W. Va. Code R. § 64-75-5 - Administrative, Staffing and Personnel Requirements

5.1. General Administrative Requirements.

5.1.a. The licensee shall, in consultation with a licensed health care professional, establish and adopt written policies and procedures, which are consistent with this rule and specific to the residential care community, governing the care and safety of residents ( i.e., notification of a resident's family, legal representative and physician regarding any apparent significant deviations from the resident's normal condition; administration of medications and treatments, disposal of outdated or discontinued medications in accordance with applicable State and federal laws, assistance with activities of daily living, the provision of limited and intermittent nursing care if applicable, infection control, admission, discharge and transfer of residents, and release of information from resident records). Policies and procedures will be developed by the residential care community governing the protection of residents' personal property (i.e., periodic inventories of each resident's personal possessions) and rights, the operation of the residential care community, the services provided by the residential care community, emergency procedures and disaster plan, complaint procedures, and all other policies and procedures required by this rule. (Class III)

5.1.b. Policies and procedures shall be in writing, signed and dated by the administrator at the time of adoption and kept current with changes indicated by a dated signature of the administrator. (Class III)

5.1.c. A copy of each policy and procedure shall be available for inspection on request by employees, residents and the general public. (Class III)

5.1.d. The residential care community shall have written rules governing resident behavior and responsibilities as follows: smoking; alcohol consumption; visitation; recreational activities (including television); laundry; and the use and storage of personal belongings such as furnishings and clothing. House rules may not be inconsistent with this rule. (Class III)

5.1.e. Those residential care communities that provide limited and intermittent nursing care shall comply with the requirements established in Section 12 of this rule. (Class I)

5.1.f. The licensee shall not manage the personal finances or funds of its residents. The licensee shall not serve as a resident's legal representative. (Class III)

5.2. The Licensee.

5.2.a. The licensee is responsible for compliance with this rule; the terms of the residential care community's license; W. Va. Code ''16-5N-1 et seq.; other relevant federal, State or local laws and regulations; and with the residential care community's policies. (Class II)

5.2.b. The licensee shall:

5.2.b.1. Give evidence of financial responsibility; (Class III)

5.2.b.2. Protect the physical and mental well-being of the residents; (Class II)

5.2.b.3. Keep the records and make the reports required by this rule; (Class III) and

5.2.b.4. Meet the qualifications of the administrator if he or she assumes those duties. (Class III)

5.2.c. The licensee shall maintain fiscal records which accurately identify, summarize, and classify funds received and disbursed for the operation of the residential care community. A recognized system of accounting shall be used to accurately reflect details of the business. The residential care community shall be administered on a sound financial basis consistent with good business practices. Evidence of issuance of bad checks or accumulation of delinquent bills shall constitute prima facie evidence that the ownership lacks satisfactory proof of financial ability to operate the residential care community in accordance with the requirements of W. Va. Code '16-5N-6. (Class III)

5.2.d. The licensee shall maintain a liability insurance policy in an amount that will cover all injuries to any residents. (Class III)

5.2.e. The licensee shall notify the secretary in writing within ten (10) days of any permanent change in the administrator of a residential care community. A licensee shall not operate a residential care community more than thirty (30) days without a qualified administrator unless the secretary grants an extension, based on a determination that a reasonable attempt has been made to find a suitable replacement. (Class III)

5.3. Administrator.

5.3.a. A residential care community shall have an administrator who is at least twenty-one (21) years of age and has an associate degree, or its equivalent in a related field. (Class III)

5.3.b. The administrator of a residential care community shall have a personal history which does not contain the following: evidence of abuse, fraud, or substantial and repeated violations of applicable laws and rules in the operation of any health or social care facility or service organization, or in the care of dependent persons; and conviction of crimes relevant for the provision of care to a dependent population as evidenced by a criminal investigative background check. (Class II)

5.3.c. The administrator shall participate in ten (10) hours of training related to the administration and operation of a residential care community annually. Attendance records shall be maintained on file at the residential care community. (Class III)

5.3.d. The administrator is responsible and accountable for the development and execution of all policies and procedures required by this rule and shall be able to conform to applicable statutes, rules and regulations; know the requirements of the rule for residential care communities; and ensure the adequacy and appropriateness of services delivered to the residents. (Class II)

5.3.e. The administrator or a responsible employee, designated in writing, shall be available and in charge of the residential care community at all times. (Class III)

