Current through Register No. 40, October 3, 2024
(a) The licensee
shall develop a job description for each position in the HHCP 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 patients 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 in (1) above in accordance with (c) (1) -(2) below; and
(3) Verify the qualifications of all
applicants prior to employment.
(c) Unless a waiver is granted in accordance
with He-P 809.10 and(e) 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 patients.
(d) 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.
(e) 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, after investigation, it determines that the person poses a threat to
the health, safety, or well-being of a patient; 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 patient(s) .
(f) 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;
(2) Only employ,
contract with, or engage board of nursing licensees who are listed on the
nursing assistant registry or licensing site with the NH board of
nursing.
(g) In lieu of
(b) and (f) 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 (f) above and
do not meet the criteria in (c) and (f) above.
(h) 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 as required by state statute;
(4) Receive an orientation prior to contact
with a patient that includes:
a. The HHCP's
policy on patient 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 HHCP's policies, procedures, and guidelines;
d. The HHCP's infection control
program;
e. The HHCP'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 HCCP's:
a. Policies and procedures on patient rights
and responsibilities;
b. Infection
control program; and
c. Fire and
emergency procedures;
(6) Be at least 18 years of age if working as
direct care personnel unless they are:
a. An
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 patients
or food, submit to the HHCP 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.
(i) In lieu of (h) (8) above, independent
agencies contracted by the facility to provide direct care or personal care
services may provide the licensee with a signed statement that its employees
have complied with (h) (7) and (9) above before working at the HHCP.
(j) 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 patient
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 patient 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 patient and arranging items to assist the transfer of the
patient; and
b. Non-weight bearing
assistance on a case-by-case basis as specified by the HHCP;
(3) Mobility assistance as
follows:
a. Accompanying the patient as he or
she moves from one location to another, removing obstacles from his or her
path, opening doors, and handing the patient his or her cane or
walker;
b. Pushing a wheelchair
which has been fitted to the patient; and
c. On a case-by-case basis steadying the
patient as he or she ambulates;
(4) 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 patient after instances of vomiting, diarrhea, and
incontinence;
e. Assistance with
ostomy care in a long term, well healed, trouble free ostomy, such as assisting
in application of the stoma bag on a case-by-case basis as individually trained
by the appropriate professional staff; and
f. Assistance with catheter care only by
emptying the urinary drainage bag on a case-by-case basis as individually
trained by the appropriate professional staff;
(5) 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 HHCP and individually
trained by the appropriate professional staff; and
(6) 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 patient's fork or
spoon;
d. Encouraging the patient
to eat or drink; and
e. Feeding the
patient by mouth on a case-by-case basis as determined by the agency.
(k) The HHCP shall
determine the patient-related training required by the personal care service
provider, in addition to the basic training described in (m) below, in order to
provide the personal care services which are on a case-by-case basis as
described in (j) above.
(l) Prior
to assisting patients with transfers, bathing, feeding, 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, the
clinical portion of which shall be conducted by a licensed professional such as
an LPN or RN.
(m) The training in
(j) above shall include at a minimum:
(1)
Orientation to home care including the role of the personal care service
provider and the general orientation required by (h) (4) above;
(2) Communication with patients, and
understanding patient needs;
(3)
Personal and home safety including environmental safety and emergency
response;
(4) 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 patient after elimination and use of products related to hygiene
care;
d. Moving and transferring
patients;
e. Nutrition, the
mechanics of eating, hydration, and how to prepare, serve, and encourage the
patient to eat and drink;
f. Use of
assistance devices;
g. Fall
prevention; and
h. Medication
reminder training; and
(5) Responsibility, accountability, and
record keeping.
(n) LNAs
who are working as personal care service providers shall be deemed as already
having received the training required in (m) above but shall be required to
receive the training required by (h) (4) above.
(o) The HHCP shall maintain a record for
training of each personal care service provider.
(p) The HHCP shall provide supervision of the
personal care service provider every 6 months.
(q) The director of patient services shall:
(1) Coordinate the individual training
required for personal care services provided on a case-by-case basis;
and
(2) Assure that the care plan
is being carried out.
(r) All personnel shall sign a statement at
the time the initial offer of employment 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, fraud, theft, abuse, neglect, or
exploitation or pose a threat to the health, safety, or well-being of a
patient; 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.
(s) Personnel,
volunteers, or independent contractors hired by the licensee who will have
direct care contact with patients or food who have a history of TB or a
positive skin test shall have a symptomatology screen in lieu of a TB
test.
(t) All personnel shall
follow the orders of the licensed practitioner for each patient and encourage
patients to follow the practitioner's order.
(u) Current, separate, and complete employee
files shall be maintained and stored in a secure and confidential manner at the
HHCP licensed premises.
(v) The
employee records required by (u) 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 HHCP's policy setting forth the patient 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 (h)
(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 (h) (5) above;
(8) Documentation of training as required by
(m) above;
(9) The statement signed
at the time of the initial offer of employment and renewed annually thereafter
by all personnel as required by (r) above;
(10) Documentation of the criminal records
check; and
(11) The results of the
registry checks in (f) above.
(w) The HHCP 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 patients 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 (v)
(2) and (6) -(10) above; and
(2)
For independent contractors, the information in (v) (2), and (4) -(12) above,
except that the letter in (h) and (j) above may be substituted for (v) (6),
(9), and (10) above, if applicable.
#9466, eff
5-2-09
