Job Opportunities
Benefits Guide
2026 benefits guide: KEHP 2026 BSG
Holidays:
- Martin Luther King, Jr. Day – Monday, January 19, 2026
- Good Friday (1/2 day) – Friday, April 3, 2026
- Memorial Day – Monday, May 25, 2026
- Juneteenth – Friday, June 19, 2026
- Independence Day – Friday, July 3, 2026
- Labor Day – Monday, September 7, 2026
- Veterans Day – Wednesday, November 11, 2026
- Thanksgiving – Thursday, November 26, 2026 & Friday, November 27, 2026
- Christmas – Thursday, December 24, 2026 & Friday, December 25, 2026
- New Year’s – Thursday, December 31, 2026 & Friday, January 1, 2027
Accrued time:
- 3.5 hrs sick per pay period
- 3.5 hrs vacation per pay period, increases every five years
- Compensatory time, accrued and paid in straight time. 200 hour cap, must be used or cashed out in 30 or 50 hr increments.
Additional leaves:
Jury, inclement weather, elections
Other benefits:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Life insurance
- HRA if medical is waived, if applicable
- Flex spending account
- Pension 6% of wages
- 401k and 457b plans offered (employee funded)
- 5% wage increase at 6 months
- National Health Service Corps Site
Public Health Nurse I - Float
APPLICATION SUBMISSION: CLICK HERE
Public Health Nurse I (Float)
Full-Time
Location: Hickman City & McCracken County
Schedule: Monday – Friday
Pay Range: $20.30/hr – $25.24/hr + 5% increase after 6 months
Position Overview
The Public Health Nurse I (Float) provides entry-level nursing services across multiple Purchase District Health Department locations based on operational needs. This role supports both clinic and community-based programs, focusing on disease prevention, health promotion, and continuity of care across the district.
This position is ideal for a newly licensed or early-career RN seeking broad clinical exposure, skill development, and meaningful community impact in a public health setting.
Primary Responsibilities
Clinical Services
- Perform basic nursing assessments in clinic and community settings
- Deliver services in accordance with Core Clinical Service Guide (CCSG), nursing standards, and agency policies
- Administer immunizations, screenings, and other public health services
- Assist with care planning based on identified health risks
- Maintain accurate and confidential patient documentation
Community & Public Health Support
- Assist with community health assessments and outreach initiatives
- Support epidemiological investigations and disease prevention efforts as needed
- Provide education to individuals and families on health promotion and disease prevention
- Serve diverse and at-risk populations with limited access to care
Team Collaboration
- Float between multiple clinic sites to support staffing needs
- Work under supervision while developing competency across programs
- Collaborate with multidisciplinary public health staff to ensure continuity of care
Minimum Qualifications
Position Requirements & Qualifications
- Active Registered Nurse (RN) license in Kentucky, compact state, or eligibility for provisional licensure (RNA) per KRS 314.041
- Ability to obtain and maintain full RN licensure in Kentucky
- Strong communication and interpersonal skills
- Ability to adapt to multiple clinical environments and responsibilities
- Basic knowledge of nursing practices and public health principles
Pay & Schedule
- $20.30 – $25.24/hour based on qualifications and experience
- 5% wage increase after 6 months
- Full-time, Monday through Friday schedule
- 6-month initial probationary period
- Non-exempt position eligible for state benefits, retirement, and structured pay increases
Additional Requirements
- Must maintain active RN licensure
- Completion of required annual trainings and certifications
- May be required to pass background check and drug screening
- Travel between clinic locations required
Public Health Nurse II - Float
APPLICATION SUBMISSION: CLICK HERE
Public Health Nurse II (Float)
Full-Time
Location: Hickman City and McCracken County
Schedule: Monday – Friday
Pay Range: $21.52/hr – $26.76/hr + 5% increase after 6 months
Position Overview
The Public Health Nurse II (Float) provides professional nursing services across multiple Purchase District Health Department locations based on operational needs. This role delivers care in both clinic and community settings with increased independence, supporting disease prevention, health promotion, and continuity of care across the district.
This position is ideal for an experienced RN seeking to expand their impact in public health while taking on more advanced clinical responsibilities, program involvement, and mentorship opportunities.
