Employee Handbook

Welcome Message

Dear Team Member,

Welcome to Noble Care Home Health LLC. We are honored to have you join our team of dedicated professionals committed to providing compassionate, high-quality home health care throughout Central Ohio.

At Noble Care, we believe that every patient deserves to be treated with dignity, respect, and excellence — in their own home, on their own terms. As a member of our team, you play a vital role in fulfilling this mission with every visit you make and every patient you serve.

This Employee Handbook is designed to provide you with important information about your employment, our policies, our expectations, and the resources available to you. Please read it carefully, ask questions if anything is unclear, and keep it as a reference throughout your employment.

We are building something special here — a home health agency known not just for the quality of its care, but for the character of its people. Thank you for being part of that.

Sincerely,

Sahur Aser, RN BSN
Owner / Administrator
Noble Care Home Health LLC

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1. About Noble Care Home Health

1.1 Company Overview

Noble Care Home Health LLC is a home health agency based in Lewis Center, Ohio, providing non-skilled and skilled home health services to patients throughout Central Ohio. We serve patients in Franklin, Delaware, Licking, Fairfield, Pickaway, Union, and Madison Counties.

Our agency was founded on the belief that every person deserves access to compassionate, professional care in the comfort and familiarity of their own home. We serve patients of all ages who need assistance with daily living, companionship, personal care, and skilled nursing and therapy services.

Noble Care holds an Ohio Department of Health license to provide Skilled Home Health Services (License No. 4942HHS).

1.2 Company Information

1.3 Services We Provide

Noble Care provides the following non-skilled home health services:

1. Companion Care — Conversation, social engagement, activities, supervision, and emotional support
2. Personal Care — Bathing, grooming, dressing, toileting, oral hygiene, skin care, and mobility assistance
3. Homemaker Services — Light housekeeping, laundry, meal preparation, and household organization
4. Respite Care — Temporary relief for family caregivers, available for a few hours or extended periods
5. Transportation and Errands — Medical appointments, pharmacy pick-ups, grocery shopping, and other essential errands
6. Medication Reminders — Verbal cues only (for example, "It's time for your medication"). Aides do NOT administer medications.
7. Overnight Care — Extended evening and nighttime shifts for patients who need supervision during sleeping hours
8. Live-In Care — 24-hour caregiver presence for patients who require around-the-clock support

Under ODH License No. 4942HHS, Noble Care is also licensed to provide skilled home health services, including nursing (RN/LPN), physical therapy, occupational therapy, and speech-language pathology. Skilled services are provided under a physician-ordered plan of care and supervised by the agency's Supervising RN. Which skilled disciplines are actively staffed changes as the agency grows — your supervisor will tell you which services are available to your patients.

Your scope of practice does not change because the agency is licensed for skilled services. Aides and companion caregivers perform only the tasks in the patient's care plan and permitted by their credential. See Section 3 (Workplace Conduct and Expectations) for scope-of-practice rules.

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2. Our Mission

To provide compassionate, professional home health services that honor the dignity of every patient and support families throughout Central Ohio.

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3. Our Vision

To be the most trusted home health agency in Central Ohio — recognized for clinical excellence, genuine human connection, and unwavering integrity.

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4. Our Core Values — CARES

Every Noble Care team member is expected to embody our five core values, represented by the acronym CARES:

C — Compassion

Meet every patient where they are — emotionally and physically. Listen with empathy. Care genuinely. Our work is personal, not transactional.

A — Accountability

Own your actions and your outcomes. Document honestly. Report truthfully. When you make a mistake, acknowledge it and correct it. Do not pass blame.

R — Respect

Treat every patient, family member, and colleague with dignity — regardless of condition, background, or circumstance. Respect cultural differences, personal preferences, and individual autonomy.

E — Excellence

Do your job to the highest standard, every visit. Never settle for "good enough" when it comes to patient care. Pursue continuous improvement in your skills, your knowledge, and your professionalism.

S — Safety

Protect your patients and yourself. Follow infection control procedures. Use proper body mechanics. Report hazards immediately. When in doubt, ask before acting. Safety is never optional.

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5. Organizational Structure

Noble Care Home Health operates under the following organizational structure:

Owner / Administrator (Sahur Aser, RN BSN)
|
+-- Office Manager / Care Coordinator
|     |-- Scheduling and intake
|     |-- Personnel file management
|     |-- Billing and invoicing
|
+-- Supervising RN
|     |-- Patient assessments and care plans
|     |-- Aide supervision and competency
|     |-- Skilled nursing visits and plan-of-care oversight
|     |-- OASIS documentation (upon Medicare certification)
|
+-- Home Health Aides / STNAs
|     |-- Direct patient care per care plan
|     |-- Documentation and reporting
|
+-- Companion Caregivers
      |-- Non-clinical companionship and homemaker services

As a startup agency, Sahur Aser, RN BSN, serves as Administrator and may also perform supervisory nursing functions. As the agency grows, additional supervisory positions will be added.

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6. Purpose of This Handbook

This Employee Handbook provides policies, procedures, and guidelines for your employment with Noble Care Home Health LLC. It is designed to:

• Inform you of your rights and responsibilities as an employee
• Describe the standards of conduct and performance we expect
• Explain the benefits and resources available to you
• Outline the procedures for common employment situations
• Ensure consistent and fair treatment of all employees

This handbook is not an employment contract. It does not create contractual obligations of any kind. Noble Care Home Health LLC reserves the right to revise, supplement, or discontinue any policy in this handbook at any time, with or without prior notice. Employees will be notified of significant changes. The most current version of this handbook supersedes all prior versions.

If any provision of this handbook conflicts with applicable federal, state, or local law, the law will control.

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7. At-Will Employment Statement

All employment with Noble Care Home Health LLC is at-will. This means that either you or Noble Care may terminate the employment relationship at any time, for any lawful reason or no reason, with or without cause, and with or without prior notice.

No supervisor, manager, or representative of Noble Care has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the at-will nature of your employment, except the Owner/Administrator in a signed written agreement.

Nothing in this handbook, any policy, any practice, any job description, any offer letter, or any statement made during your employment creates an express or implied contract of employment for any specific duration.

Ohio is an at-will employment state. This at-will relationship is consistent with Ohio common law as established in Mers v. Dispatch Printing Co., 19 Ohio St.3d 100 (1985), and its progeny.

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8. Equal Employment Opportunity

Noble Care Home Health LLC is an Equal Opportunity Employer. We do not discriminate in hiring, compensation, promotion, termination, or any other term, condition, or privilege of employment on the basis of:

• Race or color
• Religion or creed
• Sex (including pregnancy, childbirth, and related medical conditions)
• Sexual orientation
• Gender identity or expression
• National origin or ancestry
• Age (40 or older)
• Disability (physical or mental)
• Genetic information
• Military or veteran status
• Citizenship status (in compliance with federal immigration law)
• Any other characteristic protected by federal law, Ohio law (Ohio Revised Code Chapter 4112), or applicable local ordinance

This commitment applies to all aspects of the employment relationship, including but not limited to: recruitment, hiring, placement, promotion, demotion, transfer, layoff, recall, termination, compensation, benefits, training, and social and recreational programs.

Noble Care is committed to providing a work environment free from unlawful discrimination and harassment of any kind. Any employee who believes they have been subjected to discrimination may report it using the procedures described in Section 3 of this handbook (Workplace Conduct and Expectations).

External Agencies:
Employees also have the right to file complaints with the following agencies:

• Ohio Civil Rights Commission (OCRC): 888-278-7101 | crc.ohio.gov
• U.S. Equal Employment Opportunity Commission (EEOC), Cincinnati District: 800-669-4000 | eeoc.gov
• Ohio Department of Health: 1-800-342-0553

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9. Americans with Disabilities Act (ADA) Compliance

Noble Care complies with the Americans with Disabilities Act (ADA), the ADA Amendments Act (ADAAA), and Ohio Revised Code Section 4112.02. We provide reasonable accommodations to qualified individuals with disabilities who can perform the essential functions of the job, with or without accommodation.

If you need an accommodation, contact the Owner/Administrator, Sahur Aser, RN BSN, to begin the interactive process. Accommodation requests are evaluated individually and confidentially. Noble Care will engage in a good-faith interactive process to identify effective accommodations.

Medical information obtained through the accommodation process is maintained in a separate, confidential file apart from your personnel file, in compliance with the ADA.

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10. Immigration Law Compliance

Noble Care complies with the Immigration Reform and Control Act (IRCA) of 1986. All employees must complete Form I-9 (Employment Eligibility Verification) on or before their first day of work and present acceptable identity and work authorization documents within three (3) business days of their start date.

Noble Care does not discriminate on the basis of citizenship or immigration status, except as required by law.

