YOU HIRED THEM MONDAY. CAN THEY ACTUALLY WORK TUESDAY?

YOU HIRED THEM MONDAY. CAN THEY ACTUALLY WORK ?
YOU HIRED THEM MONDAY. CAN THEY ACTUALLY WORK TUESDAY?

Florida ALF New-Hire Requirements Every Administrator Needs to Know

You interviewed someone on Monday.

They seemed like a great fit. You hired them, completed some paperwork and added them to Tuesday’s schedule.

But there is another question every Florida assisted living facility administrator should be asking:

Are they actually ready to work with residents?

Hiring an employee and having that employee ready to perform their assigned duties are not necessarily the same thing.

Florida assisted living regulations contain several requirements for new employees. The important part is understanding when each requirement must be completed.

Some requirements apply before an employee interacts with residents.

Others apply before providing personal care.

Several additional training requirements must be completed within the employee’s first 30 days.

Understanding the difference can help prevent an unnecessary AHCA deficiency.

Before They Interact With Residents

Rule 59A-36.011(2), F.A.C. — Preservice Orientation

A new employee who has not previously completed ALF core training must receive at least:

2 hours of preservice orientation before interacting with residents.

The orientation must cover, at a minimum:

  • Resident rights
  • The facility’s license type
  • Services offered by the facility

After completing the orientation, both the employee and facility administrator must sign a statement documenting completion.

That documentation must be maintained in the employee’s personnel record.

Compliance Tip

Build the two-hour preservice orientation directly into your onboarding process.

Don’t hire someone Monday, put them on the floor Tuesday and plan on completing the orientation sometime later.

If the requirement applies to that employee, it must be completed before resident interaction.

Before They Provide Personal Care

Rule 59A-36.011(3)(a), F.A.C. — Infection Control

There is another requirement operators should pay close attention to.

Direct-care staff, except for the nurses, CNAs and qualifying home health aides identified in the rule, must receive at least:

1 hour of infection-control training before providing personal care to residents.

The training includes:

  • Universal precautions
  • Facility sanitation procedures

The facility’s infection-control policies and procedures must be used when providing this training.

Documentation of compliance with applicable bloodborne-pathogen training under 29 CFR 1910.1030 may also be used to satisfy this requirement.

The important words here are:

BEFORE PROVIDING PERSONAL CARE.

Don’t confuse this requirement with training that can be completed within the first 30 days.

What Must Be Completed Within the First 30 Days?

Florida ALF regulations also establish several training requirements that may be completed within the employee’s first 30 days.

Adverse Incidents and Emergency Procedures

Direct-care staff must receive at least 1 hour of in-service training within 30 days of employment covering:

  • Reporting adverse incidents
  • Facility emergency procedures
  • Chain of command
  • Staff roles relating to emergency evacuation

Imagine asking a newly hired caregiver:

“If we had to evacuate this facility right now, what is your responsibility?”

Your staff should know the answer.

Resident Rights, Abuse, Neglect and Exploitation

Direct-care staff who have not taken ALF core training must receive at least 1 hour of training within 30 days of employment covering:

  • Resident rights
  • Recognizing abuse, neglect and exploitation
  • Reporting abuse, neglect and exploitation

The facility’s abuse-prevention policies and procedures must be used when providing this training.

Resident Needs and Activities of Daily Living

Certain direct-care staff must also receive at least:

3 hours of in-service training within 30 days of employment

covering:

  • Resident behavior and needs
  • Providing assistance with activities of daily living

The rule contains exceptions for certain nurses, CNAs and qualifying home health aides, so administrators should determine which requirements apply based on the employee’s position, credentials and responsibilities.

Don’t Forget Employees Who Prepare or Serve Food

Employees who prepare or serve food and who have not completed ALF core training must receive at least:

1 hour of safe food-handling training within 30 days of employment.

This is an important reminder that ALF training compliance doesn’t apply only to caregivers.

Look at what each employee actually does in your facility.

All Staff Need Elopement-Response Training

Florida’s ALF rules also require all facility staff to receive training regarding the facility’s resident-elopement response policies and procedures within 30 days of employment.

Staff must be provided with a copy of those policies and procedures and demonstrate understanding and competency in implementing them.

