164.086: Interruption or Suspension of Services.

(E) Change of Program or Service Provision: A licensee shall notify the Department in writing at least 30 days
before any change in program or service provision. The Department shall determine whether such change
requires re-licensure:

(F) Change of Administrator. Executive or Program Director: A licensee shall notify the Department at least
two weeks before a planned change of Administrator, Executive or Program Director. In the event of an
unplanned departure of a director, the licensee shall notify the Department within two business days of the
change of director.

(G) Death, Serious Incident, Accident or Fire:

(1) The licensee shall notify the Department 1n writing within one business day of learning of the death of any
person currently admitted to the program, regardless of where the death occurs. Where appropriate, the licensee
shall notify the dededent"s family or next?of?kin.

(2) The licensee shall orally notify the Department immediately, and in writing within one business day of any
serious injury which occurs under program auspices, regardless of location 
(3) The licensee Shall orally notify the Department immediately, and in writing within one business day of any
?re or other event resulting in damage to the program

(H) Safety and Health Conditions: The licensee shall orally notify the Department immediately, and in writing
within one business day, of the following:

(1) any alleged abuse or neglect, or physical or sexual assault, which occurs between or among clients at the
program, or which occurs between or among clients and staff regardless of location, including any incident
which is reported to another agency or law enforcement. I

(2) any condition at the program which poses a threat to the health or safety of clients or staff, for example,
conditions which limit access, unsanitary conditions, fire hazards, loss of essential services, regardless of
whether the conditions cause an interruption of service. The licensee shall consult with the Department to
determine whether the condition requires an interruption or suspension of service, as provided for in 105 CMR

2

164.086: Interruption or Suspension of Service.

(3) con?rmed cases among staff or clients of communicable diseases which are reportable under 105 CMR

300. 000: Reportable Diseases.

(1) Reports of Abuse and Neglect: When alleged abuse or neglect occurs at the program, the licensee shall
immediately notify the Department of:

(1) any reports of child abuse or neglect made under M.G.L. c. 119, section 

(2) any reports of elder abuse or neglect made under M.G.L. 0. 19A, section 15; and

(3) any reports of abuse of a disabled person made under M. GL c. 19C

The licensee shall document its evaluation of whether any such incident should be reported to any other agency,
including professional licensing bodies or law enforcement

Areas of non compliance:
During document review it was identi?ed the programs had several incidents that a required noti?cation should
have been submitted to BSAS and had not been.

During interviews it was reported there had been several incidents where clients have taken the elevator to other
floors and to the roof to have sex or smoke

Instructions:
Provide af?rmation from this point forward all required noti?catiOns will be submitted per above regulation.

Submit a plan on how the program will provide oversight and security of the elevator access.

 

Due Date: Aug 03 .2017 -

Regulation Not in Compliance!
164.048: Staf?ng Pattern

(A) The licensee shall provide an adequate number of quali?ed personnel to ful?ll the service objectives.

(B) The licensee shall establish a multidisciplinary team that includes professionals with recognized expertise in
a variety of areas, of substance abuse treatment. The team may include licensee's staff as well as other treatment
professionals through Quali?ed Service Organization Agreements. The team may include physicians,
acupuncturists, nurse practitioners, physician assistants, registered nurses, licensed
practical nurses, social workers, nurses, substance abuse counselors with master' or bachelor's
degrees 1n a related ?eld and certi?ed or licensed substance abuse counselors.

(1) The multidisciplinary team shall review initial assessments, treatment plans and other client-speci?c 1ssues
to ensure quality of services and to provide education and training to staff

(2) The licensee shall ensure that the multidisciplinary team is incorporated into the staf?ng plan.

addition, the licensee shall ensure that on each shift speci?c staff members are designated to:

(1) Initiate an emergency response as described in section 105 CMR 164.062 All Hazards Emergency Planning
and Procedures; and

(2) Perform cardio?pulmonary resuscitation.

 

(D) The licensee shall establish a staf?ng pattern which includes paid staff in numbers, quali?cations and shift
coverage to ensure:

(I) provision of required services

(2) safety of clients and staff

(3) operation of the program in accordance with 105 164.000.

The Department may issue guidance specifying minimum numbers of staff, and may determine that a staf?ng
pattern is insuf?cient to ensure 105 CMR through (3).

Areas of non compliance.
Interviews and document review identi?ed that the program is not in compliance with BSAS staf?ng
guidelines

Instructions: -

Submit a plan and time line for both programs to comply with staf?ng guidelines The plan needs to include
what recruitment effort IS being taken to ?ll positions. Documents to be included are as follows: an updated
staff schedule for all shifts and positions for the Month of August 2017 identifying dates, shifts and positions
for both pro grams.

 

Due Date: Aug 03 2017

Regulation Not in Compliance:
164.017: Plan of Correction

(A) ,The licensee shall submit to the Department a written plan for correction of each violation cited in a
de?ciency correction order within a time period speci?ed by the Department in the correction order.

(B) The plan of correction shall set forth, 'with respect to each de?ciency, the speci?c corrective 'step(s) to be
taken, a timetable for each step, and the date by which full compliance will be achieved. The timetable and the
compliance dates shall be consistent with achievement of compliance in the most expeditious manner possible.
The plan of correction shall be signed by either the applicant or liCensee' or his/her designee.

(C) Unless the Department states in the de?ciency correction order that more urgent corrective action is
necessary, based on the seriousness of the de?ciency, the licensee shall be given a maximum 30 days from
receipt of the correction order to remove the de?ciency. The Department may specify a different date by which
the correction(s) shall be completed, in the event that the licensee requests additional time and the Department
determines that it is necessary.

(D) The Department shall review the plan of correction and will notify the licensee of either the acceptance or
re] ection of the plan. An unacceptable plan must be amended and resubmitted within ten business days of the
date of notice of rejection

(E) Failure to submit an acceptable and timely plan of correction or failure to timely correct in accordance with
the plan are grounds for an enforcement action including suspension or revocation of a license.

Areas of non compliance:

Please submit to Jim Hogan at the Department of Public Health, Bureau of Substance Abuse
Services, 250 Washington Street. 3rd Floor, Boston, Ma 02108, a written plan for correction of each
violation cited in the deficiency correction order (DCO) within 10 days. Your response should be
received not later than August 3, 2017?.

Instructions:

 

 

060 information License No: 0396

Program Name: New England Center for Addiction Medicine

Program Address: 2701 Renaissance King of Prussia, PA 19406

DCO issue Date: July 20, 2017

Due Date: August 3, 2017

 

CBSAS-

- Areas of-Non-tiompliance

instructions

?errective; Action Plan

Attachments-(if
. applicable)

 

Regulation
164.035

there had been severallncidents

During document review it was 1.
identified the programs had several

incidents that a required noti?cation
should have been submitted to BSAS 2.
and had not been.

During the interview, it was reported
where ciients have taken the elevator

to other floors and to the roof to have
sex or smoke. 

Provide affirmation from this point
forward all required notifications
will be submitted per the regulation
Submit a plan on how programs will
provide oversight and security of 
the elevator access.

1. f?Piease see the attached affirmation
regarding required noti?cations

2. A Grounds Monitor has been higed to
help provide additional oversight and
security. Please see the attached job
description and job duties sheet. Piease
also see the attached Program plan
inciuding rounding and rail call policies
for RSS staff. The Grounds monitors ride
the elevators and check the vacant ?oors

5 part of their rounds.