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Handbook Acknowledgment

By signing below, I acknowledge that:

1. I have received a copy of the Noble Care Home Health Employee Handbook (Effective March 1, 2026).
2. It is my responsibility to read, understand, and comply with the policies in this handbook.
3. This handbook is not an employment contract and does not create contractual obligations of any kind.
4. My employment with Noble Care Home Health LLC is at-will and may be terminated at any time by either party, for any lawful reason or no reason, with or without cause or notice.
5. Noble Care reserves the right to modify, revise, supplement, or discontinue any policy in this handbook at any time, with or without notice.
6. If I have questions about any policy, I will direct them to my supervisor or the Owner/Administrator.
7. This handbook supersedes all prior handbooks, policies, and understandings regarding the subjects covered herein.

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Noble Care Home Health LLC | (740) 262-9845 | hello@noblecareohio.com | noblecareohio.com
This handbook is effective March 1, 2026, last revised August 23, 2026, and supersedes all prior versions.

1. Hiring Process

1.1 Application and Selection

Noble Care Home Health follows a structured hiring process for all positions:

1. Application Submission — Applicants complete a formal employment application (online or paper) and submit a current resume.
2. Initial Screening — The Administrator or Office Manager reviews applications for minimum qualifications, licensure, and certification requirements.
3. Interview — Qualified candidates participate in an in-person or video interview with the Administrator. Interview questions are standardized by position to ensure fair, consistent evaluation.
4. Reference Checks — A minimum of two (2) professional references are verified before a conditional offer is extended.
5. Conditional Offer — A written offer letter is extended, conditioned on successful completion of all pre-employment requirements.
6. Pre-Employment Screening — Background checks, drug screening, health screening, and credential verification (see Section 1.2 below).
7. Onboarding — Completion of all employment paperwork, orientation training, and initial competency evaluation.

1.2 Pre-Employment Requirements

Every individual must complete all of the following before their first patient visit. No exceptions.

1. Employment Application — Completed and signed, with full employment history for the past ten (10) years and explanation of any gaps.
2. Criminal Background Check — Ohio Bureau of Criminal Investigation (BCI) and Federal Bureau of Investigation (FBI) fingerprint-based criminal history check, as required by Ohio Revised Code Section 3701.881 for healthcare workers with direct patient contact. Conducted through Checkr or Ohio Attorney General WebCheck.
3. Ohio Sex Offender Registry Check — Verification against the Ohio eSORN database (esorn.ag.state.oh.us).
4. National Sex Offender Public Website (NSOPW) Check — Verification against the U.S. Department of Justice national registry (nsopw.gov).
5. OIG/SAM Exclusion Verification — Checked against the Office of Inspector General List of Excluded Individuals/Entities (LEIE) and the System for Award Management (SAM.gov) prior to hire and monthly thereafter. No excluded individual may be employed by Noble Care.
6. Ohio Nurse Aide Registry Check — Confirmation of no findings of abuse, neglect, or misappropriation of patient property via the Ohio Department of Health Nurse Aide Registry.
7. Professional License Verification — For RNs, LPNs, and other licensed professionals, verified through the Ohio eLicense system (elicense.ohio.gov). License must be current, active, and unencumbered.
8. Reference Checks — Minimum of two (2) professional references verified by phone or in writing.
9. Form I-9 — Employment Eligibility Verification, completed on or before the first day of work, with acceptable identity and work authorization documents presented within three (3) business days, per the Immigration Reform and Control Act (IRCA).
10. Tuberculosis (TB) Screening — Two-step tuberculin skin test (TST) or QuantiFERON-TB Gold blood test, completed before any patient contact. Results must be negative or, if positive, followed by a chest X-ray with physician clearance.
11. Drug Screening — Pre-employment 10-panel drug screen with negative result required. Testing conducted through a SAMHSA-certified laboratory.
12. CPR and First Aid Certification — Current certification from the American Heart Association (AHA) or American Red Cross. Must remain current throughout employment.
13. Health Attestation — Physician clearance confirming the employee can perform the essential physical functions of the position (lifting, bending, standing, driving, etc.).
14. Signed Employment Documents — The following must be signed on or before the first day:
    • Offer Letter
    • At-Will Employment Agreement
    • Employee Confidentiality & Non-Solicitation Agreement (NC-F-14F) — covers patient health information (HIPAA) and Noble Care's client and staff relationships. This is a non-solicitation agreement, not a non-compete.
    • Employee Handbook & Employment Acknowledgment (NC-F-14G)
    • Job Description Acknowledgment (NC-F-14H)
    • Form W-4 and Ohio Form IT-4 (tax withholding)
    • Direct Deposit Authorization

Failure to complete any requirement before the first patient visit will delay the start of employment. There are no provisional starts.

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2. New Employee Orientation

2.1 Orientation Program

All new employees complete a structured orientation program during their first week of employment. No employee may provide unsupervised patient care until orientation is complete and documented.

2.2 Orientation Curriculum (14 Topics)

The following topics are covered during orientation:

2.3 Orientation Documentation

Orientation completion is documented on a signed Orientation Checklist that includes:

• Each topic covered, with the date completed and trainer initials
• Employee signature confirming completion
• Supervisor signature confirming verification

The signed checklist is retained in the employee's personnel file.

2.4 Competency Evaluation

Home Health Aides and STNAs must demonstrate competency in the following skills during orientation before providing unsupervised care:

• Hand hygiene technique
• Proper gloving and PPE donning/doffing
• Safe patient transfer and body mechanics
• Vital sign measurement (temperature, pulse, respiration, blood pressure)
• Daily Visit Log completion

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3. Introductory Period (90 Days)

3.1 Purpose

The first ninety (90) calendar days of employment are an introductory period during which your performance, reliability, attendance, professionalism, and fit with Noble Care's culture and expectations are evaluated closely.

3.2 Evaluation

During the introductory period:

• Your supervisor will provide ongoing feedback and coaching
• A formal 30-day check-in and 90-day evaluation will be conducted
• Concerns about performance, attendance, or conduct will be addressed promptly

3.3 At-Will Status

The introductory period does not alter the at-will nature of your employment. Either you or Noble Care may terminate the employment relationship at any time during or after the introductory period, for any lawful reason or no reason, with or without cause or notice.

3.4 Completion

Successful completion of the introductory period does not guarantee continued employment, change your at-will status, or entitle you to any additional benefits not otherwise described in this handbook.

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4. Employment Classifications

4.1 Classification Definitions

Noble Care classifies employees as follows:

4.2 FLSA Classification

Each position is classified as either exempt or non-exempt under the Fair Labor Standards Act (FLSA):

• Non-Exempt: Entitled to overtime pay at 1.5 times the regular hourly rate for all hours worked over 40 in a workweek. Includes Home Health Aides, STNAs, Companion Caregivers, and Office Manager/Care Coordinator.
• Exempt: Not entitled to overtime pay. Must meet FLSA salary basis and duties tests. Includes Registered Nurses who meet the learned professional exemption criteria.

Your FLSA classification is stated in your offer letter and job description.

4.3 Reclassification

Noble Care reserves the right to change an employee's classification or status at any time based on business needs. Employees will be notified in writing of any change.

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5. Work Schedules

5.1 Office Hours

Noble Care's administrative office hours are Monday through Friday, 8:00 AM to 5:00 PM. The office phone, (740) 262-9845, is monitored during office hours and has voicemail available after hours.

5.2 Patient Visit Schedules

Patient visits are scheduled based on patient needs and care plans. Schedules may include:

• Weekday, weekend, and holiday shifts
• Morning, afternoon, evening, and overnight shifts
• Split shifts (multiple patients in one day with gaps between visits)
• Live-in shifts (24-hour caregiver presence with designated rest periods)

Your supervisor will communicate your schedule. Noble Care will provide as much advance notice as possible for schedule changes, but schedules may change on short notice due to patient needs, hospitalizations, discharges, or caregiver call-offs.

5.3 On-Call

Certain positions (RNs) may be assigned to an on-call rotation. On-call employees must remain reachable by phone and able to respond within a reasonable time. On-call expectations, compensation, and response requirements are communicated at the time of hire.

5.4 Workweek Definition

For purposes of overtime calculation, Noble Care's workweek is defined as Sunday 12:00 AM through Saturday 11:59 PM.

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6. Attendance and Call-Off Policy

6.1 Attendance Expectations

Reliable attendance is essential. Patients depend on you for their safety, comfort, and well-being. When you are absent without adequate notice, patients may be left without care. Punctuality and consistent attendance are core job requirements.

6.2 Call-Off Procedure

If you are unable to work a scheduled shift, you must:

1. Call the office at (740) 262-9845 at least two (2) hours before the start of your shift.
2. Speak with a supervisor or leave a detailed voicemail if no one answers.
3. Provide: Your name, the patient(s) affected, the reason for the absence, and your expected date of return.
4. Text messages and emails are NOT acceptable for call-offs. You must call.

