NEW STAFFING REQUIREMENTS
The February 1, 2018 effective date for the revised Virginia assisted living regulations is right around the corner! Nixon Law Group has been posting a series of summaries highlighting key changes under the new regulations. This summary is the second that focuses on some of the new staffing requirements, including staff qualifications, training, and records.
Remember: This series is intended to summarize what some of the new regulations say. This information should not be confused with advice on how to actually comply with the new requirements. Compliance with the new regulations will likely require—among other things—new and revised policies and procedures that are specific to your community.
Staff Orientation and Initial Training: 22 VAC 40-73-120
The new regulations clarify that staff orientation and initial training must occur within the first seven working days of employment, and these activities may count toward meeting annual training requirements for the first year. The only new requirement in this section is that all staff be oriented to the facility’s organizational structure. While the existing regulations require that staff records contain verification that the staff member has received a copy of the facility’s organizational chart (22 VAC 40-72-290(C)(6)), this subtle move to an orientation requirement could indicate that licensing inspectors will expect greater efforts by facilities to ensure employees have a clear understanding of the reporting and compliance hierarchy.
The requirement that all staff be trained in “[t]echniques of complying with emergency and disaster plans including evacuating residents when applicable” (22 VAC 40-72-290(C)(2)) does not appear in the new regulations; however, this is likely due to its redundancy in relation to training requirements described elsewhere in the regulations.
Staff Records and Health Requirements: 22 VAC 40-73-250
There are several deletions from the requirements for staff records and health requirements. Social security numbers are no longer listed as mandatory content, and the requirement for at least two references has been replaced with a more flexible standard for documenting qualifications and relevant information. Documentation of disciplinary actions and the reason for termination are also omitted from this section of the new regulations. Lastly, the regulations eliminate provisions related to the facility administrator or Department of Social Services having the authority to require a physician examination and report on a staff person or household member based on indication of a physical or mental condition that may “jeopardize” resident safety.
Additional health requirements include documentation of vaccinations and screenings in accordance with the “staff health program” under the new infection control regulations. (Click here to read the NLG “Infection Control” summary for information on the new staff health program.)
First Aid and CPR Certification: 22 VAC 40-73-260
At least one staff person certified in first aid and at least one certified in CPR must be in each building at all times. In contrast, the existing regulations require at least one staff member with each certification type be on the premises at all times. Therefore, ALFs located on the same campus as a skilled nursing facility can no longer rely on the staffing of their higher acuity neighbor to satisfy this requirement. The new regulations also add certified EMTs, first responders, and paramedics to the list of those exempt from the first aid certification requirements for all direct care staff.
Staffing: 22 VAC 40-73-280
The new regulations expressly limit the “awake and on duty” exception (currently at 22 VAC 40-72-320(D)) to buildings housing 19 or fewer residents, if: (1) the facility is licensed for residential care only; and (2) it ensures compliance with 22 VAC 40-73-930(C) (concerning rounding on residents hourly if the facility is not equipped with a call system that permits staff to determine the origin of the signal). The existing requirement that no staff person be permitted to work in direct contact with a resident until receipt of a background check, unless that person is under the direct supervision of an employee for whom a background check has been completed has been relocated to this section. The requirement for maintaining written work schedules is now part of a new section, which is discussed next.
Work Schedule and Posting: 22 VAC 40-73-290
This is a separate section under the new regulations. In addition to existing required content, the written work schedule must indicate the person in charge at any given time. The facility must also “develop and implement a procedure for posting the name of the current on-site person in charge … in a place in the facility that is conspicuous to the residents and the public.” Absences and substitutions must still be noted on the written schedule, but so must any other scheduling changes.
The effective date of these new regulations is almost here! Contact a Nixon Law Group attorney today if you have questions or require assistance ensuring your community is ready.
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