All Staff Requirements

Skilled Nursing Alabama Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://www.adph.org/healthcarefacilities/assets/nursingfacilitiesrules.pdf Retrieved on: April 14, 2017 Regulation date: last updates May 25, 2005 RULES OF ALABAMA STATE BOARD OF HEALTH ALABAMA DEPARTMENT OF PUBLIC HEALTH CHAPTER 420-5-10 NURSING FACILITIES 420-5-10-.03 Administrative Management. (15) 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 in-service training must: (a) Be sufficient to ensure that continuing competence of nurse aides, but must be no less than 12 hours per year; (b) 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 (c) For nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired. *Please also see Skilled Nursing Federal Education Requirements Authoring Tool Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client

Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation (4) Personnel Qualifications, Requirements and Training. (b) Staff Development. Each employee shall receive appropriate orientation to the facility and its policies and to his/her position and job duties, to ensure competency in the job placement. All employees shall participate in in-service educational programs planned and conducted for the development and improvement of their skills. *Please also see Skilled Nursing Federal Education Requirements Authoring Tool

Skilled Nursing Alaska Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://www.hpm.umn.edu/nhregsplus/nhregs_by_state/alaska/aac_title7_part1_chapter12_article5.pdf Retrieved on: April 14, 2017 Regulation date: Title 7 Health and Social Services Part 1 Administration Chapter 12 Facilities and Local Units Article 12 General Provisions 7 AAC 12.660. Personnel (a) A facility must plan and retain records of employee orientation, in-service training programs, and employee supervision. In addition, the facility must maintain for each employee a file that includes (c) Physicians, licensed nurses, pharmacists, physical therapists, dietitians, and social workers must be involved in the orientation and in-service education program for patient care personnel. *Please also see Skilled Nursing Federal Education Requirements

Skilled Nursing Arizona Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements All Staff Retrieved from: http://www.azdhs.gov/documents/director/administrative-counsel-rules/rules/rulemaking/hci/nursing/hci-nursing-care-new-rules-2014.pdf Retrieved on: April 24, 2017 Regulation Date: last updated July 1, 2014 Title 9. Health Services Chapter 10. Department of Health Services Health Care Institutions: Licensing Article 4. Nursing Care Institutions R9-10-403 Administrations C. An administrator shall ensure that: 1. Policies and procedures are established, documented, and implemented to protect the health and safety of a resident that: b. Cover orientation and in-service education for personnel members, employees, volunteers, and students h. Cover resident rights, including assisting a resident who does not speak English or who has a disability to become aware of resident rights *Please see Skilled Nursing Federal Education Requirements Elder Justice Act HIPAA HITECH: What All Employees Need to Know Home Care Bill of Rights Implementing HIPAA and HITECH Right on target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation q. Cover misappropriation of resident property Ethics Right on Target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation

Skilled Nursing Arkansas Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://humanservices.arkansas.gov/dms/oltcdocuments/nfregs.pdf Retrieved on: April 20, 2017 Regulation date: Last updated in March of 2006 Rules and Regulations for Nursing Homes Office of Long Term Care 304 STAFF DEVELOPMENT 304.1 Job orientation shall be provided for all personnel to acquaint them with the needs of the residents, the physical facility, disaster plan, and the employee's specific duties and responsibilities. There should be written documentation maintained to verify that orientation and in-service training are planned and conducted. A continuing in-service training program is planned and conducted. Attendance at such training shall be verified by each employee by signing their names on the attendance record. Records of orientation shall include the signature of the employee as well as topic of instruction and date of successful completion. *Please also see Skilled Nursing Federal Education Requirements Authoring Tool Code Response Introduction to Safety Fire Safety Environmental Safety 306 REPORTING SUSPECTED ABUSE, NEGLECT, EXPLOITATION, INCIDENTS, ACCIDENTS, DEATHS FROM VIOLENCE AND MISAPPROPRIATION OF RESIDENT PROPERTY Facility policies and procedures regarding reporting, as addressed in these regulations, must be included in orientation training for all new employees, and must be addressed at least annually during in-service training for all facility staff. Elder Justice Act Ethics HIPAA HITECH: What All Employees Need to Know Home Care Bill of Rights Implementing HIPAA and HITECH QIS Abuse Prohibition

