rcfe administrator initial certification programmary smith is an 84 year old female resident living...
TRANSCRIPT
RCFE ADMINISTRATOR INITIAL CERTIFICATION PROGRAM
Day 2
3) Reporting Requirements
Incident Reporting
Abuse Reporting
4) Human Resources
Staffing Requirements
Criminal Clearance
Managing Staff
OSHA
DAY 2
1) Enforcement
CCL Inspections
Deficiencies
Ombudsman
2) Resident Rights
Resident Rights
Resident Councils
Family Councils
2
3
ABOUT YOUR INSTRUCTOR
Name
Background
Years with CCG
An “interesting” fact…
Pre-Test
4
PRE‐TEST
a) True
b) False
Residents have the right to leave or depart the facility at any time.
5
a) True
b) False
Every RCFE is required to have a resident and family council.
6
What is the purpose of the Ombudsman program?
7
a) When a resident with dementia hits another resident
b) When a resident falls and gets a skin tear
c) When a resident requires CPR
d) All of the above
Which of the following must be reported to Community Care Licensing?
8
a) 1 employee for every 6 residents
b) 1 employee for every 15 residents
c) 1 employee for every 50 residents
d) None of the above
What is the required staffing ratio in an RCFE?
9
Enforcement
10
ENFORCEMENT
• What’s the most important thing you need to know about inspections and evaluations or surveys? (Regulations 87755, 87756, 87757)
DIG IN!
11
SB1
Applicable Regulations
INSPECTION AUTHORITY
• 87755
12
Be ready at any time!
Slide 11
SB1 addedSharon Brothers, 12/9/2015
TYPES OF INSPECTIONS
13
Pre-licensing
Post-licensing
Complaint
Unannounced
Applicable Regulations
EVALUATION VISITS
• 87756
• 87757
14
Unannounced to 20%
Inspections at least once every 5 years
Increasing frequency to annual
Key indicator
Key Indicator Tool #1
15
LIC809
16
Applicable Regulations
DEFICIENCIES
• 87758
• 87759
17
Serious (Type A)
Non-serious (Type B)
Technical violations (Type C)
Applicable Regulations
PENALTIES
• 87761
• 87766
18
• 87768
• 87769
Serious deficiencies
Criminal clearance
Deficiency types
Progressive penalties
• Write the page number for each of the serious violations next to each entry in regulation 87758
• Review each of the 17 serious deficiencies listed
• Find each subsection where the deficiency is listed and not “Serious Type A Violation”
• Review and discuss each of these 17 deficiencies in your group.
FIND THE DEFICIENCIES (30 MIN)
19
• Write the page number for each of the serious violations next to each entry in regulation 87758
• Review each of the 17 serious deficiencies listed
• Find each subsection where the deficiency is listed and not “Serious Type A Violation”
• Review and discuss each of these 17 deficiencies in your group.
Applicable Regulations
APPEALS
• 87763
20
Your right
If you disagree
If a penalty
If you’re denied
Must be in writing
Resident Rights
21
RESIDENT RIGHTS
AB 2171 – RESIDENT RIGHTS
Rights
Requirements
AB 2171 – RESIDENT RIGHTS
Must advise residents
Must post copy
Must train staff
AB 2171 – RESIDENT RIGHTS
Dignity
Privacy
Confidential Treatment
Exercising of Rights
AB 2171 – RESIDENT RIGHTS
Safe accomodations
Services that meet needs
Quality food
Choices
AB 2171 – RESIDENT RIGHTS
Participate in care
Free from neglect
AB 2171 – RESIDENT RIGHTS
Present complaints
Contact DSS
AB 2171 – RESIDENT RIGHTS
Fully informed
Agreement requirements
AB 2171 – RESIDENT RIGHTS
Informed of limits to stay
Accommodation
Roommates
AB 2171 – RESIDENT RIGHTS
Notice of room changes
Share a room if desired
Selection of own providers
AB 2171 – RESIDENT RIGHTS
Access to records
Protection from transfers
AB 2171 – RESIDENT RIGHTS
Move out
Visits
Right to advanced directives
Independent living
AB 2171 – RESIDENT RIGHTS
Have a resident council
Safe Property
Manage Finances
ac) …shall not do any of the following
AB 2171 – RESIDENT RIGHTS
Be a guardian (without consent)
Be a payee (without consent)
Serve as POA
Share a bank account
Loan or borrow money
AB 2171 – RESIDENT RIGHTS
To own and access personal possessions
Resident Councils
36
RESIDENT COUNCILS
• Find and share two things about resident councils you didn’t know before? (Regulations AB1572)
DIG IN!
