58A-5.0191 Staff Training Requirements and Competency Test.
(1) ASSISTED LIVING FACILITY CORE TRAINING REQUIREMENTS AND COMPETENCY TEST.
(a) The assisted living facility core training requirements established by the department pursuant to Section 429.52, F.S., shall
consist of a minimum of 26 hours of training plus a competency test.
(b) Administrators and managers must successfully complete the assisted living facility core training requirements within 3
months from the date of becoming a facility administrator or manager. Successful completion of the core training requirements
includes passing the competency test. The minimum passing score for the competency test is 75%. Administrators who have
attended core training prior to July 1, 1997, and managers who attended the core training program prior to April 20, 1998, shall not
be required to take the competency test. Administrators licensed as nursing home administrators in accordance with Part II of
Chapter 468, F.S., are exempt from this requirement.
(c) Administrators and managers shall participate in 12 hours of continuing education in topics related to assisted living every 2
years as provided under Section 429.52, F.S.
(d) A newly hired administrator or manager who has successfully completed the assisted living facility core training and
continuing education requirements, shall not be required to retake the core training. An administrator or manager who has
successfully completed the core training but has not maintained the continuing education requirements will be considered a new
administrator or manager for the purposes of the core training requirements and must:
1. Retake the assisted living facility core training; and
2. Retake and pass the competency test.
(e) The fees for the competency test shall not exceed $200. The payment for the competency test fee shall be remitted to the
entity administering the test. A new fee is due each time the test is taken.
(2) STAFF IN-SERVICE TRAINING. Facility administrators or managers shall provide or arrange for the following in-service
training to facility staff:
(a) Staff who provide direct care to residents, other than nurses, certified nursing assistants, or home health aides trained in
accordance with Rule 59A-8.0095, F.A.C., must receive a minimum of 1 hour in-service training in infection control, including
universal precautions, and facility sanitation procedures before providing personal care to residents. Documentation of compliance
with the staff training requirements of 29 CFR 1910.1030, relating to blood borne pathogens, may be used to meet this requirement.
(b) Staff who provide direct care to residents must receive a minimum of 1 hour in-service training within 30 days of
employment that covers the following subjects:
1. Reporting major incidents.
2. Reporting adverse incidents.
3. Facility emergency procedures including chain-of-command and staff roles relating to emergency evacuation.
(c) Staff who provide direct care to residents, who have not taken the core training program, shall receive a minimum of 1 hour
in-service training within 30 days of employment that covers the following subjects:
1. Resident rights in an assisted living facility.
2. Recognizing and reporting resident abuse, neglect, and exploitation.
(d) Staff who provide direct care to residents, other than nurses, CNAs, or home health aides trained in accordance with Rule
59A-8.0095, F.A.C., must receive 3 hours of in-service training within 30 days of employment that covers the following subjects:
1. Resident behavior and needs.
2. Providing assistance with the activities of daily living.
(e) Staff who prepare or serve food, who have not taken the assisted living facility core training must receive a minimum of 1-
hour-in-service training within 30 days of employment in safe food handling practices.
(f) All facility staff shall receive in-service training regarding the facility’s resident elopement response policies and procedures
within thirty (30) days of employment.
1. All facility staff shall be provided with a copy of the facility’s resident elopement response policies and procedures.
2. All facility staff shall demonstrate an understanding and competency in the implementation of the elopement response
policies and procedures.
(3) HUMAN IMMUNODEFICIENCY VIRUS/ACQUIRED IMMUNE DEFICIENCY SYNDROME (HIV/AIDS). Pursuant to
Section 381.0035, F.S., all facility employees, with the exception of employees subject to the requirements of Section 456.033, F.S.,
must complete a one-time education course on HIV and AIDS, including the topics prescribed in the Section 381.0035, F.S. New
facility staff must obtain the training within 30 days of employment. Documentation of compliance must be maintained in
accordance with subsection (12) of this rule.
(4) FIRST AID AND CARDIOPULMONARY RESUSCITATION (CPR). A staff member who has completed courses in First
Aid and CPR and holds a currently valid card documenting completion of such courses must be in the facility at all times.
(a) Documentation of attendance at First Aid or CPR course offered by an accredited college, university or vocational school; a
licensed hospital; the American Red Cross, American Heart Association, or National Safety Council; or a provider approved by the
Department of Health, shall satisfy this requirement.