Right on Target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Accident Prevention 306.6 REPORTING SUSPECTED ABUSE OR NEGLECT 306.6.5 The requirement that all facility personnel receive annual, inservice training in identifying, reporting and preventing suspected abuse/neglect, and that the facility develops and maintains policies and procedures for the prevention of abuse and neglect, and accidents. Elder Justice Act Ethics HIPAA HITECH: What All Employees Need to Know Home Care Bill of Rights Implementing HIPAA and HITECH QIS Abuse Prohibition Right on Target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Accident Prevention 518 REHABILITATIVE NURSING 518.1 Nursing personnel shall be trained in rehabilitative nursing measures. This shall be documented in the orientation program, and inservice on this subject shall be conducted at least annually. Creating a Personalized Activities Program QIS Rehabilitation and Community Discharge Restorative Care/ROM 905 STAFFING Alzheimer s Special Care Units shall staff according to the Rules and Regulations for Nursing Facilities. Furthermore, the following staffing requirements are established for Alzheimer's Special Care Units. B. On-going, in-service training consisting of at least two (2) hours every quarter. The topics to be addressed in the in-service training shall include the following, and each topic shall be addressed at least once per year: Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client

Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation

Skilled Nursing California Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements: All Staff Retrieved from: http://ca.eregulations.us/code/t.22_d.5_ch.3_art5_sec.72517 Retrieved on: April 20, 2017 Regulation date: last updated August 6, 2014 72517. Staff Development. (a) Each facility shall have an ongoing educational program planned and conducted for the development and improvement of necessary skills and knowledge for all facility personnel. Each program shall include, but not be limited to: (1) Problems and needs of the aged, chronically ill, acutely ill and disabled patients. Activities of Daily Living (ADLs) Advanced Pain Management in Long Term Care Age Specific Creating a Personalized Activity Program Ergonomics Hydration Needs: Assessment and Care Nutritional Care Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Pressure Ulcer Determination and Management Restorative Care/ ROM Safe Resident Handling for Housekeepers: Ergonomics for the Prevention of MSDs Understanding the Aging Process Understanding Diet Modifications for Certain Health Conditions Understanding MDROs

Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Wandering: Elopement Prevention (2) Prevention and control of infections. Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations (3) Interpersonal relationship and communication skills Communication Basics Cultural Diversity Customer Service Strategies Elderly Stereotypes Is There a Solution Ethics (4) Fire prevention and safety Introduction to Safety Fire Safety Environmental Safety (5) Accident prevention and safety measures Fall and Restraint Reduction Patient Safety: Prevention of Medical Errors Environmental Safety

Introduction to Safety Accident Prevention (6) Confidentiality of patient information HIPAA HITECH: What All Employees Need to Know Implementing HIPAA and HITECH (7) Preservation of patient dignity, including provision for privacy Death, Dying and Post-Mortem Care Hospice Care for Residents in LTC/NF Ethics Spiritual Care (8) Patient rights and civil rights. Elder Justice Act Home Care Bill of Rights Right on Target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation (9) Signs and symptoms of cardiopulmonary distress. Cardiac Nursing Curriculum o Cardiac Medications I, II, and III o Cardiovascular Anatomy and Physiology o Cardiovascular Pathophysiology with a Focus on Coronary Artery Disease o Electrocardiograms (ECGs) Code Response (10) Choking prevention and intervention Heimlich Maneuver Information on CPR can be found in the Healthcare Academy lesson Code Response. Healthcare Academy recommends attending a class where the learner can practice their skills.

Skilled Nursing Colorado Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements: All Staff Retrieved from: http://www.sos.state.co.us/ccr/generaterulepdf.do?ruleversionid=5332 Retrieved on: April 20, 2017 Regulation date: last updated August 14, 2013 4.3.3 The facility shall provide annual inservice education for staff in at least the following areas: infection control, fire prevention and safety, accident prevention, confidentiality of resident information, rehabilitative nursing, resident rights, dietary, pharmacy, dental, behavior management, disaster preparedness, and, if it has developmentally disabled residents, developmental disabilities, residents with Alzheimer's conditions, those conditions, or mentally ill residents, mental illness. Infection control Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations

