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  1. <?php
  2. error_reporting(1);
  3. ini_set('error_reporting', 1);
  4. ini_set('display_errors', true);
  5. $data = array();
  6. ?>
  7. <!DOCTYPE html>
  8. <html>
  9. <head>
  10. <title>Hospice HR</title>
  11. <meta charset="utf-8">
  12. <meta name="viewport" content="width=device-width, initial-scale=1">
  13. <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.0.0-beta.2/css/bootstrap.min.css">
  14. </head>
  15. <body>
  16. <header>
  17. <div class="jumbotron text-center">
  18. <h5>Update Employees</h5>
  19. <p><?php echo date("F j, Y");?></p>
  20. </div>
  21. </header>
  22. <div class="container-fluid">
  23. <nav class="navbar navbar-expand-sm bg-primary navbar-dark">
  24. <!-- Brand/logo -->
  25. <a class="navbar-brand" href="index.php">Employees</a>
  26.  
  27. <!-- Links -->
  28. <ul class="navbar-nav">
  29. <li class="nav-item">
  30. <a class="nav-link" href="logout">Log Out</a>
  31. </li>
  32. </ul>
  33. </nav>
  34.  
  35. <?php
  36. require("qwe.php");
  37. $db = new dbconn();
  38.  
  39. $get_id = $db->safe($_GET["id"]);
  40.  
  41. $idc = $db->con->query("SELECT * FROM hospicestaff WHERE id='{$get_id}'");
  42.  
  43. $data = $idc->fetch_assoc();
  44.  
  45. if($idc->num_rows<1)
  46. {
  47. header("refresh:1; url=employer.php");
  48.  
  49. }
  50.  
  51.  
  52. if(isset($_POST["update"]))
  53. {
  54. $line = $_POST["line"];
  55. $fname = rtrim($_POST["fname"]);
  56. $lname = rtrim($_POST["lname"]);
  57. $phone = $_POST["phone"];
  58. $email = $_POST["email"];
  59. $hourly = $_POST["hourly"];
  60. $eval = $_POST["eval"];
  61. $missed_visit = $_POST["missed_visit"];
  62. $death_visit = $_POST["death_visit"];
  63. $oncall_outofarea = $_POST["oncall_outofarea"];
  64. $trip_pay = $_POST["trip_pay"];
  65. $visit_outofarea = $_POST["visit_outofarea"];
  66. $over_time = $_POST["over_time"];
  67. $eval_ooa = $_POST["eval_ooa"];
  68. $reassessment = $_POST["reassesment"];
  69. $follow_up = $_POST["follow_up"];
  70. $on_call_weeknight = $_POST["on_call_weeknight"];
  71. $rip_pay_ooa = $_POST["rip_pay_ooa"];
  72. $hh_eval = $_POST["hh_eval"];
  73. $hh_follow_up = $_POST["hh_follow_up"];
  74. $resume = $_POST["resume"];
  75. $interviewsummary = $_POST["interviewsummary"];
  76. $telreference = $_POST["telreference"];
  77. $bgcheck_auth = $_POST["bgcheck_auth"];
  78. $bgcheck = $_POST["bgcheck"];
  79. $sexoffender = $_POST["sexoffender"];
  80. $oig = $_POST["oig"];
  81. $employment_verification = $_POST["employment_verification"];
  82. $equal_employment = $_POST["equal_employment"];
  83. $emergency_contact = $_POST["emergency_contact"];
  84. $i9 = $_POST["i9"];
  85. $w4 = $_POST["w4"];
  86. $offer_letter = $_POST["offer_letter"];
  87. $statements = $_POST["statements"];
  88. $payroll_sheet = $_POST["payroll_sheet"];
  89. $computer_key = $_POST["computer_key"];
  90. $hipaa = $_POST["hipaa"];
  91. $confidentiality = $_POST["confidentiality"];
  92. $bill_of_rights = $_POST["bill_of_rights"];
  93. $elderly_report = $_POST["elderly_report"];
  94. $employee_handbook = $_POST["employee_handbook"];
  95. $infection_control = $_POST["infection_control"];
  96. $compliance = $_POST["compliance"];
  97. $conflict = $_POST["conflict"];
  98. $atwill = $_POST["atwill"];
  99. $consent_form = $_POST["consent_form"];
  100. $drug_alcohol = $_POST["drug_alcohol"];
  101. $service_areas = $_POST["service_areas"];
  102. $car_utilization = $_POST["car_utilization"];
  103. $emergency_preparedness = $_POST["emergency_preparedness"];
  104. $basic_employee = $_POST["basic_employee"];
  105. $workschedule = $_POST["workschedule"];
  106. $newhire = $_POST["newhire"];
  107. $acktimeofhire = $_POST["acktimeofhire"];
  108. $reportingrequirements = $_POST["reporting"];
  109. $orientationchecklist = $_POST["orientationchecklist"];
  110.  