3.. Patients now how color-cod ed wrist
bands to identify which unit they are
assigned to and determine what areas

/thev should be in.

4. Roof access has been latched and

ecured.

5.1 Agency is awaiting custom screws which

Exhibit 1: Affirmation

Exhibit 2: Grounds
Monitor Job Description

Exhibit 3: Grounds
monitor rounds sheet

Exhibit 4: Program Plan

 

are anticipated to be received no rater
than August 15, 2017

 

154.048

 

 

interviews and document review 1.
identified that the program is not in
compliance with BSAS staf?ng
guidelines

 

Submit a pian and time line for both
programs to compiy with staffing
guidelines. The plan needs to
inciude what recruitment effort is
being taken to ?ll positions.
Documents to be inciuded are as
follows: an updated staff schedule
for all shifts and positions for the
Month of August 2017 identifying

 

1. JATS and CSS progra ms were officially
separated on .lulv' 21, 2017. Piease see
the attached staff schedules for August.
Recovery Centers of America, Talent
Acquisition Team is providing the
following recruiting efforts for BCAT:

I Six full?ti me recruiters sourcing,
interviewing and hiring for ali
positions at BCAT

 

Exhibit 5: Staffing
schedules

 

H-

 

 

 

 

 

 

 

dates, shifts and positions for both
programs.

 

One full-time recruiter - College
Fairs, posting all posit-ions at
colleges in Boston

Job Fairs are held at our
BEAT facility

Attend career fair events in
the Boston area

?Marketing Department advertising
on all social media print, radio, TV,
internet

We hire an average of 20 people a
week for our BEAT facility

 

 

 

.. .E..

. .., 



u.

 

Affirmation Statement

 

Affirmation: _l af?r . that from this point forward all reouired notifications
be Smei?ed P9 CMR .

    

 

 

 

 

Recovery Centers 0f America 

JOB DESCRIPTION

 

 

 

 

 

 

Dept: Operations Job Code
We

 

 

 

NOTES:

 

 

 

 

Function

 

 

Position Overview:

Identifying safety related conce
environment of the site with an
proper assistance.

The Grounds Monitor provides 1:16 on supervision of the site with the intent of

?peci?c Resansibillties:

 

 

 

The right section above

ns speci?c to patient interaction and the is for HR codmg only.

 

 

 

bility to intervene as necessary or identify the

schedule as assigned by the Director of Operations to include both the interior

 

. Complete site rounding
and exterior of the facil
identify areas of concer
Intervene with patients
Contact facilities and ja
Assist with room, K9, 3
Review security footag
Contact authorities as
Document incident rep
Respond to calls from 

 
 
 



Education and Experience:
0 High School Diploma or
2 or more years of beha
- Ability to remain comp
- Background in iaw enfo

Comgencies:

Customer Service: Dem

as evident by patient behavior and site environment
safety becomes an issue as indicated by clinical recommendations
itorial staff if an environment of care concern arises
bag searches as needed
asnceded
eded
as needed
rsing and R55 staff related to physical violence and emergency codes

Equivalent

rioral health experience

ed and decisive

ement, security, or similar experience a plus

onstrates concern for meeting internal and external customers? needs In a

manger that provides smisfaction for the customer within the resources that can be made available.

Impact and In?uence: Works effectively with and through others including those whom there is no

formal authority over.

Project Management: 
cost, and quality.

Communication: Com
reports, delivers presen

oordinates the diverse components of the project by balancing scope, time,

nicates well both verbaliy and in writing, creates accurate and punctual
tions, shares information and ideas with others, has good listening skills.

 

 



 

From Wor
points for

 

i Environment to end, these are usually standard
all positions. You may edit here are needed.

 

 

Work Environment: ?May work in a variety of environments including professional of?ces, clinics, hospitals, or out-

. patient facilities. They Spend much

of their time on their feet, actively working with patients.

 

Physical Demands: While perform
hear. The employee frequently is

rig the duties of this position, the employee is regularly required to talk or
equired to use hands to ?nger, handle or feel objects,-tools or controls. The

employee is occasionally required a stand; walk; sit; reach with hands and arms climb or balance; and stoop,
kneel, crouch or crawl. The empl ee must occasionally lift and/or move objects up to 25 pounds. Speci?c vision

abilities required by this position
ability to adjust focus.

Travel: Travel is primarily local do
be expected

clude close vision, distance vision, color vision, peripheral vision and the

?ing the business day, although some out~of~the-area and overnight travel may

 

Employee Signature

Non-Discrimination Statement:

Date

it is the paiicy of Recovery Centers ofAmi rica (RCA) to ensure equal employment opportunity without discrimination or harassment on the
basis of race, coior, reiigion, sex, sexual a 'ieniation, gender iden tity or expression, age, marital status, citizenship, genetic
information, or any other characteristic protected bylaw.

 

 

 

Grounds Monitor Rounds

Grounds Monitor Name:

Door Checks
Time Door number

Patient Flow unsu wised smoke breaks, alone in cafeteria in unauthorized bedroom etc.
Time Patient Name Location . Findings

Perimeter Check
Time Location Findin

 

 

 

Monitoring, Rounds 
and Role Call

 

 

 


g-

Recovery Centers #Americ:

THE 81
PATIENT ROUNDS AND

JSTON CENTER FOR ADDICTION TREATMENT
LEVELS OF OBSERVATTON-ACUTE TREATMENT STABILIZATION (ATS)

 

PURPOSE: 
To de?ne the level of mo
within the Boston Center

SCOPE:
This polit

POLICY momma

rioting of all patients admitted to any acute treatment stabilization (ATS) unit

Addiction Treatment. Monitoring is conducted twenty~four hours per day
for patient safety and wail?being.

.y applies to acute treatment stabilization (ATS) units only. 

 

Due to the serious nature
are at risk for seizures or 
and emotional [ability are 3
their substance use diso
compassionate, res

Patient rounds are para?;

unit. They also create a the

Observing 
Monitoring
Noting and
Being able 

  

. medical complications that can accompany the withdrawal period, patients
er adverse medical events during their initial hospitalization. Anxiety, stress
0 present at this time, as is expected with any patient seeking treatment for

r. The Boston Center tor Addiction Treatment is committed to pmviding 

and high quality treatment while utilizing the, least restrictive means to

ensure the safety of all patients and staff.

not in maintaining the safety and security of all patients and staff on each

rapeutic milieu by ensuring that patients needs are met in a timely manner.

This is accomplished by:

Patient Rounds are conducted in order to:

to patients? physical/mental state and physiological stability
patient behavior and activity on the unit

'eporting any environmental hazards

3 quickly locate a patient if the need arises

 

Inspecting
Three levels of staff n1

Standard Observation:
- considered a ?standard

increased Observation.
increased observation 1?

(document at 15?minute

  
 

One to One: An assignell

maintaining the integrity of the unit
boring are available on the Acute Treatment Stabilization IATSI Units:

aSSess and document at 30-minute intervals). All patients on the unit will be
bservation? level unless otherwise documented by medical staff.

ndividuai Patient): Assess and document at 15-minute intervals anthe
rm. 

staff member canstantly with the patient not less than arm?s length away.
intervals on the increased observation form).

