6 Colo. Code Regs. § 1011-1-5-6

Current through Register Vol. 47, No. 20, October 25, 2024

Section 6 CCR 1011-1-5-6 - PERSONNEL

6.1 POLICIES

The facility shall maintain written approved personnel policies, job descriptions and rules prescribing the conditions of employment, management of employees and quality and quantity of resident care to be provided.

A) The facility shall complete a job-specific orientation for all new employees within 90 days of employment.

B) All personnel shall be informed of the purpose and objectives of the facility.

C) All personnel shall be provided access to the facility's personnel policies and the facility shall provide evidence that each employee has reviewed them.

6.2 DEPARTMENTS

Each department of the facility shall be under the direction of a person qualified by training, experience, and ability to direct effective services.

A) The facility shall provide a sufficient number of qualified personnel in each department to effectively operate the department and comply with state and federal requirements.

B) All persons assigned to direct resident care shall be prepared through formal education or on-the-job training in the principles, policies, procedures, and appropriate techniques of resident care. The facility shall provide educational programs for employees to be informed of new methods and techniques.

6.3 STAFF DEVELOPMENT

The nursing care facility shall employ staff who shall be responsible for coordinating orientation, in-service, on-the-job training and continuing education programs, and for determining that facility personnel have been properly trained and are implementing the results of their training. The objective of this standard is that staff be appropriately trained in necessary aspects of resident care to carry out their job responsibilities.

A) The facility shall identify staff to meet in-service, orientation, training and supervision needs.

B) The identified staff shall have experience in and ability to prepare and coordinate in-service education and training programs for adult learners in the area of geriatrics.

C) The facility shall provide annual in-service education for staff in, at a minimum, the following topics:

1) Infection control;

2) Fire prevention and safety;

3) Accident prevention;

4) Confidentiality of resident information;

5) Rehabilitative nursing;

6) Resident rights;

7) Dietary;

8) Pharmacy;

9) Dental;

10) Behavior management;

11) Person centered care; and

12) Disaster preparedness.

D) If a facility has residents with intellectual and developmental disabilities, dementia or behavioral health issues, it shall also provide annual in-service education for staff in those topics.

E) The facility shall maintain attendance records with original signatures on in-service programs and course materials or outlines that staff who are unable to attend the program may review.

F) Dementia Training Requirements

1) As of January 1, 2024, each nursing care facility shall ensure that its direct-care staff members meet the dementia training requirements in this sub-section 6.3 (F).

2) Definitions: For the purposes of dementia training as required by Section 25-1.5-118, C.R.S.:

a) "Direct-care Staff Member" means a staff member caring for the physical, emotional, or mental health needs of residents in a covered facility and whose work involves regular contact with residents who are living with dementia diseases and related disabilities.

b) "Equivalent Training" in this section shall mean any initial training provided by a covered facility meeting the requirements of sub-section 6.3(F)(3).

3) Initial Training: Each nursing care facility is responsible for ensuring that all direct-care staff members are trained in dementia diseases and related disabilities.

a) Initial training shall be available to direct-care staff at no cost to them.

b) The training shall be competency-based and culturally-competent and shall include a minimum of four hours of training in dementia topics including the following content:

i) Dementia diseases and related disabilities;

ii) Person-centered care of residents with dementia;

iii) Care planning for residents with dementia;

iv) Activities of daily living for residents with dementia; and

v) Dementia-related behaviors and communication.

c) For direct-care staff members already employed prior to January 1, 2024, the initial training must be completed as soon as practical, but no later than 120 days after January 1, 2024, unless an exception, as described in sub-section 6.3(F)(4)(a), applies.

d) For direct-care staff members hired or providing care on or after January 1, 2024, the initial training must be completed as soon as practical, but no later than 120 days after the start of employment or the provision of direct-care services, unless an exception, as described in sub-section 6.3(F)(4)(b), applies.

4) Exception to Initial Dementia Training Requirement

a) Any direct-care staff member who is employed by or providing direct-care services prior to the January 1, 2024, may be exempted from the facility's initial training requirement if sub-sections I and II below are met:

i) The direct-care staff member has completed an equivalent training, as defined in these rules, within the 24 months immediately preceding January 1, 2024; and

ii) The direct-care staff member can provide documentation of the satisfactory completion of the equivalent training.

iii) If the equivalent training was provided more than 24 months prior to the date of hire as allowed in this exception, the individual must document participation in both the initial training and all required continuing education subsequent to the initial training.

b) Any direct-care staff member who is hired by or begins providing direct-care services on or after January 1, 2024, may be exempted from the facility's initial training requirement if the direct-care staff member:

i) Has completed an equivalent training, as defined in these rules, either:

(A) within the 24 months immediately preceding January 1, 2024; or

(B) Within the 24 months immediately preceding the date of hire or the date of providing direct-care services;

ii) Provides documentation of the satisfactory completion of the equivalent training; and

iii) Provides documentation of all required continuing education subsequent to the initial training.

c) Such exceptions shall not negate the requirement for dementia training continuing education as described in sub-part 6.3(F)(5).

5) Dementia Training: Continuing Education

a) After completing the required initial training, all direct-care staff members shall have documented a minimum of two hours of continuing education on dementia topics every two years.

b) Continuing education on this topic must be available to direct-care staff members at no cost to them.

c) This continuing education shall be culturally competent, include current information provided by recognized experts, agencies, or academic institutions, and include best practices in the treatment and care of persons living with dementia diseases and related disabilities.

6) Minimum Requirements for Individuals Conducting Dementia Training

a) Specialized training from recognized experts, agencies, or academic institutions in dementia disease;

b) Successful completion of the training being offered or other similar initial training which meets the minimum standards described herein; and

c) Two or more years of experience in working with persons living with dementia diseases and related disabilities.

6.4 RECORDS

A) The facility shall maintain personnel records on each employee, including an employment application that includes training and past experience, verification of credentials, references of past work experience, orientation and evidence that health status is appropriate to perform duties in the employee's job description.

B) Documentation of Initial Dementia Training and Continuing Education

1) The facility shall maintain documentation of each employee's completion of initial dementia training and continuing education. Such records shall be available for inspection by representatives of the Department.

2) Completion shall be demonstrated by a certificate, attendance roster, or other documentation.

3) Documentation shall include the number of hours of training, the date on which it was received, and the name of the instructor and/or training entity.

4) Documentation of the satisfactory completion of an equivalent training as defined in sub-section 6.3(F)(2)(b) and as required in the criteria for an exception discussed in sub-section 6.3(F)(4), shall include the information required in this sub-section 6.4(B)(2) and (3).

5) After the completion of training and upon request, such documentation shall be provided to the staff member for the purpose of employment at another covered facility. For the purpose of dementia training documentation, covered facilities shall include assisted living residences, nursing care facilities, and adult day care facilities as defined in Section 25.5-6-303(1), C.R.S.

6.5 REFERENCE MATERIALS

The facility shall provide current reference material related to the care that is provided in the facility for use by all personnel.

6.6 STAFF IDENTIFICATION

All facility staff shall wear name and title badges while on duty, except where they may pose a danger to staff or residents due to the nature of residents' physical or mental conditions.

6 CCR 1011-1-5-6

46 CR 24, December 25, 2023, effective 1/14/2024