1. This is an application for employment. Any representation in regards to your appointment, setting of wages, or any other personnel action made to you by other than the Administrator or Human Resources Director is without authority and you are advised that you have no right to rely upon such representation.

  2. Under Maryland law, an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment, except law enforcement officers as defined in 727 of Article 27 of the Annotated Code of Maryland, or any employee of any law enforcement agency of the State of Maryland, or any county incorporated city or town, or other municipal corporation. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.

  3. In submitting this application for employment, I authorize investigation of all statements contained therein, I hereby authorize St. Mary’s Nursing Center, Inc. to make any contacts considered applicable to my employment, such as previous employers, criminal or credit bureau records. I authorize any person or organization whose name I have given as a character reference or by whom I have been previously employed and any educational institution which I have stated I attended to furnish St. Mary’s Nursing Center, Inc. any information they may have concerning me. I hereby release all such persons, organizations, and institutions from any claims for damages or otherwise by reason of furnishing such information and records. It is understood and agreed that any misrepresentations or omissions by me in this application will be sufficient cause for cancellation of the application or for separation from employment at St. Mary’s Nursing Center, Inc.

  4. I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for substance abuse. I also understand and agree that, if employed, I may be required to submit to an alcohol or substance abuse screening as required by Law and St. Mary’s Nursing Center, Inc. Policies and Procedures. I hereby consent to having the result of any such alcohol or substance abuse screening I may be required to undergo disclosed to St. Mary’s Nursing Center, Inc.

  5. I understand that St. Mary’s Nursing Center, Inc. is an at-will employer, and as such should I become employed by St. Mary’s Nursing Center, Inc. I will have the right, at any time, to terminate my employment. Similarly, St. Mary’s Nursing Center, Inc. reserves the same right to terminate my employment at anytime, with or without cause.

  6. St. Mary’s Nursing Center, Inc. obtains criminal history information from a state criminal history records check or private agency background check on all new employees. This information will disclose the existence of past criminal convictions (including plea or verdict of guilty, a plea of nolo contendere, a disposition or probation before judgment, or a disposition of not criminally responsible), as well as pending criminal charges awaiting disposition. If disclosed to us and called to our attention in advance, such information will not necessarily be a bar to employment; factors such as age at the time of the offense, the date of the offense, the seriousness and nature of the offense, and rehabilitation will be taken into account. However, failure to disclose such information to us and call it to our attention in advance will be grounds for not hiring the person or for terminating the employment if the person has been hired when the information is discovered, even if the nature of the information w ould not ha ve been a bar to employment if it had been disclosed in advance.




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St. Mary's Nursing Center, Inc. • 21585 Peabody St. • Leonardtown, MD 20650TEL: (301) 475-8000 • FAX: (301) 475-3085
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