64a
2600.64(a) - Prior to initial employment as an administrator, a candidate shall successfully complete the following:
(1) An orientation program approved and administered by the Department.
(2) A 100-hour standardized Department-approved administrator training course.
(3) A Department-approved competency-based training test with a passing score.
Discussion: The approved orientation program is a daylong course offered each month in each of the
Department’s regional offices. A schedule of courses may be obtained by calling the regional office in which the home is located, calling the Department’s headquarters office, calling the Operator Support Hotline, or visiting the Department’s website.
The 100-hour standardized Department-approved administrator training course (“the 100-hour course”) is provided by several colleges and universities throughout Pennsylvania. Information on the 100-hour course may be obtained by calling the regional office in which the home is located, calling the Department’s headquarters office, calling the Operator Support Hotline, or visiting the Department’s website.
Applicability - This requirement does not apply to an administrator hired or promoted prior to October 24, 2005 who has not had more than a one-year break in service.
The One-Day Orientation Program - Once an administrator attends the orientation program, (s)he does not need to attend it again. It is strongly recommended that an administrator who has a break in service longer than one year voluntarily attend the orientation program again as a refresher course.
The 100-hour Course - Once an administrator takes the 100-hour course, (s)he does not need to take it again.
If an administrator took the 40-hour course required by 55 Pa.Code Chapter 2620 (the personal care home regulations in place prior to October 25, 2005) and has not had more than a one year break in service since the course was completed, the 100-hour course is recommended but not required.
A Pennsylvania-licensed Nursing Home Administrator (NHA) does not need to take the 100-hour course at any time.
An NHA who was hired or promoted prior to January 1, 2009 does not need to complete the web-based competency test at any time.
The Competency Test - The competency test is an online, computerized assessment that is part of the 100-hour course. After completing the 100-hour course, participants take the test to verify that they have fully grasped the concepts of the course. Note: the competency test was not available until January 1, 2009.
An administrator hired or promoted prior to January 1, 2009 does not need to take the competency test, as it was not offered before that date. An administrator who completed the 100-hour course prior to January 1, 2009 and who was not hired or promoted to work as an administrator on or after April 1, 2012 must take the competency test.
Inspection Procedures: Inspectors will review documentation of completion of each requirement, and/or documentation of exemption from one or more requirements.
Primary Benefit: Ensures that the administrator will have the basic training to establish and maintain regulatory compliance and meet residents’ needs.
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64c 2600.64(c) - An administrator shall have at least 24 hours of annual training relating to the job duties.
Discussion: Administrators are encouraged to take a variety of training courses to enrich and expand their knowledge and skills to help them operate the personal care home successfully.
In order to count toward the 24 hours of annual training, the training must be approved in advance by the Department. An administrator may complete up to 12 of the 24 hours of annual training online.
Department-approved training includes:
• Any training listed in the Department’s “Personal Care Home Administrator Training Resource Directory,”
which may be obtained by calling the regional office in which the home is located, calling the Department’s headquarters office, calling the Operator Support Hotline, or visiting the Department’s website.
• Training hours approved for completion of continuing education requirements for Nursing Home
Administrator, Registered Nurse and Licensed Practical Nurse licensure. Documentation that the course has been approved as a training source by the Pennsylvania Department of State must be kept.
• Any course from an accredited college or university.
• Up to 6 hours of medication administration training, medication administration train-the-trainer course or train-the-trainer recertification required by § 2600.190(a).
• Training hours spent in the diabetes education required by § 2600.190(b).
• Up to 4 hours of CPR, obstructed airway and first aid training required by § 2600.63(a).
• Courses approved by the National Continuing Education Review Service of the National Association of Long-Term Care Administrator Boards (NAB) where:
a. The “Domain” of practice is approved by the Department.
b. The “Sponsor” is not the legal entity that employs the administrator.
c. The “Program Type” is “in person.”
• Any course offered by an agent of the Department of Public Welfare that relates to the operation of a personal care home may be counted. This includes the direct care staff training offered on the
Department’s website; the actual amount of time it took to complete these courses should be counted and documented by the administrator.