Notice the language:

ALL FACILITY STAFF.

Don’t limit your new-hire compliance review only to direct-care employees.

What Should Be in the Personnel File?

Rule 59A-36.015(2), F.A.C. — Staff Records

Training isn’t the only issue.

The personnel record for each staff member must contain, at minimum:

  • A copy of the employee’s application
  • References furnished
  • Documentation verifying freedom from signs or symptoms of communicable disease

As applicable, the personnel record must also contain:

  • Documentation of required staff training and continuing education
  • Copies of licenses or certifications when the employee provides services requiring licensure or certification
  • Documentation of Level 2 background-screening compliance for staff subject to screening requirements
  • Required job descriptions for facilities licensed for 17 or more residents
  • Documentation verifying required participation in resident-elopement drills

Facilities must also maintain written work schedules and staff time sheets for the most current six months.

Don’t Forget Level 2 Background Screening

Background screening should be part of your new-hire compliance process.

Rule 59A-36.015 requires facilities to maintain documentation of Level 2 background-screening compliance for employees who are subject to the applicable screening requirements.

The background-screening requirements are addressed through Rule 59A-36.010, F.A.C., and the applicable Florida statutes, including Section 429.174.

This isn’t something you want to discover is missing while AHCA is reviewing personnel files.

Administrators and Managers Have Additional Requirements

Rule 59A-36.011(1), F.A.C.

Administrators and managers have separate training requirements.

They must successfully complete the required ALF core training within 3 months of becoming an administrator or manager.

The core training consists of at least:

26 hours of training plus the competency test.

Successful completion requires a score of at least 75% on the competency test.

Administrators and managers must also complete 12 hours of assisted-living-related continuing education every two years.

There are provisions for administrators and managers who have previously completed core training, so facilities should review an individual’s training history when hiring someone into these positions.

The Dangerous Assumption: “We Have 30 Days”

This is probably one of the biggest lessons from these requirements.

You may hear someone in your facility say:

“Don’t worry. We have 30 days to get their training done.”

That statement can get you into trouble.

Yes, some requirements have a 30-day deadline.

But others don’t.

The preservice orientation requirement applies before resident interaction.

The applicable infection-control training applies before providing personal care.

Other training requirements may be completed within 30 days.

Your onboarding system needs to distinguish between them.

Create a Florida ALF New-Hire Compliance Checklist

I recommend dividing your new-hire process into four categories:

BEFORE RESIDENT INTERACTION

Verify whether the employee requires the two-hour preservice orientation. If so, complete it, obtain the required signatures and place the documentation in the personnel file.

BEFORE PROVIDING PERSONAL CARE

Determine whether the infection-control training requirement applies and make sure it is completed before the employee begins providing personal care.

WITHIN 30 DAYS

Track all applicable training deadlines, including adverse incidents, emergency procedures, resident rights, abuse/neglect/exploitation, resident needs and ADLs, safe food handling and elopement-response training.

PERSONNEL FILE

Make sure required documentation is actually collected and maintained, including applicable training records, licenses or certifications, background-screening documentation and other records required under Rule 59A-36.015.

Don’t Wait Until AHCA Walks Through the Door

One of the worst times to discover a personnel-file problem is during an AHCA survey.

You shouldn’t be searching emails trying to locate a training certificate.

You shouldn’t be asking:

“Didn’t we do that training when she started?”

And you definitely don’t want to discover that an employee has already been performing duties that required prerequisite training.

Create a system.

Use a new-hire checklist.

Assign someone responsibility for monitoring compliance.

Audit your personnel files periodically.

Most importantly, remember:

HIRING SOMEONE AND CLEARING THEM TO PERFORM THEIR JOB ARE TWO DIFFERENT THINGS.

Florida’s regulations tell you what must be completed.

Your responsibility as an operator is to create a system that makes sure it gets completed when it is supposed to be completed.

Regulations Referenced

Rule 59A-36.010, F.A.C. — Staffing Standards

Rule 59A-36.011, F.A.C. — Staff Training Requirements and Competency Test

Rule 59A-36.015, F.A.C. — Records

Section 429.174, Florida Statutes — Background Screening