37
SB1
AB 1572 – RESIDENT COUNCILS
Council formation
AB 1572 – RESIDENT COUNCILS
Participation
Slide 37
SB1 addedSharon Brothers, 12/9/2015
AB 1572 – RESIDENT COUNCILS
Promote
Inform
Offer to create
AB 1572 – RESIDENT COUNCILS
Liaison
AB 1572 – RESIDENT COUNCILS
Be Responsive
AB 1572 – RESIDENT COUNCILS
Post “Rights of Resident Councils”
Inform of right to be interviewed
Violation considered violation of resident rights
Family Councils
44
FAMILY COUNCILS
AB 1572 – FAMILY COUNCILS
Allow to form
You participate only if invited
Promote
Respond in writing to concerns
Share council contact info
Interference is violation
• Your residents and family member hold a join council. They just held their quarterly meeting and sent you the following requests/complaints.
• Walk through how you would handle each of them, including what your response would be to the council.
COUNCIL FEEDBACK
46
• “The food here is not living up to our expectations. The meat is a poor quality cut, there isn’t enough salt on anything, and we need more variety.”
COUNCIL FEEDBACK
47
• “There isn’t enough parking. Whenever we come to visit our parents all of the guest spaces are taken, and often they are being used by your staff.”
COUNCIL FEEDBACK
48
• “We are very worried about two of your employees. We have seen them using keys to enter apartments late at night and believe they are stealing things from our apartments. Several of us have lost money and jewelry on the nights they are working.”
COUNCIL FEEDBACK
49
Ombudsman
50
OMBUDSMAN
ADULT PROTECTIVE SERVICES
51
State funded
Help adults and elders who may be victims
OMBUDSMAN
52
Authorized by OAA
Responsibility to resolve complaints
ROLE OF THE OMBUDSMAN
53
Resolving complaints
Observing conditions
Speaking with residents
Assisting in protecting
OMBUDSMAN
54
Rights
Attend resident council
Review records (with approval)
Cannot review employee files
CONTACT INFO
55
Resident information
List three ways the ombudsman can be your ally:
• _______________________________________
• _______________________________________
• _______________________________________
YOUR ALLY…
56
• Caringbridge.org
• Hospice
• What else?
OTHER COMMUNITY RESOURCES
57
Reporting Requirements
58
REPORTING AND REQUIREMENTS
REPORTING REQUIREMENTS
59
Calling 911
Incident Reports
Abuse Reports
Notification of family
CALLING 911
60
Call 911 if in doubt
Follow Instructions
Be aware of DNR
Document!
Applicable Regulations
INCIDENT REPORTING
• 87211
61
7 days
VIDEO: INCIDENT REPORTING
62
INCIDENT REPORTING
63
Death
Injury
Defibrillator use
Safety threat
• Yes or no? _______________________________
• If yes, why? ______________________________
• If no, why? _______________________________
SHOULD YOU REPORT EVERY FALL?
64
Mary Smith is an 84 year old female resident living in your RCFE. Mary’s daughter brought her to your Community when her cognitive functioning became more impaired after her third stroke a year ago.
Mary fell while walking to the dining room one morning and hit her head on the tile floor. She had a small cut on her temple, but otherwise reported that she felt fine. Mary asked a caregiver to simply place a bandage on the cut and let her go to bed.
How should you handle this? Should you call 911?