Fire Prevention and safety Introduction to Safety Fire Safety Environmental Safety Accident prevention Fall and Restraint Reduction Patient Safety: Prevention of Medical Errors Introduction to Safety Environmental Safety Accident Prevention Confidentiality of resident information HIPAA HITECH: What All Employees Need to Know Implementing HIPAA and HITECH Rehabilitative nursing Creating a Personalized Activities Program Pulmonary Rehabilitation Program QIS Rehabilitation and Community Discharge Restorative Care/ROM Resident rights Elder Justice Act Home Care Bill of Rights Right on Target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Dietary Dining Experience Food Preparation and Safe Food Handling Hydration Needs: Assessment and Care MDS 3.0 Section K: Swallowing and Nutritional Status New Dining Standards of Practice Nutritional Care

QIS Dining Observation QIS Hydration Status QIS Kitchen/Food Service Observation Understanding Diet Modifications for Certain Health Conditions Pharmacy Introduction to Medication Assistance MDS 3.0 Section N: Medications Medication Administration Psychotropic Medications QIS Medication Storage and Labeling QIS Psychoactive Medications QIS Unnecessary Medication Review Dental MDS 3.0 Section L: Oral/Dental Status QIS Dental Status and Services New lesson Behavior management QIS Behavioral and Emotional Status New Lesson Disaster preparedness Environmental Safety Introduction to Safety If it has developmentally disabled residents, developmental disabilities, residents with Alzheimer's conditions, those conditions, or mentally ill residents, mental illness. Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease

Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation

Skilled Nursing Connecticut Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://www.sots.ct.gov/sots/lib/sots/regulations/title_19/013d.pdf Retrieved on: April 20, 2017 Regulation date: March 7 th, 2015 Sec. 19-13-D8t. Chronic and convalescent nursing homes and rest homes with nursing supervision (J) Together with the medical director and director of nurses, development of a coordinated program for orientation to the facility, in-service training, and continuing education for all categories of staff in order to develop skills and increase knowledge so as to improve patient care; *Please see Skilled Nursing Federal Education Requirements Sec. 19-13-D71. Personnel policies (2) In-service education policy which provides an annual average of at least one (1) hour per month for each employee serving patients. The in-service education shall include current information regarding drugs and treatments; specific service procedures and techniques; recognized professional standards, criteria and classification of clients served. *Please see Skilled Nursing Federal Education Requirements

Skilled Nursing Delaware Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://regulations.delaware.gov/admincode/title16/department%20of%20health%20and%20social%20services/division%20of%20long%20term%20care %20Residents%20Protection/3225.shtml Retrieved on: April 20, 2017 Regulation date: January 13 th, 2016 TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF LONG TERM CARE RESIDENCE PROTECTION 3225 Assisted Living Facilities 16.0 Staffing 16.14.2.1 Fire and life safety, and emergency disaster plans Code Response Introduction to Safety Fire Safety Environmental Safety 16.14.2.2 Infection control, including Standard Precautions Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control)

Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations 16.14.2.3 Basic food safety; Food Preparation and Safe Food Handling QIS Dining Observation 16.14.2.4 Basic first aid and the Heimlich Maneuver Heimlich Maneuver New First Aid Lesson 16.14.2.6 The health and psychosocial needs of the population being served; Activities of Daily Living (ADLs) Advanced Pain Management in Long Term Care Age Specific Creating a Personalized Activity Program Ergonomics Hydration Needs: Assessment and Care Nutritional Care Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Pressure Ulcer Determination and Management Restorative Care/ROM Safe Resident Handling for Housekeepers: Ergonomics for the Prevention of MSDs Understanding the Aging Process Understanding Diet Modifications for certain Health Conditions Understanding MDROs Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Wandering: Elopement Prevention

Psychosocial Needs of the Resident 16.14.2.9 16 Del.C. Ch. 11, pertaining to residents rights; reporting of abuse, neglect, mistreatment, and financial exploitation; and the Ombudsman Program; 16.14.3 Receive, at a minimum, 12 hours of regular in-service education annually which may include but not be limited to the topics listed in 16.14.2; 16.14.4 Receive training to competently assist in activities of daily living or provide documentation of such training, and Elder Justice Act Ethics HIPAA HITECH: What All Employees Need to Know Home Care Bill of Rights Implementing HIPAA and HITECH QIS Abuse Prohibition Right on target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation *Please also see Skilled Nursing Federal Education Requirements Activities of Daily Living (ADLs) Body Positioning: A Welcome Change Coding and Documentation of Activities of Daily Living Creating a Personalized Activities Program Ergonomics QIS Activities QIS Activities of Daily Living Restorative Care/ROM

