• A Caring Connection Onboarding Application

    Please complete all of the required fields for onboarding
  • All fields in this application are required. If a field does not apply to you, please fill it in with the term N/A for not applicable. If you have any questions while filling out this form you can contact A Caring Connection's main office during office hours, (M-F from 9AM-5PM) at 908-232-6484 or email accoffice@acccares.net. You may save your progress throughout your application progress by clicking on the "Save" button at the bottom of this page. Note: saved progress may only be saved for a few days.
  • IMPORTANT: Be sure to have all your personal documents available electronically before starting this application, see below.

  • Items you will need to have scanned and available electronically in order to complete this form:

    • Social security number or Alien number
    • A copy of your most recent physical
    • A copy and dates of your current vaccines
    • A copy of your nursing license or aide certification
    • A copy of your CPR certification(s) and any other certifications, i.e., IV certs, wound care, etc
    • A copy of your resume
    • Contact information to Employers and personal references
    • A copy of your drivers license
    • A copy of your malpractice insurance
    • Acceptable identification documents needed for payroll, i.e., passport, social security card, school ID, etc. See I-9 below for more details.
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  • RN, LPN or CHHA license/certificate information:
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  • Emergency contacts

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  • State required physical and immunization records

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  • Education, work experience and references



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  • Clinical experience

    Check all that apply
  • Work experience

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  • Personal references

    Ex: former employer, minister, teacher, or someone with good standing in the community.
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  • If needed, copy and send this link to any of your references
    so they can complete and send to ACC for recording purposes.

    ACC Employee Reference Request - https://hipaa.jotform.com/220775663045155

  • Criminal background check

    You will not be denied employment based solely on your following answers
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  • Driver's license and other insurance information

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  • ACC strongly suggests that all professional nurses carry their own insurance. You may call or go on line, NSO Nurses Service Organization to obtain/purchase your malpractice insurance.

  • Nurse clinical test

    Please click on the link below to launch a brief nurse clinical test. Please acknowledge that you completed the test below.
  • Click here to open the nurse clinical test

  • Employee handbook

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  • It's required that you download a copy of the employee handbook to keep for your personal files and reference. Download here

  • Job descriptions

    The following are three job descriptions that pertain to this employee application. Please sign the job description that you are applying for to help us ensure you are aware of the job responsibilities of this position.
    • Territory Nurse Supervisor 
    • Territory Nurse Supervisor

      The Territory Nurse Supervisor will oversee a team of nurses who provide highly skilled home healthcare services to our patients. The Territory Nurse Supervisor will evaluate the field nurses upon visit to grade their quality of care, attention to detail and recording of visit notes. The Territory Nurse Supervisor duties will also include training and mentoring the nursing staff and consulting on patient care plans.

      Staff management:

      • Management of field staff which includes (RNs, LPNs and Aides).
      • Address staff concerns.
      • Complete performance evaluations for staff.
      • Perform orientations and teaching the staff on trach, ventilator and g-tube patients.
      • Oversee the quality of nurse note submission.

      Client management:

      • Create and/or maintain all patient clinical charts:
        • Care plans
        • Medication documentation
        • 485 physician signatures
      • Visit each nurse and patient every 30 days.

      General duties and responsibilities:

      • Ensure patient short and long term goals are being met.
      • Communicate with staff and department heads.
      • Keep and organize records of the patient list through our online clinical software.
      • Solve any problems patients might have on site.
      • Ensure agency quality assurance.
      • Listening to the concerns of family members and answering their questions.

      Required skills:

      • Current RN license in good standing.
      • Experience in home healthcare or public health nursing preferred.
      • A completed apprenticeship or experience in a similar role.
      • Excellent observational and problem-solving skills.
      • The ability to follow instructions but also to act independently where necessary.
      • Excellent reporting and writing skills.
      • Active listening skills and empathy.
      • Physical and mental strength.
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    • Registered Nurse 
    • Licensed Registered Nurse

      Position Scope:
      • To ensures quality and safety delivery of home health services for assigned clients
      • To assist in the provision of home health care services that reflect agency philosophy and standards in the care of assigned clients.
      • To ensure provide adequate qualifications to service those patients that fall under various levels of care, including, but not limited to high-tech nurses.
      • Position Qualifications:
      • Graduate of an accredited School of Practical Nursing required
      • Those LPN's who service high tech cases must have evidence of high tech skills or education, not limited to, but including such experience as vent, pediatric, ER, or acute care.
      • Current licensure as a Practical Nurse with the New Jersey with the New Jersey Board of Nursing required.
      • Experience in home health care preferred
      • Good verbal and written skills required.

      Physical Requirements:
      • Visual/hearing ability sufficient to comprehend written/verbal communication.
      • Ability to perform tasks involving physical activity, which may include heavy lifting and
      • Extensive bending and standing.
      • Ability to deal effectively with stress.

      Performance Responsibilities:
      • To ensure quality and safe of practical nursing services provided to assigned clients
      • Complies with agency policies and procedures
      • Fulfills assignments as scheduled by the agency.
      • Physician orders are accurately implemented
      • Provides practical nursing services to assigned clients that are in accordance with the Individual’s plan of care.
      • Client clinical record documentation is completed in a timely manner and accurately reflects delivery of practical nursing services
      • Accurately reports observations of client condition to the Registered Nurse in a timely manner
      • Communicates information regarding the client to appropriate individuals.

