Welcome to the Employee Concern Resolution Process
Your Facility regards employee concerns of discrimination, harassment and unethical or unfair conduct as a serious matter.
The prompt resolution of misunderstandings or conflicts is important to ensure effective working relations and to prevent the
development of serious problems. The following is a formal problem solving process for employees to follow should a concern
arise from the interpretation, application or claimed violation of any policy, rule, regulation or practice taken by the Facility
with an employee. It is important that the employee follow the steps as presented in the Employee Concern Resolution Procedure to
ensure the proper handling of a concern.
Employee Concern Resolution Procedure
Step One - Talk to Your Supervisor
When you have a concern or problem, you should first discuss the matter with your immediate supervisor or department manager
within seven (7) calendar days of the incident. Following this discussion, the supervisor/manager will respond to your concerns
within seven (7) calendar days either verbally or in writing with a recommendation to resolve the problem. If you do not believe
your supervisor/ manager is the appropriate person to address your concern, or if you are uncomfortable discussing the situation
with that person, proceed to 'Step Two.'
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Employee Concern Resolution Procedure
Step Two - Written Request to the Administrators
If you feel your concern has not been satisfactorily resolved in 'Step One,' you should then present your written concern to the
Administrator within five (5) calendar days following the supervisor/ manager's response, detailing the incident.
(Use of the "Employee Problem/ Concern Form" is recommended, but not required.) The Administrator will contact you directly and
respond with a written recommendation, typically within seven (7) calendar days. During this 7-day period, the Administrator may talk with you,
your supervisor/ manager or witnesses, separately and/or jointly, regarding the circumstances surrounding the incident in question.
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Employee Concern Resolution Procedure
Step Three - Written Appeal for an Outside Review
If you feel your concern has not been satisfactorily resolved after 'Step Two,' you can appeal the Administrator's decision by completing
the 'on-line;' Employee Problem/Concern form found at www.foundationshealth.net/employee-concern. Your appeal will be reviewed by a 3rd
party HR professional. This appeal must be filed within seven (7) calendar days following the Administrator's response from 'Step Two.'
The assessment completed by the 3rd party professional will include a review of any previous steps taken at the Facility level and
determine if additional measures are required. Supplemental information and/ or interviews may be requested. Upon completion, you will
receive a written response to your appeal, typically within seven (7) calendar days. The 3rd party reviewer's decision and/or
recommendations are final and will conclude the appeal process.
This Employee Concern Resolution Procedure is not to be used for reporting resident abuse.
Employee Concern Resolution Procedure
So that we may properly investigate your concern, you are requested to fill out this form as completely as possible.
This form must be submitted on-line. Please refer to the Employee Concern Resolution Procedure
for the applicable guidelines.
Employee Information
State
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Business Group
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What is your current employment status with this Facility?
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Employee Concern Resolution Procedure
I believe my concern involves the following: (check all that apply)
Name of Person Involved (type none if this does not apply)
Where did the Incident occur?
Witness(es) to the Incident (type none if this does not apply)
Please describe the nature of your concern, including the identity of all known persons, documents and witnesses to your concern
Please describe the decision(s) of any previous 'Steps' taken in the Concern Procedure
Please explain specifically how or why you disagree with the outcome or decision(s) that have been made in the previous 'Steps' taken in the Concern Procedure
Please explain how you have been harmed by this decision or how it has affected your ability to perform your job
Please describe the outcome or remedy you seek for this concern
Employee's SSN (last 4 digits)
Date of Filing
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Please review your completed Employee Concern form. If the information you have entered is correct select 'Submit Form'.
NOTE: You will not be able to make changes to your Employee Concern form after selecting 'Submit Form'.
There are errors on the form! Please correct them!