Residents Files and records

“If you don’t have proof, it didn’t happen”, is something many administrators have heard from surveyors over the years due to their inability to track employee records properly. If training employees is the number 1 key to success then 1b would be ensuring you keep an accurate and up-to-date employee file, complete with all the necessary information. Check out this regulation provided by ADPH for what is required to be kept in every employee file:

420-5-4-.04 Personnel

(4) Personnel Records.

An assisted living facility shall maintain a personnel record for each employee. This record shall contain:

(a) An application for employment that contains information regarding the employee’s education, training, and experience.

(b) Verification of current certification or licensure, if applicable.

(c) Record of required physical examinations and vaccinations.

(d) Verification the facility has not hired an individual whose name is on the Alabama Department of Public Health Nurse Aide Abuse Registry.

(e) Date of hire.

(f) Date of initial resident contact.

(g) Date employment ceased.

(5) No member of the assisted living facility governing authority, and no employee of an assisted living facility, including the administrator, shall serve as legal guardian, as conservator, or as attorney-in-fact for any resident of the facility, nor shall any such individual solicit or accept control over the property of any resident, such as by becoming authorized to sign checks for the resident, or by becoming authorized to enter a resident’s safe deposit box, or by having authority to control real property or securities owned by the resident. No member of the assisted living facility governing authority, and no employee of an assisted living facility, including the administrator, shall accept gifts, cash, or any item of value from a resident of the assisted living facility other than what the resident is obligated to pay the facility for services rendered, as specified in the resident’s financial agreement with the facility. Provided, however, that assisted living facility residents, sponsors, and family members may offer, and employees may accept, gifts whose value does not exceed $25, on appropriate occasions such as holidays or birthdays if the gift is offered freely and voluntarily. In the case of a gift from a resident, the resident must have sufficient cognitive ability to knowingly, freely, and voluntarily offer a gift. Provided further, that none of these prohibitions shall apply between a resident and any member of the governing authority or employee if the two individuals are related to one another as defined in Section 420-5-4-.01(2)(b). Notwithstanding the foregoing, individuals appointed before October 5, 2001, as legal guardians for assisted living facility residents may continue to serve. This subsection is not intended to prevent assisted living facilities from offering to place resident funds in an escrow or trust account for the benefit of the resident whose funds are deposited, so long as exclusive decision-making authority for fund disbursement is vested in the resident or responsible family member, and so long as the disposition of escrowed funds is periodically reported to the resident or family member as appropriate. This subsection is also not intended to prohibit facilities from accepting memorial gifts in any amount from family members of deceased relatives, nor is it intended to prohibit facilities from accepting testamentary bequests in any amount from the estates of deceased residents.

(6) Training.

(a) All staff who have contact with residents, including the administrator, shall have initial training prior to resident contact and refresher training annually and as necessary. Documentation of all staff training to include attendance records and any required post-test or evaluations shall be maintained in the facility. In addition to any information otherwise required by the facility’s policies and procedures, the facility shall ensure that prior to resident contact, all staff members receive training on the subject matter listed below:

  1. State law and rules on assisted living facilities.
  2. Facility policies and procedures.
  3. Resident rights.
  4. Current certification from the American Heart Association or the American Red Cross in cardiopulmonary resuscitation (CPR) within 90 days of hire.
  5. Identifying and reporting abuse, neglect, and exploitation.
  6. Basic first aid.
  7. Advance directives.
  8. Protecting resident confidentiality.
  9. Resident fire and environment safety.
  10. Special needs of the elderly, mentally ill, and mentally retarded.
  11. Safety and nutritional needs of the elderly.
  12. Identifying signs and symptoms of dementia.

(b) Cardiopulmonary Resuscitation. An assisted living facility shall be staffed at all times by at least one individual who has a current certification from the American Heart Association or the American Red Cross in CPR. All employees of an assisted living facility who have contact with residents must be certified in CPR from the American Heart Association or the American Red Cross. New employees must obtain certification in CPR within 90 days of hire. An assisted living facility equipped with an automated external defibrillator (AED) shall be staffed at all times by at least one individual who has a current certification from the American Heart Association or the American Red Cross in AED utilization. Substitute training approved by the Department for use by emergency medical services personnel (EMSP) may be utilized in lieu of those courses or certifications offered by the American Heart Association or American Red Cross in CPR or AED utilization.

(c) If the facility admits or retains residents with special needs such as diabetes, hospice, or oxygen therapy, the facility shall provide staff with the appropriate training.

(d) Continuing Education. All staff must receive annual continuing education sufficient to remain knowledgeable of the training specified above.

Top Takeaway:

  1. (a) All staff who have contact with residents, including the administrator, shall have initial training prior to resident contact and refresher training annually and as necessary. Documentation of all staff training to include attendance records and any required post-test or evaluations shall be maintained in the facility. In addition to any information otherwise required by the facility’s policies and procedures, the facility shall ensure that prior to resident contact, all staff members receive training on the subject matter listed below: 1-12

Your orientation process CANNOT be an afterthought. Not just for the obvious regulatory purpose, but for the fact that providing staff with top-notch training has been proven to reduce your turnover rating, improve employee satisfaction and ultimately improve your resident care tenfold. As the administrator, you should take a huge role in the initial orientation process and set your new employees off on the right foot.

 

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