 

 


Elli

Recovery Centers if America:

A registered or licensed nurse
an individual at any time as clin
intervention must be utiliz
observation or 1:1, the attend]
noti?ed as soon as possible 3
include observatio

Discontinuation of an increase
(on

At any time during their stay
evaluation and assessment A:

bf

may increase the level of observation to 15 minute intervals or a 1:1fdr
ically necessary. in all cases, the least restrictive yet clinically appropriate

ed. If a registered or licensed nurse implements an increased level of
Ig physician (on?call physician physician assistant or nurse practitioner} is

the appropriate orderis obtained and documented. The order should

it level to be utilized and the reason for increased monitoring.

level of observation or 1:1 must be ordered by the attending physician

~call, physician assistant or nurse practitioner).

a change in level of observation may be initiated by an RN or LPN after
signed staff will assess and document the patient's condition, 
behaviors and safety needs 

PROCEDURE

1. Dining shj? report at the start of each shift, the muse in charge of the unit will assign sta?= (RSS, CNA
or MA) to perform patient rouxds for a speci?c time block during their shift. The nurse in charge is

responsible for ensuring that p?tr

placed on an increased level of
assigning a speci?c staff to me

2. New patients will be immed
assigned to patient rounds shut
procedure.

3. Assigned staff will complete
rounds sheet or for
interval. Rounds are NOT to i:
should also perform an cuviror

'ent rounds are completed in accordance with this policy. Ifa patient is
observation or a the nurse in charge ofihe unit will be responsible for

nitor.

arely added to the appropriate rounds form upon arrival to the unit. Sta??

Lid introduce themselves to the patient and provide a brief overview of the

the patient observations as rounds are made and document on the

[11 Sia?'w?l document 111 all sections of the form at each observation
documented in advance. Any time a round is completed assigned staff
mental check to ensure that all doors that should be locked are locked and

that any maintenmrce issues are noted andreported.

 

4. During wakh1g hours, pati

rounds should include "checking in" With the patient verbally to ensure

their safety and well-being as ell as identifying any needs for fluthcr assessment or assistance. If a
patient is in group or with one or staff member, assigned staff should continue completing their patient

rounds as normal and should

5. When a level of observation
increased and the procedure is

direct visual contact with patient in a quiet rm manner.

rs increased, the patient is educated on why the observation level has been

explained to the patient.

6. When a level of obserVation' rs changed it is communicated to all musing and RSS sta?? within that

unit

?Staff must hand?off relaponsibility for maintaining observation of assigned patients for

any break or potential int:

 

arrup?on in completing assigned rounds for patients on any level

of observation.

 

 

Recovery Contact: 

DEFINITIONS

 

Standard Observation-ll inute rounds:

increased Observation:

 
 
   

 

The staff member observe and check in with patient at least every 30 minutes and document
the patients loeati at each inter-vat. -

Assignedsta?' 
distress. 

Observations may at be completed standing in doorway or at a distance particularly for patients
who one sleeping. is expected that staff will enter ?lB room?, approach the patient and check

their identity, resp ?ons and ensrne they are not in any distress.
Sta?'will provide cations as appropriate and notify registered or licensed nurse of any
change in patients? condition

All patients at a mem are on Standard Observations level.

The staifmember observeand cheekin withpa?ent at leastevery 15 minutes anddocument
the patients Iocati at each interval.

Assigned stn??willmaire direMVisualcontact with patients andeon?rrn?iey are inno dangeror
Observations may trot be completed standing in doorway or at a distance particularly for patients
who-are sleeping. I. is expected thatsta?'wili'enter?ie room, approach the patient and check
their identity, respi ations and ensure they are not in any distress.

Sta??will provide i nerven?ons as appropriate and notify registered or licensed nurse of any
change in patients? condition.

An increased level of monitoring needs to be implemented by the attending physician (on can
physician, physicizhi assistant or nurse practitioner) or a registered or licensed nurse.

eria for this level of observation may include:

Patient who ruruiretfrequent redirection, prompting, and eneomagement to maintain cent-01
Extreme or unusual ursingcare needs that requires at least 2!3 ofnursing sta?'time timing one
shift . .

of disorisntation, confusion, agitation, delusions, or hallucinations that require
interventions of Ion get duration or higher frequency of observation 

Clinical indicate a moderate self?harm or harm to others with signi?cant support
needs

High risk of Falls

 

 






IE1

mauve-r7 Centers of America

a The patient is assigns

 

GD

3 Constant 1:1 staff member to be at arm's length. The sta?? member

continuously assesses patient's status and documents everyr 15 minutes on the 1:1 form.

I When patient shown 
observation. Theref

?1 Patient requires total
constant stuff supervu



changes clothes or uses the bathroom they MUST remain on the 1:1
the staff person must remain within arm?s length of the patient.

titer-in for this level of observation may include:

assistance with ADL and/or is incontinent of bowel/bladder and requires
tier:

0 Patient is highly voldtile, Impulsive, andfor suicidal requiring constant observation within arm's?

. length

a Patient requires
continuous loss of

I Extreme or unusual 1:
time (hiring shift.

I Severe risk for falls.

0 A registered or li
and document the ass

I 1:1 observation level
if still required.

team meeting.

 

 

um staff structure for protection for self or others due to frequent or

Vior control

using care needs that requires the equivalent of one sm?membe$ total

nurse will assess the need for continuation of 1:1 throughout the shift

ssment in the medical record
will be reevaluated by the attending physician every 24 hours and reordered .

. If 1:1 is required longer than 48 hours the case will be reviewed inthe next scheduled treatment

 

 

I El- I 

E-

Rccovcry Centers of Ame - -
Level of Observation: 15 minute intervals El Constant Obse Nation Cl
DATE:

ALLERGIES:
AG- AGITATED AK- ANXIOUS

 

   

PATIENT NAME:
DOB:
CODE: 5- PAGNG

Wm Ba- aamoou nu ?mum
STATION

NOTES

 

TIME

SFAFF SIGNATURE

 

The Eastern Center for Addiction Treatment 
Recovery Support Staff?Monitoring and Role Call

Purpose:

To ensure that staff are ble to manage safe, organized and supervised movement throughout the
building while escorting ients to group, meals, cigarette breaks, appointments, visitation, activities
and recreation. 

Scape:
This policy applies to all Linits and levels of care within The Boston Center for Addiction Treatment.

Policy Statement:

All patients within The Boston Center for Addiction Treatment may freely move around their assigned
Unit without an escort but must be escorted by a staff member when leaving their assigned unit at any
given time. When a staff member escorts a patient off their assigned unit they must sign the patient out
using the patients sign-out sheet located at each nursing station and specify what time the patient left
and where the patient is going. Upo?n return staff should sign the patient back in.

Roll Call:

 

recreation. Upon roun ng patients to leave their assigned unit for any reason a roll call will be
performed by staff to acc nt for all patients leaving the unit. After the daily activity is complete and
staff are prepared to escori patients back to their assigned unit a roll call she be performed to ensure
that staff have accounted for all patients who left the unit.

Staff will escort patients t1groups, meals, cigarette breaks, appointments, family visits, activities, and

Procedure:

Patients should be rounded 15?20 minutes prior to leaving the unit for any daily activity to ensure all
patients have been noti?ed of the Upcoming activity. Once all patients are ready to leave the unit, the
RSS performing rounds will all out each patient name listed on the rounds sheet. once all patients are

accounted for the group may leave the unit together. If a patient is late to roll call and the grain has left
already, the patient may be walked to the destination if staff are available to do so, if there are no staff
- available?the patient must remain on the unit. 