  111. $db->updateEmploy($get_id,$line,$fname,$lname,$phone,$email);
  112.  
  113.  
  114. }
  115.  
  116. if(isset($_POST["delete"]))
  117.  
  118. {
  119.  
  120. $db->removeEmploy($get_id);
  121. echo $db->response;
  122.  
  123. }
  124.  
  125.  
  126.  
  127. ?>
  128.  
  129. <form method="post" class="form-inline">
  130. <div class='row'>
  131. <div class='col-sm-4'>
  132. <legend>Personal Information</legend>
  133. Status: <select name="status">
  134. <option><i><?php echo $data['status'];?></i></option>
  135. <option value="active">active</option>
  136. <option value="inactive">inactive</option>
  137. </select><br>
  138. Role :
  139. <div class="form-group">
  140. <select name="line" class="btn btn-warning dropdown-toggle">
  141. <option><?php echo $db->roleConvert($data["type"]); ?></option>
  142. <option value="MD">Phycician</option>
  143. <option value="NP">Nurse Practitioner</option>
  144. <option value="RN">Registered Nurse</option>
  145. <option value="LVN">Licensed Vocational Nurse</option>
  146. <option value="OF">Office Staff</option>
  147. <option value="HA">Health Aide</option>
  148. <option value="PT">Physical Therapist</option>
  149. <option value="PTA">Physical Therapy Assistant</option>
  150. <option value="OT">Occupational Therapist</option>
  151. <option value="MSW">Medical Social Worker</option>
  152. <option value="SC">Chaplain</option>
  153. <option value="ST">Speech Therapist</option>
  154. </select>
  155. </div>
  156. Firstname
  157. <div class="form-group">
  158. <input type="text" name="fname" value="<?php echo $data['firstname']; ?>">
  159. </div>
  160. LastName
  161. <div class="form-group">
  162. <input type="text" name="lname" value="<?php echo $data['lastname']; ?>">
  163. </div>
  164. Phone
  165. <div class="form-group">
  166. <input type="text" name="phone" value="<?php echo $data['phone']; ?>">
  167. </div>
  168. Email
  169. <div class="form-group">
  170. <input type="text" name="email" value="<?php echo $data['email']; ?>">
  171. </div>
  172. <input type="submit" name="update" class="btn btn-sm btn-danger" value="Update">
  173. <input type="submit" name="delete" class="btn btn-sm btn-danger" value="Delete">
  174.  
  175. </div>
  176. <div class='col-sm-4'>
  177. <legend>Hotspice Pay Rate</legend>
  178. <div class='row'>
  179. <div class='col-sm-6'>
  180. <div class="form-group" >
  181. Hourly: <input type="text" name="hourly" value="<?php echo $data['hourly']; ?>">
  182. </div>
  183. <div class="form-group" >
  184. SOC/Eval: <input type="text" name="eval" value="<?php echo $data['eval']; ?>">
  185. </div>
  186. <div class="form-group" >
  187. Missed Visit: <input type="text" name="missed_visit" value="<?php echo $data['missed_visit']; ?>">
  188. </div>
  189. <div class="form-group" >
  190. Death Visit: <input type="text" name="death_visit" value="<?php echo $data['death_visit']; ?>">
  191. </div>
  192. <div class="form-group" >
  193. On-Call OOA: <input type="text" name="oncall_outofarea" value="<?php echo $data['oncall_outofarea']; ?>">
  194. </div>
  195. <div class="form-group" >
  196. Trip Pay: <input type="text" name="trip_pay" value="<?php echo $data['trip_pay']; ?>">
  197. </div>
  198. <div class="form-group" >
  199. Visit OOA: <input type="text" name="visit_outofarea" value="<?php echo $data['visit_outofarea']; ?>">
  200. </div>
  201. </div>
  202. <div class='col-sm-6'>
  203.  