Case Study
65
LIC624
66
LIC624A
67
ABUSE REPORTING
68
Mandated reporters
Misdemeanor
VIDEO: YOUR LEGAL DUTY
69
SB7
Slide 69
SB7 newSharon Brothers, 12/9/2015
STAFF TRAINING
70
Show video
SOC 341
Mandated Reporter
Responsibilities
Train on Hire & Annual
Sign SOC341A
YOUR LEGAL DUTY
71
SOC341A
72
ABUSE REPORTING
73
Suspected / witnessed
Use SOC 341
Report to Ombudsman
ABUSE REPORTING
74
Ombudsman cannot report without consent of resident
Report directly to law enforcement
If suspected or alleged physical abuse
results in serious bodily injury:
ABUSE REPORTING
1. Call local law enforcement immediately.
2. Send a written report.
75
If suspected or alleged physical abuse does
NOT result in serious bodily injury:
ABUSE REPORTING
1. Call local law enforcement within 24 hoursAND
2. Send a written report to law enforcement, local ombudsman, and CCL within 24 hours
76
If suspected or alleged physical abuse is
caused by a resident with dementia, and does NOT result in
serious bodily injury:
ABUSE REPORTING
1. Call the local ombudsman OR law enforcement agency immediately or as soon as possibleAND
2. Make a written report within 24 hours
77
If suspected or alleged abuse is not physical abuse (abandonment,
abduction, isolation, financial, neglect):
ABUSE REPORTING
1. Call the local ombudsman OR law enforcementagency immediately or as soon as possibleAND
2. Make a written report within two working days
78
ABUSE REPORTING
79
Serious bodily injury
ABUSE REPORTING
80
SOC341
81
Human Resources
82
HUMAN RESOURCES
Your staff are the key to your success!
HUMAN RESOURCES
83
HUMAN RESOURCES
84
Identify Needs
Recruit
Screen and Interview
Hire
Manage
Terminate
Staffing Requirements
85
STAFFING REQUIREMENTS
• You’re getting ready to hire the staff you need for a new 50 bed community. What 3 things do you need to know? (Regulations: 87405, 87411, 87413, 87415)
DIG IN!
86
GENERAL CONSIDERATIONS
87
Size
Universal worker?
Assignments
UNIVERSAL WORKERS
88
Direct care and more
Offers flexibility and continuity
Not right for all
DEPARTMENTS
89
Executive Director
Resident Care
Nurse
Caregivers
Sales Food Service
Chef
Cooks
Wait staff
Maintenance
Assistants
Business Office
Billing
Accounting
Human resources
Activities
COMMON ROLES, DUTIES, AND QUALIFICATIONS
90
Department Heads
Line Staff
JOB DESCRIPTIONS
91
Explains job
Lists criteria
Performance measure
Lists requirements
Applicable Regulations
ADMINISTRATOR QUALIFICATIONS AND DUTIES
• 87405
92
Provide services
Meet special needs
Address unmet needs
Have ability to do job
Administer according to Regulations
Report on operations
Develop policies and procedures
Recruit, hire, train staff
Applicable Regulations
STAFFING REQUIREMENTS
• 87411
• 87413
93
Screened
Scheduled
Enough
Competent
18 or older
Trained
LIC500
94
STAFFING PATTERNS
95
Wage Order 5
8, 12, or 24 hours
Staffing adequate
Overtime consideration
Exempt vs. non
LIVE-IN FORMULA AS OF JANUARY 1, 2016
96
8 hours X $10.00 $80.00
1 hour meal break relieved of all duties, unpaid $0.00
8 hours of sleep, unpaid as long as staff is uninterrupted $0.00
4 hours X $10.00 X 1.5 times rate (overtime) $60.00
3 hours X $10.00 X 2 times rate (overtime) $60.00
TOTAL DAILY RATE $200.00 per day
TOTAL WEEKLY RATE (Daily Rate X 5 days) $1000.00 per week
Less Meals, $15.27 (3 meals daily) X 5 days - $76.35
Less lodging - $47.03
TOTAL FOR 5 DAYS COVERAGE $876.62 per week
TOTAL MONTHLY COVERATE (4.2 X weekly total) $3,681.81 per month
Applicable Regulations
STAFFING PATTERNS AND RATIOS
• 87415
97
Regulations
Sufficient
24/7/365
Scheduling
STAFFING/SCHEDULING IDEAS
98
4-on/2-off staffing patterns
Weekend vs week day
Live-in
Holiday Pay
Shift differentials
Recruiting and Hiring Staff
99
RECRUITING AND HIRING STAFF
WHERE TO FIND QUALITY STAFF?