6.3 No-Call / No-Show

A no-call/no-show — failing to report for a scheduled shift without notifying the office — is an extremely serious offense. Patients may be left without care, creating a safety risk.

• A single no-call/no-show is grounds for immediate termination.
• Two consecutive no-call/no-shows (two or more scheduled shifts missed without any contact) will be treated as voluntary job abandonment and automatic separation from employment.

6.4 Excessive Absences

Excessive unscheduled absences are defined as:

• More than three (3) unscheduled absences in any rolling 30-day period, OR
• A pattern of absences (e.g., consistently absent on Mondays, Fridays, or around holidays)

Excessive absences will trigger progressive discipline. Noble Care understands that emergencies and genuine illness occur, but the agency cannot fulfill its mission without reliable staff.

6.5 Tardiness

You are expected to arrive at the patient's home at the scheduled time, ready to begin work. Arriving more than five (5) minutes after your scheduled start time is considered tardy. Repeated tardiness will result in progressive discipline:

• 1st and 2nd tardiness in 30 days: Verbal counseling
• 3rd tardiness in 30 days: Written warning
• 4th tardiness in 30 days: Final written warning
• 5th tardiness in 30 days: Termination

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7. Timekeeping

7.1 Accurate Time Records

Accurate time records are required by the Fair Labor Standards Act (FLSA) and Ohio Revised Code Section 4111.08. Noble Care uses AxisCare as its scheduling and visit record system. You are responsible for recording your actual hours worked, including:

• Arrival time at each patient's home
• Departure time from each patient's home
• Miles driven between patients (for mileage reimbursement)
• Any break periods

7.2 Clocking In and Out

Clock in when you arrive at the patient's home and clock out when you leave, using AxisCare. Clock in and out at the point of care — not from your vehicle, not in advance, and not after the fact from home.

If a visit cannot be clocked electronically (no signal, device failure, or a missed clock-in), report it to the office the same day so the visit can be corrected in AxisCare with a documented reason. Do not let a correction wait until the end of the pay period.

Your visit records must be complete and accurate by the end of each pay period (every two weeks). Incomplete or disputed records may delay your pay.

7.3 Payroll Processing

Noble Care uses Gusto for payroll processing. Hours are taken from your AxisCare visit records and imported into Gusto each pay period. Pay stubs, tax documents (W-2), and direct deposit information are accessible through Gusto.

Review your visit records in AxisCare before the end of each pay period. If something is wrong, tell the office before payroll is processed — that is far easier than correcting it afterward. If you find an error after you are paid, report it immediately; see Section 4 (Compensation, Benefits, and Leave Policies) for the pay correction policy.

7.4 Prohibition on Falsification

Falsification of time records is grounds for immediate termination. This includes but is not limited to:

• Recording hours not actually worked
• Failing to record hours that were worked
• Clocking in or out for another employee
• Altering or backdating visit or time records

Falsification of time records may also constitute fraud under Ohio Revised Code Section 2913.

7.5 Rounding

Noble Care does not use time rounding. Record your actual start and stop times.

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8. Mileage Reimbursement

8.1 Reimbursable Travel

Employees who drive between patient homes during their workday are reimbursed at the current IRS standard mileage rate for business use of a personal vehicle. As of January 1, 2026, the IRS standard mileage rate is $0.67 per mile (subject to annual IRS adjustment — verify the current rate at irs.gov).

8.2 What Is Reimbursable

• Miles driven from one patient's home to another patient's home during the workday
• Miles driven for authorized errands on behalf of a patient (pharmacy, grocery, appointments) when using your personal vehicle
• Miles driven for required training, meetings, or office visits during the workday

8.3 What Is NOT Reimbursable

• Commuting miles — from your home to your first patient and from your last patient to your home — are not reimbursable unless specifically authorized in writing by the Administrator
• Personal errands or detours during the workday
• Miles driven during unpaid time

8.4 Documentation

Submit the Monthly Mileage Log by the last business day of each month. The log must include:

• Date of travel
• Starting location and destination
• Purpose of trip
• Odometer readings (start and end) or total miles
• Patient name(s) associated with travel

Falsification of mileage records is grounds for discipline up to and including termination.

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9. Personnel Files

9.1 Maintenance

Noble Care maintains a confidential personnel file for each employee containing: application, offer letter, signed agreements, performance evaluations, disciplinary records, training records, licensure/certification copies, and other employment-related documents.

9.2 Access

Employees may request to review their own personnel file by contacting the Administrator. Review will be scheduled within a reasonable time and must take place at the Noble Care office with the Administrator or designee present. Employees may request copies of documents they have signed.

9.3 Confidentiality

Personnel files are confidential. Access is limited to the Administrator, the employee's direct supervisor (for job-related purposes), and authorized third parties (auditors, regulators, or legal counsel) with a legitimate need.

9.4 Retention

Personnel files are retained for a minimum of six (6) years after separation from employment, in compliance with Ohio record retention requirements and EEOC recordkeeping regulations (29 CFR 1602).

9.5 Updates

Employees must notify the office promptly of changes to:

• Legal name
• Home address
• Phone number
• Emergency contact information
• Banking/direct deposit information
• Licensure, certification, or credential status
• Driver's license status or driving record changes

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Noble Care Home Health LLC | (740) 262-9845 | hello@noblecareohio.com | noblecareohio.com

1. Professional Standards

All Noble Care employees are expected to:

• Treat every patient, family member, and colleague with dignity, courtesy, and respect
• Maintain professional boundaries at all times
• Follow all Noble Care policies, procedures, and applicable laws and regulations
• Perform all duties to the highest standard of care and professionalism
• Report concerns, incidents, and unsafe conditions promptly through appropriate channels
• Protect patient privacy and confidential information
• Represent Noble Care positively in every interaction — you are the face of this agency in every home you enter
• Arrive on time, prepared, and appropriately dressed for every scheduled visit
• Communicate clearly and respectfully with supervisors, patients, families, and referral sources

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2. Code of Conduct

Every Noble Care team member is required to adhere to the following Code of Conduct:

1. Act with Integrity — Be honest in all communications, documentation, and interactions. Never falsify, misrepresent, or omit material information.
2. Comply with All Laws — Follow all applicable federal, state (Ohio), and local laws and regulations, including but not limited to HIPAA, FLSA, OSHA, ORC Chapter 4112 (civil rights), and ORC Section 5101.61 (mandatory reporting).
3. Avoid Conflicts of Interest — Disclose any situation where your personal interests, relationships, or outside activities could conflict with your duties to Noble Care or its patients. Examples include: outside employment with a competing agency, personal relationships with patients or their families, and financial interests in vendors or referral sources.
4. Protect Confidentiality — Safeguard all patient, employee, and company information. Access only the information you need to do your job.
5. Report Violations — Report any known or suspected violation of law, regulation, or Noble Care policy without fear of retaliation. Reports may be made to your supervisor, the Administrator, or anonymously to compliance@noblecareohio.com.
6. Respect Patient Autonomy — Honor patient preferences, choices, and right to refuse care. Never coerce, pressure, or deceive a patient.
7. Accept No Gifts of Significant Value — Do not accept gifts, tips, money, or items from patients or families exceeding $25 in value. Politely decline and report to your supervisor. Never borrow money, property, or vehicles from patients.
8. Maintain Professional Boundaries — Do not develop personal, romantic, or financial relationships with patients or their families (see Section 9 below).

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3. Dress Code for Home Care

Your appearance is the first impression patients and families have of Noble Care. You must present a clean, neat, professional appearance at all times during patient visits.

