Phone: 660.265.4212

630 W 3rd Street Milan, MO 63556

We appreciate your interest in joining us as an employee at Sullivan County Memorial Hospital (SCMH). Before you complete an application, we would like you to take a few minutes to review the following information regarding employee competencies. We believe the accomplishment of these competencies is critical for your success at SCMH. All employees at SCMH are expected to successfully meet the following nonnegotiable expectations:

1. Service Excellence: It is an SCMH expectation that every employee provides excellent customer service. At Sullivan County Memorial Hospital, we put the customer first. A customer is defined as a patient, visitor, co-worker, medical staff, vendor or any other person you come in contact with at SCMH. This is done by creating enthusiastic customer loyalty by exceeding the needs and expectations of all customers. The customer measures this by; a.) Does the person who is helping me care about me? b.) Are they responsive to my needs/requests? c.) Did they give me the information I needed? In order to exceed the customer’s needs and expectations, you will be expected to:

• Be courteous in all contacts with people at SCMH;
• Have a desire to work in health care;
• Remain positive and create enthusiastic customer loyalty by exceeding the needs and expectations of all customers;
• Maintain customer confidentiality; and,
• Communicate effectively both verbally and nonverbally.

2. Business Results: As an SCMH employee, you will be expected to exhibit pride in your work and the service you provide. You will be expected to:

• Show good judgment in your job performance;
• Realize that no matter what job you have, you have an impact on patient care and the image of
SCMH; and,
Be committed to continuously improving the quality of work at the lowest possible cost.

3. Change Management: Change is a major part of the life of an SCMH employee. In order to adapt to change, you will need to be willing to learn new skills – and be willing to grow in your current abilities. You will be expected to:

• Try new tasks as opportunities arise;
• Ask for training if you do not know how to do a task;
Remain flexible and adaptable to change.

4. Leadership: Every SCMH employee is expected to be a leader in continuous improvement by participating as a team player. As a team player, you will be expected to:

Communicate effectively with others to meet total customer needs;
• Improve processes by creatively solving problems;
Learn from individuals from other cultures and backgrounds;
• Treat co-workers and employees in other departments with respect;
• Pitch in and help other employees when they need help;
• Participate in Quality Improvement (QI) activities.

5. Strategic Thinking: An SCMH employee is responsible for continuously finding ways to enhance their skills to meet the needs and expectations of our customers: You will be expected to:

• Demonstrate technical knowledge;
• Maintain excellent job skills.

6. Personal Accountability: All employees are expected to present an appropriate demeanor that meets
Sullivan County Memorial Hospital’s standard of excellence. You will be expected to:

• Present a clean and neat appearance and dress appropriately to hospital and department standards;
• Communicate and act in an open, honest, and trustful manner;
• Have a ‘can-do’ attitude;
Take responsibility for learning and developing;
• Be in attendance and on time for the days you are scheduled to work.

Note: After reading these expectations, if you are interested in becoming an employee at Sullivan County Memorial Hospital, we invite you to complete the attached application.

APPLICANT TO COMPLETE ALL INFORMATION REQUESTED.

In compliance with Federal and State employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status disability or any other protected group status.


APPLICATION FOR EMPLOYMENT


GENERAL


LIST ALL PRESENT AND PAST EMPLOYMENT, BEGINNING WITH MOST RECENT




Work References



Special Skills

Please check the skills for which you have received training

** SCMH reserves the right to test candidates for employment and employees, randomly or for cause for nicotine.

Please Read Carefully Before Signing Below

This application shall remain active for 180 days. After 180 days, if you are still interested in employment at Sullivan County Memorial Hospital, you must fill out a new application.

I hereby certify that the information given by me in this application is true and correct to the best of my knowledge. I understand and agree that any false information, misrepresentation or omission of facts in this application and the application process may be justification for refusal to hire or immediate termination of employment without recourse. I further understand and agree that all information furnished in this application and the application process may be verified by Sullivan County Memorial Hospital.

I authorize all employers, schools, persons and organizations having relevant information and knowledge of my employment, work habits, character and any criminal or other relevant records to provide it to Sullivan County Memorial Hospital or its duly authorized representative for its use in deciding whether or not to offer me employment and specifically waive any required written notification. I hereby release such employers, schools, persons, organizations and Sullivan County Memorial Hospital from all liability for any claims or damage which may result.

I further understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Sullivan County Memorial Hospital and me for either employment or for the providing of any benefit. If an employment relationship is established, I agree to comply with the rules and regulations of Sullivan County Memorial Hospital and further understand and agree that my employment and compensation can be terminated at any time, with or without cause or notice, at the option of either Sullivan County Memorial Hospital or myself.

Further, if granted a position with Sullivan County Memorial Hospital, I also agree to submit to a medical history report and physical examination, which includes drug testing, provided by Sullivan County Memorial Hospital, and understand that my employment is conditional on satisfactorily passing the examination.

To comply with the Immigration Reform and Control Act of 1986, if you are hired you will be required to provide documents to establish your identity and your authorization to be employed in the United States. Such documents will be required at the time of your new employee orientation.

A PHOTOCOPY OF THIS APPLICATION IS TO BE CONSIDERED AS VALID AS THE ORIGINAL.