100
Advertising
Classifieds
Online
Word of mouth
Refer a friend
Local schools/colleges
How do you become a preferred employer in your area?
• ________________________________________
• ________________________________________
• ________________________________________
• ________________________________________
PREFERRED EMPLOYER?
101
SCREENING
102
Pre-Screen Interview Offer of employment
PRE-SCREENING
103
Review application
Form 995F
Review position
Review Pay
Interview if qualified
• As a group, create at least one open-ended interview question for each group member
• Everyone find a person from another group and ask your open-ended question. Switch so both people get to ask their question, and both get to answer like an applicant.
• Repeat 2-3 times
• Did your question help you identify whether the applicant would be a good fit? How?
INTERVIEWING SKILLS
104
LIC995 F
105
THE INTERVIEW
106
Application
Equal employer
No promise
THE INTERVIEW
107
Open ended
Evaluate critically
No promises
Take notes
• Questions to avoid
• Fair Employment and Housing (CA DFEH)
THE INTERVIEW
108
• One volunteer to be the hiring manager
• One volunteer to be the applicant
• Practice asking open-ended questions
ROLE PLAY!
109
THE HIRING DECISION
110
More than one interview
Check References
Avoid a bad hire!
OFFER OF EMPLOYMENT
111
Contingencies
Offer Letter
No promises
Effective January 1, 2012, California law requires offer letters for non-exempt employees
OFFER LETTERS
112
OFFER LETTERS
113
Pay rate
Allowances
Pay day
Employer name
Address
Telephone number
Employer name
Insurance information
Criminal Clearance
114
CRIMINAL CLEARANCE
Applicable Regulations
CRIMINAL CLEARANCE REQUIREMENTS
• 87355
115
Who must be cleared
Who is exempt
Timeframes for clearances
Transfers
Criminal Record statements
Penalties for violation
Applicable Regulations
WHO MUST BE CLEARED?
• 87355
116
Licensee
Administrator
Adults living in
Caregivers
Staff and volunteers
CEO and Officers
Applicable Regulations
WHO IS EXEMPT?
• 87355
117
Visitors
Volunteers (criteria)
Contractors (criteria)
Medical professionals
Hospice/home health staff
Clergy
Must be completed “prior to working, residing or volunteering in a licensed facility”
TIMEFRAMES FOR CLEARANCE
118
CRIMINAL RECORD STATEMENT
(LIC508)
119
CRIMINAL CLEARANCE PROCESS
120
Fingerprints Submitted
DOJ Conducts Background Check
No Criminal History
Clearance forwarded to individual and
CBCB
Criminal History
CBCB reviews transcript from DOJ
Exemption or denial
LIVESCAN
121
Replaced ink fingerprints
CCL offices
Fees vary
3455 88888
CRIMINAL CLEARANCE FEES
122
DOJ Fee $42
FBI Fee $17
DOJ CACI Fee n/a
Livescan Fee (varies) $16
TOTAL $75
Applicable Regulations
CRIMINAL RECORD EXEMPTION
• 87356
123
All Convictions require it
Serious crimes not eligible
Health Screening
124
HEALTH SCREENING
HEALTH SCREENING
125
All personnel
Health Screening
TB test
6 months prior to 7 days post
Managing Staff
126
MANAGING STAFF
VIDEO: SEXUAL HARASSMENT
127
MANAGING STAFF
128
Federal and state laws
Required postings
Worker’s comp
Employee records
Staff training
Performance management
OSHA
• Paychex
• ADP
• Labor attorneys
• California Chamber of Commercewww.calchamber.com
DON’T DO IT ALONE!