(b) A nurse shall be considered as having met the training requirement for First Aid. An emergency medical technician or
paramedic currently certified under Part III of Chapter 401, F.S., shall be considered as having met the training requirements for
both First Aid and CPR.
(5) ASSISTANCE WITH SELF-ADMINISTERED MEDICATION AND MEDICATION MANAGEMENT. Unlicensed
persons who will be providing assistance with self-administered medications as described in Rule 58A-5.0185, F.A.C., must meet
the training requirements pursuant to Section 429.52(5), F.S., prior to assuming this responsibility. Courses provided in fulfilment of
this requirement must meet the following criteria:
(a) Training must cover state law and rule requirements with respect to the supervision, assistance, administration, and
management of medications in assisted living facilities; procedures and techniques for assisting the resident with self-administration
of medication including how to read a prescription label; providing the right medications to the right resident; common medications;
the importance of taking medications as prescribed; recognition of side effects and adverse reactions and procedures to follow when
residents appear to be experiencing side effects and adverse reactions; documentation and record keeping; and medication storage
and disposal. Training shall include demonstrations of proper techniques and provide opportunities for hands-on learning through
practice exercises.
(b) The training must be provided by a registered nurse or licensed pharmacist who shall issue a training certificate to a trainee
who demonstrates an ability to:
1. Read and understand a prescription label;
2. Provide assistance with self-administration in accordance with Section 429.256, F.S., and Rule 58A-5.0185, F.A.C.,
including:
a. Assist with oral dosage forms, topical dosage forms, and topical ophthalmic, otic and nasal dosage forms;
b. Measure liquid medications, break scored tablets, and crush tablets in accordance with prescription directions;
c. Recognize the need to obtain clarification of an “as needed” prescription order;
d. Recognize a medication order which requires judgment or discretion, and to advise the resident, resident’s health care
provider or facility employer of inability to assist in the administration of such orders;
e. Complete a medication observation record;
f. Retrieve and store medication; and
g. Recognize the general signs of adverse reactions to medications and report such reactions.
(c) Unlicensed persons, as defined in Section 429.256(1)(b), F.S., who provide assistance with self-administered medications
and have successfully completed the initial 4 hour training, must obtain, annually, a minimum of 2 hours of continuing education
training on providing assistance with self-administered medications and safe medication practices in an assisted living facility. The 2
hours of continuing education training shall only be provided by a licensed registered nurse, or a licensed pharmacist.
(6) NUTRITION AND FOOD SERVICE. The administrator or person designated by the administrator as responsible for the
facility’s food service and the day-to-day supervision of food service staff must obtain, annually, a minimum of 2 hours continuing
education in topics pertinent to nutrition and food service in an assisted living facility. A certified food manager, licensed dietician,
registered dietary technician or health department sanitarians are qualified to train assisted living facility staff in nutrition and food
service.
(7) EXTENDED CONGREGATE CARE TRAINING.
(a) The administrator and extended congregate care supervisor, if different from the administrator, must complete core training
and 4 hours of initial training in extended congregate care prior to the facility’s receiving its extended congregate care license or
within 3 months of beginning employment in the facility as an administrator or ECC supervisor. Successful completion of the
assisted living facility core training shall be a prerequisite for this training. ECC supervisors who attended the assisted living facility
core training prior to April 20, 1998, shall not be required to take the assisted living facility core training competency test.
(b) The administrator and the extended congregate care supervisor, if different from the administrator, must complete a
minimum of 4 hours of continuing education every two years in topics relating to the physical, psychological, or social needs of frail
elderly and disabled persons, or persons with Alzheimer’s disease or related disorders.
(c) All direct care staff providing care to residents in an extended congregate care program must complete at least 2 hours of inservice training, provided by the facility administrator or ECC supervisor, within 6 months of beginning employment in the facility.
The training must address extended congregate care concepts and requirements, including statutory and rule requirements, and
delivery of personal care and supportive services in an extended congregate care facility.
(8) LIMITED MENTAL HEALTH TRAINING.
(a) Pursuant to Section 429.075, F.S., the administrator, managers and staff, who have direct contact with mental health
residents in a licensed limited mental health facility, must receive the following training:
1. A minimum of 6 hours of specialized training in working with individuals with mental health diagnoses.
a. The training must be provided or approved by the Department of Children and Families and must be taken within 6 months of
the facility’s receiving a limited mental health license or within 6 months of employment in a limited mental health facility.
b. Staff in “direct contact” means direct care staff and staff whose duties take them into resident living areas and require them to
interact with mental health residents on a daily basis. The term does not include maintenance, food service or administrative staff, if
such staff have only incidental contact with mental health residents.
c. Training received under this subparagraph may count once for 6 of the 12 hours of continuing education required for
administrators and managers pursuant to Section 429.52(4), F.S., and subsection (1) of this rule.
