Section He-P 804.18 - Personnel(a) The licensee shall ensure that sufficient numbers of qualified personnel are present in the ALR-RC to meet the needs of residents at all times as determined by each RAT.(b) For those ALR-RCs licensed for 17 or more beds, at least one awake personnel shall be on duty at all times, including overnight, while residents are in the ALR-RC.(c) For those ALR-RCs licensed for 16 or fewer beds, at least one awake personnel shall be on duty at all times, including overnight, while residents are in the ALR-RC, unless: (1) There is a communication system whereby residents can contact and awaken the sleeping personnel member via an intercom or other communication system in the personnel member's room;(2) If the ALR-RC has residents with a history of exit seeking, the licensee has installed and maintains a functioning wander prevention system that will awaken the sleeping personnel; and(3) All residents: a. Require nothing more then occasional reminding or cueing;b. Require nothing more then verbal prompting for mobility and evacuation issues;c. Have no acute medical needs or ongoing nursing needs; andd. Have no history of being verbally or physically abusive. (d) For all applicants for employment, for all volunteers, for all independent contractors who will provide direct care or personal care services to residents or who will be unaccompanied by an employee while performing non-direct care or non-personal care services within the facility, and for all household members, the licensee shall: (1) Obtain and review a criminal records check from the New Hampshire department of safety, except, pursuant to RSA 151:2-d, VI, for those licensed by the New Hampshire board of nursing; and(2) Review the results of the criminal records check in (1) above in accordance with (e) below; and(3) Verify the qualifications of all applicants prior to employment.(e) Unless a waiver is granted in accordance with (g) (2) below, the licensee shall not offer employment, contract with, or engage a person in (d) above, or allow a household member to continue to reside in the residence, if the person:(1) Has been convicted of a felony in this or any other state;(2) Has been convicted of a sexual assault, other violent crime, assault, fraud, theft, abuse, neglect, or exploitation in this or any other state;(3) Has had a finding by the department or any administrative agency in this or any other state for assault, fraud, theft, abuse, neglect, or exploitation of any person; or(4) Otherwise poses a threat to the health, safety, or well-being of residents.(f) If the information identified in (e) above regarding any person in (d) above is learned after the person is hired, contracted with, or engaged, or after the person becomes a household member, the licensee shall immediately notify the department and either: (1) Cease employing, contracting with, or engaging the person, or not permit the household member to continue to reside in the residence; or(2) Request a waiver of (e) above.(g) If a waiver of (e) above is requested, the department shall review the information and the underlying circumstances in (e) above and shall either: (1) Notify the licensee that the person cannot or can no longer be employed, contracted with, or engaged by the licensee, or the person cannot or can no longer reside in the facility if, after investigation, it determines that the person poses a threat to the health, safety, or well-being of a resident; or(2) Grant a waiver of (e) above if, after investigation, it determines that the person does not pose a current threat to the health, safety, or well-being of a resident(s) .(h) The licensee shall check the names of the persons in (d) above against the bureau of elderly and adult services (BEAS) state registry, maintained pursuant to RSA 161-F:49 and He-E 720, and against the NH board of nursing, nursing assistant registry, maintained pursuant RSA 326-B:26 and 42 CFR 483.156, prior to employing, contracting with, or engaging them, or prior to allowing or continuing to allow a household member to reside at the residence.(i) The licensee shall not employ, contract with, engage, or allow to reside in the facility any person in (d) above who is listed on the BEAS state registry or the NH board of nursing, nursing assistant registry unless a waiver is granted by BEAS or the NH board of nursing, respectively.(j) In lieu of (d) and (h) above, the licensee may accept from independent agencies contracted by the licensee or by an individual resident to provide direct care or personal care services a signed statement that the agency's employees have complied with (d) and (h) above and do not meet the criteria in (e) and (i) above.(k) All administrators appointed after the 2017 effective date of these rules shall be at least 21 years of age and have one of the following combinations of education and experience: (1) A bachelor's degree from an accredited institution and one year of experience working in a health care facility;(2) A New Hampshire license as an RN and at least 6 months of experience working in a health care facility;(3) An associate's degree from an accredited institution and at least 2 years of experience working in a health care facility; or(4) A New Hampshire license as an LPN and at least one year of experience working in a health care facility.(l) All administrators shall obtain and document 12 hours of continuing education related to the operation and services of the ALR-RC each annual licensing period, in accordance with (t) and (u) below.(m) All direct care personnel shall be at least 18 years of age unless they are: (1) A licensed nursing assistant working under the supervision of a nurse in accordance with Nur 700; or(2) Involved in an established educational program working under the supervision of a nurse.(n) The licensee shall inform personnel of the line of authority at the ALR-RC.(o) The licensee shall educate personnel about the needs and services required by the residents under their care.(p) Prior to having contact with residents or food, personnel shall: (1) Submit to the licensee the results of a physical examination or a health screening performed by a licensed nurse or a licensed practitioner and the results of a 2-step tuberculosis (TB) test, Mantoux method, or other method approved by the Centers for Disease Control, both conducted not more than 12 months prior to employment, contract, or engagement;(2) Be allowed to work while waiting for the results of the second step of the TB test when the results of the first step are negative for TB; and(3) Comply with the requirements of the Centers for Disease Control and Prevention "Guidelines for Preventing the Transmission of M. tuberculosis in Health-Care Settings" (2005 edition), available as noted in Appendix A, if the person has either a positive TB test, or has had direct contact or potential for occupational exposure to M. tuberculosis through shared air space with persons with infectious tuberculosis.