Primary Responsibilities
Clinical Services
Conduct comprehensive nursing assessments using Core Clinical Service Guide (CCSG) standards
Develop and implement individualized plans of care based on identified health risks
Provide nursing care in accordance with established policies, procedures, and scope of practice
Administer immunizations, screenings, and other public health services
Maintain accurate, timely, and confidential documentation
Public Health & Community Engagement
Conduct communicable disease investigations and support prevention efforts
Assist with community health assessments and identification of at-risk populations
Deliver education to individuals, families, and community groups on health promotion topics
Support outreach initiatives and program-specific clinics
Program Support & Leadership
Participate in program planning, implementation, and evaluation
May serve as a coordinator for specific programs or service areas
Apply problem-solving and analytical skills to address public health challenges
Provide guidance and mentorship to Public Health Nurse I staff as needed
Team Collaboration
Float between multiple clinic sites to support staffing and service delivery needs
Collaborate with multidisciplinary teams to ensure continuity of care
Contribute to a team-based approach to improving population health outcomes
Minimum Qualifications
Position Requirements & Qualifications
Active Registered Nurse (RN) license in Kentucky or compact state
One (1) year of RN experience required
BSN may substitute for required experience
Strong clinical judgment and critical thinking skills
Ability to work independently and adapt across multiple settings
Effective communication and interpersonal skills
Knowledge of public health principles and nursing best practices
Pay & Schedule
$21.52 – $26.76/hour based on qualifications and experience
5% wage increase after 6 months
Full-time, Monday through Friday schedule
6-month initial probationary period
Non-exempt position eligible for state benefits, retirement, and structured pay increases
Additional Requirements
Must maintain active RN licensure
Completion of required annual trainings and certifications
May be required to pass background check and drug screening
Travel between clinic locations required
Public Health Dentist
APPLICATION SUBMISSION: CLICK HERE
Dentist
Full-Time, Part-Time, and Daily Pay options available
Location: McCracken Co (Paducah), KY
Service Area: K–12 schools within the Purchase District Health Department’s service region as well as on-site at our local health centers (McCracken, Ballard, Carlisle, Fulton, and Hickman)
Annual Hours: Flexible Hours to Full-Time
Starting Pay: $85.00/hour + 5% increase after successful 6-month probation if Full-Time or Part-Time
$900/day if dailly pay option
Position Overview
As a Public Health Dentist, you will play a key role in the Tooth Transit in-school dental program, delivering restorative care directly to students in grades K–12 across the Purchase District. Services are provided in a state-of-the-art Dental Mobile Unit in partnership with our public health dental hygiene team. This position combines clinical practice with community impact, allowing you to improve access to dental care and help establish a dental home for children in our region.
This is a non-exempt, hourly contracted role ideal for dentists seeking work-life balance, meaningful community impact, and a mission-driven environment.
Primary Responsibilities
Patient Care
Conduct routine dental examinations and screenings for students.
Diagnose and treat common dental conditions such as cavities, infections, and minor injuries.
Provide basic restorative care, including fillings and simple extractions.
Maintain accurate and confidential patient records using electronic systems.
Refer patients to specialists as appropriate.
Collaborate with dental hygienists, school staff, and public health team members to address oral health needs.
Program Implementation
Work in conjunction with the dental hygiene team to deliver restorative services within the Tooth Transit program.
Support program development, including treatment protocols and compliance with state dental regulations.
Participate in school and community outreach events related to oral health.
Education & Outreach
Provide oral health education to students, families, and school staff.
Deliver presentations and workshops on proper brushing techniques, nutrition, and the importance of preventive care.
Support distribution of educational materials such as handouts, brochures, and posters.
Minimum Qualifications
Position Requirements & Qualifications
Doctor of Dental Surgery (DDS) or Doctor of Medicine in Dentistry (DMD) degree from an accredited dental school.
Valid Kentucky dental license in good standing.
Experience providing clinical dental care; experience with children or in a school setting preferred.
Strong skills in general dentistry, including restorative treatment.
Excellent communication and interpersonal skills, with ability to educate and engage children and families.
Knowledge of dental best practices, oral health principles, and public health values.
Familiarity with dental software and electronic health record systems.
Pay and Schedule
Pay & Schedule
$85.00/hour starting rate with a 5% raise after successful 6-month probationary period.
Contracted part-time starting with flexible hours, transitioning to a full-time role.
Non-exempt position with eligibility for state retirement programs, robust healthcare benefits, and potential student loan forgiveness.
