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B1 NURSING CARE

A Service of B1 Healthcare Solutions

Main Office: 1910 Lakeland Dr., Ste. C, Jackson, MS 39216

Satellite Office: 3100 Cottage Hill Rd., Building 5, Office 115, Mobile, AL 36606

Phone: 769-572-7207 | Fax: 606-510-4844

EMPLOYMENT APPLICATION PACKETS

Welcome
Thank you for your interest in joining B1 Nursing Care. We are honored to serve our clients and their families, 
and we are looking for compassionate, dependable team members who share that commitment. Please complete
every section of this packet fully and honestly. Incomplete applications may delay consideration.

 

What to Include
          • This completed application packet (all pages), signed and dated.
          • A current resume, if available.
          • Copy of a valid government-issued photo ID.
          • Copies of any certifications or licenses relevant to the position (e.g., CNA, CPR/First Aid), if applicable.
B1 Nursing Care is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, 
religion, sex, national origin, age, disability, genetic information, or any other status protected by law. 
Employment is at-will and contingent upon successful completion of background screening and preemployment drug and alcohol testing.

Section 1 - Personal Information

Multi-line address
Are you 18 years of age or older?
Are you legally authorized to work in the United States?
Do you have a valid driver's license?
State

Section 2 - Position & Availability

Employment type desired:

Date available to start:
Month
Day
Year

Days/hours you are available (check all that applies)

Are you willing to travel to clients in surrounding areas?
Do you have reliable transportation?
Section 3 -- Education & Certification

Certifications / licenses held (check all that apply):

Section 4 -- Employment History

List your most recent employers first. Include any caregiving or healthcare experience.

Employer 1

May we contact this employee?

Employer 2

May we contact this employee?

Employer 3

Date from & to:
May we contact this employor?

Section 5 -- Professional References

Please list at least two professional references who are not relatives

Section 6 -- Pre-Employment Questions

A “yes” answer will not necessarily disqualify you from employment; each situation is considered individually

and in accordance with applicable law.

Have you ever been convicted of a crime? (excluding sealed/expunged records)
Can you perform the essential functions of the position, with or without reasonable accommodation?
Are you able to lift and assist clients as required by the position?

Section 7 — Applicant Certification & Authorizations

Please read each statement carefully and sign below. Your signature indicates your understanding and

agreement.

Certification of Accuracy

I certify that the information provided in this application is true, complete, and accurate to the best of my

knowledge. I understand that any false statement, omission, or misrepresentation may disqualify me from

consideration or, if discovered after hire, result in termination of employment.

Background Check Authorization.

I authorize B1 Nursing Care to verify the information in this application, including contacting my references

and former employers, and to conduct a criminal background check and any screening required for the position

for which I am applying.

Drug & Alcohol Testing Consent.

I understand that B1 Nursing Care maintains a drug-free workplace and that employment is contingent upon

successfully passing pre-employment drug and alcohol testing. I consent to such testing in accordance with

company policy.

At-Will Employment.

I understand that, if hired, my employment is at-will, meaning that either I or B1 Nursing Care may end the

employment relationship at any time, with or without cause or notice. I understand that this application is not a

contract of employment.

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Section 8 — Transportation Policy & Acknowledgment

Transporting clients is not a required job duty and is generally not permitted. Employees may transport a client

only with prior written authorization from B1 Nursing Care. Where transportation occurs, the following applies

and the employee acknowledges and agrees:

• The employee will not transport any client in a personal vehicle without prior written authorization from B1

Nursing Care.

• The employee must maintain a valid driver's license and personal automobile liability insurance meeting or

exceeding state minimum requirements at all times while employed.

• The employee's personal automobile insurance is the primary and sole coverage for the operation of the

employee's personal vehicle. B1 Nursing Care does not insure employees' personal vehicles and provides no

coverage for their use.

• The employee is solely responsible for the safe operation of any vehicle he or she drives, and assumes full

responsibility for any traffic violations, accidents, injuries, or property damage arising from the employee's

operation of a personal vehicle.

