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Long Term Care Inservice Regulations

Regulations governing mandatory long term care inservices come from a variety of agencies that regulate long term care practices, enforce compliance, and make recommendations on employee education.

Centers for Medicare and Medicaid Services or CMS mandates that facilities must complete a performance review of every nursing assistant at least once every 12 months, and must provide regular inservice education based on the outcome of these reviews, and that the inservice training must:
  • Be no less than 12 hours per year
  • Address areas of weakness as determined in nurse aides’ performance reviews, and for nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired.
OSHA, the Centers for Disease Control or CDC, and the National Fire Protection Association or NFPA also mandate certain long term care inservices. 

Generally, a long term care staff development department will provide an inservice at least once per year on each of the following topics: 
  • Abuse Prevention
  • Activities of Daily Living 
  • Catheter Care and Urinary Tract Infections
  • Cognitive Impairment
  • Constipation 
  • Dementia Management
  • Falls
  • Feeding Residents
  • Infectious Diseases 
  • Nutrition and Hydration
  • Pain Care
  • Range of Motion
  • Resident Rights
  • Restraints
  • Sensory and Communication Impairments 
  • Sexual Harassment and Professional Communication
  • Skin Care and Pressure Ulcer Prevention
  • Standard Precautions 
  • Toileting Programs
  • Transfers and Lifts
  • Urinary Incontinence 
  • Wandering and Elopement Risk
  • Workplace Violence
The following is an excerpt from CMS Code of Federal regulations, Title 42, Part 483, CMS, 1999 : 42 C FR483.75

(e) (8) Required Training of Nursing Aides, Regular In-Service Education
The facility must complete a performance review of every nurse aide at least once every 12
months, and must provide regular inservice education based on the outcome of these reviews.
The inservice training must:
(i) Be sufficient to ensure the continuing competence of nurse aides, but must be no less than 12
hours per year;
(ii) Address areas of weakness as determined in nurse aides' performance reviews and may
address the special needs of residents as determined by the facility staff; and
(iii) For nurse aides providing services to individuals with cognitive impairments, also address
the care of the cognitively impaired.
(f) Proficiency of Nurse Aides
The facility must ensure that nurse aides are able to demonstrate competency in skills and
techniques necessary to care for residents' needs, as identified through resident
assessments, and described in the plan of care.

Excerpts from State Operations Manual, Guidance to Surveyors, Guidelines: §483.75(e) (8):
The adequacy of the inservice education program is measured not only by documentation of hours of completed inservice education, but also by demonstrated competencies of nurse aide staff in consistently applying the interventions necessary to meet residents' needs.

If there have been deficient care practices identified during Phase 1 of the survey, review as
appropriate training received by nurse aides in that corresponding subject area. For example, if the facility has deficiencies in infection control, review the infection control unit in the facility's
inservice nurse aide training program.
 
Each nurse aide must have no less than twelve hours of in-service education per year. Calculate
the date by which a nurse aide must receive annual in-service education by the employment date
rather than the calendar year.

 

Guest Blog by Debra Collins RN, RAC-CT, and Pedagogy author of multiple Inservices and Compliance online education courses for certified nursing assistants, CNA’s,  and home health care aides.

As CEO and President of LTCS Books, Inc., Debra maintains a knowledge base and writes weekly articles on long term care and home health care federal regulatory changes.

She has written and published twelve books for long term care and home health care documentation. Her publications include care plans, policies and procedures, and quality assurance audits for Directors of Nursing, Administrators, Nursing, Restorative Nursing, MDS Coordinators, Social Services, Activities, and Infection Control. The books are used by over one third of long term care facilities in the United States.

Debra has over 25 years of experience in long term care and home health care. She worked as an MDS Consultant for many years, and is certified as a Resident Assessment Coordinator by AANAC, the American Association of Nurse Assessment Coordinators.
Posted: 7/5/2013 12:55:16 PM
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