  204. <div class="form-group" >
  205. Over Time: <input type="text" name="over_time" value="<?php echo $data['over_time']; ?>">
  206.  
  207. </div>
  208. <div class="form-group" >
  209. SOC/Eval Out Of Area: <input type="text" name="eval_ooa" value="<?php echo $data['eval_ooa']; ?>">
  210.  
  211. </div>
  212. <div class="form-group" >
  213. Reassessment: <input type="text" name="reassessment" value="<?php echo $data['reassessment']; ?>">
  214.  
  215. </div>
  216. <div class="form-group" >
  217. Follow-Up: <input type="text" name="follow_up" value="<?php echo $data['follow_up']; ?>">
  218.  
  219. </div>
  220. <div class="form-group" >
  221. On-Call Week Night: <input type="text" name="on_call_weeknight" value="<?php echo $data['on_call_weeknight']; ?>">
  222.  
  223. </div>
  224.  
  225. <div class="form-group" >
  226. Trip Pay OOA: <input type="text" name="trip_pay_ooa" value="<?php echo $data['trip_pay_ooa']; ?>">
  227.  
  228. </div>
  229. </div>
  230. </div>
  231. </div>
  232. <div class='col-sm-4'>
  233. <legend>HOMEHEALTH PAY RATES</legend>
  234. HOME HEALTH Eval:
  235. <div class="form-group" >
  236. <input type="text" name="hh_eval" value="<?php echo $data['hh_eval']; ?>">
  237. </div>
  238. HOME HEALTH Follow-Up:
  239. <div class="form-group" >
  240. <input type="text" name="hh_follow_up" value="<?php echo $data['h_follow_up']; ?>">
  241. </div>
  242. </div>
  243. </div>
  244. <div class="row">
  245. <div class='col-sm-6'>
  246. <legend>[TAB 1] Pre-Employment Documents (date received)</legend>
  247. Resume/Application:
  248. <div class="form-group" >
  249. <input type="date" name="resume">
  250. </div>
  251. Interview Summary:
  252. <div class="form-group" >
  253. <input type="date" name="interviewsummary">
  254. </div>
  255. Tel. Reference:
  256. <div class="form-group" >
  257. <input type="date" name="telreference">
  258. </div>
  259. Background Check Auth:
  260. <div class="form-group" >
  261. <input type="date" name="bgcheck_auth">
  262. </div>
  263. Background Check:
  264. <div class="form-group" >
  265. <input type="date" name="bgcheck">
  266. </div>
  267. Sex Offender Results:
  268. <div class="form-group" >
  269. <input type="date" name="oig">
  270. </div>
  271. OIG Exclusion's List:
  272. <div class="form-group" >
  273. <input type="date" name="oig">
  274. </div>
  275. Employment Verification Form:
  276. <div class="form-group" >
  277. <input type="date" name="employment_verification">
  278. </div>
  279.  
