1. FAHA ANNUAL LEGISLATIVE WORKSHOP HANDOUT Assisted Living Facility Changes in Rules and Surveyor Guidelines MARCH 22, 2006

2. UPDATED ALF GUIDELINES Updates to Surveyor Guidelines Pursuant to Changes to Chapter 58A-5.0191, F.A.C.: ALF Staffing and Staff Record Standards ECC Staffing Requirements Limited Mental Health Staffing Standards

3. UPDATED ALF GUIDELINES (Continued) All References to Department of Elder Affairs (DOEA) Providing Required ALF Training Have Been Deleted All References to ALF Update Training, Which is No Longer Required, Have Been Deleted

4. STAFFING STANDARD 504 Administrators and Managers Must Successfully Complete the Assisted Living Facility Core Training Requirements within Three Months From the Date of Becoming a Facility Administrator or Manager. Successful Completion of the Core Training Requirements Includes Passing the Competency Test. 58A-5.0191(1)(b), F.A.C.

5. STAFFING STANDARD 511 Staff Who Provide Direct Care to Residents Must Receive a Minimum of One Hour In-service Training within 30 Days of Employment that Covers the Following Subjects: Reporting of Major Incidents Reporting Adverse Incidents Facility Emergency Procedures Including Chain of Command and Staff’s Roles Relating to Emergency Evacuation 58A-5.0191(2)(b), F.A.C. 58A-5.0191(11)(a), F.A.C.

6. STANDARD 511 (Continued) When Must ALFs Complete In-service Training on Reporting Adverse Incidents for Direct Care Staff Hired On or After July 5, 2005? ALFs Licensed On or After July 5, 2005, Must Complete In-Service Training Within 30 Days of Employment ALFs Licensed Before July 5, 2005, Must Complete In-Service Training by January 4, 2006

7. STAFF RECORDS STANDARD 1103 Freedom From Tuberculosis Must be Documented Annually A Person With a False Positive Tuberculosis Test Must Submit a Health Care Provider’s Statement that the Person Does Not Constitute a Risk of Communicating Tuberculosis. 58A-5.019(2)(a), F.A.C. Guideline: The Annual Tuberculosis Documentation Must be Signed by The Health Care Provider.

8. STAFF RECORDS STANDARD 1104 New facility staff must obtain an initial training on HIV/AIDS within 30 days of employment, unless the new staff person previously completed the initial training and has maintained the biennial continuing education requirement. All facility employees must complete a biennial continuing education course on HIV and AIDS. 400.4275(2), F.S. 58A-5.0191(3), F.A.C. 58A-5.024(2)(a)1., F.A.C. 58A-5.0191(11), F.A.C.

9. SURVEYOR INFO– STANDARD 1104 (Continued) Did new staff complete initial training within 30 days of employment and maintain biennial continuing education requirements? Completion of the HIV and AIDS Continuing Education Course is Required For All Employees Every Two Years Review Dates Of Employment For Compliance Review Employee Files For Documentation of Completion of Initial Training and Continuing Education This Training is Also Required For RNs, LPNs, and CNAs Two Years Is A Total Of 730 Days

10. STANDARD 1104 (Continued) When Must ALF Staff, Hired On or After July 5, 2005, Complete Initial Training on HIV/AIDS? ALFs Licensed On or After July 5, 2005 - All Staff Must Receive Initial Training within 30 Days of Employment ALFs Licensed Before July 5, 2005 - All Staff Must Receive Initial Training by January 4, 2006

11. STAFF RECORDS STANDARD 1106 Unlicensed Persons Providing Assistance with Self-Administered Medications Must Receive a Minimum of Four Hours of Training Prior to Assuming This Responsibility. 400.4256, F.S. 400.452(5), F.S. 58A-5.0191(5), F.A.C. 58A-5.024(2)(a)1., F.A.C.

12. GUIDELINE – STANDARD 1106 (Continued) Added: Training Must be Provided By a Registered Nurse Or Licensed Pharmacist Who Must Issue a Training Certificate to a Trainee Who Demonstrates an Ability to: 1. Read and Understand a Prescription Label

13. NEW STAFF RECORDS STANDARD 1107 Unlicensed Persons Providing Assistance with Self- Administered Medications and Have Successfully Completed the Initial Four Hour Training, Must Obtain Annually a Minimum of Two Hours of Continuing Training on Providing Assistance with Self- Administered Medications and Safe Medication Practices in an ALF. 400.4256, F.S. 58A-5.0191(5)(c), F.A.C. 58A-5.024(2)(a)1., F.A.C.

14. GUIDELINE- STANDARD 1107 (Continued) The Two Hours of Continuing Education Must Be Provided by a Licensed Registered Nurse or a Licensed Pharmacist Annually Means Every 365 Days

15. SURVEYOR INFO – STANDARD 1107 (Continued) Verify Unlicensed Persons Providing Assistance With Self- Administered Medications Have Received the Appropriate Continuing Education Training Certificate and is Documented in Their Personnel File. Training Documentation Shall Include: Subject Matter Trainee’s Name Date of Attendance Training Provider’s Name, Signature and Credentials, Professional License Number, if Applicable Number of Hours of Training

16. When Must Staff Assisting with Self-Administration of Medication Complete Continuing Education? STANDARD 1107 (Continued) If Initial Training was Completed Over One Year Ago, or Will be Over One Year by January 4, 2006, Continuing Education Must be Completed by January 4, 2006 All Others Must Obtain Continuing Education Within One Year of Completion of Initial Training

17. STAFF RECORDS STANDARD 1108 Staff Who Prepare or Serve Food, Who Have Not Taken The ALF Core Training, Must Receive a Minimum of One Hour In- Service Training Within 30 Days of Employment in Safe Food Handling Practices. 58A-5.0191(2)(e), F.A.C. 58A-5.020(1)(d), F.A.C. 58A-5.024(2)(a)1., F.A.C.