3.1 Required

• Noble Care photo ID badge worn visibly during all patient visits — no exceptions
• Closed-toe, non-slip shoes at all times during patient visits (athletic shoes, nursing shoes, or similar)
• Clean, professional attire: Scrubs or business casual attire are acceptable
• Hair must be clean, neat, and secured away from the face during personal care tasks
• Fingernails must be short (no longer than 1/4 inch beyond fingertip), clean, and free of artificial nails, gel nails, acrylics, or chipped polish — this is an infection control requirement per CDC guidelines

3.2 Prohibited

• Jeans, shorts, sweatpants, leggings (unless under a tunic-length top), tank tops, halter tops, or crop tops
• Open-toed shoes, sandals, flip-flops, or high heels
• Excessive perfume, cologne, or scented products (patients may have respiratory sensitivities, allergies, or chemical sensitivities)
• Excessive or dangling jewelry (earrings, bracelets, necklaces) that could be grabbed by a patient, caught on equipment, or pose a safety hazard
• Visible offensive tattoos (must be covered if requested by management or patient/family)
• Hats or head coverings, except for documented religious or medical reasons
• Clothing with political messages, profanity, or offensive imagery

3.3 Infection Control Reminders

• Remove rings (except a plain band) and bracelets before providing personal care
• Watches with expandable bands should be pushed above the wrist during hand hygiene
• Long sleeves must be rolled above the elbow during hand washing and patient care

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4. Scope of Practice

4.1 What You MAY Do (Home Health Aides / STNAs / Companion Caregivers)

You may perform only the tasks outlined in the patient's individualized Care Plan and Aide Assignment Sheet:

• Provide personal care: bathing, grooming, dressing, toileting, oral hygiene, skin care (non-medicated lotions only)
• Assist with mobility, transfers, and ambulation using proper body mechanics and assistive devices
• Prepare meals and snacks according to the patient's dietary requirements or preferences
• Provide medication reminders — verbal cues only (for example: "It's time for your medication" or "Your pills are on the counter")
• Perform light housekeeping: tidying, dishes, laundry, vacuuming, dusting, bed making, taking out trash — limited to the patient's living areas
• Provide companionship: conversation, reading, games, activities, walks, social engagement
• Run errands: grocery shopping, pharmacy pick-ups, mail, essential household errands
• Provide authorized transportation to medical appointments, pharmacy, and other approved outings (only with prior written authorization and verified insurance)
• Take and record vital signs: temperature, pulse, respiration, blood pressure (if trained and directed by the supervising RN)
• Observe and report changes in the patient's condition, mood, appetite, mobility, skin, or behavior
• Complete the Daily Visit Log in AxisCare accurately and completely after every visit
• Follow infection control procedures (hand hygiene, glove use, PPE as indicated)
• Assist with range of motion exercises as directed by the supervising RN or therapist

4.2 What You MAY NOT Do

The following are strictly prohibited and constitute working outside your scope of practice:

• Administer medications — You may NOT give pills, apply medicated creams or ointments, administer injections, apply medicated patches, insert suppositories, give eye/ear drops, or manage medications in any way. Verbal reminders only.
• Perform any clinical or medical procedure — Including wound care, wound packing, catheter insertion or irrigation, blood glucose testing, tracheostomy care, ostomy care, or any procedure requiring a nursing license — unless you hold the appropriate license AND are specifically authorized in writing
• Change the Care Plan — Do not add, remove, or modify any tasks without written approval from the supervising RN or Administrator
• Accept gifts, tips, or money from patients or families exceeding $25 in value
• Borrow money, property, or vehicles from patients or their families
• Engage in personal financial transactions with patients — buying, selling, lending, borrowing, cosigning, opening joint accounts, or being named in a patient's will or power of attorney
• Transport patients in your personal vehicle without prior written authorization from Noble Care and verification of appropriate insurance coverage
• Use a patient's phone, computer, television, or personal belongings without explicit permission from the patient
• Consume a patient's food, beverages, or medications
• Smoke, vape, or use tobacco products in a patient's home or on their property
• Bring unauthorized persons (children, friends, family members, pets, other patients) to a patient's home during a visit
• Sleep during a shift — except during designated rest periods on authorized overnight or live-in shifts, as specified in the care plan
• Take photographs or videos of patients, their homes, their belongings, or their medical information — under any circumstances, on any device
• Provide medical advice or diagnoses to patients or families
• Restrain a patient physically or chemically without a physician's order

Performing tasks outside your scope of practice is a safety risk to patients and is grounds for immediate disciplinary action up to and including termination. If you are uncertain whether a task is within your scope, stop and call your supervisor before proceeding.

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5. Professional Boundaries

5.1 Boundary Requirements

Maintaining professional boundaries protects both you and your patients. You must:

• Keep the relationship professional, caring, and focused on the patient's care plan
• Use the Noble Care office number, (740) 262-9845, for all patient/family communication — do not give your personal cell phone number, email, or social media accounts to patients or their families
• Refer all questions about care plans, billing, scheduling, or complaints to the office

5.2 Prohibited Boundary Violations

Do NOT:

• Develop personal, romantic, or sexual relationships with patients or their family members
• Share your personal problems, financial situation, relationship issues, or health concerns with patients
• Accept or make personal loans with patients or their families
• Visit patients outside of your scheduled shifts without authorization from the Administrator
• Become involved in a patient's personal, legal, family, or financial disputes
• Discuss other Noble Care patients with a patient or their family
• Provide care to family members or close personal friends without disclosure and Administrator approval
• Accept employment, side jobs, or "private pay" arrangements directly with a Noble Care patient outside of Noble Care

5.3 Reporting

If you become aware of a boundary violation — by yourself or another employee — report it to the Administrator immediately. Boundary violations may result in disciplinary action up to and including termination.

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6. Social Media Policy

6.1 Patient Information

• Never post any information about Noble Care patients, their families, their homes, their conditions, or their care on any social media platform, blog, website, or online forum — even without using names. Descriptions of specific situations, conditions, locations, or details can indirectly identify a patient and constitute a HIPAA violation.
• Never take or post photos or videos of patients, their homes, or their belongings.

6.2 During Work

• Do not use social media during patient visits. Your focus must be on the patient.
• Brief personal phone use is permitted only during scheduled breaks or in genuine emergencies.

6.3 Representing Noble Care

• Do not represent yourself as a spokesperson for Noble Care without written authorization from the Administrator.
• Do not post disparaging, defamatory, or false comments about Noble Care, its patients, its employees, or its business partners.
• If you identify yourself as a Noble Care employee on social media, you are expected to conduct yourself professionally and in a manner consistent with our values.

6.4 Consequences

Violation of this social media policy may result in disciplinary action up to and including immediate termination. A social media post that discloses patient information is a HIPAA violation subject to civil and criminal penalties.

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7. Substance-Free Workplace

Noble Care maintains a drug-free and alcohol-free workplace in compliance with the Drug-Free Workplace Act of 1988.

7.1 Prohibited Conduct

The following are prohibited and grounds for immediate termination:

• Using, possessing, distributing, selling, manufacturing, or being under the influence of illegal drugs or alcohol while on duty, on Noble Care premises, at a patient's home, or while representing Noble Care in any capacity
• Using prescription or over-the-counter medications that impair your ability to safely perform your duties without notifying your supervisor in advance (you are not required to disclose the specific medication, but you must report any impairment)
• Refusing to submit to a drug or alcohol test when requested by Noble Care

7.2 Drug and Alcohol Testing

Noble Care may require drug and/or alcohol testing under the following circumstances:

7.3 Consequences

• A positive drug or alcohol test is grounds for immediate termination.
• Refusal to submit to a test is treated as a positive result.
• Adulteration or substitution of a test sample is grounds for immediate termination.

7.4 Employee Assistance

If you have a substance abuse problem and seek help voluntarily (before a positive test or incident), Noble Care encourages you to contact:

• SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7, 365 days a year)
• Ohio Mental Health & Addiction Services: 614-466-2596

Voluntarily seeking help will not, by itself, result in disciplinary action. However, seeking help does not excuse prior violations or relieve you of the obligation to meet all job performance and attendance standards.

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8. Anti-Harassment and Anti-Discrimination Policy

8.1 Policy Statement

Noble Care Home Health LLC maintains a zero-tolerance policy for harassment, discrimination, and bullying of any kind. This policy applies to all employees, contractors, patients, vendors, and any person in the Noble Care work environment, including patient homes.

Noble Care complies with:

• Title VII of the Civil Rights Act of 1964 (race, color, religion, sex, national origin)
• Age Discrimination in Employment Act (ADEA) (age 40 and older)
• Americans with Disabilities Act (ADA) and ADA Amendments Act (disability)
• Genetic Information Nondiscrimination Act (GINA) (genetic information)
• Equal Pay Act (sex-based pay discrimination)
• Ohio Revised Code Chapter 4112 (Ohio civil rights — race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, ancestry, military status)
• Pregnancy Discrimination Act (pregnancy, childbirth, related conditions)

8.2 Prohibited Conduct

Prohibited conduct includes but is not limited to:

• Sexual harassment — Unwelcome sexual advances, requests for sexual favors, sexually suggestive comments or jokes, inappropriate touching, display of sexually explicit materials, or any conduct of a sexual nature that creates a hostile, intimidating, or offensive work environment. Both quid pro quo (conditioning employment benefits on sexual favors) and hostile work environment harassment are prohibited.
• Verbal harassment — Slurs, epithets, derogatory comments, insults, mockery, name-calling, or jokes based on any protected characteristic
• Physical harassment — Unwanted physical contact, intimidation, threats, blocking movement, or assault
• Visual harassment — Offensive images, cartoons, drawings, gestures, or objects displayed or circulated in the workplace
• Cyberbullying and electronic harassment — Harassment via text message, email, social media, or any electronic communication

8.3 Harassment by Non-Employees

Noble Care recognizes that employees may experience harassment from patients, family members, or other non-employees. If a patient or family member engages in harassing behavior:

1. You are NOT required to tolerate harassment from anyone, including patients.
2. Remove yourself from the immediate situation if you feel unsafe.
3. Report the incident to your supervisor or the Administrator immediately.
4. Noble Care will take appropriate action, which may include reassigning the employee, speaking with the patient/family, or — in serious cases — discontinuing services to the patient.