  280. Equal Employment Opportunity Data:
  281. <div class="form-group" >
  282. <input type="date" name="equal_employment">
  283. </div>
  284. Emergency Contact:
  285. <div class="form-group" >
  286. <input type="date" name="emergency_contact">
  287. </div>
  288. Form I-9:
  289. <div class="form-group" >
  290. <input type="date" name="i9">
  291. </div>
  292. Form W-4/W-9:
  293. <div class="form-group" >
  294. <input type="date" name="w4">
  295. </div>
  296. Offer Letter:
  297. <div class="form-group" >
  298. <input type="date" name="offer_letter">
  299. </div>
  300. Employee Statements:
  301. <div class="form-group" >
  302. <input type="date" name="statements">
  303. </div>
  304. Payroll Information Sheet:
  305. <div class="form-group" >
  306. <input type="date" name="payroll_sheet">
  307. </div>
  308. Authentication For Computer Key:
  309. <div class="form-group" >
  310. <input type="date" name="computer_key">
  311. </div>
  312. </div>
  313. <div class='col-sm-6'>
  314. <legend>[TAB 2] HR DOCUMENTS </legend>
  315. HIPAA:
  316. <div class="form-group" >
  317. <input type="date" name="hipaa">
  318. </div>
  319. Confidentiality:
  320. <div class="form-group" >
  321. <input type="date" name="confidentiality">
  322. </div>
  323. Bill Of Rights:
  324. <div class="form-group" >
  325. <input type="date" name="bill_of_rights">
  326. </div>
  327. Child & Elderly Abuse Reporting Form:
  328. <div class="form-group" >
  329. <input type="date" name="elderly_report">
  330. </div>
  331. Employee Handbook:
  332. <div class="form-group" >
  333. <input type="date" name="employee_handbook">
  334. </div>
  335. Infection Control Tr. Acknowledgment:
  336. <div class="form-group" >
  337. <input type="date" name="infection_control">
  338. </div>
  339. Corporate Compliance:
  340. <div class="form-group" >
  341. <input type="date" name="compliance">
  342. </div>
  343. Conflict Of Interest:
  344. <div class="form-group" >
  345. <input type="date" name="conflict">
  346. </div>
  347. Statement of At-Will Employment:
  348. <div class="form-group" >
  349. <input type="date" name="atwill">
  350. </div>
  351. Consent Form For BGCheck/Photo/Badge:
  352. <div class="form-group" >
  353. <input type="date" name="consent_form">
  354. </div>
  355. Drug & Alcohol-Free Workplace:
  356. <div class="form-group" >
  357. <input type="date" name="drug_alcohol">
  358. </div>
  359. Service Areas
  360. <div class="form-group" >
  361. <input type="date" name="service_areas">
  362. </div>
  363. Personal Car Utilization:
  364. <div class="form-group" >
  365. <input type="date" name="car_utilization ">
  366. </div>
  367. Emergency Preparedness Plan Acknowledgment:
  368. <div class="form-group" >
  369. <input type="date" name="emergency_preparedness">
  370. </div>
  371. Basic Employee Procedures:
  372. <div class="form-group" >
  373. <input type="date" name="basic_employee">
  374. </div>
  375. Weekly Work Schedule:
  376. <div class="form-group" >
  377. <input type="date" name="workschedule">
  378. </div>
  379. </div>
  380. </div>
  381. <div class="row">
  382. <legend>[TAB 3] NEW HIRE CHECKLIST</legend>
  383. <div class="col-md-6">
  384. <div class="form-group">
  385. New Hire Checklist:
  386. </div>
  387. <div class="form-group">
  388. Employee Acknowledgment At Time Of Hire:
  389. </div>
  390. <div class="form-group">
  391. Reporting Requirements:
  392. </div>
  393. <div class="form-group">
  394. Employee Orientation Checklist:
  395. </div>
  396.  
  397.  
  398. </div>
  399.  
  400.  
  401. <div class="col-md-6">
  402. <div class="form-group" >
  403. <input type="date" name="newhire">
  404. </div>
  405. <div class="form-group" >
  406. <input type="date" name="acktimeofhire">
  407. </div>
  408. <div class="form-group" >
  409. <input type="date" name="reportingrequirements">
  410. </div>
  411. <div class="form-group" >
  412. <input type="date" name="orientationchecklist">
  413. </div>
  414.  
  415. </div>
  416.  
  417.  
  418.  
  419.  
  420.  
  421. </div>
  422. </div>
  423.  
  424.  
  425. <div class="row">
  426.  
  427. <div class='col-md-4'>
  428. <LEGEND>Document</LEGEND>
  429.  