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    • Licensed Practical Nurse 
    • Licensed Practical Nurse

      Position Scope:
      • To ensures quality and safety delivery of home health services for assigned clients
      • To assist in the provision of home health care services that reflect agency philosophy and standards in the care of assigned clients.
      • To ensure provide adequate qualifications to service those patients that fall under various levels of care, including, but not limited to high-tech nurses.
      • Position Qualifications:
      • Graduate of an accredited School of Practical Nursing required
      • Those LPN's who service high tech cases must have evidence of high tech skills or education, not limited to, but including such experience as vent, pediatric, ER, or acute care.
      • Current licensure as a Practical Nurse with the New Jersey with the New Jersey Board of Nursing required.
      • Experience in home health care preferred
      • Good verbal and written skills required.

      Physical Requirements:
      • Visual/hearing ability sufficient to comprehend written/verbal communication.
      • Ability to perform tasks involving physical activity, which may include heavy lifting and
      • Extensive bending and standing.
      • Ability to deal effectively with stress.

      Performance Responsibilities:
      • To ensure quality and safe of practical nursing services provided to assigned clients
      • Complies with agency policies and procedures
      • Fulfills assignments as scheduled by the agency.
      • Physician orders are accurately implemented
      • Provides practical nursing services to assigned clients that are in accordance with the Individual’s plan of care.
      • Client clinical record documentation is completed in a timely manner and accurately reflects delivery of practical nursing services
      • Accurately reports observations of client condition to the Registered Nurse in a timely manner
      • Communicates information regarding the client to appropriate individuals.

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    • Home Health Aide 
    • Home Health Aide

      Summary
      Responsible for providing care for people confined to their homes due to being disabled, cognitively impaired, or chronically ill. Cares for elderly people who prefer to remain in their home as opposed to health facilities or institutions. Applicants are considered appropriate for hire after the agency is satisfied that the potential employee can treat clients with respect, consideration, individuality and personal property. This can be satisfied by reference checks before start of employment, have provided evidence that they have met the standards of the Board of Nursing, are certified in good standing and have passed their application requirements.

      Primary responsibilities:
      • Provide healthcare in someone's residence.
      • Assist people in hospices and day programs.
      • Go to same home or homes every day or months or even years.
      • Work under direct supervision of a nurse.
      • Keep records of services performed.
      • Record and note clients' condition and progress.
      • Report changes to case manager.
      • Check patient's pulse rate, temperature, and respiration rate.
      • Perform prescribed exercises and other physical therapy.
      • Remind patient to take medications.
      • Change dressings.
      • Turn or ambulate patient.
      • Provide skin care.
      • Massage limbs.
      • Assist with braces and artificial limbs.
      • Assist with medical equipment.
      • Ensure equipment is functioning properly.
      • Replace batteries on equipment.
      • Prepare food and feed patient.
      • Provide counseling on diet and exercise.
      • Implement behavior plans.
      • Teach self-care skills.
      • Perform light housekeeping.
      • Provide patient with groceries.
      • Pick up medication.
      • Transport patient to doctors' office or hospital.
      • Signs and dates documents such as necessary per policy manual standards, Best Practices, accrediting agencies and federal/state regulations

      Organizational Relationship:
      The position of Home Health Care Certified Home Health Aide reports to the Director of Nursing

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    • Handbook summary

      1. Your shift clock in/clock out must be submitted online via our Alayacare clinical management software.
      2. Nurses notes must be submitted online via our Alayacare clinical management software.
      3. Care plans, vent sheets, and MARS sheets should be dropped at the office monthly or coordinated for pickup with Nurse Supervisor.
      4. Any changes in patient's care must be submitted daily to your Nurse supervisor.
      5. A Caring Connection reserves the right to deduct a penalty and hold pay for any employee that does not abide by the agency polices specified above and in the employee handbook.
    • Initial all below and sign your name

    • * I have received the entire handbook, and have had a full explanation of all agency policies, forms, and expectations. I agree to fulfill my obligations in a professional manner at all times. 

    • * I have signed the office permission documents that will be used to obtain references, NJ Central Registry of Offenders. 

    • * I understand the Right to Privacy Policy as explained in the right to know area with only the exception of Abuse and Neglect (HIPPA Guidelines).

    • * I understand the expense plan.

    • * I understand the Caregiver Agreement.

    • * I have received the required annual in-service education including initial orientation and annual education on:
      ·      Complaints & Grievances
      ·      Emergency disaster training
      ·      Clients/patients right and responsibilities
      ·      Ethics training
      ·      Workplace and client/patient safety (OSHA)
      ·      Compliance Program

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    • Payroll and tax information

    • Below is the informaiton needed for payroll and tax benefits. First download the employee I-9 form. Once completed, scan and upload your I-9 form below along with any unexpired acceptable identification documents seen on page 3 of the I-9 form. Download I-9 form here. 

      Once we recieve all of the required documentation needed for payroll, you will recieve an email requesting bank information, routing information and tax withholding selections directly from our payroll company.

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