8.4 Reporting Procedures

If you experience or witness harassment or discrimination:

1. Report immediately to your direct supervisor.
2. If your supervisor is involved or you are uncomfortable reporting to them, report directly to the Owner/Administrator, Sahur Aser, RN BSN:
   • Phone: (740) 262-9845
   • Email: hello@noblecareohio.com
3. For anonymous reports, submit to compliance@noblecareohio.com or by written report marked "COMPLIANCE — CONFIDENTIAL" delivered to the office.

All complaints will be investigated promptly, thoroughly, and as confidentially as possible. Noble Care will take appropriate corrective action based on the findings.

8.5 Non-Retaliation

Noble Care strictly prohibits retaliation against any employee who:

• Reports harassment or discrimination in good faith
• Participates in an investigation
• Opposes discriminatory practices
• Files a complaint with an external agency

Retaliation is itself a serious policy violation and a terminable offense. If you believe you are being retaliated against, report it immediately using the same procedures above.

8.6 Consequences

Employees who engage in harassment, discrimination, or retaliation are subject to disciplinary action up to and including immediate termination.

8.7 External Agencies

Employees have the right to file complaints with the following external agencies at any time:

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9. Progressive Discipline

9.1 Policy

Noble Care uses a progressive discipline process to address performance deficiencies and conduct violations. The purpose of progressive discipline is to provide employees with notice of the problem, an opportunity to improve, and clear expectations. Discipline is applied consistently, documented thoroughly, and retained in the employee's personnel file.

9.2 Four Levels of Progressive Discipline

9.3 Management Discretion

Noble Care reserves the right to skip levels of progressive discipline based on the severity of the offense. Not every situation will start at Level 1. The progressive discipline process does not alter the at-will employment relationship.

9.4 Immediate Termination Offenses

The following offenses are considered so serious that they may result in immediate termination without prior progressive discipline:

1. Patient abuse, neglect, or exploitation (as defined by ORC 5101.61)
2. Theft, embezzlement, fraud, or dishonesty
3. Drug or alcohol use on duty or a positive drug/alcohol test
4. Falsification of any record (time and visit records, applications, incident reports, clinical records)
5. No-call/no-show (a single occurrence)
6. HIPAA violation or unauthorized disclosure of patient information
7. Possession of a weapon (firearm, knife, or other weapon) during work hours or in a patient's home
8. Insubordination — willful refusal to follow a lawful directive from a supervisor
9. Threatening, intimidating, or violent behavior toward any person
10. Conviction of a disqualifying criminal offense during employment
11. Appearing on the OIG LEIE exclusion list or SAM.gov during employment
12. Working outside scope of practice in a manner that causes or risks patient harm
13. Sleeping on duty (except during authorized rest periods on overnight/live-in shifts)
14. Abandoning a patient — leaving a patient's home during a scheduled shift without arranging coverage
15. Sexual harassment or assault
16. Destruction of Noble Care or patient property

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10. Grievance and Complaint Procedure

10.1 Employee Grievances

If you have a workplace concern, complaint, or grievance:

1. Step 1: Discuss the concern directly with your immediate supervisor.
2. Step 2: If unresolved within five (5) business days, or if the concern involves your supervisor, submit a written grievance to the Owner/Administrator, Sahur Aser, RN BSN, at (740) 262-9845 or hello@noblecareohio.com. The Administrator will investigate and provide a written response within ten (10) business days.
3. Step 3: For compliance, ethical, or legal concerns, you may submit an anonymous report to compliance@noblecareohio.com or by written report marked "COMPLIANCE — CONFIDENTIAL" delivered to the Noble Care office.
4. Step 4: You may also contact external agencies at any time:

10.2 Non-Retaliation

Noble Care prohibits retaliation against any employee who files a grievance, reports a concern, participates in an investigation, or exercises any right under law. Retaliation is a terminable offense.

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11. Solicitation and Distribution

Employees may not solicit for any cause, sell products, or distribute literature during work time or in patient homes. This includes but is not limited to: fundraising, political campaigns, religious materials, multi-level marketing, and personal business ventures.

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12. Personal Phone Use

Personal phone use during patient visits is limited to brief, necessary calls during breaks or genuine emergencies only. Extended phone calls, texting, social media browsing, or video watching during patient visits is prohibited and grounds for discipline.

Your personal phone should be on silent or vibrate during patient visits. The patient deserves your full, undivided attention.

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13. Nepotism

Noble Care does not prohibit the employment of relatives. However:

• Relatives may not directly supervise one another
• Relatives may not be assigned to the same patient without disclosure and approval from the Administrator
• All employees must disclose family relationships with other Noble Care employees or patients to the Administrator

For this policy, "relative" includes: spouse, domestic partner, parent, child, sibling, grandparent, grandchild, aunt, uncle, niece, nephew, cousin, in-law, or step-relation.

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14. Outside Employment

Employees may hold outside employment provided it:

• Does not interfere with your Noble Care schedule, performance, or responsibilities
• Does not create a conflict of interest
• Does not violate your Employee Confidentiality & Non-Solicitation Agreement (NC-F-14F)

Notify the Administrator in writing of any outside employment. Noble Care's scheduling needs take priority.

Noble Care does not require employees to sign a non-compete agreement. You are free to work for another home health agency. What you may not do, during your employment and for the restricted period stated in NC-F-14F, is solicit Noble Care's patients or employees, or use or disclose Noble Care's confidential information or patient health information. Diverting a Noble Care patient or recruiting a Noble Care employee to another agency is a violation of that agreement and grounds for termination.

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Noble Care Home Health LLC | (740) 262-9845 | hello@noblecareohio.com | noblecareohio.com

1. Pay Schedule

1.1 Biweekly Pay

Noble Care pays employees on a biweekly basis — every two (2) weeks. Pay is distributed via direct deposit on Fridays. If a payday falls on a bank holiday, deposits will be made on the preceding business day.

1.2 Pay Periods

Each pay period covers two consecutive workweeks (Sunday through Saturday). The payroll calendar is distributed at the beginning of each year and is available from the office.

1.3 Direct Deposit

All employees are required to enroll in direct deposit. Complete the Direct Deposit Authorization Form during onboarding. Allow one (1) to two (2) pay cycles for direct deposit to activate; you may receive a paper check during this activation period.

1.4 Payroll System

Noble Care uses Gusto for payroll processing. Through Gusto, you can access:

• Pay stubs for each pay period
• Year-end tax documents (W-2)
• Direct deposit settings
• Tax withholding elections (W-4)

1.5 Pay Errors

If you believe there is an error in your pay, notify the office immediately at (740) 262-9845. Noble Care will investigate and correct any verified error within one (1) pay period. Noble Care does not retaliate against employees who raise pay concerns.

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2. Overtime

2.1 FLSA Compliance

Noble Care complies with the Fair Labor Standards Act (FLSA) and Ohio Revised Code Section 4111.03 regarding overtime compensation.

2.2 Overtime Rate

Non-exempt employees (including all Home Health Aides, STNAs, Companion Caregivers, and Office Manager/Care Coordinator) are paid overtime at 1.5 times (time-and-a-half) their regular hourly rate for all hours worked in excess of 40 hours in a single workweek.

2.3 Workweek

For overtime purposes, the Noble Care workweek runs from Sunday 12:00 AM through Saturday 11:59 PM.

2.4 Pre-Approval Requirement

All overtime must be pre-approved by your supervisor or the Administrator. Working unauthorized overtime is a policy violation subject to progressive discipline. However, Noble Care will always pay for all hours actually worked, whether or not overtime was pre-approved. Federal law requires payment for all hours worked.

2.5 Exempt Employees

Employees classified as exempt (e.g., Registered Nurses meeting the FLSA learned professional exemption) are paid a salary and are not entitled to overtime pay. Exempt status is determined based on FLSA salary basis and duties tests and is stated in your offer letter and job description.

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3. Ohio Minimum Wage

Noble Care pays all employees at or above the current Ohio minimum wage as established annually under Article II, Section 34a of the Ohio Constitution. The current Ohio minimum wage is posted in the office and is available upon request. Noble Care will adjust pay rates as necessary when the Ohio minimum wage changes.

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4. Holiday Pay

4.1 Recognized Holidays

Noble Care recognizes the following six (6) holidays:

1. New Year's Day (January 1)
2. Memorial Day (last Monday in May)
3. Independence Day (July 4)
4. Labor Day (first Monday in September)
5. Thanksgiving Day (fourth Thursday in November)
6. Christmas Day (December 25)

4.2 Holiday Pay Rate

Employees who work on a recognized holiday are compensated at 1.5 times (time-and-a-half) their regular hourly rate for all hours worked on that holiday.