129
Federal and State Employment Laws
130
FEDERAL AND STATE EMPLOYMENT LAWS
• Sexual Harassment
VIDEO BREAK
131
OTHER AGENCIES INVOLVED
132
• State and federal
• Department of Labor
• IRS
• Employment Development Department (EDD)
• US Citizenship and Immigration Services
• Cal/OSHA
• COBRA
• FLSA
• FMLA
• OSHA
• Wage Order 5
KEY EMPLOYMENT LAWS
133
FLSA
134
Fair Labor Standards Act
Standards for pay
Restricts hours for children
Learn more: www.dol.gov/compliance/laws/comp-flsa.htm
• California Department of Industrial Relations
• Regulates wages
• www.dir.ca.gov/iwc/wageorderindustries.htm
WAGE ORDER 5
135
CALIFORNIA OVERTIME REQUIREMENTS
136
Rate Applies To
Regular rate of pay
• Up to eight hours in any workday• Up to 40 hours in a workweek
1.5 x regular rate of pay
• All hours worked in excess of eight hours up to and including 12 hours in any workday, and
• The first eight hours worked on the seventh consecutive day of work in a workweek
2 x regular rate of pay
• All hours worked in excess of 12 hours in any workday, and
• All hours worked in excess of eight on the seventh consecutive day of work in a workweek.
Learn more: www.dol.gov/dol/topic/health-plans/cobra.htm
COBRA
137
COBRA
Continuation of benefits
Circumstances vary
Associated cost
Group plans
Learn more: www.dol.gov/compliance/laws/comp-fmla.htm
FMLA
138
Family and Medical Leave Act
12 weeks unpaid leave
50 employees to qualify
Learn more: www.dol.gov/compliance/laws/comp-osha.htm
OSHA
139
Occupational Safety
Assure safety and health
Federal level
State level
Required Postings
140
REQUIRED POSTINGS
For more information:www.dol.gov/elaws/posters.htm
REQUIRED POSTERS
141
Laws
Displayed
Update Annually
• Industrial Welfare Commission (IWC) Orders
• Pay Day Notice
• Harassment or Discrimination in Employment is Prohibited by Law
• Equal Employment Opportunity is the Law (includes ADA poster)
• Safety and Health Protection on the Job (CAL-OSHA)
• Notice of Workers’ Compensation Carrier
• Notice to Employees: Unemployment Insurance & Disability Insurance
• Emergency Phone Numbers
• Notice: Employee Polygraph Protection Act
• Notice to Employees: Time Off to Vote
REQUIRED POSTERS
142
• Minimum Wage (State)
• Minimum Wage (Federal)
• Family and Medical Leave Act of 1993 (Federal) (50 or more employees)
• Family Care/Medical Leave/Pregnancy Disability (State) (50 or more employees)
• Pregnancy Disability Leave (five or more employees)
• No Smoking/Smoking Prohibited Except in Designated Areas
• Your Rights Under USERRA (Only certain size employers: Contact Labor Board)
• Military Duty
• National Labor Relations Act Notice
• Your Right to Know - Injuries Caused by Work
DOL eLAWS TOOL
143
Workers Compensation Insurance
144
WORKERS COMPENSATION INSURANCE
WORKERS COMPENSATION INSURANCE
145
California law
Employer paid
Notice must be posted
SICK OR HURT ON THE JOB
146
Provide claim form
Return copy to employee
Forward to claims admin
Up to $10,000 in treatment
Light duty when appropriate
Employee Records
147
EMPLOYEE RECORDS
Applicable Regulations
• Personnel record
• Health screening/TB test
• Criminal record statement
• Criminal clearance
• Administrator certificate, if applicable
• First aid card, if applicable
• Verification of education/experience
• Copy of driver’s license
• Training documentation
• SOC 341A
EMPLOYEE RECORDS
• 87412
148
CCL STAFF RECORDS CHECKLIST
149
LIC501
150
FORM I-9
151
FORM W-4
152
Staff Training
153
STAFF TRAINING
EMERGENCY TRAINING AND STAFFING
154
AB2044
Requires Administrator
Sufficient number
Requires training
• 40 hours total
• 20 hours before
independence
• 20 hours within
4 weeks
CAREGIVER ORIENTATION TRAINING
155
• 20 hours annually
• 8 hours of dementia
• 4 hours hospice, supports
CAREGIVER ONGOING TRAINING
156
• 16 or more residents