 

 

 

 

- Nd) Patients

 

WithoutStaff Escort

 

 

 

 

 

 

The 

 

+ston Center for Addiction Treatment
Required RSS Orientation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day RCA Orientation WIth Human Yes
Resources
1, Week Orientation math the Clinical No
Tramers
2nd and Week 10 Days of Shadotwng R55 Staff Yes
on Shaft
Within 30 Days of Start. 041m Clinical Bootcamp Training Yes
Within 30 Days of Start +e RSS All Star Training Yes
Within 90 Days of Start All Requarect Relies Yes
Trainings
90 Days After Start ?at 3 90 Day Staff Review Yes

 

 

TH BOSTON CENTER FOR ADDICTION TREATMENT ?4
RECO SUPPORT SPECIALIST HIRE ORIENTATION PACKET

 

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 

RSS Trainee: Work Status (FT, PT, PRN):
Start Date: 90 Day Evaluation Date: 4
Res 
All new hire paperwork completec and returned to Human Resources? EJ
Ail required forms of identi?cation brought to HR and emailed or faxed to the
appropriate location? Cl
Introduction to ADP
LINK: s: workforcenowad -
Click: 0

 

Registration code: 

 

Trainer demonstrated how to pro erly punch in and out for your shift and how 
to punch in and out for your brea 
Trainee conducted a practice punc Cl

 

 

 

 

 

 

introduction to Outlook Email Address and SharePoint {0f?ce365l
UNK: 
USER NAME: First initial iast na followed by @recoverycoa.com (example Cl
John Smith would be -
PASSWORD: RCA-2017 followed by initials

(example John Smith would be RC1 l-ZOlst}

 

 

 

 

 

Trainer demonstrated how to acc 5 SharePoint directly from Outlook email by El
clicking the square icon in the up left comer of the page?

 

 

Trainer demonstrated how to navi te the ?Clinical Training?, ?Resources? and

 

 

 

   

 

 

 

 
 
    

 

   
   

 

 

 

 

 

 
 

 

 

 

 

?Avata r" sections of SharePoint an how to locate the patient group modules CI
Seminars).

Trainee sent a test email to RSS Su ervisor? C1
R55 Supervisor email:

Introduction to Relias Learning -

(Look for a prompt in your Outloo email, if not follow the link below)

UNK:

http://recovervcenterso erlca.t ainin .rellaslearnin .corn iib authenticate. Ci
E25 .
USERNAME: First initial last nam followed by @recoverycoa.com (example

John Smith would be ?smith eco we 

PASSWORD: RCA123

Trainee sent an email to to request an

Avatar login? 
Email should include the trainees st/last name, location of facility {Danvers)

and position Recovery Support Sp cialist).

Trainee soccessfully logged into thii Avatar med record system? 
Completed at lea st one competency on Relias Learning? D.

 

Introduction to Nursing Report
Trainee was showed the location ere nursing report is conducted?
(Nursing report is about the Nu rsiiIdepartment passing on info from the last Cl
shift. RSS staff should attend repon once a shift, at the start of the shift and

should quietly take notes and refrain from being disruptive or asking to many
questions.)

 

 

 

 

 

 

 

 

 

THE 305T ON CENTER FOR ADDICTION TREATMENT 
SUPPORT SPECIALIST HIRE ORIENTATION PACKET

 

     

Introduction to Walkie Talkies 
Trainer showed trainee how to use 1 he communication system; what channels reach the supe visor? -
Introduction to "Codes?
Trainer and trainee studied all code: listed on the back of employee badges and El
tested each other?
introduction to "Patient Rounds? -
Trainee read the ?Patient Rounds ar Levels of Observation? policy and
procedure and has been familiarize: with all forms associated?
introduction to "Patient Belonging: -Searching and Documentation? El
Trainee read the ?Patient Beiongings?Searching and Documentation? policy and
procedure, has been familiarized wi :h all forms associated and has been shown
the search room? 

Patient Rounds and levels of Obsel vation 
Trainee properly conducted and do: umented rounds at the appropriate time El
intervals for at least 4 hours under the supervision of the assigned trainer?

 

 

 

 

 

 

 

Trainer has explained how to: 
1. Log in to Of?cea?s using the computers in one of the 
Management of?ces.

2. Download all forms associated with patient rounds to the desktop to 13
have an icon for each unit. -

3. How to use adobe to update and print the rounds sheets at the end of
each shift.
Trainer has introduced the R55 shift note form and explained the procedUre and
?ling system? . . . - Ci

 

 

 

 

Patient Beiongings?Searching and ocumentation
Trainee properly conducted a mock bag search and documented all ?Patient Cl
Belongings? in the correct areas oft he ?Avatar Quick Notes? sheet?

 

 

Trainee entered ail items listed on 1- 1e ?Avatar Quick Notes? sheet into the
?Resident Valuables Form? located Avatar? El

 

 

Trainee ?led the Avatar quick note rm in the patient belongings record binder
in the RSS of?ce after entering ali into avatar? (if the patient is on El
unit 1 the sheet is stored in the unit 1 of?ce)

Trainee has been shown the locatio 1 of the hygiene closets on units and is
familia rized with the sign out sheet and procedure? El

 

 

 

 

Attendance, Punctuaiity, Time Off nd Call Outs
Trainer has expiained proper proto for requesting time off, call outs, Cl
returning back from breaks and pu uality?

 

 

Trainee understands the start and Tish times of each shift and understands 1
the importance of starting and ?nis ing at the assigned times. Cl
Day: Yarn-3:30pm Evening: 3pm-11 30pm Night: 11:15pm-7:15am

 

 

 

 

 

 

 

 

 

 

TH BOSTON CENTER FOR ADDICTION TREATMENT 
RECOVE SUPPORT SPECIALIST-NEW HIRE ORIENTATION PACKET

 
  

 

 

#i lf-?ff? . Egyuat?y
iiglfg?

 

  

 

 

 

 

introduction to Group Facilitation
Trainer assisted in helping trainee

-Preparationli-?acilitation
:hoose a group from SharePoint to facilitate?

 

 

Trainer assisted with preparation 

projector, setting up PowerPoints,

fthe group?

(Le. SharePoint, where to locate paperwork, supplies, handouts, setting up the

videos and some tips on time ma nagement]

 

 

keep within the appropriate time

Trainee was successful in facilitatiEa group from SharePolnt and was able to

me?

 

introduction to Group Facilitation
Trainer demonstrated how to loca
?Individualized Note? form in the 

-lndividuallzed[Group Notes
:e and ?ll out the ?Group Note? form and
Natal? system.

 

Introduction to Notes

 

write a group note in DAP. format i

the allotted time frame?

Trainer explained what'a nTe is (Data, Assessment, Plan) and how to-

 

Trainee practiced writing at least
supervision of an assigned trainer

 

group notes in format under the

 

 

Trainee entered 3 practice group 

ates in DAP format into the Avatar system?

 

Introduction to Morning! Evening
Trainee obsen?red a morning and er

Group Facilitation
rening meeting?

 

Trainee facilitated a morning meet

Hg or an evening meeting at least once?