4.3 Full-Time Employees — Holiday Off

Full-time employees who are not scheduled to work on a recognized holiday and would normally be scheduled on that day receive eight (8) hours of holiday pay at their regular rate.

4.4 Part-Time and PRN Employees

Part-time and PRN employees receive holiday pay (1.5x) only for hours actually worked on a recognized holiday. They do not receive paid time off for holidays not worked.

4.5 Holiday and Overtime Interaction

Holiday premium pay hours count toward the 40-hour overtime threshold. If holiday hours cause total hours to exceed 40 in the workweek, overtime rules apply to the excess hours.

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5. Mileage Reimbursement

5.1 Reimbursement Rate

Employees who drive between patient homes during their workday are reimbursed at the current IRS standard mileage rate for business use of a personal vehicle. As of January 1, 2026, the rate is $0.67 per mile (verify current rate at irs.gov; rate is subject to annual adjustment).

5.2 Reimbursable Miles

• Travel from one patient's home to another patient's home during the workday
• Authorized errands on behalf of a patient (pharmacy, grocery, medical appointments)
• Required training sessions, meetings, or office visits during the workday

5.3 Non-Reimbursable Miles

• Commuting — from your home to your first patient and from your last patient to your home — is not reimbursable unless specifically authorized in writing
• Personal errands or detours
• Miles driven during unpaid time

5.4 Documentation

Submit the Monthly Mileage Log by the last business day of each month with:

• Date, starting location, destination, purpose, and total miles for each trip
• Patient name(s) associated with each trip

Mileage reimbursement is paid on the next regular payroll following submission and approval.

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6. Payroll Deductions

6.1 Required Deductions

The following deductions are withheld from each paycheck as required by law:

6.2 Voluntary Deductions

Any additional voluntary deductions (e.g., garnishments ordered by a court, child support withholding) will be processed as required by law and documented in writing.

6.3 Questions

Questions about payroll deductions should be directed to the office. You may review your deductions at any time through Gusto.

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7. Workers' Compensation

7.1 Ohio Bureau of Workers' Compensation (BWC) Coverage

All Noble Care employees are covered under the Ohio Bureau of Workers' Compensation (BWC) system. Ohio is a monopolistic state fund state — Noble Care pays premiums directly to the Ohio BWC, not to a private insurance carrier. This coverage is provided at no cost to the employee.

Workers' compensation provides benefits for employees who suffer a work-related injury or occupational disease, including:

• Medical treatment related to the injury
• Temporary total disability (wage replacement) benefits
• Permanent partial or total disability benefits (if applicable)
• Death benefits (if applicable)

7.2 Reporting a Work Injury

If you are injured on the job or develop symptoms of a work-related illness:

1. Seek immediate medical attention if the injury requires it. For emergencies, call 911.
2. Report the injury to your supervisor within 24 hours, no matter how minor. Early reporting protects your rights.
3. Complete an Incident Report (see Policy NC-16).
4. Noble Care will provide you with a First Report of Injury (FROI) form and information about your BWC rights.
5. Noble Care will file the BWC claim on your behalf through the Ohio BWC system.

7.3 Managed Care Organization (MCO)

Noble Care's BWC claims are managed through a Managed Care Organization (MCO) assigned by the Ohio BWC. The MCO coordinates medical treatment, reviews claims, and manages return-to-work planning. You will be informed of your assigned MCO if you file a claim.

7.4 Return to Work

Noble Care supports return-to-work and transitional duty programs. If you are injured, we will work with you and your treating physician to identify transitional or modified duties when possible. You must provide a physician's release before returning to full duties.

7.5 Workers' Compensation Fraud

Filing a fraudulent workers' compensation claim is a felony under Ohio Revised Code Section 2913.48. It is also grounds for immediate termination.

7.6 Contact

• Ohio Bureau of Workers' Compensation: 800-644-6292 | bwc.ohio.gov
• BWC Fraud Hotline: 800-644-6292

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8. Leave Policies

8.1 Paid Time Off (PTO) — Full-Time Employees

Full-time employees (30+ hours/week) accrue Paid Time Off as follows:

PTO Rules:

• PTO begins accruing on your first day of employment but may not be used during the 90-day introductory period.
• PTO accrues on a per-pay-period basis (annual allotment divided by 26 pay periods).
• PTO requests must be submitted in writing at least two (2) weeks in advance.
• PTO is subject to supervisor approval based on scheduling needs and patient care coverage.
• Unused PTO does not carry over to the next calendar year. Use it or lose it.
• PTO is not paid out upon separation from employment. Ohio law (ORC 4113.15) does not require payout of unused PTO unless the employer has a written policy providing for it. Noble Care's policy does not provide for payout.

8.2 Sick Leave

Ohio does not currently mandate paid sick leave for private employers. Noble Care provides the following:

• Full-time employees: Three (3) paid sick days per calendar year, available after the 90-day introductory period.
• Part-time and PRN employees: Unpaid sick leave as needed, subject to attendance policy.

Important: If you are ill with a communicable condition (fever of 100.4F or higher, vomiting, diarrhea, active respiratory illness, or any condition that could be transmitted to patients), you must NOT report to patient visits. Contact the office immediately so coverage can be arranged. Protecting patients is the priority.

8.3 Bereavement Leave

Full-time employees may take up to three (3) paid days of bereavement leave for the death of an immediate family member: spouse, domestic partner, child, stepchild, parent, stepparent, sibling, grandparent, grandchild, or parent-in-law.

One (1) paid day of bereavement leave is available for the death of an extended family member: aunt, uncle, niece, nephew, cousin, or brother/sister-in-law.

The Administrator may grant additional unpaid bereavement leave on a case-by-case basis.

8.4 Jury Duty

Employees summoned for jury duty will be granted time off as required by law. Notify your supervisor immediately upon receiving a jury summons. Noble Care will pay full-time employees their regular base pay for up to five (5) days of jury duty per year. Employees must provide documentation of jury service. If you are released from jury duty early, you are expected to return to work for the remainder of the day.

Ohio Revised Code Section 2313.18 prohibits employers from discharging or threatening to discharge an employee for serving on a jury.

8.5 Family and Medical Leave Act (FMLA)

The Family and Medical Leave Act (FMLA) provides eligible employees of covered employers with up to 12 weeks of unpaid, job-protected leave per 12-month period for qualifying reasons. FMLA applies to employers with 50 or more employees within a 75-mile radius.

Current status: As a startup, Noble Care does not currently employ 50 or more employees and is not currently subject to FMLA. However, Noble Care commits to the following:

• When Noble Care reaches 50 employees, FMLA will be fully implemented per federal regulations (29 CFR Part 825).
• In the interim, Noble Care will consider requests for unpaid medical or family leave on a case-by-case basis and will not retaliate against employees who make such requests.
• Noble Care complies with the ADA interactive process for disability-related leave requests regardless of employee count.

8.6 Military Leave (USERRA)

Noble Care complies with the Uniformed Services Employment and Reemployment Rights Act (USERRA) and Ohio Revised Code Chapter 5903. Employees who serve in the uniformed services are entitled to:

• Unpaid leave for military service
• Reemployment rights upon return from service
• Protection from discrimination based on military service

Notify the Administrator as soon as you receive military orders.

8.7 Voting Leave

Ohio Revised Code Section 3599.06 provides that employees are entitled to a reasonable amount of time off to vote on Election Day if their work schedule does not allow sufficient time to vote. Notify your supervisor in advance if you need time to vote.

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9. Training and Professional Development

9.1 Required Training

Noble Care requires the following training for all employees:

• New Hire Orientation: 10 training modules completed during the first week of employment (see Section 2 of this handbook)
• Annual Refresher Training: 5 modules completed annually, covering: HIPAA update, infection control update, abuse/neglect/exploitation, emergency procedures, and documentation standards

9.2 Continuing Education

Noble Care supports employee growth and professional development through:

• Supervisory visits with feedback and coaching
• In-service training on specific clinical and professional topics
• Support for obtaining additional certifications (CPR renewal, STNA certification, etc.)

9.3 Training Time

Time spent in mandatory Noble Care training is compensable work time for non-exempt employees and will be paid at your regular hourly rate.

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10. Separation from Employment

10.1 Voluntary Resignation

If you choose to resign, please provide at least two (2) weeks' written notice to your supervisor. Providing notice allows Noble Care to arrange continued care for your assigned patients and demonstrates professionalism that supports a positive reference.

10.2 Involuntary Termination

Noble Care may terminate employment at any time consistent with the at-will employment relationship. Terminated employees will be informed of the reason for termination and provided with required documentation.