Skilled Nursing Florida Education Requirements Requirement Definition Potential HCA Lesson Retrieved from: https://www.flrules.org/gateway/ruleno.asp?id=59a-4.106 Retrieved on: April 20, 2017 Regulation Date: last updated 12/23/2015 59A-4.106 Facility Policies. Required training All Staff (5) Staff Education. (a) Each nursing home licensee must develop, implement, and maintain a written staff education plan which ensures a coordinated program for staff education for all facility employees. The staff education plan must be reviewed at least annually by the risk management and quality assurance committee and revised as needed. (b) The staff education plan must include both pre-service and in-service programs. HCA recommendation Complete Staff Development Lesson on HCA Develop facility-specific Plan (c) The staff education plan must ensure that education is conducted annually for all facility employees, at a minimum, in the following areas: Any of the following HCA lessons can be used as part of education on the prevention and control of infection: 1. Prevention and control of infection; Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection

Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations 2. Fire prevention, life safety, and disaster preparedness; 3. Accident prevention and safety awareness program; 4. Resident s rights ; (d) The staff education plan shall ensure that all nonlicensed employees of the nursing home complete an initial educational course on hiv/aids. If the employee does not have a certificate of completion at the time they are hired, they must have two hours within six months of employment or before the staff provides care for an hiv/aids diagnosed resident. All employees shall have a minimum of one hour biennially. STATUTES: 400.1755 Care for persons with Alzheimer s disease or related disorders. Fire Safety Environmental Safety Fall and Restraint Reduction Patient Safety: Prevention of Medical Errors Introduction to Safety Environmental Safety Elder Justice Act Home Care Bill of Rights Right on target: Respecting Residents Rights Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation HIV/Aids Retrieved on: April 20, 2017 Retrieved from: http://www.leg.state.fl.us/statutes/index.cfm?app_mode=display_statute&search_string=&url=0400-0499/0400/sections/0400.1755.html

(1) As a condition of licensure, facilities licensed under this part must provide to each of their employees, upon beginning employment, basic written information about interacting with persons with Alzheimer s disease or a related disorder. Recommendation: Organization Policy Review HCA options: (2) All employees who are expected to, or whose responsibilities require them to, have direct contact with residents with Alzheimer s disease or a related disorder must, in addition to being provided the information required in subsection (1), also have an initial training of at least 1 hour completed in the first 3 months after beginning employment. This training must include, but is not limited to, an overview of dementias and must provide basic skills in communicating with persons with dementia. Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation (3) An individual who provides direct care shall be considered a direct caregiver and must complete the required initial training and an additional 3 hours of training within 9 months after beginning employment. This training shall include, but is not limited to, managing problem behaviors, promoting the resident s independence in activities of daily living, and skills in working with families and caregivers. (a) The required 4 hours of training for certified nursing assistants are part of the total hours of training required annually. HCA options: Abuse Prevention in Residents with Dementia Alzheimer s Disease Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Understanding Dementia

(b) For a health care practitioner as defined in s. 456.001, continuing education hours taken as required by that practitioner s licensing board shall be counted toward this total of 4 hours. HCA options: (4) For an employee who is a licensed health care practitioner as defined in s. 456.001, training that is sanctioned by that practitioner s licensing board shall be considered to be approved by the Department of Elderly Affairs. Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Total hours = 4.5 ANCC and FL approved CE provider contact hours of continuing education (5) The Department of Elderly Affairs or its designee must approve the initial and continuing training provided in the facilities. The department must approve training offered in a variety of formats, including, but not limited to, Internet-based training, videos, teleconferencing, and classroom instruction. The department shall keep a list of current providers who are approved to provide initial and continuing training. The CE Broker/Florida Department of Health