 

 

Group Facilitation Competencies
Trainee has completed and passed
(This should be completed within 5

all assigned Relies teaming competencies?
our ?rst 90 days.)

 

 

 

Monitoring Cigarette Breaks
Trainee has been shown the appro
been eXplained proper procedure.

 



red areas for patients to smoke and has

 

 

 

 

 

 

 

 

 

 

The Boston Center for Addiction Treatment
New Hire Orientation?R55 All Stars

The RSS All Stars are a highly specialized group of top performing Recovery Support Staff at The Boston Center for Addiction Treatment

Each member of the RSS All Star Team has been handpicked to develop a 1- hour training on a topic or area that they have shown exceptional skili

MD - Night Shift Duties a J, 

 

 

 

9:003m-10:003m Marni-n Meetin and Rounds

 

 

10:00am-11:naam emu? Fadmatm Cl 1/ 

 

 

11:003m-12:00pm

  

Avatar and Group Notes 

 

 

 

 

 

 

 

12:00pm-12:30pm Lunch Break

 

 

Searching and Documentation

 

12:30pm-1:30pm v? 

 

 

 

atlent Ori 'ntation
1:30pm-2:30pm New . 

 

 

 

 

 

 

 

 

 

2:30pm-3r30pm

 

Monitoring Visitation 8: Dali Activities 

 

 

 

3:30pm-4:30prn Bloc-king - v?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Boston Center for Addiction Treatment 

Group Supervision

 

 

Supervisor: Attendees: Nursing/R85 Staff
Frequency: Eli-Weekly Duration: 1 Hour 

 

 

 

 

 

Nursing/R55 Staff Supervision:

Group Supervision will be held in either the BCAT training room or the 
meeting rooms on 15" and Thursday Of every month from 8:OOarn~9:00arn
and again from 2:00pm-3:00pm. All staff are encouraged to attend.

Topics:

The topics of group supervision will vary from week to week depending on new
policies and procedures, recurring issues, the amount of new hires onboarding,
and guest Speakers attending. 

Group Supervision Agenda:

All staff in attendance will receive a meeting agenda through email and again at
the meeting. A copy of the meeting agenda will be provided to the Human
Resources Department. 

Group Supervision Sign-In Sheets:

Each staff in attenda rice will sign the grow supervision sign-in sheets for proof of
attendance. There wil be separate signwin sheets for Nursing and RSS staff. A copy
of each sign?in sheet will be provided to the Human Resources Department.

 

 

 

 

Recovery Support Specialist
Group Supervision Agenda

 

 

 

 

 

 

 

 

 

Date: 1?t and 3"i Thursday of Eve rMonth Time: 
Location: BCAT Training Room ve Visitation Lobby} Attendees: RSS/Nursing Staff
Group Supervision Agenda:
Welcome Aboard!
Recovery 50990? RSS Supervisor will introduce all new staff and'weloome them

8am-8m5am/me-Zzl35pm

 

Recovery Support Supervisor

2:25pm

 

Clinical 
8253m-8353m/2259m-
2:35pm

 

Quality Manager
prn~
2:45pm

0
0
bill address the following:

0

 

Facilities
8:45am8:SSam/2:4Spm?
2:559m

 

 

Recovery Support Supervisor
8:553m-9:OOa m/2:55pm-
3:00pm

 

 

?le  address the following

Staff will introduce themselves and explain their roles

 

 

What to remain in our next expansion and how to prepare
Rounds and Levels of Observation

New search rooms/Zapp bug room, valuables storage area
New 855 Training Team

Patient Satisfaction Surveys

ADP, Punching and Unauthorized Overtime Reports
Admissions and Discharges

Group Facilitation and Rounding for Groups

 

 

 

 

Patient daily schedule
A

 

will address the following:

incident reports
Group notes/individual notes
Satisfaction Surveys

 

 

ill address the following:



Fire safety

Locked doors/keys/lD cards
Emergency codes

Walkie Talkies

 

 

 

ll address the following:



 

 

 

 

Boston Center for Addiction Treatme?t 4
Recovery Support-Group Supervision

Attendees:
Time:

 

 

 

 

Census:

Admls?ions;

Transfers:

Discharges:

00/00/0000 DETOX SHIFT REPORT SHIFT: ORANGE TEAM: - TEAM:

?Per DON, all patients are to be given BCAT stock narcotics. not their own (its: Suhaxone, Rana): etc). 

?Nursing Assessments, Treatment Plans? ?Please remember to have the narcotic consent signed" Please wake patients up for meal times?


?st-I ?gm;

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1

gm

 

 

 



 

9391'?

. 

 

?at-1:91 3

 

Wm

 

 

251521;;

 

 

 

9 ?aw-i
f. .vgutetj

 

 

 

 

 

 

 



 

 

 

 

 

 

,3 emf

 

 

 

  

Patient Name 

Boston Center for Addiction Treatment
Recovery Support?Shift Report

Shift:

Patient Name Patient Name .

 

 

 

-.

 

 

 

 

 

 

 

ATS Daily Schedule

of

 

Sunday

Monday:

Tuesday

Wednesday

. Thursday

Friday-

?Saturday-

 

7am

Wake up

Wake Up

Wake Up

Wake Up

Wake Up

Wake Up

Wake Up

 

7:30-8 am

Community Goals
Meeting
In Lounge

Community Goals

Meeting
In Lounge

Community Goals

Meeting
In Lounge

Community Goals

Meeting
In 

Comm-unity Goats

Meeting
in Lounge

Community Goals

Meeting
In Lounge

Community Goals

Meeting
In Lounge

 

8 -10-am

Mods 81. Vitals Begin

Meds 8i Vitals Begin

Meds 8i Vitals Begin

 

Meds 8i Vitals Begin

 

IMeds 81 Vitals Begin

Meds El Vitals Begin

Meds Vitals Begin

 

3.33m

Breakfast

Breakfast

wBreaitias't

Breakfast

Break-fast

Break-fast

Breakfast

 



Seminar:

Seminar:

Seminar:

Seminar:

 

11:15 am

Wm
Rm 14?

orain and outiy
Rm 14?

Luping okriis
Rm 147



Rm 147

Seminar:

Seminar:

Seminar:

 

Wadi-swirl}:
Rm 143'

Mindfulness
Rm 147

Sustaining Change
Rm 147

 

11:15 am-
12:15pm

Orientation
Rm 147

Orientation
Rm 147

Orientation
Rm .147

Orientation
Rm 147

Orientation
Rm 147

Orientation
Rm 147

Orientation
Rm 147

 

1-2i?il-21pm

Meds/Vitals Begin

Meds/Vitals Begin

Meds/Vitals
Begin 

Meds/Vitals Beg-in

Meds/Vitals Begin

Meds/Vitals
Begin

Meds/Vitals Begin

 

14:30 pm

Lunch

Lunch

Lunch

Lunoh

Lunch

"Lunch

Lunch-'

 

2- 3:00 pm

12 Step Toolkit
Rm 147

12 Step Toolkit
Rm 14?

Health Risks
w]5and.ra Rm 141

Overdose Prevention
vii/Sandra Rm 143?