5.4. Employment Standards.

5.4.a. The residential care community shall have written personnel policies and procedures which appropriately meet the needs of the residential care community. (Class III)

5.4.b. The administrator shall assure that all staff of the residential care community meet the age requirements of applicable State and federal law, rules and regulations and are free from communicable disease in an infectious stage. (Class I)

5.5. Staffing Requirements.

5.5.a. Each residential care community shall have a minimum of one (1) residential staff twenty-four (24) hours per day (i.e., one per eight (8) hour shift) and shall have a sufficient number of qualified employees on duty to provide the residents with all of the care and services they require. (Class I)

5.5.b. Awake staff shall be present in the residential care community during normal resident sleeping hours when residents require supervision during sleeping hours or are in need of limited and intermittent nursing services unless all residents are certified by a physician or psychologist as not being in need of sleep time supervision and they are not in need of limited and intermittent nursing services. (Class I)

5.5.c. A multi story residential care community shall maintain at least one (1) awake staff per story while residents are sleeping, except that the secretary shall permit one (1) awake staff in a multi story residential care community if:

5.5.c.1. The residents of the residential care community are certified by a physician or psychologist as not being in need of supervision during sleeping hours; (Class I)

5.5.c.2. The residential care community has no residents who are in need of limited and intermittent nursing services; (Class I) and

5.5.c.3. The residential care community has an immediate emergency call system from the residents to the awake staff person. (Class I)

5.5.d. The residential care community shall have the staff needed to meet the laundry, food service, housekeeping, and maintenance requirements of this rule. (Class II)

5.5.e. When regular staff and supervisory staff are absent due to illness and vacations, there shall be coverage by substitute personnel with comparable qualifications. (Class I)

5.5.f. The licensee of the residential care community shall maintain and furnish to the secretary upon request, information setting forth the number (in full-time equivalents) and types of employees on duty in the residential care community at any given time. (Class III)

5.5.g. If a resident experiences a poor outcome related to a lack of supervision or unmet care needs, the secretary may require the licensee to add staff. (Class II)

5.6. Employee Orientation and Training.

5.6.a. The licensee shall provide training to new employees within the first twenty-four (24) hours of association with the residential care community in emergency procedures and disaster plans, including the following: evacuation procedures, procedures to report a missing resident, medical emergencies, accidents, fire, natural disasters or other emergencies. (Class II)

5.6.b. The licensee shall maintain a written plan of orientation and training for employees. The training shall be provided within the first fifteen (15) days of employment and shall include the following:

5.6.b.1. Policies and procedures; (Class III)

5.6.b.2. The rights and responsibilities of residents including protection of resident privacy and confidentiality; (Class III)

5.6.b.3. Complaint procedures; (Class III)

5.6.b.4. Procedures and agencies available in instances of abuse, neglect, and mistreatment: the State adult protective services agency, including its toll-free hot line number; the State licensure and certification agency, including its telephone number; the state bureau of senior services, including its telephone number; and various other concerned advocacy and protection organizations; (Class III)

5.6.b.5. The care of aged, infirm or disabled adults with consideration for individual capabilities and needs; (Class III)

5.6.b.6. Personal assistance procedures as needed for resident care, including at a minimum, personal grooming care, personal hygiene care, nutritional services, and signs and symptoms of alteration in skin integrity; (Class III)

5.6.b.7. Specific duties and responsibilities of the residential staff for assisting current residents (i.e., a review of individualized service plans, the activities program and/or professionally-designed intervention strategies to help a resident with behavioral health needs to manage his or her behavior); (Class III)

5.6.b.8. Cardiopulmonary resuscitation (CPR), as applicable, and first aid; (Class II) and

5.6.b.9. Infection control. (Class II)

5.6.c. The licensee may modify the initial orientation and training for individual employees if the individual is registered as a nursing assistant and maintained as such on the nursing assistant registry maintained by the secretary. The registration satisfies the requirement for training in the areas of personal grooming, hygiene, assistance in feeding and activities of daily living. All other topics required by this rule shall be addressed in the employee's initial orientation and training program. This subdivision does not exclude individuals registered as nursing assistants from participation in annual ongoing in-service training. (Class III)

5.6.d. The licensee shall provide ongoing in-service training annually in these areas:

5.6.d.1. Resident rights and confidentiality; (Class III)

5.6.d.2. Abuse, neglect, mistreatment, and procedures to prevent the occurrence of those incidents; (Class II)