• The 100-hour course required by § 2600.64(a).
The Training Year - The home may select the administrator training year for calculation of the
24-hour training requirement, which may differ from the direct care staff training year (see § 2600.65(e)). The year may be the calendar year, the home’s fiscal year, the administrator’s anniversary date, or another 12-month period as determined by the home. The home must document its selected training year in writing.
Inspection Procedures: Inspectors will review the administrator’s training records for the most recent 12-month training year to ensure the training was approved by the Department and that the administrator completed 24 hours of approved training.
Primary Benefit: Ensures that administrators receive high quality training to continue to develop their knowledge of regulatory requirements and best practices in personal care home operation.
64e 2600.64(e) - An administrator who has successfully completed the training in § 2600.64(a)-(d) shall provide written verification of successful completion to the Department’s personal care home
regional office.
Discussion: Retention of the documents at the home or producing them upon request is sufficient for compliance with this regulation. Homes do not need to transmit the information to the regional office unless it is requested to be considered compliant with this regulation.
Inspection Procedures: Inspectors will review the administrator’s training records when completing an on-site inspection.
Primary Benefit: Verifies that new administrators have the credentials required by Chapter 2600.
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64f 2600.64(f) - A record of training including the individual trained, date, source, content, length of each course and copies of certificates received shall be kept.
Discussion: Self-explanatory.
Inspection Procedures: Inspectors will review the administrator’s training records to ensure all the required information is present.
Primary Benefit: Allows the administrator to track his/her training progress throughout the year and provides evidence of successful training completion.
Direct Care Staff Person Training and Orientation
65a
2600.65(a) - Prior to or during the first work day, all direct care staff persons including ancillary staff persons, substitute personnel and volunteers shall have an orientation in general fire safety and emergency preparedness that includes the following:
(1) Evacuation procedures.
(2) Staff duties and responsibilities during fire drills, as well as during emergency evacuation, transportation and at an emergency location if applicable.
(3) The designated meeting place outside the building or within the fire-safe area in the event of an actual fire.
(4) Smoking safety procedures, the home’s smoking policy and location of smoking areas, if applicable.
(5) The location and use of fire extinguishers.
(6) Smoke detectors and fire alarms.
(7) Telephone use and notification of emergency services.
Discussion: The “first work day” means the day a person begins to perform job duties on-site at the home in a paid status.
The orientation training required by this regulation is designed to ensure all staff persons working in the home, including management, administrative staff, direct care staff, contract staff, ancillary staff and volunteers, are trained to handle an emergency situation to ensure resident safety. The training should be specific to the home, as each home has different fire-safety procedures.
Due to the importance of this training for life safety, it should be provided by an experienced staff person who has been properly trained in the home’s fire safety and emergency preparedness procedures and the proper use of a fire extinguisher.
Inspection Procedures: Inspectors will review the training documentation and staff records to ensure staff persons were trained in all the areas of this regulation on the first day of employment in the home. Inspectors may also interview staff to determine if the training was provided.
Primary Benefit: Ensures that all staff persons are immediately trained to respond to an emergency situation.
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65b
2600.65(b) - Within 40 scheduled working hours, direct care staff persons, ancillary staff persons, substitute personnel and volunteers shall have an orientation that includes the following:
(1) Resident rights.
(2) Emergency medical plan.
(3) Mandatory reporting of abuse and neglect under the Older Adult Protective Services Act (35 P.S. § 10225.101-10225.5102).
(4) Reporting of reportable incidents and conditions.
Discussion: It is very important for all staff persons who work in the home, including management, administrative staff, direct care staff, contract staff, ancillary staff, and volunteers, to be trained in the areas required by this regulation in order to protect the residents’ rights and resident safety. Remember, a “volunteer” is an individual who, of his own free will, and without monetary compensation, provides direct care services for residents in the home, and does not include visitors or individuals who provide non-direct services or entertainment on an occasional basis
Inspection Procedures: Inspectors will review the training documentation and staff records to ensure staff persons were trained in all the areas required by this regulation within the first 40 hours of working in the home.
Inspectors may also interview staff to determine if the training was provided.