• 24 hours training
• 16 hours hands-on shadowing
• 8 hours of other training
• 1-15 residents
• 10 hours training
• 6 hours hands-on shadowing
• 4 hours of other training
MEDICATION TRAINING
157
• Employee safety
• Injury and Illness Prevention
• Handwashing
• Back safety
• Workplace violence
• Bloodborne pathogens
• Personal protective equipment
• Disaster, emergency, and fire safety
DON’T FORGET OSHA
158
Performance Management
159
PERFORMANCE MANAGEMENT
• 90 days
• Annually
• Important feedback tool
• Opportunity for pay increases
• Set measurable goals
PERFORMANCE REVIEWS
160
Terminating Staff
161
TERMINATING STAFF
TERMINATING STAFF
162
Documentation critical
Performance Reviews
Opportunities to improve
Performance improvement plans
“At-will” but keep documentation
Final paycheck and Change of Employment documentation required
163
OSHA
ABOUT OSHA
164
Federal agency
Safe, healthy workplaces
Required to follow
WHY OSHA MATTERS
165
Protect your Assets
Reduce injuries
Accidents are expensive
Fines are high
INJURY AND ILLNESS PREVENTION PROGRAMS
166
Required
Improves workplace
YOUR IIPP MUST INCLUDE
167
Responsible Party ID
Hazard ID
Correction plan
System for reporting
ONGOING TRAINING FOR ALL EMPLOYEES
168
Hazardous Substances
Fire Prevention
Emergency Response
Safety Plan
Medical Waste Disposal
Infection Control
PPE Training
HAZARD COMMUNICATION
169
Staff Training
Notification of Hazards
Globally harmonized System
Labels
Safety Data Sheets
!
MEDICAL WASTE DISPOSAL PLAN
170
Identification of wastes
Training on disposal
Systems for disposal
EPA registration number
Sharps container
EMERGENCY ACTION PLAN
171
Disaster plan actions
Evacuation plans
Personnel trained
Location of assembly
Shut down procedures
FIRE PREVENTION PLAN
172
Location of fire extinguishers
Training in fire prevention
Fire department location
Identification of hazards
Site plan
SPECIALIZED TRAINING FOR HEALTHCARE FACILITIES
173
Tuberculosis exposure plan
Blood borne Pathogens training
Ergonomics training
VIDEO: BLOODBORNE PATHOGENS
174
End of Day Quiz
175
End of Day Quiz
END OF DAY QUIZ
a) Remove resident records for copying
b) Permanently remove personnel records
c) Inspect the entire premises
d) Interview residents privately
Which of the following is an LPA not allowed to do during an inspection?
176
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Describe the posting requirements for resident rights:
177
a) When the Ombudsman feels it is necessary to protect resident safety
b) When invited by the Administrator
c) When invited by the resident council
d) None of the above
When is the Ombudsman allowed to attend the resident council?
178
__________________________________________
__________________________________________
__________________________________________
__________________________________________
When is the RCFE required to assist with the formation of a family council?
179
a) Within 7 days
b) Within 14 days
c) Within 30 days
d) Within 90 days
When does the written incident report have to be submitted to CCL?
180
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Describe the minimum staffing requirements according to Title 22 regulations.
181
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Give three examples of individuals that must be criminally cleared:
182
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Describe the criminal clearance requirements for volunteers:
183
a) All residents
b) All RCFEs
c) All employers
d) All LPAs
In general, OSHA requirements apply to:
184
a) Injury and Illness Prevention Program
b) Injury and Sickness Prevention Program
c) Incident Prevention Program
d) Incidental Medical Services Plan
The name of the safety policies and procedures Cal/OSHA requires employers maintain is:
185
Any Questions
186