16 Del. Admin. Code § 3220-4.0

Current through Register Vol. 28, No. 3, September 1, 2024

Section 3220-4.0 - Mandatory Orientation Period

4.1 Nursing Facilities General Requirements

4.1.1 All CNAs hired to work in a facility shall undergo a minimum number of clock hours of orientation. The requirements for certified nursing assistant orientation shall be specified by the Department in a written order signed by the Secretary.

4.1.2 Any CNA undergoing orientation may be considered a facility employee for purposes of satisfying the minimum facility staffing requirements. Orientation may also be considered as part of the 64 hour work requirement for certification renewal.

4.1.3 If a CNA who is not employed, or does not have an offer to be employed as a CNA, becomes employed by, or receives an offer of employment from a federally certified nursing facility not later than 12 months after completing a nurse aide training and competency evaluation program, the federally certified nursing facility shall reimburse all documented personally incurred costs in completing the CNA Training program.

4.1.3.1 Facilities shall accept as documentation: canceled checks, paid receipts, written verification from a training program or other written evidence which reasonably establishes the CNA's personally incurred costs.

4.1.3.2 Such costs include tuition, tests taken and fees for textbooks or other required course materials.

4.1.3.3 Such costs shall be reimbursed in equal quarterly payments with full reimbursement to coincide with the CNA's completion of one year of employment including the orientation period.

4.1.3.4 Any nursing facility which reimburses a CNA for documented personally incurred costs of a nurse aide training and competency evaluation program shall notify the Department of such reimbursement.

4.1.3.5 Notice of such reimbursement shall be entered in the CNA Registry database and information regarding such reimbursement shall be available to facilities upon request.

4.2 Orientation Program Requirements

4.2.1 The mandatory orientation program shall be under the supervision of a nurse and must include:

4.2.1.1 Tour of the facility and assigned residents' rooms

4.2.1.2 Fire and disaster plans

4.2.1.3 Emergency equipment and supplies

4.2.1.4 Communication (including the facility chain of command) and documentation requirements

4.2.1.5 Process for reporting emergencies, change of condition and shift report

4.2.1.6 Operation of facility equipment and supplies, including scales, lifts, special beds and tubs

4.2.1.7 Review of the plan of care for each assigned resident/patient including:

4.2.1.7.1 ADL/personal care needs

4.2.1.7.2 nutrition, hydration and feeding techniques and time schedules

4.2.1.7.3 bowel and bladder training programs

4.2.1.7.4 infection control procedures

4.2.1.7.5 safety needs

4.2.1.8 Role and function of the CNA

4.2.1.9 Resident/patient rights; abuse reporting

4.2.1.10 Safety and body mechanics; transfer techniques

4.2.1.11 Vital signs

4.2.1.12 Psychosocial needs

4.2.1.13 Facility policies and procedures

4.3 Temporary Agency Requirements

4.3.1 All CNAs employed by temporary agencies and placed in a facility in which they have not worked within the previous six (6) months shall undergo a minimum of two (2) hours of orientation prior to beginning their first shift at the facility.

4.3.2 Any CNA employed by a temporary agency and undergoing orientation shall not be considered a facility employee for purposes of satisfying the minimum facility staffing requirements.

4.3.3 The mandatory two-hour orientation program shall be under the supervision of a nurse and must include:

4.3.3.1 Tour of the facility and assigned resident/patient rooms

4.3.3.2 Fire and disaster plans

4.3.3.3 Emergency equipment and supplies

4.3.3.4 Communication and documentation requirements

4.3.3.5 Process for reporting emergencies, change of condition and shift report

4.3.3.6 Operation of facility equipment and supplies including but not limited to scales, lifts, special beds and tubs

4.3.3.7 Review of the plan of care for each assigned resident/patient including:

4.3.3.7.1 ADL/personal care needs

4.3.3.7.2 Nutrition, hydration and feeding techniques and time schedules

4.3.3.7.3 Bowel and bladder training programs

4.3.3.7.4 Infection control procedures

4.3.3.7.5 Safety needs

16 Del. Admin. Code § 3220-4.0

26 DE Reg. 107( 8/1/2022) (Final)