Primary Benefit: Ensures that all staff persons working in the home are familiar with residents’ rights, mandated reporting, and the procedures for responding to a medical emergency.
65c 2600.65(c) - Ancillary staff persons shall have a general orientation to their specific job functions as it relates to their position prior to working in that capacity.
Discussion: This regulation requires that staff persons who are not direct care staff are taught how to do their jobs.
Inspection Procedures: Inspectors will review staff records for ancillary staff persons to ensure the orientation was completed before the ancillary staff person began working in his/her position.
Primary Benefit: Ensures that ancillary staff persons have the training needed to perform their job duties.
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65d
2600.65(d) - Direct care staff persons hired after April 24, 2006 may not provide unsupervised ADL services until completion of the following:
(1) Training that includes a demonstration of job duties, followed by supervised practice.
(2) Successful completion and passing the Department-approved direct care training course and passing of the competency test.
(3) Initial direct care staff person training to include the following:
(i) Safe management techniques.
(ii) ADLs and IADLs.
(iii) Personal hygiene.
(iv) Care of residents with dementia, mental illness, cognitive impairments, mental retardation and other mental disabilities.
(v) The normal aging-cognitive, psychological and functional abilities of individuals who are older.
(vi) Implementation of the initial assessment, annual assessment and support plan.
(vii) Nutrition, food handling and sanitation.
(viii) Recreation, socialization, community resources, social services and activities in the community.
(ix) Gerontology.
(x) Staff person supervision, if applicable.
(xi) Care and needs of residents with special emphasis on the residents being served in the home.
(xii) Safety management and hazard prevention.
(xiii) Universal precautions.
(xiv) The requirements of this chapter.
(xv) Infection control.
(xvi) Care for individuals with mobility needs, such as prevention of decubitus ulcers (bed sores), incontinence, malnutrition and dehydration, if applicable to the residents served in the home.
Discussion: The following staff are exempt from these requirements:
• Any staff person hired on or before April 24, 2006 who has not had more than one year’s break in service
• Any volunteer retained on or before April 24, 2006 who has not had more than one year’s break in service
• A Certified Nurse Assistant (CNA) with a current certificate in good standing
• A Licensed Practical Nurse (LPN) with a current license in good standing
• A Registered Nurse (RN) with a current license in good standing
• A Physician with a current license in good standing
• An Emergency Medical Technician (EMT) with a current license in good standing
• Any staff hired between April 24, 2006 and October 31, 2007 do not need to successfully complete the Department-approved direct care staff training course and pass the online competency test.
The training course and competency test are web-based and available on the Department’s website. After
successful completion of the course and the test, direct care staff persons will receive a “Certificate of Completion”
that must be printed and kept in the employee’s file. An individual may start and stop the training at any time.
If a staff person has completed the required initial direct care staff person training and competency testing as a direct care staff person at another home, the requirement for initial direct care staff person training and
competency testing in this section does not apply if the staff person provides written verification of completion of the prior training and competency testing. There is no time limit as to how long prior to the employment transfer the orientation and competency testing may be completed.
Inspection Procedures: Inspectors will review staff records to determine the required training and passing of the test were completed before the direct care staff person performed unsupervised ADL services, or if the staff person is exempt from the requirement.
Primary Benefit: Ensures that each individual who provides assistance with ADLs is trained to do so properly.
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65e 2600.65(e) - Direct care staff persons shall have at least 12 hours of annual training relating to their job duties.
Discussion: This applies to all staff persons who perform direct care duties including contract staff, volunteers, and part time direct care staff. Please note that Departmental approval of the annual training sources or training instructors for direct care staff persons is not required.
The home is encouraged to provide training on a variety of topics to enhance the direct care person’s job knowledge and skills. The training must include all of the topics required by § 2600.65(f) and (g), but can include other topics as well. In addition to training provided by the home, the following types of training also apply:
• Training hours approved for completion of continuing education requirements for Nursing Home
Administrator, Registered Nurse, and Licensed Practical Nurse licensure. Documentation that the course has been approved as a training source by the Pennsylvania Department of State must be kept.
• Any course from an accredited college or university.