2. A minimum of 3 hours of continuing education, which may be provided by the ALF administrator or through distance
learning, biennially thereafter in subjects dealing with one or more of the following topics:
a. Mental health diagnoses; and
b. Mental health treatment such as mental health needs, services, behaviors and appropriate interventions; resident progress in
achieving treatment goals; how to recognize changes in the resident’s status or condition that may affect other services received or
may require intervention; and crisis services and the Baker Act procedures.
3. For administrators and managers, the continuing education requirement under this subsection will satisfy 3 of the 12 hours of
continuing education required biennially pursuant to Section 429.52(4), F.S., and subsection (1) of this rule.
4. Administrators, managers and direct contact staff affected by the continuing education requirement under this subsection
shall have up to 6 months after the effective date of this rule to meet the training requirement.
(b) Administrators, managers and staff do not have to repeat the initial training should they change employers provided they
present a copy of their training certificate to the current employer for retention in the facility’s personnel files. They must also ensure
that copies of the continuing education training certificates, pursuant to subparagraph (a)2. of this subsection, are retained in their
personnel files.
(9) ALZHEIMER’S DISEASE AND RELATED DISORDERS (“ADRD”) TRAINING REQUIREMENTS. Facilities which
advertise that they provide special care for persons with ADRD, or who maintain secured areas as described in Chapter 4, Section
434.4.6 of the Florida Building Code, as adopted in Rule 9N-1.001, F.A.C., Florida Building Code Adopted, must ensure that
facility staff receive the following training.
(a) Facility staff who have regular contact with or provide direct care to residents with ADRD, shall obtain 4 hours of initial
training within 3 months of employment. Completion of the core training program between April 20, 1998 and July 1, 2003 shall
satisfy this requirement. Facility staff who meet the requirements for ADRD training providers under paragraph (g) of this
subsection will be considered as having met this requirement. “Staff who have regular contact” means staff who interact on a daily
basis with residents but do not provide direct care to residents. Initial training, entitled “Alzheimer’s Disease and Related Disorders
Level I Training,” must address the following subject areas:
1. Understanding Alzheimer’s disease and related disorders;
2. Characteristics of Alzheimer’s disease;
3. Communicating with residents with Alzheimer’s disease;
4. Family issues;
5. Resident environment; and
6. Ethical issues.
(b) Staff who have received both the initial one hour and continuing three hours of ADRD training pursuant to Sections
400.1755, 429.917, and 400.6045(1), F.S., shall be considered to have met the initial assisted living facility Alzheimer’s Disease and
Related Disorders Level I Training.
(c) Facility staff who provide direct care to residents with ADRD must obtain an additional 4 hours of training, entitled
“Alzheimer’s Disease and Related Disorders Level II Training,” within 9 months of employment. Facility staff who meet the
requirements for ADRD training providers under paragraph (g) of this subsection will be considered as having met this requirement.
Alzheimer’s Disease and Related Disorders Level II Training must address the following subject areas as they apply to these
disorders:
1. Behavior management;
2. Assistance with ADLs;
3. Activities for residents;
4. Stress management for the care giver; and
5. Medical information.
(d) A detailed description of the subject areas that must be included in an ADRD curriculum which meets the requirements of
paragraphs (a) and (b) of this subsection can be found in the document “Training Guidelines for the Special Care of Persons with
Alzheimer’s Disease and Related Disorders,” dated March 1999, incorporated by reference, available from the Department of Elder
Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000.
(e) Direct care staff shall participate in 4 hours of continuing education annually as required under Section 429.178, F.S.
Continuing education received under this paragraph may be used to meet 3 of the 12 hours of continuing education required by
Section 429.52, F.S., and subsection (1) of this rule, or 3 of the 6 hours of continuing education for extended congregate care
required by subsection (7) of this rule.
(f) Facility staff who have only incidental contact with residents with ADRD must receive general written information provided
by the facility on interacting with such residents, as required under Section 429.178, F.S., within three (3) months of employment.
“Incidental contact” means all staff who neither provide direct care nor are in regular contact with such residents.