• The employee agrees that B1 Nursing Care is not responsible or liable for claims, damages, or losses arising

from the employee's operation of a personal vehicle.

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Section 9 — Safe Lifting & Client Handling Policy & Acknowledgment

B1 Nursing Care is committed to the safety of both clients and staff. Safe client handling protects everyone. By

signing below, the employee acknowledges and agrees to the following:

• The employee will use proper body mechanics and all provided assistive or mechanical lifting equipment

when moving, transferring, or repositioning a client.

• The employee will not attempt any lift, transfer, or task that exceeds safe limits or that the employee cannot

perform safely alone, and will request additional assistance or equipment when needed.

• The employee will follow each client's written plan of care and will not perform any lift or transfer prohibited

by that plan.

• The employee will complete any required safe-handling training before performing client transfers.

• The employee will immediately report to a supervisor any unsafe condition, any inability to safely perform a

task, and any injury — to the employee or the client — no matter how minor.

The employee understands that performing an unauthorized or unsafe lift in violation of this policy is grounds

for disciplinary action, up to and including termination. The employee agrees to assume personal

responsibility for injuries or damages that result from the employee's failure to follow this policy or from

performing tasks outside the assigned plan of care.

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Section 10 — General Policy Acknowledgment & Assumption of Responsibility

By signing below, the employee acknowledges and agrees to the following:

• The employee has received, read, and understands B1 Nursing Care's policies, including the Drug & Alcohol

Use Policy, Infectious Disease Control Policy, Transportation Policy, and Safe Lifting & Client Handling

Policy, and agrees to comply with all company policies as a condition of employment.

• The employee agrees to perform only those duties assigned and authorized by B1 Nursing Care, and to follow

each client's plan of care.

• The employee assumes full personal responsibility for his or her own acts, omissions, and conduct that occur

outside the scope of assigned duties or in violation of company policy, and agrees to hold B1 Nursing Care

harmless for any such acts, omissions, or conduct.

• The employee agrees to promptly report any incident, injury, accident, or unsafe condition in accordance with

company procedures.

Nothing in this acknowledgment waives any right or remedy provided to the employee under applicable

workers' compensation law or other law, or alters the at-will nature of employment.

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Company Policies:


The following policies apply to all employees of B1 Nursing Care as a condition of employment. Please read each policy carefully and sign the Policy Acknowledgment that follows. Violation of any policy may result in disciplinary action, up to and including termination and, where applicable, referral to law enforcement.



Section 11 — Theft Policy



B1 Nursing Care maintains a zero-tolerance policy toward theft. Employees may not take, misuse, or remove any property that does not belong to them, including property of the company, its clients, client family members, or coworkers.



• Prohibited theft includes, without limitation: money or valuables; medications or medical supplies; food or household goods; equipment or company property; and a client's or coworker's personal belongings.


• Time theft is prohibited, including falsifying time records, clocking in for another person, or billing time not actually worked.


• Unauthorized use of a client's or the company's property, funds, credit cards, or accounts is theft.



Any employee who commits theft is subject to immediate termination and may be reported to law enforcement for criminal prosecution. Suspected theft must be reported to a supervisor immediately.



Section 12 — No Weapons Policy



To protect the safety of clients, families, and staff, B1 Nursing Care prohibits employees from carrying, possessing, or using any weapon while performing job duties.



• Employees may not possess or carry firearms, knives (other than ordinary tools required for a task), or any other weapon while providing services in a client's home, in any company office or facility, or while otherwise on duty.


• Brandishing, threatening with, or using any object as a weapon is strictly prohibited and is grounds for immediate termination.


• This policy does not prohibit an employee from lawfully transporting or storing a firearm within a locked, privately owned motor vehicle, consistent with Mississippi law.



Violation of this policy is grounds for immediate termination and may be reported to law enforcement.