Why Join Purchase District Health Department?
If you’re looking to make a meaningful impact while enjoying one of Kentucky’s most competitive public benefits packages, this role is for you. Our dental hygienists don’t just serve—they thrive with:
Holidays & Time Off
- 13 Paid Holidays including Juneteenth, Veterans Day, and two days each for Thanksgiving, Christmas, and New Year’s.
- Accrual of 3.5 hours of vacation and 3.5 hours of sick leave per pay period, with vacation increasing based on years of service.
- Up to 12 days of vacation and 12 days of sick leave available within your first year of employment.
- Additional leave opportunities for jury duty, voting, and inclement weather, ensuring you have time for civic responsibilities and unforeseen circumstances.
- Supports a healthy work-life balance, allowing you to manage personal needs, family obligations, and self-care while contributing to public health.
Comprehensive Health & Wellness Coverage
- Low-premium medical insurance plans starting as low as $20.88 per month for single coverage, with additional options for family coverage
- Annual employer-funded allowance, depending on your plan ($500 – $1000) loaded onto a HealthEquity card each year (HRA dollars roll over each year, up to $7,500)
- HRA card can be used for eligible medical, dental, and vision expenses, including copays, coinsurance, deductibles, and prescriptions.
- Preventive care is covered at 100% across all plans — annual checkups, routine screenings, and vaccinations are included at no cost
- Flexible Spending Accounts (FSAs) available for health and dependent care
- Telehealth and virtual care options are available, often at lower copays than in-person visits. (Including parenting resources, nurse lines, and more)
- Prescription coverage includes tiered copays for generic, brand, and specialty medications; pharmacy expenses may count toward your deductible and out-of-pocket maximum
- All plans include mental health services such as counseling, psychiatric care and behavioral health care
Dental & Vision Benefits
- Dental insurance plans starting at $14 per month
- 100% coverage on preventive care (cleanings, exams, and X-rays) when using in-network providers
- Coverage for major services such as crowns, implants, and oral surgery
- Teledentistry available 24/7, giving you remote access to dental consultations anytime
- Vision insurance available for less than $6 per month for single coverage, with family options also available
- $150–$175 allowance for contacts, frames, and lenses, with co-pays as low as $10
- Covers routine eye exams for adults and children, including dilation, when necessary, to support overall eye health
- Discounts on frames, lenses, and contacts for costs exceeding the plan allowance
Retirement & Financial Security
- 6% pension contribution through the Kentucky Employee Retirement System (KERS)
- Optional 401(k) and 457(b) plans (employee-funded)
- Mileage reimbursement for approved work-related travel
- $20,000 of basic life insurance provided at no cost to you, including Accidental Death & Dismemberment (AD&D) benefits. You also have the option to purchase additional life insurance for yourself and eligible dependents for enhanced financial protection.
Additional Fringe Benefits
These benefits support your physical, mental, and financial well-being:
- Carrum Health: Available under certain plans, access top surgeons and cancer specialists for major procedures, including cancer care, orthopedic surgeries (knee, hip, shoulder, spine), heart surgery, and weight-loss surgery—with most services covered at no cost to you.
- LiveHealth Online: 24/7 virtual visits with doctors, therapists, psychiatrists, and lactation consultants
- LivingWell Clinics: In-person or telehealth for annual exams, chronic care, labs, immunizations, and women’s health
- 24/7 NurseLine & Substance Use Support: Get care guidance, provider referrals, and confidential substance use help
- Tobacco Cessation: Free prescription and OTC aids, online or phone-based counseling programs
- Diabetes & Chronic Care: Personalized 24/7 coaching, education, and tracking tools through Lark and DSMES programs
- Maternity & Family Support: Digital tools, prenatal/postpartum guidance, lactation consulting, and newborn tracking.
- Joint & Musculoskeletal Care: Virtual therapy for back, knee, hip, neck, or shoulder pain via Hinge Health
- Acupuncture: Covered pilot program for eligible KEHP members at UK Healthcare
- Behavioral & Mental Health: Online therapy, psychiatry, and coaching through LiveHealth Online, RethinkCare, and Learn to Live
- Cash Rewards & Wellness Incentives: Earn $25–$850. Wellness engagement can reduce premiums by nearly $500
Maintenance/Custodial Worker
Maintenance/Custodial Worker
CLICK HERE TO APPLY
Full-Time Position
Location: Paducah-McCracken County Health Center
Pay: $17.00/hour + 5% increase after 6 months
Position Overview
The Maintenance/Custodial Worker performs routine building maintenance, groundskeeping, custodial, and facility support services at the Paducah-McCracken County Health Center. This position helps ensure the facility remains safe, clean, and fully operational for staff and the public. This is a hands-on role essential to daily operations.