(q) In lieu of (p) (1) above, independent agencies contracted by the facility or by an individual resident to provide direct care or personal care services may provide the licensee with a signed statement that its employees have complied with (p) (1) and (3) above before working at the ALR-RC.(r) Prior to having contact with residents or food, personnel shall receive a tour of and orientation to the ALR-RC that includes the following: (1) The residents' rights in accordance with RSA 151:20;(2) The ALR-RC's resident complaint procedures;(3) The duties and responsibilities of the position;(4) The emergency medical procedures;(5) The emergency and evacuation procedures;(6) The infection control procedures as required by He-P 804.22;(7) The procedures for food safety for personnel involved in preparation, serving, and storing of food; and(8) The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29.(s) The licensee shall provide all personnel with an annual continuing education or in-service education training, which at a minimum contains the following: (1) The licensee's resident's rights and complaint procedures required under RSA 151;(2) The licensee's infection control program;(3) The licensee's written emergency plan; and(4) The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29.(t) The facility administrator, licensed nurse, if available, or the administrator's designee who has completed the 4-hour medication assistance supervision program required by He-P 804.17(ak) shall provide and document in writing, an annual review of its policies and procedures for self administration of medication without assistance, self administration of medication with assistance, and self-directed medication administration to all direct care personnel.(u) The ALR-RC shall maintain a separate employee file for each employee, which shall include the following:(1) A completed application for employment or a resume;(2) Proof that the individual meets the minimum age requirements;(3) A statement signed by each individual that he or she has received a copy of and received training on the implementation of the licensee's policy setting forth the residents rights and responsibilities as required by RSA 151:21;(4) A copy of the results of the criminal record check as described in (d) above;(5) A job description signed by the individual that identifies the: b. Qualifications and experience; andc. Duties required by the position;(6) Record of satisfactory completion of the orientation program required by (r) above;(7) Information as to the general content and length of all in-service or educational programs attended;(8) Record of satisfactory completion of all required education programs and demonstrated competencies that are signed and dated by the employee;(9) A copy of each current driver's license, including proof of insurance, if the employee transports residents using their own vehicle;(10) Documentation that the required physical examinations or health screenings, TB test results, and radiology reports of chest x-rays, if required, have been completed by the appropriate health professionals;(11) The statement required by (w) below; and(12) The results of the registry checks in (h) above.(v) The ALR-RC shall maintain the records, but not necessarily a separate file, for all volunteers and for all independent contractors who provide direct care or personal care services to residents or who will be unaccompanied by an employee while performing non-direct care or non-personal care services within the facility, as follows: (1) For volunteers, the information in (u) (1), (3), (4), (6), and (8) -(12) above; and(2) For independent contractors, the information in (u) (3), (4), (6), and (8) -(12) above, except that the letter in (j) and (q) above may be substituted for (u) (4), (10), and (12) above, if applicable. (w) All personnel shall sign a statement at the time the initial offer of employment, contract, or engagement is made and then annually thereafter stating that they: (1) Do not have a felony conviction in this or any other state;(2) Have not been convicted of a sexual assault, other violent crime, assault, theft, fraud, abuse, neglect, or exploitation or pose a threat to the health, safety, or well-being of a resident; and(3) Have not had a finding upheld by the department or any administrative agency in this or any other state for assault, fraud, theft, abuse, neglect, or exploitation of any person. (x) An individual shall not have to re-disclose any of the matters in (w) above if the documentation is available and the department has previously reviewed the material and determined that the individual can continue employment, contract, or engagement.(y) The licensee shall protect and store in a secure and confidential manner all records described in (u) and (v) above.(z) The licensee shall document evidence of immunization against influenza and pneumococcal disease for all consenting employees and shall provide to its consenting employees annual immunizations against influenza, to include: (1) That immunizations shall be provided and reported in accordance with RSA 151:9-b, I-V; and(2) The facility shall have a plan that identifies and documents, with dates, employees that have received or declined to receive immunizations.(aa) Personnel shall not be impaired while on the job by any substances including, but not limited to, legally prescribed medication, therapeutic cannabis, or alcohol.(ab) The ALR-RC shall have a written policy, as described in RSA 151:41, establishing procedures for the prevention, detection, and resolution of controlled substance abuse, misuse, and diversion, which shall apply to all personnel, and which shall be the responsibility of a designated employee or interdisciplinary team.(ac) The policy in (ab) above shall include: (2) Procedures for monitoring the distribution and storage of controlled substances;(3) Voluntary self-referral by employees who are addicted;(4) Co-worker reporting procedures;(5) Drug testing procedures to include at a minimum, testing where reasonable suspicion exists;(6) Employee assistance procedures;(8) Investigation, reporting, and resolution of controlled drug misuse or diversion; and(9) The consequences for violation of the controlled substance abuse, misuse, and diversion prevention policy.N.H. Code Admin. R. He-P 804.18
Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12047, Effective 11/19/2016, Expires 5/18/2017.Amended by Volume XXXVII Number 45, Filed November 09, 2017, Proposed by #12414, Effective 11/3/2017, Expires 11/3/2027.