Section 11-89-9 - General staff health requirements(a) All individuals living in the facility including those who provide services directly to residents shall have documented evidence that they have had examination by a physician prior to their first contact with the residents of the home and thereafter as frequently as the department deems necessary. The examination shall be specifically oriented to rule out communicable disease and shall include tests for tuberculosis. (1) If an initial tuberculin skin test is negative, a second tuberculin skin test shall be done after one week, but no later than three weeks after the first test. The results of the second test shall be considered the baseline test and shall be used to determine appropriate treatment follow-up. If the second test is negative, it shall be repeated once yearly thereafter unless it becomes positive.(2) If a tuberculin skin test is positive, a standard chest x-ray and appropriate medical follow-up shall be obtained. A satisfactory chest x-ray shall be required yearly thereafter for three successive years.(3) Additional chest x-rays may be required by the director.(b) Any individual providing services to the residents who develops evidence of a communicable disease shall be immediately relieved of any duties relating to food handling or direct resident contact, or both, and shall continue to be relieved of duties until such time as a physician certifies it is safe for the individual to resume the duties. Undiagnosed skin lesions, respiratory tract symptoms or diarrhea shall be considered presumptive evidence of a communicable disease.(c) There shall be clear documentation, that all persons who provide services to residents have been informed of the requirements provided in subsections (a) and (b).(d) The department may require an examination by a physician of any caregiver, administrator or staff as a condition for continued licensure at any time the department feels the health or safety of residents may be in danger. The examination shall be oriented to determine if the caregiver, administrator or staff person is capable of caring for the residents or has a condition which would endanger the health or safety of residents.(e) The caregiver of a facility shall give as much advance notice as possible, but not less than two weeks, except for emergencies, to residents, parents, guardians, case manager, and the division, if the caregiver plans to be absent for more than two days. Plans for coverage during the period of absence by a responsible adult shall be handled on an individual basis and shall be submitted in writing to the division for approval. Responsible adults shall have current tuberculin clearances and shall be physically and mentally capable of providing all necessary services to residents.(f) Responsible adults shall be capable of managing any emergency occurring in the facility as well as the caregiver could have managed had he or she been present. At a minimum, the responsible adult shall have the following skills during the periods of absence of the certified caregiver. This does not preclude the temporary transfer of the residents to another suitable certified and licensed facility. | Duration of absence of the carecriver | Required skills of the responsible adult |
| As long as zero-three hours | (1) Able to communicate, read and write in the English language. |
| (2) Trained to make medications available to residents and properly record such action. |
| (3) Be CPR certified. |
| (4) Have a valid certificate in first aid training. |
| (5) Give personal care as needed. |
| (6) Able to take temperature, pulse, and respiration. |
| As long as four-six hours | In addition to the above, must be able to: |
| (7) Cook and serve an appropriate meal. |
| (8) Give necessary feeding assistance. |
| (9) Dress and bathe residents. |
| (10) Follow recreational programs as prescribed in the individual plan. |
| (11) Transport residents to out of home events and appointments. |
| Greater than six hours | In addition to the above, must follow operational protocol of the home. |
(g) If the certified caregiver is to be absent from the facility for more than one week, another certified caregiver shall be required to be present.[Eff FEB 03 1992] (Auth: HRS §§ 321-9, 321-11, 321-15.9) (Imp: HRS § 321-15.9)