LPN Total number of positions needed: 1 All of the info below must be completed before I can open the req. 1. Who will be the DOO approving the contractors time each week? Raymond Boggs 2. What is the iCIMS req # corresponding to this requisition? iCIMS 2025-35539 3. How long is the contract assignment? 13 weeks is the norm: 13 weeks 4. Schedule of assignment hours? M – F 8am – 5pm? Yes 5. Will there be any weekend rotation? If so, how often? One a month 6. Will there be any on call? If so, how much? One week a month. We do have a triage RN to take the calls and LPN only goes out if the triage RN cannot solve the issue over the phone. 7. What region are you in? Home health or Hospice? HH 8. What territory this contractor will be asked to cover? Harrisonburg and 50 mile radius. 9. What’s creating the request? - work load Ect.. Work load and staffing 10. 11. Which location will this person report to for their assignment- add info below Full address: 729 Richmond Ave apt B, Staunton VA 24401 OU# (location code) 1721 12. About how many miles per week will the contractor travel? 13. What are the weekly units of productivity expectations? Ex: 25/30 ? 32 14. What EMR systems will the consultant be using: HCHB 15. Do you want the candidate to have experience in have home health, hospice or both ? HH

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