MAJ Education
Vii/Sandra Rm 147

Post-Acute
Withdrawal
(PAWS)
Rm 147

R55 Specialty Group
Recovery Jeopardy
Rm 147

 

46:09pm

Relapse

Prevention
Rm 147

Getting Motivated
Rm 1117 

Unlock Your

Thinking
Rm 147

Relapse
Prevention
Rm 147

12 Step Toolkit
Rm 1o?

Aftercare

Planning
Rm 147

Leadership:

Napoleon Hill
Rm 147

 

5:15?6 pm

Free Time]
Fresh Air Break

Free Time]
Fresh Air Break

Free Time]
Fresh Air Break

Free Time]
Fresh Air Break

Free Time]
Fresh Air Break

Free Time]
Fresh Air Breaks

Free Time]
Fresh Air Breaks

 



Meds Bi Vitals

Meds 8c Vitals

Meds Vitals

Meds Vitals

Meds a Vitals

Meds 8: Vitals

Meds Vitals

 

6?6:30. pm

Dinner

Dinner

Dinner

Dinner

thinner.

Dinner 

Dinner

 

7-8:00 pm

12 Step Meeting
Rm 6243

12 Step Meeting
Rm 6243

12 Step Meeting


12 Step Meeting
"Rm 6243

12 Step Meeting
Rm 6243

12 Step Meeting
Rm 6243

12 Step Meeting
Rm [3243

 

 

8:36?9:51?:

 

Community
Wrap-up Meeting
in Lounge

 

Community

 

Wrapaup Meeting
In Lounge

Community
Wrap-up Meeting
in Lounge

 

Community
Wrap-up Meeting

In Lounge

Community

Wrap-up Meeting
In Lou i153;

 

Community
Wrap-up Meeting

in Lounge

Community

 

Wrap-up Meeting

in Lounge

 

 

 

940335 pm

 

 

Meds &Vitais]
Relaxation Time

 

Meds El Vitals]
Relaxation Time

 

Meds 8: Vitals]
Relaxation Time

 

 

 

Meds 8; Vitals]

Meds Vitals]

 

Relaxation Time

Relaxation Time

 

Meds 8c Vitals]
Relaxation Time

 

Meds 8: Vitals]
Relaxation Time

 

 

 

 

ATS Daily Schedule - I 

11 pm Lights out Lights out Lights out Lights out Lights out Lights out Lights out

 

 

 

 

 

 

 

 

 

 

*Lounge areas-shut drown 11pm-Sam: Patients are to be in their rooms by 11pm* 

  

1 null: DM

 

nuncui

Sunday 3:30~8:30pm - These times are sub ect to chan be
range? 3:33-3:3ng - postponed or canceled
?95 av Pm . de endin on staff discretion.
Wednesday 3:00-8:00prn - 
All Phone Use Must Be Monitored
By Your Case Manager

Visits During The First 5 Days Of Treatment

Are Not Permitted.
SMOKE BREAKS:

 

Please Refer To Your Patient Handbook For

7:15 AM More information.
After Morning Meds

10:00 AM
12:30 PM
1:30 PM
3 PM
5:30 PM
6:30 PM
a pm
9?30 PM MEDICATION

  

ITAL SCHEDULE:

  

 

 

 

 

 



Centers Is? America

THE BOSTON CENTER FOR ADDICTION TREATMENT

PATIENT ROUNDS AND

LEVELS or oasenvnnon-Acm TREATMENT STABILIZATION (ATS) -

 

PURPOSE:
To de?ne the level of monit

oring of all patients admitted to any acute treatment stabilization (AT5) unit

within the Boston Center for Addiction Treatment. Monitoring is conducted Menty~four hours per day

SCOPE:
This polio

POUCY STATEMENT:

for patient safety and well-being.

applies to acute treatment stabilization (ATS) units only.

Due to the serious nature of medical compiications that can accompany the withdrawal period, patients 

 

are at risk for seizures or at
and emotional la bility are al

adverse medical events during their initial hospitalization. Anxiety, stress
present at this time, as is expected with any patient seeking treatment for

their substance use disor r. The Boston Center for Addiction Treatment is committed to providing 

compasslimate, respe

Patient rounds are param
unit. They also create a the

i and high quality treatment while the least restrictive means to
ensure the safety of all patients and staff.
nt in maintaining the safety and security of all patients and staff on each
peutic milieu by ensuring that patients needs are met in a timely manner.
This is accomplished by:

Patient Rounds are conducted in order to:

 

- Observing th a patients? physical/mental state and physiological stability
- Monitoring patient behavior and activity on the unit

- Noting and porting any environmental hazards

. Being able tiquicldy locate a patient if the need arises

- inspecting a maintaining the integrity of the unit

Three levels of staff mo

ring are available on the Acute Treatment Stabilization (ATS) Units:

Standard Observation: (assess and document at 30~minute intervals). All patients on the unit will be

considered a ?standard 0 aservation? leVel unless otherwise documented by medical staff.

increased observation form.

(document at 15-minute

Increased Obsenration (Individual Patient): Assess and document at 15?minute intervals on the

One to One: An assigned staff member constantly with the patient not less than arm's length away.

intervals on the increased observation form).

 

 

 

lhE
HE

Recovery Centers of America

A registered or licensed nurse
an individual at any time as cli
intervention must he utili:
observation or 1:1, the attend'
noti?ed as soon as possible
include observatio

Discontinuation of an increasr
(on

At any time during their stay
evaluation and assessment. 



 

i. Darling shift report at the
or MA) to perform patient no
sceponsible for ensuring that 

 
  

9!

may increase the level of observation to 15 minute intervals or a 1:1 for

iically necessary. in all cases, the least restrictive yet clinically appropriate
ed. if 'a registered or licensed nurse implements an increased level of

[on?call physician, physician assistant or nurse practitioner] is
the appropriate order is obtained and documented. The order should

level to be utilized and the reason for increased monitoring.

3d level of observation or 1:1 must be ordered by the attending physician
-cal , physician assistant or nurse practitioner].

a change in level of observation may be initiated by an RN or LPN after

signed staff will assess and document the patient?s condition, 

behaviors and safety needs accordingly.
PROCEDURE

of each shift, the nurse in charge of the unit will assign staff (RSS, CNA
for a speci?c time block dm'ing their shift. The nurse in charge is
?ent rounds are completed in with this policy. Ifa patient is

placed on an increased level 0 observation or a 1:1 the nurse in charge of the unit will be responsible for

  
  

2. New patients will be imroed
assigned to patient rounds sho
procedure.

3. Assigned staff will comple

appropriate rormds sheet or fo
interval. Rounds are NOT to

should also perform an enviro
that any maintenance issues or

4. During waking hours, patio
their safety and well~being as

patient is' in group or with and
rounds as normal and should

5. When a level of observation
increased and the procedure is

6. When a level of observation
unit

ely added to the appropriate rounds form upon arrival to the unit. Staff
introduce themselves to the patient and provide a brief overview of the

the patient observations as rounds are made and document on the

. Staff will document in all sections of the form at each observation 
documented in advance. Any time a round is completed assigned staff -
ental check to ensure that all doors that should be locked are locked and

noted and reported.

rouads should include ?checking in" with the patient verbally to ensure
all as identifying any needs for timber assessment or assistance. If a

or staff member, assigned staff should continue completing their patient
6 direct visual contact with patient in a quiet rcspect?ll manner.

is increased, the patient is educated on why the observation level has been
:xplainod to the patient.

is changed it is communicated to all nursing and RSS sta?' within that

*i?Staff must hand-oi? rcrlorsibility for maintaining observation of assigned patients for

any break or potential int

ption in completing assigned rounds for patients on any level
of observation. .