18. GUIDELINE- STANDARD 1108 (Continued) A Certified Food Manager, Licensed Dietician, Registered Dietary Technician or Health Department Sanitarians are Qualified to Train ALF Staff in Nutrition and Food Service.

19. SURVEYOR INFO – STANDARD 1108, (Continued) Employees Receive at Least One Hour In-Service Training within 30 Days, or Completed ALF Core Training Training Documented: Subject Matter, Trainee’s Name, Date of Attendance, Training Provider’s Name, Signature and Credentials, Professional License Number, if Applicable, and Number of Hours of Training The Facility Administrator or Manager Must Provide or Arrange for In-Service Training Trainer has the Necessary Credentials

20. STAFF RECORDS STANDARD 1109 The Administrator or Designee Responsible for the Facility’s Food Service and Supervision of Food Service Staff Obtains Annually a Minimum of Two Hours Continuing Education 400.452(6), F.S. 58A-5.0191(6), F.A.C. 58A-5.020(1)(d), F.A.C. 58A-5.024(2)(a)1., F.A.C.

21. GUIDELINE – STANDARD 1109 (Continued) A Certified Food Manager, Licensed Dietician, Registered Dietary Technician or Health Department Sanitarians are Qualified to Train ALF Staff in Nutrition and Food Service.

22. STAFF RECORDS STANDARD 1110 Facility Staff, Who have Regular Contact with or Provide Direct Care to Residents with ADRD, Must Obtain Four Hours of Level I Initial Training within Three Months of Employment 400.4178(2)(a), F.S. 58A-5.0191(9)(a), F.A.C. 58A-5.024(2)(a)1., F.A.C.

23. GUIDELINE – STANDARD 1110 (Continued) Completion of Core Between April 20, 1998 and July 1, 2003, Meets the Training Requirement. Issued a Certificate by Approved Training Provider which Must Include: Title of the Approved Training and the Curriculum Approval Number Number of Training Hours Trainee’s Name Attendance Date, Location and the Training Provider’s Name, Approval Number and Dated Signature Staff Who have Received Both the Initial One Hour and Continuing Three Hours of ADRD Training Pursuant to Nursing Homes, ADCC or Hospice are Exempt

24. STAFF RECORDS STANDARD 1111 Staff Who Provide Direct Care to Residents with ADRD Must Obtain an Additional Four Hours of Training Entitled “Alzheimer’s Disease and Related Disorders Level II Training,” within Nine Months of Employment 400.4178(2)(b), F.S. 58A-5.0191(9)(c), F.A.C. 58A-5.024(2)(a)1., F.A.C

25. ECC STANDARD 303 Administrator and ECC Supervisor Must Complete Core Training and Four Hours of Initial Training in ECC Prior to the Facility Receiving its ECC License or Within Three Months of Beginning Employment 400.4275(2), F.S. 58A-5.0191(7)(a), F.A.C. 58A-5.024(2)(a)1., F.A.C.

26. ECC STANDARD 305 The Administrator and ECC Supervisor Must Complete a Minimum of Four Hours of Continuing Education Every Two Years 400.4275(2), F.S. 58A-5.0191(7)(b), F.A.C. 58A-5.024(2)(a)1., F.A.C.

27. ECC STANDARD 309 Direct Care Staff in an ECC Program Must Complete at Least Hours of In-service Training Provided by the Facility Administrator Or ECC Supervisor within Six Months of Beginning Employment in the Facility 400.4275(2), F.S. 58A-5.0191(7)(c), F.A.C. 58A-5.024(2)(a)1., F.A.C.

28. LMH STANDARD 500 Within Six Months after Receiving a Limited Mental Health License or Within Six Months of Employment in a LMH Licensed Facility, the Administrator, Manager, and Staff, Who are in Direct Contact with Mental Health Residents, Must Receive a Minimum of Six Hours of Training Provided by or Approved by the Department of Children and Family Services s.400.4075(1), F.S. 58A-5.029(3)(d), F.A.C. 58A-5.0191(8), F.A.C.

29. ALF ELOPEMENT DRILLS Effective June 15, 2004, Two Elopement Drills Must be Conducted per Year Existing Facilities Must Have Conducted Drill by June 15, 2005 and Yearly Thereafter If Licensed After June 15, 2004, the Facility Must Conduct its Resident Elopement Drills within One Year of Initial Licensure and Yearly Thereafter Administrator and Direct Care Staff Must Participate

30. ALF ELOPEMENT DRILLS (Continued) ALFs Must Document the Drill Implementation Elopement Drills Must be Consistent with ALFs Elopement Policies and Procedures