Employment Application

Nurses in a group talking together around a table.
Nurses on a computer smiling.

Please complete an application for Tallgrass Healthcare Campus using the application below.

If you prefer, you may download the PDF, fill it out, and then return it to the front desk or scan and email it to administrator@tallgrasshealthcare.org.

Tallgrass Healthcare Campus Application (PDF opens in a new window)
Applicant Name(Required)
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APPLICATION

If you need help filling out this application form or any other phase of the employment process, please notify the person who gave you this form and every effort will be made to accommodate your needs in a reasonable amount of time. Please complete all pages in this form. If more space is needed to complete any question, use an extra sheet of paper. Print clearly and complete all sections, as noted. Illegible or incomplete applications will not be processed.

All qualified applicants will receive consideration without discrimination because of race, color, religion, sex, age, disability, national origin or veteran status.

INTRODUCTION

I want to take this opportunity to personally welcome you to Tallgrass Healthcare Campus. You are applying to be part of a team dedicated to providing a very special service to older adults.

We want you to know that you could be joining a dedicated group of employees who have been providing health care for many years. We are very proud of the fact that several of our employees have extended tenure with the facility…some since our opening in 1973.

Our mission statement is:
We strive to provide the highest standards of care and service at Tallgrass Healthcare Campus.
We strive to enhance the quality of life of all residents by providing an enriching and dignified environment in which to live.
We strive to create an environment for all staff that encourages productivity, teamwork, and communication.
We encourage growth and fiscal responsibility guided by principles of integrity and professionalism.

In order to meet and exceed our mission statement, it is essential that all employees lend their full support and cooperation in following the policies and practices of Tallgrass Healthcare Campus. This mission statement, which is our purpose for existing, is alive and guides this organization’s direction.

STATEMENT OF PHILOSOPHY

It is our philosophy to be supportive and to allow our residents to live as independently as possible, which means to direct his or her own life and to use one's abilities to the maximum.
It is our philosophy to accept the rights of the individual to express him or herself, to assist each individual to maintain a sense of dignity and freedom and to make a continuing contribution to one's surroundings.

The management and staff of Tallgrass Healthcare Campus appreciate your involvement in being a part of this team. The job that you do is essential to our success, and your presence and contribution will help make Tallgrass Healthcare Campus a meaningful place to work.

I want to take this opportunity to personally welcome you to Tallgrass Healthcare Campus. Your commitment to quality of living for our residents is essential to the lives of our residents. I would like to share some of our operating philosophies so there will be no misunderstandings about our expectations for your performance.

1. Talk to each other…not about each other. Please, no sandbagging.
2. Leadership is the solution to all of our problems. Leadership is not indicated by position, but rather by action. Every employee is expected to be a leader in the provision of excellence of care.
3. We are all here to serve others…residents, families, volunteers, visitors, vendors, and coworkers.
4. We must practice declared values individually and corporately, which are our desired behavioral characteristics, to create a healthy living and work environment.
5. No one wants to go to a nursing home…so Tallgrass Healthcare Campus must not be one.
6. This must be “work”, not a “job”. If the work is worthwhile, the employee will be regarded as worthwhile. The leaders of the facility honor and respect the worth of the employees.
7. Our most important “customer” is our residents and their families AND our employees.
8. There is a one-to-one correlation between the manner in which our employees perceive how their supervisor and the company treat them, and the manner in which the employee treats our residents.
9. Good enough is never good enough, if better is possible.

If you don’t think you can work within this philosophy, please do not go any further with this application.

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All qualified applicants will receive consideration without discrimination because of race, color, religion, sex, age, disability, national origin or veteran status.
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Has you License/Certification ever been under review, revoked or suspended because of activity related to patient care or the performance of your duties in your profession?
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Have you been convicted of any crime and/or felony in the last seven (7) years? (this would include any current withstanding court decisions)
Answer these questions only if you have received a copy of the job description or had the requirements of the job thoroughly explained to you:
Have you been given a job description or had the requirements of the job epxlained to you?
Do you understand the requirements?
Can you perform the requirements of this job with or without reasonable accommodations?
If the job requires, do you have an appropriate valid driver's license?
I UNDERSTAND
-That completing this application does not constitute an offer of employment and that my application may be rejected for any reason.
-That giving false or misleading information on this form or in an interview is grounds for denial or immediate termination of employment.
-That I may be required to complete a medical history form and may be required to be examined by a medical professional designated by Tallgrass Healthcare Campus.
-That if I sustain any injury or illness in the employment of Tallgrass Healthcare Campus, I agree that Tallgrass Healthcare Campus shall be entitled to receive full and complete reports and records covering any medical or related exams, and I authorize any and all such doctors, medical examiners, and hospitals to give to Tallgrass Healthcare Campus full and complete reports and records covering such examinations, condition, care, and treatment related to or resulting from the alleged illness or injury.
-That if hired, Tallgrass Healthcare Campus utilizes E-Verify to confirm through the SSA/DHS that I am authorized to work in the United States.
AUTHORIZATION TO RELEASE INFORMATION
If I am given a conditional offer of employment, I authorize Tallgrass Healthcare Campus to make a complete investigation of me, including but not limited to: my past employment history, medical history, scholastic records, criminal records, abuse records, motor vehicle driving records, workers’ compensation history and to rely on such information sources. I authorize all persons and organizations to release any information concerning my background and hereby release all persons and organizations from liability for any damage whatsoever for issuing this information. I acknowledge that a telephone facsimile (FAX) or photographic copy shall be as valid as the original.

By signing below, I certify that I have not been convicted of an offense that would preclude working in a nursing facility. I also certify that I am not excluded from participation in federal health care programs. Furthermore, I understand that I will be subject to a search of the OIG List of Excluded Individuals, and that a comprehensive criminal background screening will be completed by a third party organization acting on behalf of VV. If the findings of that background screening result in a refusal to hire, I will be notified in writing and may request a copy of the findings from the third party organization.

I understand that the use of illegal drugs is prohibited during employment. If employment policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and/or during employment.

I understand that this employment application and any other employee-related documents are not contracts of employment; and that any individual who is hired may voluntarily leave employment upon proper notice, and may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are hereby expressly disavowed and should not be relied upon by any prospective or existing employee.