(g) Persons who seek to provide ADRD training in accordance with this subsection must provide the department or its designee
with documentation that they hold a Bachelor’s degree from an accredited college or university or hold a license as a registered
nurse, and:
1. Have 1 year teaching experience as an educator of caregivers for persons with Alzheimer’s disease or related disorders; or
2. Three years of practical experience in a program providing care to persons with Alzheimer’s disease or related disorders; or
3. Completed a specialized training program in the subject matter of this program and have a minimum of two years of practical
experience in a program providing care to persons with Alzheimer’s disease or related disorders.
(h) With reference to requirements in paragraph (g), a Master’s degree from an accredited college or university in a subject
related to the content of this training program can substitute for the teaching experience. Years of teaching experience related to the
subject matter of this training program may substitute on a year-by-year basis for the required Bachelor’s degree referenced in
paragraph (g).
(10) ALZHEIMER’S DISEASE AND RELATED DISORDERS (“ADRD”) TRAINING PROVIDER AND CURRICULUM
APPROVAL.
(a) The training provider and curriculum shall be approved by the department or its designee prior to commencing training
activities. The department or its designee shall maintain a list of approved ADRD training providers and curricula. Approval as a
training provider and approval of the curriculum may be obtained as follows:
1. Applicants seeking approval as ADRD training providers shall complete DOEA form ALF/ADRD-001, Application for
Alzheimer’s Disease and Related Disorders Training Provider Certification, dated March 2005, which is incorporated by reference
and available at the Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000.
2. Applicants seeking approval of ADRD curricula shall complete DOEA form ALF/ADRD-002, Application for Alzheimer’s
Disease and Related Disorders Training Three-Year Curriculum Certification, dated March 2005, which is incorporated by reference
and available at the Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000. Approval of the
curriculum shall be granted for 3 years, whereupon the curriculum shall be re-submitted to the department or its designee for reapproval.
(b) Approved ADRD training providers must maintain records of each course taught for a period of 3 years following each
program presentation. Course records shall include the title of the approved ADRD training curriculum, the curriculum approval
number, the number of hours of training, the training provider’s name and approval number, the date and location of the course, and
a roster of trainees.
(c) Upon successful completion of training, the trainee shall be issued a certificate by the approved training provider. The
certificate shall include the title of the approved training and the curriculum approval number, the number of hours of training, the
trainee’s name, dates of attendance, location and the training provider’s name, approval number and dated signature. The training
provider’s signature on the certificate shall serve as documentation that the training provider has verified that the trainee has
completed the required training pursuant to Section 429.178, F.S.
(d) The department or its designee reserves the right to attend and monitor ADRD training courses, review records and course
materials approved pursuant to this rule, and revoke approval on the basis of non-adherence to approved curriculum, the provider’s
failure to maintain required training credentials, or if the provider is found to knowingly disseminate any false or misleading
information.
(e) Except as otherwise noted, certificates of any ADRD training required by this rule shall be documented in the facility’s
personnel files.
(f) ADRD training providers and training curricula which are approved consistent with the provisions of Sections 429.1755,
429.6045, and 429.5571, F.S., shall be considered as having met the requirements of paragraph (9)(a) and subsection (10) of this
rule.
(11) DO NOT RESUSCITATE ORDERS TRAINING.
(a) Currently employed facility administrators, managers, direct care staff and staff involved in resident admissions must receive
at least one hour of training in the facility’s policies and procedures regarding DNROs within 60 days after the effective date of this
rule.
(b) Newly hired facility administrators, managers, direct care staff and staff involved in resident admissions must receive at
least one hour of training in the facility’s policy and procedures regarding DNROs within 30 days after employment.
(c) Training shall consist of the information included in Rule 58A-5.0186, F.A.C.
12) TRAINING DOCUMENTATION AND MONITORING.
(a) Except as otherwise noted, certificates, or copies of certificates, of any training required by this rule must be documented in
the facility’s personnel files. The documentation must include the following:
1. The title of the training program;
2. The subject matter of the training program;
3. The training program agenda;
4. The number of hours of the training program;
5. The trainee’s name, dates of participation, and location of the training program;
6. The training provider’s name, dated signature and credentials, and professional license number, if applicable.
(b) Upon successful completion of training pursuant to this rule, the training provider must issue a certificate to the trainee as
specified in this rule.
(c) The facility must provide the Department of Elder Affairs and the Agency for Health Care Administration with training
documentation and training certificates for review, as requested. The department and agency reserve the right to attend and monitor
all facility in-service training, which is intended to meet regulatory requirements