  430. <div class="form-group" >
  431. Professional ID:
  432. </div>
  433. <div class="form-group" >
  434. State/DL ID:
  435. </div>
  436. <div class="form-group" >
  437. CPR:
  438. </div>
  439. <div class="form-group" >
  440. Green Card/US Passport:
  441. </div>
  442. <div class="form-group" >
  443. SSN Card:
  444. </div>
  445. <div class="form-group" >
  446. Vehicle Registration:
  447. </div>
  448. <div class="form-group" >
  449. Vehicle Insurance:
  450. </div>
  451. <div class="form-group" >
  452. 90-Day:
  453. </div>
  454. <div class="form-group" >
  455. Annual Eval:
  456. </div>
  457. </div>
  458. <div class='col-md-4'>
  459. <legend>Issue Date</legend>
  460. <div class="form-group" >
  461. <input type="date" name="bday">
  462. </div>
  463. <div class="form-group" >
  464. <input type="date" name="bday">
  465. </div>
  466. <div class="form-group" >
  467. <input type="date" name="bday">
  468. </div>
  469. <div class="form-group" >
  470. <input type="date" name="bday">
  471. </div>
  472. <div class="form-group">
  473. <select name="SNN">
  474. <option value="yes">Yes</option>
  475. <option value="no">No</option>
  476. </select>
  477. </div>
  478. <div class="form-group" >
  479. <input type="date" name="bday">
  480. </div>
  481. <div class="form-group" >
  482. <input type="date" name="bday">
  483. </div>
  484. <div class="form-group" >
  485. <input type="date" name="bday">
  486. </div>
  487. <div class="form-group" >
  488. <input type="date" name="bday">
  489. </div>
  490. </div>
  491. <div class='col-md-4'>
  492. <legend>Exp. Date</legend>
  493. <div class="form-group" >
  494. <input type="date" name="bday">
  495. </div>
  496. <div class="form-group" >
  497. <input type="date" name="bday">
  498. </div>
  499. <div class="form-group" >
  500. <input type="date" name="bday">
  501. </div>
  502. <div class="form-group" >
  503. <input type="date" name="bday">
  504. </div>
  505. <div class="form-group">
  506. <input type="text" name="US" value="US CITIZEN">
  507. </div>
  508. <div class="form-group" >
  509. <input type="date" name="bday">
  510. </div>
  511. <div class="form-group" >
  512. <input type="date" name="bday">
  513. </div>
  514. <div class="form-group" >
  515. <input type="date" name="bday">
  516. </div>
  517. <div class="form-group" >
  518. <input type="date" name="bday">
  519. </div>
  520. </div>
  521.  
  522. </div>
  523. </div>
  524.  
  525. <div class="row">
  526. <legend>CLINICAL/HEALTH/MEDICAL RECORDS</legend>
  527. <div class="col-sm-2">
  528. <div class="form-group">
  529. Physical Exam:
  530. </div>
  531. <div class="form-group">
  532. Medical History:
  533. </div>
  534. <div class="form-group">
  535. PPD:
  536. </div>
  537. </div>
  538.  
  539. <div class="col-sm-2">
  540. <div class="form-group" >
  541. <input type="date" name="bday">
  542. </div>
  543. <div class="form-group" >
  544. <input type="date" name="bday">
  545. </div>
  546. <div class="form-group" >
  547. <input type="date" name="bday">
  548. </div>
  549.  
  550. </div>
  551.  
  552.  
  553. <div class="col-sm-2">
  554. <div class="form-group">
  555. TB Acknowledgment:
  556. </div>
  557. <div class="form-group">
  558. Chest X-Ray:
  559. </div>
  560. <div class="form-group">
  561. Hep-B Declination:
  562. </div>
  563.  
  564. </div>
  565.  
  566. <div class="col-sm-2">
  567. <div class="form-group" >
  568. <input type="date" name="bday">
  569. </div>
  570.  
  571. <div class="form-group" >
  572. <input type="date" name="bday">
  573. </div>
  574. <div class="form-group" >
  575. <input type="date" name="bday">
  576. </div>
  577.  
  578.  
  579. </div>
  580.  
  581.  
  582. <div class="col-sm-2">
  583. <div class="form-group">
  584. ADA:
  585. </div>
  586. <div class="form-group">
  587. Hep-B Vaccine:
  588. </div>
  589.  
  590. </div>
  591.  
  592.  
  593. <div class="col-sm-2">
  594. <div class="form-group" >
  595. <input type="date" name="bday">
  596. </div>
  597. <div class="form-group" >
  598. <input type="date" name="bday">
  599. </div>
  600. </div>
  601.  
  602.  
  603.  
  604.  
  605.  
  606.  
  607.  
  608.  
  609.  
  610.  
  611. </div>
  612.  
  613. </form>
  614. </div>
  615. </body>
  616. </html>
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