Essential Duties & Responsibilities
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Perform routine building maintenance and general repairs.
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Conduct groundskeeping duties.
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Perform custodial/janitorial work, including cleaning floors, restrooms, windows, etc.
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Assist with minor plumbing repairs and basic facility troubleshooting.
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Maintain and repair locks, keys, and door hardware.
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and common areas to maintain a safe and sanitary environment.
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Assist with moving equipment, furniture setup, and general facility needs.
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Identify and report safety concerns or maintenance issues.
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Ensure compliance with safety standards and departmental policies.
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Perform other duties as assigned.
Minimum Qualifications
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High school diploma or GED preferred.
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Experience in general maintenance, custodial work, groundskeeping, or a related field preferred.
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Basic knowledge of hand and power tools.
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Ability to lift up to 50 pounds and perform physical labor indoors and outdoors.
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Valid driver’s license required.
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Ability to work independently and manage time effectively.
Schedule & Compensation
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Full-time, hourly (non-exempt), merit position.
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Schedule determined by facility operational needs.
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Starting rate: $17.00/hour + 5% increase after 6 months
Why Join Purchase District Health Department?
If you are looking to make a meaningful impact while enjoying one of Kentucky’s most competitive public benefits packages, this role offers both professional purpose and long-term stability.
Holidays & Time Off
-
13 paid holidays, including Juneteenth, Veterans Day, and two days each for Thanksgiving, Christmas, and New Year’s.
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Accrual of 3.5 hours of vacation and 3.5 hours of sick leave per pay period.
-
Up to 12 days of vacation and 12 days of sick leave available within your first year.
-
Additional leave for jury duty, voting, and inclement weather.
Comprehensive Health & Wellness Coverage
-
Low-premium medical plans starting as low as $20.88 per month for single coverage.
-
Employer-funded annual HRA allowance ($500–$1,000 depending on plan), with rollover up to $7,500.
-
HRA funds may be used for eligible medical, dental, and vision expenses.
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Preventive care covered at 100% across all plans.
-
Flexible Spending Accounts available.
-
Telehealth and virtual care options.
-
Prescription coverage with tiered copays.
-
Comprehensive mental and behavioral health services included.
Dental & Vision Benefits
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Dental plans starting at $14 per month with 100% preventive coverage in-network.
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Coverage for major services including crowns and oral surgery.
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Vision coverage available for less than $6 per month (single coverage).
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$150–$175 allowance for contacts, frames, and lenses.
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Routine eye exams covered.
Retirement & Financial Security
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6% pension contribution through the Kentucky Employee Retirement System (KERS).
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Optional 401(k) and 457(b) plans.
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Mileage reimbursement for approved travel.
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$20,000 employer-paid life insurance with AD&D coverage.
Additional Fringe Benefits
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Access to specialty surgical programs under eligible plans.
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24/7 virtual medical and behavioral health visits.
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Chronic disease management and diabetes support programs.
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Maternity and family support services.
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Joint and musculoskeletal virtual therapy options.
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Tobacco cessation programs.
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Wellness incentives offering cash rewards and potential premium reductions.
Ready to Make an Impact?
This role is essential to keeping the Paducah-McCracken Health Center safe, clean, and fully operational. As a Maintenance/Custodial Worker, you will provide critical facility support that directly affects staff efficiency and community health. If you are committed to hands-on work, maintaining public spaces, and supporting a mission-driven team, we encourage you to apply.
Support Services Associate
Support Services Associate
CLICK HERE TO APPLY
Location: Paducah, KY – McCracken Co. Health Center
Work Week: 37.5 hours
Pay: $13.50/hr + 5% increase after successful 6-month probationary period
Position Overview
As a Support Services Associate, you will play a vital role in ensuring efficient daily operations within the Purchase District Health Department. This position supports both administrative and public health services, providing front-line assistance to clients, maintaining records, and helping programs run smoothly.
