N.H. Admin. Code § He-P 822.17

Current through Register No. 36, September 5, 2024

Section He-P 822.17 - Personnel

(a) The licensee shall develop a job description for each position in the HCSPA containing:

(1) Duties of the position;

(2) Physical requirements of the position; and

(3) Qualifications and educational requirements of the position.

(b) For all applicants for employment, for all volunteers, and for all independent contractors who will provide direct care or personal care services to clients the licensee shall:

(1) Obtain a criminal record 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;

(2) Review the results of the criminal records check (1) above in accordance with (c) (1) -(3) below;

(3) Verify the qualifications of all applicants prior to employment; and

(4) Verify that the applicant is not listed on the BEAS registry maintained by the department's bureau of elderly and adult services.

(c) Unless a waiver is granted in accordance with He-P 822.10 and(d) below, the licensee shall not offer employment, contract with, or engage a person in (b) above, for any position if the individual:

(1) Has been convicted of any felony in this or any other state;

(2) Has been convicted for 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 clients.

(d) The department shall grant a waiver of (c) above if, after reviewing the underlying circumstances, it determines that the person does not pose a threat to the health, safety, or well-being of clients.

(e) If the information identified in (c) above regarding any person identified in (b) above, is learned after the person is hired, contracted with, or engaged, the licensee shall immediately notify the department and either:

(1) Cease employing, contracting with, or engaging the person; or

(2) Request a waiver of (c) above.

(f) If a waiver of (c) above is requested, the department shall review the information and the underlying circumstances in (c) 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 if, after investigation, it determines that the person poses a threat to the health, safety, or well-being of a client; or

(2) Grant a waiver of (c) above if, after investigation, it determines that the person does not pose a current threat to the health, safety, or well-being of a client(s) .

(g) The licensee shall:

(1) Not employ, contract with, or engage, any person in (b) above who is listed on the BEAS state registry unless a waiver is granted by BEAS; and

(2) Only employ, contract with, or engage board of nursing licensees who are listed on the licensing site with the New Hampshire board of nursing or with a compact state.

(h) In lieu of (b) and (g) above, the licensee may accept from independent agencies contracted by the licensee to provide direct care or personal care services a signed statement that the agency's employees have complied with (b) and (g) above and do not meet the criteria in (c) and (g) above.

(i) All personnel shall:

(1) Meet the educational and physical qualifications of the position as listed on their job description;

(2) Not have been convicted of a felony, sexual assault, other violent crime, assault, fraud, theft, abuse, neglect, or exploitation of any person in this or any other state by a court of law or had a complaint investigation for abuse, neglect, or exploitation adjudicated and founded by the department or any administrative agency in this or any other state;

(3) Be licensed, registered, or certified if required by state statute;

(4) Receive an orientation prior to contact with a client that includes:

a. The HCSPA's policy on client rights and responsibilities and complaint procedures as required by RSA 151:20;

b. The duties and responsibilities of the position they were hired for;

c. The HCSPA's policies, procedures, and guidelines;

d. The HCSPA's infection control program;

e. The HCSPA's fire, evacuation, and emergency plans which outline the responsibilities of personnel in an emergency;

f. The mandatory reporting requirements such as RSA 161-F:46-48 and RSA 169-C:29-31; and

g. Body mechanics training;

(5) Complete mandatory annual in-service education, which includes a review of the HCSPA's:

a. Policies and procedures on client rights and responsibilities;

b. Infection control program;

c. Fire and emergency procedures; and

d. Mandatory reporting requirements such as RSA 161-F:46-48 and RSA 169-C:29-31;

(6) Be at least 18 years of age if working as direct care personnel unless they are:

a. A licensed nursing assistant (LNA) working under the supervision of an RN in accordance with Nur 700; or

b. Part of an established educational program working under the supervision of an RN;

(7) Prior to contact with clients or food, submit to the HCSPA the results of a physical examination or health screening performed by a licensed nurse or a licensed practitioner and 2 step tuberculosis (TB) testing, 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;

(8) Be allowed to work while waiting for the results of the second step of the TB test when the results of the first test are negative for TB; and

(9) 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.

(j) In lieu of (i) (8) above, independent agencies contracted by the HCSPA to provide direct care or personal care services shall provide the licensee with a signed statement that the agency's employees have complied with (i) (8) and (10) above before working at the HCSPA.

(k) The scope of services provided by a homemaker shall be limited to those services as defined in He-P 822.03(ab) and shall not include those services described in (l) (1) -(5) below.

(l) The scope of services provided by a personal care service provider shall be as follows:

(1) Basic personal care and grooming to include:

a. Sponge bathing;

b. Gathering and handing the client materials related to bathing;

c. Regulating the bath or shower water temperature and running the water;

d. Hair care including shampooing;

e. Skin care to include application of preventive skin care products;

f. Filing of nails;

g. Assisting with oral hygiene;

h. Shaving of client using an electric razor; and

i. Dressing to include putting on or removing clothing, shoes, and stockings;

(2) Transfer assistance as follows:

a. Weight bearing assistance such as steadying the client and arranging items to assist the transfer of the client; and

b. Non-weight bearing assistance on a case-by-case basis as specified by the HCSPA;