 

 

Remand: Centers of?merim



DEFINITIONS

 

Standard Observationl 3 -minute rounds:

Increased Observation:

 

The staff member a ill observe and check in with patient at least every 30 minutes and document
at each interval. 
direct visual contact with patients and con?rm they are in no danger or

 
  
 
 

Observations may be completed standing in doorway or at a distance particularly for patients
who are sleeping. I is expected that staff will enter the room, approach the patient and Check
their identity, resp' tions and ensure they are not in any distress.

Sta?' will provide terventions as appropriate and notify registered or licensed nurse of any
change in patients? condition.

All patients at a minimum are on Standard Observations level.

The sta?? member ill observe and check in with patient at least every 15 minutes and document

the patients location at each interval. 

Assigned sta?? will .nalce direct visual contact with patients and con?rm they are in no danger or
distress.
Observations may ot be completed standing in doorway or at a distance particularly fer patients
who are sleeping. I is expected that sta?? will-enter the room, approach the patient and cheek
their identity, resp' tions and ensme they are not in any distress. 

Sta?' will provide terventions as appropriate and notify registered or licensed nurse ofany
change in patients? ndition -

An increased level monitoring needs to be implemented by the attending physician (on cal
physician, physici assistant or nurse practitioner) or a registered or licensed nurse.

 

Criteria for this level of observation may include:

Patient who rogue-cit ?equent redirection, prompting, and encouragement to maintain control
Extreme or unusual nursing care needs that requires at least 2/3 of nursing staff time during one
shift

of disoriintation, confusion agitation, delusions, or hallucinations that require
interventions of long get duration or higher frequency of observation

Clinical that indicate a moderate self-harm or harm to others with sigt??cantsupport
needs - . 
High risk of Falls

 

 

 



Recovery Centers 9" America

A Patient requires total

ENE
E-

The patient is assigns
continuously assesses

1 a constant 1:1 sta?' member to he at arm's length. The sta?' member
the patients status and documents every 15 minutes on the 1:1 form.

When patient showegi, changes clothes or uses the bathroom they MUST remain on the 1:1

observation. Theref

A

constant sta?? su 
Patient is highly vol

e, the staff person must remain within arm?s length of the patient.
riteria for this level of observation may include:

assistance with ADL and/or is incontinent of bowel/bladder and requires
ion
e, impulsive, andfor suicidal requiring observation within arm's

 

length . -

continuous loss of be vior control

Extreme or unusual

ing care needs that requires the equivalent of one sta?? members total

Patient requires manila: staff structure for protection for self or others due to frequent or

time during shift.

Severe risk for falls.
A registered or lice
and document the as
1:1 observation level 
if still required .
If1:1is required long
team meeting.

 

 

nurse will assess the need for continuation of 1:1 throughout the shift
ssment in the medical record. .
be reevaluated by the attending physician every 24 hours and reordered

.er than 48 hours the case will be reviewed in the next scheduled treaunent

 

 

LTJ- UNIT:
g. 

Recovery Centers 24?

Level of Observation: 15 minute intervals Cl Constant Observation 

ENT NAM E: DATE:
- - ALLERGIESL

CODES: S- SLEEPING AWAKE FACING AG- AGITATED AX- AMOUS

 

LDCAIIDN: Ba- BEDROOM an. -. HS- NURSES Ck COMMON
. STATION

?me cone moms STAFF. mm.
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30
:45
:00
:15
:30

SIGNATURE 

 

 

The Hoston Center for Addiction Treatment

Ra

Purpose:

To ensure that staff are a
building while escorting pal

Scope:

. This policy applies to 

All patients within The Bosh

covery Support Staff?Monitoring and Role Call

ale to manage safe, organized and supervised movement throughout the
ients to group, meals, cigarette breaks, appointments, visitation, activities
and recreation.

wits and levels of ca re within The Boston Center for Addiction Treatment.

Policy Statement:

3n Center for Addiction Treatment may freeiy move around their assigned

unit without an escort but r111 ust be escorted by a staff member when leaving their assigned unit at any


given time. When a staff 
using the patient?s signeouti

ber escorts a patient off their assigned unit they must sign the patient out
heet located at each nursing station and specify what time the patient left

and where the patient is going. Upo'n return staff should sign the patient back in.

Boil Call:

Staff will escort patients to groups, meals, cigarette breaks, appointments, family visits, activities, and

recreation. Upon roundi

1g patients to leave their assigned unit for any reason a roll call be I

performed by staff to accomt for ail patients leaving the unit. After the daily activity is complete and

staff are prepared to escort
that St

patients back to their assigned unit a roll call she be performed to ensure
aff have accounted for all patients who left the unit.

Procedure:

Patients should be roundedlS?ZO minutias prior to leaving the unit for any daily activity to ensure all

patients have been noti?ed
RSS performing ro ands will 
accounted for the group may
aiready, the patient may be 

If the upcoming activity. Once ail patients are ready to leave the Unit, the
all out each patient name listed on the rounds sheet. once all patients are
eave the unit together. if a patient? Is late to roll call and the group has left
talked to the destination if staff are available to do so, if there are no staff

vailable the patient must remain on the unit.

 

1?1 1

 

 

 

Without StaffEscort

 

 

The F:oston Center for Addiction Treatment

Purpose:
To ensure that staff are :l
building while escorting pi

Scope:

This policy applies to all 

covery Support Staff-Monitoring and Role Call

ble to manage safe, organized and supervised movement throughout the
tients to group, meals,-cigarette breaks, appointments, visitation, activities
and recreation.

nits and levels of ca re within The Boston Center for Addiction Treatment.

Policy Statement:

All patients within The Bodnn Center for Addiction Treatment may freely move around their assigned

 

unit without an escort but

ust be escorted by a staff member when leaving their assigned unit at any

given time. When a staff ber escorts a patient off their assigned unit they must sign the patient out
using the patient?s sign?out heet located at each nursing station and specify what time the patient left

and where the

Staff will escort patients to

recreation. Upon roundr

performed by staff to acco
staff are prepared to escorl
that 5?

Patients shoUld be rounded
patients have been notified

tient is going. Upo'n return staff should sign the patient back in.

Roll Call:

groups, meals, cigarette breaks, appointments, family visits, activities, and
patients to leave their assigned unit for any reason a roll call will be

nt for all patients leaving the unit. After the daily activity is complete and
patients back to their assigned unit a roll call she be performed to ensure
'aff have accounted for all patients who left the unit.

Procedure:

15?20 minutes prior to leaving the unit for any daily activity to ensure-all
of the upcoming activity. Once all patients are ready to leave the unit, the

 

RSS performing rounds will 

ail out each patient name listed on the rounds sheet. once all patients are

accounted for the group may leave the unit together. if a patient is late to roll call and the group has ie?;
already, the patient may be alked to the destination if staff are available to do so, if there are no staff

vailable the patient must remain on the unit. -

 

 

 

it . a ff rt

   

 

 

 

 .

. 

Chi

. i a:

.J. 

 

 

E. -
5..

Recovery Centers 0f Ame rice -

Page 1

TH BOSTON CENTER FOR ADDICTION TREATMENT

PURPOSE:

ADMISSION SEARCH-POLICY AND PROCEDURE

To provide for the safety of all newly admitted patients as well as the safety for other residents. and

POLICY:

staff.