10.3 Exit Requirements

Upon separation from employment for any reason, you must:

• Return all Noble Care property: ID badge, keys, uniforms, patient records, supplies, and equipment
• Ensure your AxisCare visit records are complete and accurate through your last day worked
• Participate in an exit interview if requested
• All confidentiality, HIPAA, and non-solicitation obligations continue after employment ends per the terms of those agreements

10.4 Final Pay

Per Ohio Revised Code Section 4113.15, your final paycheck will be paid by the next regular payday following your separation date. Final pay includes all wages earned through your last day of work.

10.5 Rehire Eligibility

• Employees who resign with proper notice (two weeks) and are in good standing at the time of separation may be eligible for rehire.
• Employees terminated for cause, employees who commit a no-call/no-show, and employees who resign without notice are generally not eligible for rehire. Personnel files of ineligible employees will be marked accordingly.

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Noble Care Home Health LLC | (740) 262-9845 | hello@noblecareohio.com | noblecareohio.com

1. Workplace Safety — General

Noble Care is committed to providing a safe work environment for all employees. As a home health worker, your "workplace" is the patient's home — an environment that Noble Care does not control. This makes your awareness, judgment, and compliance with safety procedures especially important.

1.1 Employee Responsibilities

Every Noble Care employee must:

• Conduct a visual safety assessment at the beginning of each patient visit — look for trip hazards (loose rugs, clutter, cords), broken equipment, unsanitary conditions, exposed wiring, pest infestations, extreme temperatures, and any condition that could endanger you or the patient
• Report any unsafe conditions to your supervisor immediately by phone at (740) 262-9845
• Use proper body mechanics for all lifting, transferring, and repositioning of patients
• Do not attempt to lift or transfer a patient who exceeds your safe capability — request assistance, a second caregiver, or appropriate equipment (gait belt, Hoyer lift, transfer board)
• Follow infection control procedures at all times (see Section 2 below)
• Know the emergency plan for each patient (posted in the Care Plan)
• Know how to call 911 and be prepared to provide the patient's full address
• Never enter a home where you feel unsafe — leave immediately, call 911 if in danger, and contact the office

1.2 Personal Safety in the Field

When making home visits:

1. Plan your route and let someone know your schedule and expected locations
2. Keep your phone charged and accessible at all times
3. Park in well-lit areas close to the patient's entrance
4. Be aware of your surroundings when entering and leaving homes — especially at night
5. Lock your vehicle and do not leave valuables visible
6. Leave immediately if you encounter a threatening situation (aggressive person, weapons, active substance use, domestic violence). Call 911 first, then call the Noble Care office
7. Do not enter if the patient does not answer and the door is unlocked — call the office for guidance
8. Carry your Noble Care ID badge visibly at all times

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2. Infection Control

Noble Care follows Standard Precautions for all patient care, consistent with CDC guidelines and OSHA regulations. For comprehensive infection control procedures, refer to Policy NC-10 (Infection Control and Standard Precautions).

2.1 Hand Hygiene

Hand hygiene is the single most important infection prevention measure. Wash hands with soap and water for at least 20 seconds, or use alcohol-based hand sanitizer (at least 60% alcohol), at the following times:

• Upon entering a patient's home
• Before and after providing any personal care
• Before handling or preparing food
• After contact with blood, body fluids, secretions, excretions, or contaminated surfaces
• After using the restroom
• After removing gloves
• After sneezing, coughing, or touching your face
• Before leaving the patient's home

When hands are visibly soiled or contaminated with blood or body fluids, soap and water must be used — hand sanitizer alone is not sufficient.

2.2 Personal Protective Equipment (PPE)

• Gloves: Wear disposable gloves when contact with blood, body fluids, mucous membranes, or non-intact skin is anticipated. Change gloves between tasks on the same patient. Remove gloves immediately after use and perform hand hygiene.
• Mask: Wear a surgical mask when caring for a patient with a respiratory infection, or when you have symptoms of a respiratory illness that have been cleared for work by your supervisor.
• Gown: Wear a disposable gown when splashing or spraying of blood or body fluids is anticipated.
• Eye Protection: Wear goggles or a face shield when splashing of blood or body fluids toward the face is anticipated.

Noble Care provides PPE at no cost to employees. If you need PPE supplies, contact the office.

2.3 Sharps Safety and Bloodborne Pathogens

Noble Care complies with OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030).

• Never recap needles. Dispose of sharps in designated sharps containers.
• If a sharps container is not available in the patient's home, report this to your supervisor and request one.
• If you experience a needlestick or exposure to blood/body fluids:
  1. Wash the area immediately with soap and water (for mucous membrane exposure, flush with water)
  2. Report the exposure to your supervisor within one (1) hour
  3. Seek medical evaluation as directed
  4. Complete an Incident Report
• All employees receive bloodborne pathogen training during orientation and annually thereafter.

2.4 When You Are Sick

If you are ill with any of the following, you must NOT report to patient visits:

• Fever of 100.4 degrees F (38 degrees C) or higher
• Vomiting or diarrhea
• Active respiratory illness (persistent cough, influenza-like symptoms)
• Open, draining, or infected skin lesions on exposed areas
• Known or suspected communicable disease (COVID-19, influenza, norovirus, tuberculosis, etc.)

Notify the office immediately at (740) 262-9845 so coverage can be arranged. You may return to work when you have been symptom-free for at least 24 hours without fever-reducing medication, or when cleared by a healthcare provider.

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3. Emergency Procedures

For comprehensive emergency procedures, refer to Policy NC-11 (Emergency Preparedness). The following are critical emergency protocols:

3.1 Patient Is Unresponsive

1. Call 911 immediately. Provide the patient's full address and describe the situation.
2. Check for a Do Not Resuscitate (DNR) order — posted in the patient's home per the care plan.
3. If no DNR is on file and you are trained: begin CPR immediately and continue until EMS arrives.
4. If a DNR is on file: do NOT begin CPR. Stay with the patient, keep them comfortable, and wait for EMS.
5. Contact the Noble Care office at (740) 262-9845 as soon as it is safe to do so.
6. Complete an Incident Report within 24 hours.

3.2 Patient Falls

1. Assess for injury. Ask the patient where they hurt. Look for visible injuries (bleeding, swelling, deformity).
2. Do NOT move the patient if spinal injury is suspected (neck pain, inability to move extremities, fall from height, loss of consciousness).
3. Call 911 if the patient is injured, unable to get up safely, or if you are unsure of the severity.
4. If the patient is uninjured and can get up safely, assist them using proper body mechanics (never pull by the arms).
5. Contact your supervisor by phone within one (1) hour.
6. Complete an Incident Report within 24 hours.

3.3 Fire

1. Evacuate the patient if it is safe to do so. Follow the evacuation path identified in the care plan.
2. Call 911.
3. Close doors behind you to slow fire spread.
4. Do NOT re-enter the home.
5. Contact the Noble Care office at (740) 262-9845.
6. Complete an Incident Report within 24 hours.

3.4 You Feel Threatened or Unsafe

1. Leave the premises immediately. Your personal safety is the priority.
2. Call 911 if you are in immediate danger.
3. Contact the Noble Care office at (740) 262-9845.
4. Do NOT return until the situation is assessed and resolved by the Administrator.
5. Complete an Incident Report within 24 hours.

3.5 Medical Emergency (Your Own Injury)

1. Seek medical attention — call 911 if needed.
2. Report the injury to your supervisor as soon as possible.
3. Follow the workers' compensation reporting procedures in Section 7 of this handbook.

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4. Incident Reporting

For comprehensive incident reporting procedures, refer to Policy NC-16 (Incident Reporting and Quality Improvement).

4.1 What Must Be Reported

You are required to report all of the following:

• Patient falls (with or without injury)
• Patient injuries of any kind
• Employee injuries or exposures (needlestick, blood/body fluid exposure, slip/fall, strain)
• Medication errors or adverse reactions
• Behavioral incidents (patient aggression, elopement, self-harm)
• Near misses (events that almost caused harm)
• Equipment failure or malfunction
• Unsafe conditions in a patient's home
• Theft or property damage
• Vehicle accidents during work
• Any event that deviates from the normal course of care

4.2 Reporting Timeline

4.3 How to Report

1. By phone: Call your supervisor or the office at (740) 262-9845
2. In writing: Complete the Incident/Accident Report form
3. Submit the completed form to the office within 24 hours

4.4 Non-Punitive Reporting

Noble Care encourages honest, complete incident reporting. Reporting an incident or near miss in good faith will not result in discipline. The purpose of incident reports is to identify problems, prevent recurrence, and improve care quality. Failure to report an incident IS a policy violation and may result in discipline.

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5. Mandatory Reporting — Abuse, Neglect, and Exploitation

5.1 Legal Obligation

All Noble Care employees are mandatory reporters under Ohio Revised Code Section 5101.61 (Adult Protective Services) and Ohio Revised Code Section 2151.421 (Child Protective Services).