(3) Assistance with toileting and toileting hygiene measures as follows:

a. Assistance with the use of the toilet, commode, bedpan, and urinal;

b. Assistance with the use of products related to hygiene care such as disposable incontinent briefs or pads;

c. Assistance with cleaning after elimination;

d. Assisting with cleaning the client after instances of vomiting, diarrhea, and incontinence;

e. Assistance with ostomy care in a long term, well healed, trouble free ostomy, limited to assisting in application of the stoma bag on a case-by-case basis as individually trained by the HCSPA's director of client services or designee who has been trained by the appropriate professional staff; and

f. Assistance with catheter care to include emptying the urinary drainage bag or switching from a leg bag or a night bag or vice versa on a case-by-case basis as individually trained by the HCSPA's director of client services or designee who has been trained by the appropriate professional staff;

(4) Assistance with personal appliances as follows:

a. Insertion and cleaning dentures;

b. Insertion and cleaning hearing aids;

c. Cleaning and putting on eye glasses; and

d. Assisting with application of some types of braces, splints, slings, and prostheses on a case-by-case basis as determined by the HCSPA and individually trained by the HCSPA's director of client services or designee who has been trained by the appropriate staff;

(5) Assistance with nutrition, hydration, and meal preparation as follows:

a. Preparation of the meal;

b. Arranging food including cutting up or mashing the food;

c. Filling the client's fork or spoon;

d. Encouraging the client to eat or drink; and

e. Feeding the client by mouth on a case-by-case basis as determined by the agency; and

(6) Homemaker services.

(m) The HCSPA shall determine the client-related training required by the personal care services provider in addition to the basic training described in (o) below, in order to provide the personal care services which are on a case-by-case basis as described in (l) above.

(n) Prior to assisting clients with transfers, feeding, bathing, or dressing, personal care service providers, whose duties include the aforementioned tasks, shall attend a minimum 8-hour training in the performance of these duties, director of client services or designee who has been trained by the appropriate professional staff.

(o) The training in (n) above shall include at a minimum:

(1) Orientation to home care including the role of the personal care services provider and the general orientation required by (i) above;

(2) Training in communication with clients, and understanding client needs;

(3) Training in personal and home safety including environmental safety and emergency response;

(4) Training in personal care skills including:

a. Supervision and verbal prompting;

b. Assisting in bathing, dressing, grooming, mouth care, hair care, and skin care;

c. Assisting in elimination including cleaning the client after elimination and use of products related to hygiene care;

d. Moving and transferring clients;

e. Nutrition, the mechanics of eating, hydration, and how to prepare, serve, and encourage the client to eat and drink;

f. Use of assistance devices;

g. Fall prevention; and

h. Medication reminder training; and

(5) Training in responsibility, accountability, and recordkeeping.

(p) LNAs who are working as personal care service providers shall be deemed as already having received the training required in (o) above but shall be required to receive the training required by (i) (4) above.

(q) The HCSPA shall maintain a record for training of each personal care service provider.

(r) The HCSPA shall provide supervision of the personal care service provider every 6 months.

(s) The director of client services or designee shall:

(1) Coordinate the individual training required for personal care services provided on a case-by-case basis;

(2) Observe the performance of the personal care services provider on a quarterly basis;

(3) Assure that the plan of care is being carried out; and

(4) Perform an annual evaluation.

(t) All personnel shall sign a statement at the time the initial offer of employment is accepted 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, fraud, theft, abuse, neglect, or exploitation or pose a threat to the health, safety, or well-being of a client; and

(3) Have not 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.

(u) Personnel, volunteers, or independent contractors, hired by the licensee, who have a history of TB or a positive skin test and who will have direct care contact with clients or food shall have a symptomatology screen in lieu of a TB test.

(v) Current, separate, and complete employee files shall be maintained and stored in a secure and confidential manner at the HCSPA licensed premises.

(w) The personnel records required by (v) above shall include the following:

(1) A completed application for employment or a resume, including:

a. Identification data, including date of birth; and

b. The education and work experience of the employee;

(2) A signed statement acknowledging the receipt of the HCSPA's policy setting forth the clients' rights and responsibilities and acknowledging training and implementation of the policy as required by RSA 151:20;

(3) A job description signed by the individual that identifies the:

a. Position title;

b. Qualifications and experience; and

c. Duties required by the position;

(4) Record of satisfactory completion of the orientation program required by (i) (4) above and any required continuing education program;

(5) A copy of each current New Hampshire license, registration, or certification in a health care field, if applicable;

(6) Documentation that the required physical examination or health screening, and TB test results or radiology reports of chest x-rays, if required, have been completed by the appropriate health professionals;

(7) Documentation of annual in-service education as required by (i) (4) above;

(8) The statement signed at the time the initial offer of employment is accepted and renewed annually thereafter by all personnel as required by (t) above;

(9) Documentation of the criminal records check; and

(10) Documentation that the elder abuse registry checks required by (g) above.

(x) The HCSPA 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 clients or who will be unaccompanied by an employee while performing non-direct care or non-personal care services for clients within the facility, as follows:

(1) For volunteers, the information in (w) (2) and (6) -(10) above; and

(2) For independent contractors, the information in (w) (2), and (4) -(10) above, except that the letter in (j) above may be substituted for (w) (5), (8), and (9) above, if applicable.

N.H. Admin. Code § He-P 822.17

#9522, eff 7-25-09

Amended by Volume XXXIX Number 02, Filed January 10, 2019, Proposed by #12702, Effective 1/3/2019, Expires 1/3/2029.