5.6.d.3. Emergency care of residents (first aid and as applicable, CPR) and emergency plans for the residential care community, including fire safety and evacuation plans; (Class II)

5.6.d.4. The responsibilities of the residential staff for assisting residents (i.e., individualized service plans, activity programs, etc.); (Class III) and

5.6.d.5. Infection control. (Class II)

5.7. Volunteers.

5.7.1. Volunteers rendering services in the residential care community shall adhere to the laws and rules governing confidential treatment of residents' personal information and provide evidence that they are free from communicable disease in an infectious stage. (Class II)

5.8. Personnel Records.

5.8.a. The licensee shall maintain a confidential personnel record on each employee, including the administrator, who provide services to residents. Each record shall contain at least the following:

5.8.a.1. An employment application which includes at least the individual's current home address and telephone number, emergency contacts, and social security number; (Class III)

5.8.a.2. Documentation of the results of a screening through the West Virginia state police central abuse registry regarding previous convictions involving abuse, mistreatment or neglect of dependent populations or theft of the property of those populations, documented verification of past employment or personal references, and a check of the nurse aide abuse registry established by the state; (Class III)

5.8.a.3. A record of orientation, annual and/or additional training, education and credentials; (Class II)

5.8.a.4. The date of employment and a position title and description; (Class III); and

5.8.a.5. A health record containing the results of an employment physical examination and annual screens for tuberculosis (tine test not acceptable) and other communicable diseases as indicated by the secretary regarding exposure, prevalence or currently accepted medical practice in congregate living situations. The employment physical and tuberculosis screening shall be obtained in the first week of employment and annually thereafter. (Class II)

5.8.b. Personnel records shall be maintained on file at the residential care community for at least three (3) years following the employee's termination of employment. The record shall have documentation of the date and reason for the employee's termination of employment. (Class III)

5.9. Administrative Admission Procedures.

5.9.a. The licensee shall not discriminate against residents or a prospective resident on the basis of race, national origin, religion, age, gender, sexual orientation or disability. The admissions policy shall state the resident population that the residential care community is licensed to serve and shall not discriminate within the confines of that definition. (Class III)

5.9.b. The relationship of a resident to the residential care community shall be covered by a written contract entered into at the time of or prior to the individual's admission. The contract shall specify the following information:

5.9.b.1. The residential care community's admission, retention and discharge criteria; (Class III)

5.9.b.2. Written assurance of the services that the residential care community will provide to meet the individual's needs; (Class III)

5.9.b.3. Full disclosure of all costs, an annual or monthly contract price, refund policy and an assurance that residents shall not be held liable for any cost that was not disclosed; (Class III)

5.9.b.4. How health care will be arranged or provided; (Class III)

5.9.b.5. The complaint process; (Class III)

5.9.b.6. How prescribed medications are obtained, and who is responsible for payment; (Class III) and

5.9.b.7. The storage, administration and disposal of medications.

5.9.c. Each party to the contract shall have a copy of the contract. If a current resident's existing contract does not meet the requirements of this rule, the resident shall be provided with new or updated contract within fourteen (14) days of the effective date of this rule, (Class III)

5.9.d. Thirty (30) days prior to any increases, additions, or other modifications of the rates, the licensee shall give written notice of the proposed changes to residents. (Class III)

5.9.e. The licensee shall inform and document notifying the resident of how to access the following information at the time of the agreement:

5.9.e.1. Information and referral services regarding the resident's utilization of social, recreational, and vocational activities within the residential care community;

5.9.e.2. How the resident's personal property will be protected from loss and theft;

5.9.e.3. How the resident will be assisted in making appointments for medical, dental, nursing or mental health services, and how transportation to and from these services will be arranged;

5.9.e.4. Policies and procedures for emergency situations that affect the well-being of residents, including, but not limited to the following: life-threatening medical emergencies (including whether CPR will be provided), fires, natural disasters, severely inclement weather, industrial accidents, major incidents, a missing resident and immediate or serious threats;

5.9.e.5. The responsibility for required medical examinations and treatment orders; policies regarding room changes, retention during temporary illness or a significant change in resident status, transfers and discharges, and the resident's and the licensee's transfer and discharge notification responsibilities;

5.9.e.6. House rules governing resident behavior and responsibilities; and

5.9.e.7. A resident's bill of rights which is consistent with this rule. (Class III)

Notes

W. Va. Code R. § 64-75-5