Section 13 — Anti-Hostility & Workplace Violence Policy



B1 Nursing Care is committed to a workplace free of hostility, violence, harassment, and intimidation. Every client, family member, coworker, and supervisor is to be treated with respect.



• Prohibited conduct includes threats, intimidation, verbal or physical aggression, bullying, hostile or abusive language, and any act or threat of violence toward clients, families, coworkers, or the public.


• Harassment of any kind — including sexual harassment or harassment based on race, color, religion, sex, national origin, age, disability, or other protected status — is prohibited.


• Retaliation against anyone who reports a concern in good faith is prohibited.



Employees who experience or witness hostile, threatening, or violent behavior must report it to a supervisor or the Compliance Director immediately. Threats or acts of violence are grounds for immediate termination and may be reported to law enforcement.




Section 14 — HIPAA & Confidentiality Policy



B1 Nursing Care complies with the Health Insurance Portability and Accountability Act (HIPAA) and protects the privacy and security of all protected health information (PHI). Client information is strictly confidential.



• Employees may access and use client information only as necessary to perform their assigned duties (the “minimum necessary” standard).


• Employees may not disclose any client's PHI to anyone not authorized to receive it, including family, friends, or other clients.


• Client information must never be posted or discussed on social media, text, email, or any public forum.


• Written and electronic records must be kept secure; devices must be protected; and records must not be left where others can view them.


• Suspected privacy breaches must be reported to the Compliance Director immediately.



The obligation to protect client confidentiality continues after employment ends. Violations may result in termination and civil or criminal penalties under federal law.




Section 15 — Company Rights & Employment Provisions (State of Mississippi)



Employment with B1 Nursing Care is governed by the laws of the State of Mississippi. The employee acknowledges and agrees to the following:



• At-Will Employment. Mississippi is an at-will employment state. Employment may be ended at any time, with or without cause or notice, by either the employee or the company. No policy or document creates a contract of employment or guarantees employment for any period.


• Right to Work. Mississippi is a right-to-work state; employment is not conditioned on membership or nonmembership in any labor organization.


• Management Rights. The company reserves the right to assign, schedule, and reassign work; to establish, modify, and enforce policies, procedures, and job requirements; and to determine staffing, pay, and business operations.


• Screening & Testing. The company reserves the right to require background checks and pre-employment and ongoing drug and alcohol testing, within the limits of applicable law.


• Right to Modify. The company reserves the right to revise, add to, or discontinue any policy at any time, with or without notice.



Nothing in these policies waives any right or remedy provided to the employee under applicable Mississippi or federal law.




Section 16 — No Cash or Gifts From Clients Policy



To protect both clients and employees and to prevent any appearance of exploitation, B1 Nursing Care prohibits employees from receiving money or gifts from clients or their families.



• Employees may not accept cash, tips, gifts, loans, or items of value from clients or their families.


• Employees may not borrow money or property from a client, lend money to a client, or enter into any financial transaction with a client.


• Employees may not use a client's money, checks, credit cards, or accounts except as specifically authorized in the plan of care for the client's own needs, with proper documentation and receipts.


• Employees may not accept being named as a beneficiary, heir, or recipient in a client's will, insurance, or estate, and may not solicit or accept property from a client.


If a client or family attempts to give an employee money or a gift, the employee must respectfully decline and report it to a supervisor. Violation of this policy is grounds for termination and may be reported to the appropriate authorities.




Policy Acknowledgment



I acknowledge that I have received, read, and understand the following policies of B1 Nursing Care, and I agree to comply with each of them as a condition of my employment: Theft Policy; No Weapons Policy; Anti-Hostility & Workplace Violence Policy; HIPAA & Confidentiality Policy; Company Rights & Employment Provisions (State of Mississippi); and No Cash or Gifts From Clients Policy.I understand that violation of any of these policies may result in disciplinary action, up to and including termination of employment and, where applicable, referral to law enforcement.



I understand that my employment is at-will and that these policies do not create a contract of employment.

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1910 Lakeland Dr., Jackson, MS

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