Current through Register No. 40, October 3, 2024
(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.
#9522, eff
7-25-09
