Welcome Doctors!

March 26, 2012

Welcome to NuHealth,
Congratulations on your acceptance into an internship, residency or fellowship program at Nassau University Medical Center. We are looking forward to you joining our staff. Each of you will be an important member of the health care delivery team.

There are several essential steps in joining the graduate medical education program i.e., completing paperwork, submitting documents and reviewing orientation training materials. We realize that some of the paperwork is redundant, but because of institutional and legal regulations we do require you to complete all of the enclosed. Doing so in an accurate and timely manner will ensure that you can begin your program on July 1st, 2012 and receive your first paycheck on time.

All documents must be returned to the Academic Affairs Department promptly; otherwise, you will not be able to start on July 1. The website is divided into four sections: Academic Affairs, Employment, Benefits and Employee Health.  Please refer to each department’s Checklist to monitor completion of all requirements.

We’re looking forward to seeing you and welcoming you to our institution. Please do not hesitate to contact us:

Academic Affairs: Yanick Joseph, 516-572-5881gmeinfo@numc.edu

Sincerely,

Robert M. Yost
Designated Institutional Official

Maureen Roarty
Senior Vice President of Human Resources

Academic Affairs

Residency/Fellowship Letter of Agreement including the Data Acknowledgement Form must be filled out in its entirety. The contract must be signed and dated.

Personal Data Form – please fill out all requested information.

Moonlighting Affirmation Form – please sign and indicate that you have read the Moonlighting Affirmation.

Consent for Information Release Form – provides consent to release information to authorized representatives free of liability.

LDSS-3370 – State-wide central registry. To be filled out only for incoming residents in Pediatrics, Osteopathic and Psychiatry programs. Instructions are attached to the form.

Life Support Training Registration for BLS, ACLS– this training will be provided during orientation, but if you are already certified, please provide us with copies of the cards.

Occupational Health

Orientation at a Glance

NPI Number

Academic Credentials/Residents Checklist

Laundry Uniform Request/Linen Services – You will be getting 3 lab coats and 3 pairs of scrubs. The color choices for the scrubs are based on your program. All Sizes are Men’s Sizes (see chart below). Request for Special sizes may take longer time to process.

To figure out your body measurements please do the following: for bust/chest measure around the fullest part of your bust/chest, for waist- measure at what you consider to be your natural waistline(where pants would sit on you), for hips - measure across the fullest part usually about 8" down from your natural waist. Inseam for pants is best measured if you measure an existing pair of pants - measure from the crotch area down the inside seam to the hem. Top/jacket/dress/vest length is found by measuring from your shoulder by your neck straight down the front to wherever you want the garment to end.

Employment Application

Nassau County Civil Service Application - Please complete the application form as well as the other forms included in the application.

Nassau Health Care Employment Application – Yellow and Orange forms will be mailed to you separately.

• Confidential Supplement to Employment Application [Yellow Form]
• Authorization for Release of Medical Records [Yellow Form]
• Fair Credit Report Act – Background Investigation [Orange Form]
• Background Screening Information [Orange Form]

Form I-9, Employment Eligibility Verification Form – The purpose of this form is to document that each new employee both citizen and noncitizen hired after November 6, 1986 is authorized to work in the United States.

Section 1 – to be completed and signed by you. Providing the Social Security Number is voluntary; however, NUMC requires a social security card at the time of your employment.

Section 2 – DO NOT FILL OUT SECTION 2. THIS SECTION WILL BE COMPLETED BY NASSAU UNIVERSITY MEDICAL CENTER.

IT 2104 NYS Department of Taxation and Finance – Complete this form so that your employer can withhold the correct federal income tax from your pay.

W4 Form Employee Withholding Allowance Certificate

Nassau Health Care Corporation General Information – We require the information in accordance with Federal requirements.

Marital & Family Status Information Form – please complete and sign this form in order to insure that fringe benefits are properly activated.

Nassau Health Care Corporation Direct Deposit Form - To enroll in Full Service Direct Deposit, simply fill out this form and return to us.  Attach a voided check for each checking account - not a deposit slip.

Nassau Health Care Corporation Confidential Policy

CSEA Application for Membership

Information Regarding Group Disability Insurance

New York State Retirement System Membership

Constitutional Pledge

Reserve and National Guard Status

Residents Employment Checklist

Health Insurance Benefits

The Nassau University Medical Center provides health benefits to its residents. Health Insurance coverage becomes effective July 1. Please see the Insurance Rate Schedule (this schedule changes every year).

Medical Benefits*: You can select one of the three Medical Insurances listed below:

• New York State Health Insurance Empire Plan Enrollment Form and Summary of Benefits
• HIP Prime HMO Enrollment and Summary of Benefits
• HIP Vytra Premium Network Enrollment Form and Summary of Benefits

Vision Benefits: You will be automatically enrolled under Davis Vision Plan.

• Davis Vision – www.davisvision.com

Dental Benefits

• DentCare Delivery Systems, Inc. Enrollment Form
• DentCare Explanation of Group Benefit
• Dental Managed Care Program

**Health Benefit Buyback Program** - For Residents who can demonstrate and attest to having other employer-sponsored group health insurance may elect to opt out of NYSHIP’s Empire Plan or Health Maintenance Organizations.

Health Insurance Buyback Program Application

Health Benefits Guidelines/Checklist

Health/Dependent Care Flexible Spending Account Enrollment Form

2012 Flexible Spending Memo

Health Insurance Fact Sheet

Health Insurance Option – provides you information about the different insurance options.

List of Acceptable Documents

OTHER IMPORTANT INFORMATION

Be sure to have the following documents available when you attend the orientation.

Visa documentation must be included for all foreign residents. Lack of valid immigration documentation by July 1 will at the very least delay both your paycheck and your employment start date. If you do not yet have a social security number, please leave blank.

*Documents must be translated in English. These items are essential to enroll in health, dental and optical insurance plans and most importantly, to receive a paycheck.

Employee Health

To all incoming Resident Physicians.

You are required to have a pre-employment physical prior to starting your residency at NUMC.

We are required to evaluate your immunity status for the following:

1. Measles, Mumps, Rubella and Varicella
2. Hepatitis B
3. Tetanus status
4. 2-step TST (PPD) is required (or a chest x-ray if you are TST positive)

These services will be provided in Employee Health at the time of your exam, there is no need to obtain these tests prior to coming to NUMC. If you had these tests performed and the results are available to you, bring the information with you at the time of your pre-employment physical.

The following information, if available, will be useful:

Employee Health Services will be processing a large number of incoming residents. To ensure the process is complete prior to the beginning of the Residency Orientation Program please present to Employee Health before June 21, 2012. If you present after this, your entrance process may be delayed.

Employee Health is located in room MP 132 and is open M-F from 8:00 am to 4:00 pm.

Thank you.

Employee Health services