New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-P - Former Division of Public Health Services
Chapter He-P 800 - RESIDENTIAL CARE AND HEALTH FACILITY RULES
Part He-P 809 - HOME HEALTH CARE PROVIDERS
Section He-P 809.17 - Personnel

Universal Citation: NH Admin Rules He-P 809.17

Current through Register No. 12, March 21, 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

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