• Up to 6 hours of medication administration training, medication administration train-the-trainer course or train-the-trainer recertification required by § 2600.190(a).
• Training hours spent in the diabetes education required by § 2600.190(b).
• Up to 4 hours of CPR, obstructed airway and first aid training required by § 2600.63(a)
• Orientation hours required by § 2600.65(a), (b), and (d).
The Training Year - The home may select the direct care staff training year for calculation of the 24-hour training requirement, which may differ from the administrator training year (see § 2600.64(c)). The year may be the calendar year, the home’s fiscal year, the direct care staff’s anniversary date, or another 12-month period as determined by the home. The home must be able to verify the training year used.
Inspection Procedures: Inspectors will review the direct care staff person’s training records for the most recent 12-month cycle to ensure the staff person completed 12 hours of training relating to the duties of a direct care staff person. Remember that only records of direct care staff persons who have worked in the home for one full training year may be reviewed when measuring compliance with this regulation.
Primary Benefit: Ensures that direct care staff persons receive high quality training to continue to develop their knowledge of regulatory requirements and best practices in resident care.
65f
2600.65(f) - Training topics for the annual training for direct care staff persons shall include the following:
(1) Medication self-administration training.
(2) Instruction on meeting the needs of the residents as described in the preadmission screening form, assessment tool, medical evaluation and support plan.
(3) Care for residents with dementia and cognitive impairments.
(4) Infection control and general principles of cleanliness and hygiene and areas associated with immobility, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration.
(5) Personal care service needs of the resident.
(6) Safe management techniques.
(7) Care for residents with mental illness or mental retardation, or both, if the population is served in the home.
Discussion: Training on each specific topic listed under this regulation must be conducted every year for all direct care staff persons. Each topic offers a wide array of possible subtopics. For example, “Personal Care Service Needs” can range from how to properly provide assistance with bathing to helping residents compose emails to family. When training on a subtopic, homes should be sure to indicate which of these topics listed in § 2600.65(f) the training relates.
Inspection Procedures: Inspectors will review the training documentation for the direct care staff persons.
Primary Benefit: Ensures that staff persons receive the necessary training to successfully provide essential resident care services.
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65g
2600.65(g) - Direct care staff persons, ancillary staff persons, substitute personnel and regularly scheduled volunteers shall be trained annually in the following areas:
(1) Fire safety completed by a fire safety expert or by a staff person trained by a fire safety expert.
(2) Emergency preparedness procedures and recognition and response to crises and emergency situations.
(3) Resident rights.
(4) The Older Adult Protective Services Act (35 P. S. § 10225.101—10225.5102).
(5) Falls and accident prevention.
(6) New population groups that are being served at the home that were not previously served, if applicable.
Discussion: Self-explanatory.
Inspection Procedures: Inspectors will review the training documentation for the direct care staff to ensure it includes all the topics required by this regulation. Inspectors will review the fire safety expert’s credentials if the fire safety training was provided by a fire safety expert or a staff person trained by a fire safety expert.
Primary Benefit: Ensures that all staff who work in the home are reminded of the home’s emergency procedures and mandated reporting requirements.
65i 2600.65(i) - A record of training including the staff person trained, date, source, content, length of each course and copies of any certificates received, shall be kept.
Discussion: Self-explanatory. A model training record is available on the Department’s website.
Inspection Procedures: Inspectors will review the training record to ensure all of the required information is documented.
Primary Benefit: Allows the administrator to track each staff person’s training progress throughout the year and provides evidence of successful training completion.
Staff Training Plan
66a 2600.66(a) - A staff training plan shall be developed annually.
Discussion: The staff training plan is the list of courses planned for each staff person for the upcoming year. It is recommended that homes combine the staff training plan with the training requirements of § 2600.65(a)-(f) to streamline operations.
Inspection Procedures: Inspectors will review the staff training plan for the current year to ensure that it exists and that it contains all of the elements required by § 2600.66(b).
Primary Benefit: Provides the home with an organized plan to ensure all staff persons receive the required
Primary Benefit: Provides the home with an organized plan to ensure all staff persons receive the required