Statutes, codes, and regulations
Delaware Administrative Code
Title 16 - Health and SafetyDepartment of Health and Social ServicesDivision of Health Care Quality
Assisted Living Facilities
Section 3225-16.0 - Staffing

16 Del. Admin. Code § 3225-16.0

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Current through Register Vol. 28, No. 3, September 1, 2024
Section 3225-16.0 - Staffing
16.1 As used herein "staff" includes permanent employees of the assisted living facility and independent contractors, including "temps."
16.2 A staff of persons sufficient in number and adequately trained, certified or licensed to meet the requirements of the residents shall be employed and shall comply with applicable state laws and regulations.
16.3 All direct care staff shall be familiar with the service agreement for each resident for whom they provide care.
16.4 Every assisted living facility shall have a Director. Facilities licensed for 25 beds or more shall have a full-time Nursing Home Administrator. Facilities licensed for 5 through 24 beds shall have a part-time Nursing Home Administrator on-site and on-duty at least 20 hours a week. If the assisted living facility is part of a continuing care retirement community (CCRC) or part of a campus under the same ownership, the CCRC or campus may operate under one licensed Nursing Home Administrator.
16.5 The Nursing Home Administrator shall comply with the provisions of 24Del.C.Ch. 52, and the Board's Rules and Regulations.
16.6 The Director/Nursing Home Administrator shall have overall responsibility for managing the assisted living facility such that all requirements of state law and regulations are met.
16.7 The Director of a facility for 4 beds or fewer shall meet one of the following criteria:
16.7.1 A baccalaureate degree in a health or social services field or business administration; or
16.7.2 An associates degree in a health or social services field or business administration and at least 2 years of full-time equivalent work experience in these disciplines; or
16.7.3 An RN with a combined total of 4 years full-time equivalent education and related work experience; or
16.7.4 At least 4 years full-time equivalent work experience as an LPN, or 5 years full-time equivalent work experience in a health or social services field or business administration.
16.8 The Director of a Facility for 4 beds or fewer shall be on-site at least 8 hours a week.
16.9 Each facility for 4 beds or fewer shall have a full-time, on-site house manager who shall at a minimum:
16.9.1 Possess a high school diploma or its equivalent;
16.9.2 Be certified as a CNA with at least three years experience providing care in a health care setting;
16.9.3 Complete an orientation program in accordance with the CNA regulations; and
16.9.4 Receive, at a minimum, 12 hours of regular in-service education annually, which may include but not be limited to the topics listed below:
16.9.4.1 The health and psychosocial needs of the population being served;
16.9.4.2 The resident assessment process;
16.9.4.3 Use of service agreements;
16.9.4.4 Cuing, coaching, and monitoring residents who self-administer medications, with or without assistance;
16.9.4.5 Providing assistance with ambulation, personal hygiene, dressing, toileting, and feeding;
16.9.4.616Del.C.Ch. 11, pertaining to resident's rights; reporting of abuse, neglect, mistreatment, and financial exploitation; and the Ombudsman Program;
16.9.4.7 Fire and life safety, and emergency disaster plans;
16.9.4.8 Infection control, including Standard Precautions;
16.9.4.9 Basic food safety;
16.9.4.10 Basic first aid, CPR, and the Heimlich Maneuver; and
16.9.4.11 Hospice services.
16.10 Assisted living facilities administering therapies and/or treatments shall have staff adequate in number and appropriately qualified and/or licensed.
16.11 Every assisted living facility shall have a Director of Nursing who is a registered nurse. Facilities licensed for 25 assisted living beds or more shall have a full-time Director of Nursing. Facilities licensed for 5 through 24 assisted living beds shall have a part-time Director of Nursing on-site and on-duty at least 20 hours a week. The nursing director of a facility for 4 assisted living beds or fewer shall be on-site at least 8 hours a week.
16.12 The Director of Nursing shall comply with the provisions of 24Del.C.Ch. 19 and the rules and regulations of the Board of Nursing.
16.13 The Director of Nursing shall have overall responsibility for the coordination, supervision and provision of the nursing department /services.
16.14 Assisted living facility resident assistants shall, at a minimum:
16.14.1 Be at least 18 years old;
16.14.2 Participate in a facility-specific orientation program that covers the following topics:
16.14.2.1 Fire and life safety, and emergency disaster plans;
16.14.2.2 Infection control, including Standard Precautions;
16.14.2.3 Basic food safety;
16.14.2.4 Basic first aid and the Heimlich Maneuver;
16.14.2.5 Job responsibilities;
16.14.2.6 The health and psychosocial needs of the population being served;
16.14.2.7 The resident assessment process; and
16.14.2.8 The use of service agreements;
16.14.2.916Del.C.Ch. 11, pertaining to residents' rights; reporting of abuse, neglect, mistreatment, and financial exploitation; and the Ombudsman Program;
16.14.2.10 Hospice services.
16.14.3 Receive, at a minimum, 12 hours of regular in-service education annually which may include but not be limited to the topics listed in 16.14.2;
16.14.4 Receive training to competently assist in activities of daily living or provide documentation of such training, and
16.14.5 Complete a Delaware Board of Nursing-approved AWSAM training course if assisting with self-administration of medications.
16.15 The assisted living facility shall have a staffing plan which shall specify supervisory responsibilities, including the person responsible in the Assisted Living Director's absence.
16.16 The assisted living facility shall maintain staffing records which document what personnel were on duty as well as specific hours worked for each day.
16.17 The assisted living facility shall maintain a copy of each employee's signature and handwritten initials.
16.18 The assisted living facility shall maintain records of each employee's regular in-service education hours.
16.19 The assisted living facility shall provide orientation training to all new staff.
16.20 Temporary agency staff placed in a facility in which they have not worked within the past 6 months shall undergo an orientation prior to beginning their first shift. The orientation shall cover the following topics:
16.20.1 Tour of the facility;
16.20.2 Fire and disaster plans;
16.20.3 Emergency equipment and supplies;
16.20.4 Communication and documentation requirements of the facility;
16.20.5 Process for reporting emergencies and change of condition; and
16.20.6 Review of current assigned resident issues/ needs.
16.21 All personnel records for permanent employees, including employment applications, shall be maintained for a minimum of five years consistent with the assisted living facility policies and applicable state laws.
16.22 At a minimum, every assisted living facility shall have an awake staff person on-site 24 hours per day who is qualified to administer or assist with self-administration of medication ("AWSAM") and who has knowledge of emergency procedures, basic first aid, CPR, and the Heimlich Maneuver.
16.23 Written policies and procedures shall be required and adhered to for any assisted living facility utilizing volunteers.

16 Del. Admin. Code § 3225-16.0