This is a full-time, entry-level role ideal for detail-oriented, organized individuals seeking a rewarding career in public health administration. Comprehensive on-the-job training is provided.
Primary Responsibilities
Administrative Support
• Greet and direct clients, visitors, and callers to appropriate staff or resources.
• Prepare correspondence, labels, and other routine materials.
• Maintain accurate and confidential medical and administrative records.
• Collect, record, and reconcile fees to ensure accuracy and completeness.
• Order and maintain office and program inventory supplies.
Data Entry & Record Management
• Enter information from Patient Encounter Forms (PEF), Outcome or Assessment Information Set (OASIS), and other program reports.
• Process and issue WIC vouchers, environmental permits, and program applications.
• Generate and review reports to verify completeness and accuracy.
Program Support & Customer Service
• Assist in gathering information from patients, clients, and insurance providers.
• Use department systems such as the Environmental Health Management Information System (EHMIS) to support data accuracy and compliance.
• Provide certificates and documentation for services rendered.
• Support agency staff and public health initiatives as assigned.
Minimum Qualifications
Education & Experience
• High school diploma or GED required.
• No prior experience required — on-the-job training provided.
Special Requirements
• Must participate in agency-provided training to become knowledgeable in Patient and Community Health Services Reporting and Billing Procedures (PSRS).
• Must complete ongoing required trainings as outlined by agency policy.
Skills & Competencies
• Strong customer service and communication skills.
• Ability to organize and manage multiple tasks efficiently.
• Basic computer literacy and accurate data entry skills.
• Commitment to confidentiality, professionalism, and teamwork.
Pay and Schedule
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$13.50/hour starting rate.
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5% raise after successful completion of 6-month probationary period.
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Full-time, non-exempt role with a 37.5-hour work week.
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Eligible for full benefits, paid holidays, retirement programs, and professional development opportunities.
Why Join Purchase District Health Department?
If you’re looking to make a meaningful impact while enjoying one of Kentucky’s most competitive public benefits packages, this role is for you. Our Support Services Associates are essential to our day-to-day operations and thrive with:
Holidays & Time Off
-
13 Paid Holidays including Juneteenth, Veterans Day, and two days each for Thanksgiving, Christmas, and New Year’s.
-
Accrual of 3.5 hours of vacation and 3.5 hours of sick leave per pay period, with vacation increasing based on years of service.
-
Up to 12 days of vacation and 12 days of sick leave available within your first year of employment.
-
Additional leave opportunities for jury duty, voting, and inclement weather, ensuring you have time for civic responsibilities and unforeseen circumstances.
-
Supports a healthy work-life balance, allowing you to manage personal needs, family obligations, and self-care while contributing to public health.
Comprehensive Health & Wellness Coverage
-
Low-premium medical insurance plans starting as low as $20.88 per month for single coverage, with additional options for family coverage
-
Annual employer-funded allowance, depending on your plan ($500 – $1000) loaded onto a HealthEquity card each year (HRA dollars roll over each year, up to $7,500)
-
HRA card can be used for eligible medical, dental, and vision expenses, including copays, coinsurance, deductibles, and prescriptions.
-
Preventive care is covered at 100% across all plans — annual checkups, routine screenings, and vaccinations are included at no cost
-
Flexible Spending Accounts (FSAs) available for health and dependent care
-
Telehealth and virtual care options are available, often at lower copays than in-person visits. (Including parenting resources, nurse lines, and more)
-
Prescription coverage includes tiered copays for generic, brand, and specialty medications; pharmacy expenses may count toward your deductible and out-of-pocket maximum
-
All plans include mental health services such as counseling, psychiatric care and behavioral health care
Dental & Vision Benefits
-
Dental insurance plans starting at $14 per month
-
100% coverage on preventive care (cleanings, exams, and X-rays) when using in-network providers
-
Coverage for major services such as crowns, implants, and oral surgery
-
Teledentistry available 24/7, giving you remote access to dental consultations anytime
-
Vision insurance available for less than $6 per month for single coverage, with family options also available
-
$150–$175 allowance for contacts, frames, and lenses, with co-pays as low as $10
-
Covers routine eye exams for adults and children, including dilation, when necessary, to support overall eye health
-
Discounts on frames, lenses, and contacts for costs exceeding the plan allowance
Retirement & Financial Security
-
6% pension contribution through the Kentucky Employee Retirement System (KERS)
-
Optional 401(k) and 457(b) plans (employee-funded)
-
Mileage reimbursement for approved work-related travel
-
$20,000 of basic life insurance provided at no cost to you, including Accidental Death & Dismemberment (AD&D) benefits. You also have the option to purchase additional life insurance for yourself and eligible dependents for enhanced financial protection.