If you know or have reasonable cause to believe that:

• An adult aged 60 or older, OR
• An adult aged 18 or older with a disability

is suffering or has suffered abuse, neglect, or exploitation, you are legally required to report it to the county Department of Job and Family Services (DJFS) Adult Protective Services.

If you know or suspect abuse or neglect of a child (under 18), you are legally required to report it to the county Children Services agency or law enforcement.

This is an individual legal obligation — not just a company policy. Failure to report is a violation of Ohio law.

5.2 Definitions (Per ORC 5101.60)

5.3 Signs to Watch For

• Unexplained bruises, burns, fractures, or injuries
• Sudden changes in behavior, mood, or personality (withdrawal, fearfulness, agitation)
• Poor hygiene, malnutrition, or dehydration without medical explanation
• Unsuitable living conditions (no heat, no food, unsanitary)
• Caregiver (family or other) who is verbally abusive, controlling, or isolating the patient
• Unexplained financial transactions, missing money, or sudden changes to legal documents (wills, powers of attorney)
• Patient expresses fear of a caregiver or family member

5.4 How to Report

1. Call the county DJFS Adult Protective Services hotline for the county where the patient resides. Key county numbers:

2. Simultaneously notify the Noble Care office at (740) 262-9845.
3. For child abuse or neglect, call the applicable county Children Services agency or the statewide child abuse hotline.
4. Your identity as a reporter is confidential under Ohio law (ORC 5101.61(D)).
5. Noble Care will conduct an internal investigation in parallel with any APS investigation.

5.5 Non-Retaliation

Ohio law (ORC 5101.61(E)) protects reporters from retaliation. Noble Care strictly prohibits retaliation against any employee who makes a good-faith report of suspected abuse, neglect, or exploitation. Retaliation is a terminable offense.

5.6 Employee-Perpetrated Abuse

Any Noble Care employee who abuses, neglects, or exploits a patient is subject to immediate termination, criminal prosecution, and reporting to the Ohio Nurse Aide Registry (if applicable) per OAC 3701-18.

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6. HIPAA Compliance Overview

Noble Care is a covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the HITECH Act of 2009. For comprehensive HIPAA policies, refer to Policy NC-04 (HIPAA Privacy and Security).

6.1 Protected Health Information (PHI)

PHI is any individually identifiable health information about a patient, including: names, addresses, dates of birth, Social Security numbers, diagnoses, medications, treatment information, care plans, photographs, and any other information that could identify a patient.

6.2 Your Obligations

• Access only the minimum necessary PHI required to perform your job duties
• Never discuss patient information with anyone who is not authorized — including your own family, friends, other Noble Care patients, or other patients' families
• Never discuss patient information in public places (elevators, restaurants, waiting rooms, parking lots, grocery stores)
• Never post, share, or reference any patient information on social media, personal email, text messages, or any public platform — even without using names
• Never photograph, copy, or remove patient records from authorized locations
• Safeguard physical documents — do not leave records unattended in your vehicle, at home, or in any unsecured location
• Use strong passwords, never share login credentials, and lock devices when unattended (15-minute auto-lock is required on any device accessing patient information)
• Report any known or suspected breach of confidentiality immediately to compliance@noblecareohio.com or (740) 262-9845

6.3 HIPAA Penalties

HIPAA violations can result in:

Your signed Employee Confidentiality & Non-Solicitation Agreement (NC-F-14F) covers client health information, and your duty of confidentiality remains in effect during and after your employment with Noble Care, without time limit.

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7. Vehicle and Transportation Requirements

7.1 Driving Requirements

Employees who drive as part of their duties (traveling between patients, transporting patients, running errands) must maintain at all times:

1. A valid Ohio driver's license — not expired, not suspended, not revoked
2. A clean driving record — defined as:
   • No DUI/OVI convictions in the past five (5) years
   • No more than two (2) moving violations in the past three (3) years
   • No reckless driving convictions in the past three (3) years
3. Current automobile insurance meeting or exceeding Ohio minimum requirements per ORC Section 4509.01:
   • $25,000 per person for bodily injury
   • $50,000 per accident for bodily injury
   • $25,000 per accident for property damage
4. A reliable, safe, clean vehicle — properly registered, inspected, and maintained

7.2 Reporting Driving Record Changes

You must notify the Administrator within 24 hours of any of the following:

• Driving-related arrest or citation (DUI/OVI, reckless driving, hit-and-run)
• License suspension, revocation, or restriction
• Vehicle accident (whether on or off duty)
• Lapse in auto insurance coverage

Failure to report may result in immediate suspension from driving duties and progressive discipline.

7.3 Patient Transportation

You may transport patients only when specifically authorized in the patient's Care Plan. When transporting patients:

• Follow all traffic laws
• Ensure the patient wears a seatbelt
• Do not use your phone while driving (hands-free for emergency calls only)
• Do not eat, drink, or engage in distracting activities while driving
• Drive at safe speeds appropriate for conditions
• Patient must sit in the back seat when possible
• Report any vehicle accident immediately to the police, your supervisor, and the Noble Care office

7.4 Vehicle Accident During Work

If you are involved in a vehicle accident while on duty:

1. Check for injuries — call 911 if anyone is injured
2. Exchange insurance and contact information with the other driver
3. File a police report
4. Contact the Noble Care office at (740) 262-9845 as soon as possible
5. Complete an Incident Report within 24 hours
6. If the accident occurred while transporting a patient, the patient's safety is the first priority

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8. Workers' Compensation Filing

8.1 Coverage

All Noble Care employees are covered by the Ohio Bureau of Workers' Compensation (BWC) for work-related injuries and illnesses. Coverage is automatic — you do not need to sign up.

8.2 How to File a Claim

1. Report the injury to your supervisor within 24 hours
2. Seek medical treatment (inform the provider it is a work-related injury)
3. Noble Care will provide you with a First Report of Injury (FROI) form
4. Noble Care will submit the FROI to the Ohio BWC on your behalf
5. The BWC will assign your claim to a Managed Care Organization (MCO) for medical management

8.3 Your Rights

• You have the right to choose your own treating physician (within the MCO network)
• You have the right to file a claim even if Noble Care disagrees about whether the injury is work-related
• You have the right to appeal claim denials through the Industrial Commission of Ohio
• You are protected from retaliation for filing a workers' compensation claim (ORC 4123.90)

8.4 Contact

• Ohio BWC: 800-644-6292 | bwc.ohio.gov
• Industrial Commission of Ohio: 800-521-2691

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9. Client Rights

Every Noble Care patient has the right to:

1. Be treated with dignity, respect, and courtesy at all times
2. Receive care that is considerate of their personal values, beliefs, cultural background, and preferences
3. Privacy and confidentiality of personal and health information
4. Participate in the development and revision of their Care Plan
5. Be informed about the services to be provided and any changes to those services
6. Refuse any service, treatment, or caregiver without fear of reprisal or discrimination
7. Be free from abuse, neglect, exploitation, and discrimination of any kind
8. Voice complaints and grievances without fear of retaliation
9. Access their own records upon written request
10. Be informed of the agency's charges, payment policies, and billing procedures
11. Be informed of the agency's complaint process and contact information for external agencies

Patients may file complaints with:

You are required to respect and uphold patient rights at all times. Violation of patient rights is grounds for immediate termination.

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10. Documentation Requirements

10.1 Daily Visit Log

You must complete a Daily Visit Log in AxisCare after every patient visit. The log documents:

• Date of visit
• Arrival and departure times
• Tasks performed (linked to care plan)
• Patient condition observations (mood, appetite, mobility, skin, behavior)
• Any concerns, changes, or incidents
• Employee signature

The Daily Visit Log is a legal record of care provided. Incomplete, missing, or falsified visit logs are grounds for discipline up to and including termination.

10.2 Time and Mileage Records

Clock in and out in AxisCare at the point of care for every visit, and record miles driven between patients. Your records for the period must be complete and accurate by the end of each pay period. Record:

• Actual arrival and departure times for each patient visit
• Miles driven between patients
• Any break periods

Report any missed clock-in, device failure, or incorrect visit record to the office the same day so it can be corrected with a documented reason. See Section 2 (Employment Policies) for the full timekeeping policy.

10.3 Incident Reports

Report any incident within 24 hours using the Incident/Accident Report form. Notify your supervisor by phone within 1 hour of any serious incident (see Section 4 above).

10.4 Prohibition on Falsification

Never falsify, alter, backdate, or fabricate any document. This includes visit logs, time records, mileage records, incident reports, clinical records, and any other agency documentation. Falsification of records is grounds for immediate termination and may constitute fraud under Ohio Revised Code Section 2913 and federal law.

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Noble Care Home Health LLC | (740) 262-9845 | hello@noblecareohio.com | noblecareohio.com