During the admission seara'h procedure all patients and their belongings will be searched as outlined in

PROCEDURE:

 

1. SEARCH PROCEDU 

this policy.

All newly admitted for retu lag) patients must be escorted to an exam room and not left alone until the
search of body and valaab have been completed. other patient belongings Le. du??le bags, suitcases,

backpacks etc. may be co
and personal belongings 

plated after admission but should be done in a timely manner. All clothing
ast be carefully examined. If there is on escorting family member or f?end

any item that the patient does not Want to keep should be returned to them. Below is a de?nition of

each type of personal be

onging and how they should be processed upon admission. The Body and

Belongings Seardh sh all be conducted in the some manner and as described below.

2. HYGIENE (Kept with

patient): These items may be kept by the patient and the patient is

 

responsible for the
hygiene item not co

3. 
prohibited items for
by BCAT. Disposabl
located on each un?
patie nt hygiene are
being mindful of its

I properly disposed 

4. HYGIENE (Sign out):
in their hygiene bin a
0 Any item with a 
Razors (electric a

Staff may sign out an

 
 
  

.. (Example: toothbrush, toothpaste, deodorant, sham poo, conditioner, any
taining alcohol, or anything in an aerosol can). 

RAZORS: Razors brought in from the outside will be kept with patient

afe keeping until discharge. Patients may use disposable razors provided

razors provided by BCAT can be found in the locked patient hygiene closets
Staff may sign out razors using the ?Hygiene Sign~0ut Log" located in the
if any staff member signs out a razor that staff member is responsible for
turn. Razors are disposable and should only be used once and then

by staff.

These are items a patient MAY use during their stay but they mustbe kept
an! signed out to use. They include: -

:ord including hair dryers, flat irons, cu riing irons etc.
battery operated only)

of the above items for the patient to use without staff supervision

 

 

 

Page 2

5.1-.
E. . 

Recovery Centers - of And :tica

BOSTON CENTER FOR TREATMENT
ADMISSION AND PROCEDURE

?Prohibited? items be used at any time.

5. PROHIBITED: These items CANNOT be used at any time. They need to be locked up or sent 
home. They include dangerous or hazardous items, items deemed inappropriate or any item
that could pose an nfectious risk such as: Knives, household tools, lighters, ?ammable items or
anything in an aero rol can, inappropriate clothing, luggage, Personal towels, blankets, pillows,
stuffed animals. 'ene items containing alcohol, plastic bags, bar soap, disposable razors.
Valuables such as hey, creditfdehit cards, computers, laptops, cellphones (unless to access
for phone numbers authorized and supervised by patients Case Manager), cameras (or any
electronic device a camera or internet access). if you are questioning an item found notify
your immediate su rvisor or the nurse in charge of the unit. -

 

  
 
 
 
 
    
   
  
 
 
 

6. PATIENT DEPENDE ITEMS: These are items that the patient is dependent on and personal to
them. They include entures, poly-grip or denture cream, glasses, contact lenses, lens
solution, hearing at mobility aids and prosthetic devices. Patients may keep them in their
possession or put in their hygiene bins.

7. VALUABLES: All ney, jewelry, wallets, credit cards, purses etc. These items are not allowed
on the units and will be locked in the safe located in the admissions area. Upon admission
patient should be as ed to remove any items in their pockets including cell phones, wallets or

dmission counselor should complete and document the valuables search

was the admissions area. Any ?Valuables" locked up need to be listed in

the Avatar system and signed by the patient electronically using an

ad. 

any other valuables.
before the patient I
detail and entered i
electronic signature

3. AVATAR ALUABLES (documentation of belongings): The ?Resident
Valuables Farm? has och item the patient has brought into the facility pro-entered into the
system. Check all ongings in the appropriate category within the form i.e. ?Valuables?,
'identi?cation?, ?Cre it/Debit?, ?Personal Belongings? etc. and list in as much detail as possible.
tistAu. items includi 9 ?Miscellaneous Contraband?, luggage items etc. Any item not We

entered onto theft: should be listed in detail in the ?Other? categonr.

 

 

The Boston Center for Ad iiction Treatment

 

 



 

 

 

 

 

 

 

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Recovery Support Specialist
Schedule: Unit 5 ATS

 

D-Day Shift . E-Evening Shift N-Night Shift
Yam-3:30pm 3pm-1lz30pm 

18157-3111 I21 A t.

     

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. . - .. 

 

 

. . .L..-.. .

 

RecoVery Support Specialist
Schedule: Unit 7-CSS {Female}

 

 

D-Day Shift
7am-3:30pm

 

E-Evening 

 

N-nght Shift
11: I15pm-:7 153m

 

    

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8/6/17-9/2/17

3pm-11:30pm 

  

 

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The Bostori Center for Addiction Treatment
Nursing Schedule-ATS

 


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22221-

 

 

 

The Boston Center for Addiction Treatment
Nursing Schedule-C55

Total Per Shift

Total Per Shift

Total Per 

 

 

 

- .. I a

 

 

ATS 26 beds. 39 hour per day. a, 26 hours per day
Staff Name Shift Hours Sunda Monda
Su Thurs
BBOmn?Spm
Sun-?Thum
830mn~5pm
Monday
830mn?5pm
Tues-Sat
830mnn5pm
12 8:30pm
Thur Mon
12 8:30pm
Th er5 -- Mon
12~8:30pm
TbtalIIo?Provided

 

 

 

 

 

 

 

 

 

 

 

 

August 088 Case Management Schedule .
CSS 46 beds. 23 hour per day.
Shift Hours Sunday Monday Tuesday Wednesday Thursday Friday Saturday

8:30 5pm

- 
8:30 5pm


12 8:30pm

 

 

 

 

 

  

 

 

Total Hours
Provided

 

 

 

 

 

 The Boston Center for ?Cid-ic?cicm Treatment 
Nursing Schedule/ATS

.. .- . -. . Ell 1?00120
00
CI
DOC-OPEN SHIFTS:
Total Staff Per Shift



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPEN SHIFTS:
Total Staff Per Shift

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



OPEN SHIFTS: .2 - . .. -.
Total Staff Per 3
no DAY VACATION
E0 EVENING SICK
N0 2 NIGHT 

:7 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I I I 

 

I UUJLUII IUI 

MA UNIT 

MEDICAL ?Sis-rams

 

 

 

 

no no no no a 
IFTS: 

 

 

UNIT SECRETARY

 

 

0000 [100000 D-DD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAUREN 'MEDICAL 

 

 

 

 

 

 

 

 

E0 E0 E0 E0 E0 

 

 

 

 

SECREYARY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL ASSISTANTS

 

 

 

 

 

 

 

Per Diem

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPEN SHIFTS: 

 
 

 

 

 

 

 

 

 

 

 

 

00 DAY - VACATION
E0 EVENJNG 

N0 NIGHT ORIENTATIO 



  

.. . 
?it 

 

 

nun- cqu-Howuvult 

Nursing lule-CSS 

OPEN SHIFTS:
AGENCY:

Total Per Shift

PEN 
AGENCY:

Total Per Shift

OPEN SHIFTS:
AGENCY:

Total Per Shift

 

DD DAY VACATION
E0 EVEMNG . SICK
N0: 

wrigg- my; 

 

 

The Boston Center for Addiction Treatment
Nursing 

Total