Additional Fringe Benefits
These benefits support your physical, mental, and financial well-being:
-
Carrum Health: Available under certain plans, access top surgeons and cancer specialists for major procedures, including cancer care, orthopedic surgeries (knee, hip, shoulder, spine), heart surgery, and weight-loss surgery—with most services covered at no cost to you.
-
LiveHealth Online: 24/7 virtual visits with doctors, therapists, psychiatrists, and lactation consultants
-
LivingWell Clinics: In-person or telehealth for annual exams, chronic care, labs, immunizations, and women’s health
-
24/7 NurseLine & Substance Use Support: Get care guidance, provider referrals, and confidential substance use help
-
Tobacco Cessation: Free prescription and OTC aids, online or phone-based counseling programs
-
Diabetes & Chronic Care: Personalized 24/7 coaching, education, and tracking tools through Lark and DSMES programs
-
Maternity & Family Support: Digital tools, prenatal/postpartum guidance, lactation consulting, and newborn tracking.
-
Joint & Musculoskeletal Care: Virtual therapy for back, knee, hip, neck, or shoulder pain via Hinge Health
-
Acupuncture: Covered pilot program for eligible KEHP members at UK Healthcare
-
Behavioral & Mental Health: Online therapy, psychiatry, and coaching through LiveHealth Online, RethinkCare, and Learn to Live
-
Cash Rewards & Wellness Incentives: Earn $25–$850. Wellness engagement can reduce premiums by nearly $500
Ready to Make an Impact?
Support Services staff play an important role in keeping our clinics running smoothly each day. In this position, you’ll assist with clerical support, help maintain organized workspaces, and provide general assistance to staff and visitors across multiple clinic locations. Your work helps ensure patients and team members have a safe, welcoming, and efficient environment.
Nutritionist/Dietitian
Nutritionist/Dietitian
Full-Time Position
Location: Paducah-McCracken County Health Center
Pay Range: $21.52 – $28.36/hour + 5% increase after 6 months
Position Overview
Under close supervision, performs moderate to complex nutrition case management for medically high-risk individuals. Provides physician-prescribed dietary counseling and Medical Nutrition Therapy (MNT) services in clinic and community settings. Reports to the Nutrition Services Supervisor or Director of Nutrition.
Minimum Requirements
Education:
You must have completed didactic coursework from a program accredited by ACEND (Accreditation Council for Education in Nutrition and Dietetics). This program is usually attached to a BS degree in Dietetics that would end with a DPD verification statement (Didactic Program in Dietetics).
Licensure:
Must obtain status or Registered Dietitian (RD) licensed by the Kentucky State Board of Licensure and Certification (KRS 310.021); or
Certified Nutritionist (CN) licensed by the Kentucky State Board of Licensure and Certification (KRS 310.031) within 6 months of hire.
No prior experience required.
Essential Duties & Responsibilities
Assess nutrition status and develop individualized nutrition and MNT care plans.
Provide individual and group nutrition counseling.
Implement physician-prescribed dietary regimens.
Interpret nutrition research and provide consultation to healthcare staff.
Participate in on-the-job training and competency development activities.
Maintain documentation in accordance with agency policy and WIC & Nutrition Manual guidelines.
Obtain and maintain National Provider Identification (NPI) number for MNT reimbursement.
Assist with community outreach, program development, and in-service education.
Perform other duties as assigned.
Additional Requirements
Must maintain required licensure and complete annual updates.
Subject to background check and drug screening per agency policy.
Employee Requirements
All employees of the Health Department are required to meet the following conditions as part of employment:
Immunization Requirements:
Proof of MMR, TDaP, and Varicella vaccinations or immunity must be provided prior to or within 10 days of hire.
Background Check:
Employment is contingent upon the successful completion of a background check.
Training:
All employees must complete infection control orientation, OSHA Bloodborne Pathogen training, and hand hygiene education within ten days of hire