department shall adopt rules to establish standards for the trainers and the training required in this section. (6) Upon completing any training listed in this section, the employee or direct caregiver shall be issued a certificate that includes the name of the training provider, the topic covered, and the date and signature of the training provider. The certificate is evidence of completion of training in the identified topic, and the employee or direct caregiver is not required to repeat training in that topic if the employee or direct caregiver changes employment to a different facility or to an assisted living facility, home HCA issues certificate of participation upon successful completion of each Alzheimer s/dementia Lesson health agency, adult day care center, or adult family-care home. The direct caregiver must comply with other applicable continuing education requirements. History. s. 26, ch. 2001-45; s. 62, ch. 2005-2. 400.211 Persons employed as nursing assistants; certification requirement. Retrieved from: http://www.leg.state.fl.us/statutes/index.cfm?app_mode=display_statute&search_string=&url=0400-0499/0400/sections/0400.211.html Retrieved on: April 20, 2017 (4) When employed by a nursing home facility for a 12-month period or HCA course content: longer, a nursing assistant, to maintain certification, shall submit to a performance review every 12 months and must receive regular inservice Dining Experience education based on the outcome of such reviews. The inservice training QIS Dining Observation must: New Dining Standards of Practice (a) Be sufficient to ensure the continuing competence of nursing assistants and must meet the standard specified in s. 464.203(7); (b) Include, at a minimum: 1. Techniques for assisting with eating and proper feeding; Nutritional Status Nutritional Care Your Role as a Nursing Assistant Hydration Status Swallowing and Nutritional Status QIS Behavioral and Emotional Status Cognitive Patterns

2. Principles of adequate nutrition and hydration; 3. Techniques for assisting and responding to the cognitively impaired resident or the resident with difficult behaviors; 4. Techniques for caring for the resident at the end-of-life; and 5. Recognizing changes that place a resident at risk for pressure ulcers and falls; and (c) Address areas of weakness as determined in nursing assistant performance reviews and may address the special needs of residents as determined by the nursing home facility staff. Understanding Dementia QIS Hospice and/or Palliative Care Death, Dying and Post-Mortem care Pressure Ulcer Determination Fall and Restraint Reduction QIS Nutrition QIS Hydration Status QIS Pressure Ulcers MDS 3.0 Skin Conditions Many HCA lessons may help facilities meet this requirement Costs associated with this training may not be reimbursed from additional Medicaid funding through interim rate adjustments. Miscellaneous Florida Education Requirements Requirement Definition Potential HCA Lesson Nursing Requirements Retrieved from: http://floridasnursing.gov/help-center/how-many-continuing-education-hours-are-required-for-licensure-renewal/ Retrieved on: April 2, 2015 See Rule 64B9-5, Florida Administrative Code (FAC) for more information about continuing education requirements. Licensed Practical Nurses, Registered Nurses, Clinical Nurse Specialists and Advanced Registered Nurse Practitioners are required to complete 24 hours of appropriate CE during each renewal period, including: two (2) hours relating to prevention of medical errors Patient Safety: Medical Errors two (2) hours in Laws and Rules in Nursing Nurses need to have complete by the end of 2015.

Introduction to Rules and Regulations for Nursing Homes in Florida Laws and Rules for Nurses Practicing in Florida In addition to these 24 hours of general CE, every third renewal two (2) hours of domestic violence CE must be completed for a total of 26 hours Domestic Violence: Advanced HIV/AIDS HIV/AIDS

Skilled Nursing Georgia Education Requirements Requirement Definition Potential HCA Lesson Required training All Staff Retrieved from: http://www.hpm.umn.edu/nhregsplus/nhregs_by_state/georgia/georgia_rules_and_regulations_complete_04.06.07.pdf Retrieved on: April 25, 2017 Regulation Date: Last updated: 04-2007 290-5-8-.04 Nursing Service (9) An active in-service nursing education program shall be in effect for all nursing personnel. This program shall be developed and conducted by a registered nurse who may be employed part-time and under the direction of the director of nursing services. 290-5-8-.07 Social Service (3) All nursing personnel and employees having contact with patients shall receive social service orientation and in-service training toward understanding emotional problems and social needs of patients. *Please also see Skilled Nursing Federal Education Requirements Activities of Daily Living (ADLs) Age Specific Body Positioning: A Welcome Change Creating a Personalized Activities Program Communication Basics Cultural Diversity Customer Service Strategies Elderly stereotypes Is There a Solution Ethics QIS Activities QIS Activities of Daily Living QIS Behavioral and Emotional Status Spiritual Care Understanding the Aging Process

Skilled Nursing Hawaii Education Requirements Requirement Definition Potential HCA Lesson Retrieved from: http://health.hawaii.gov/opppd/files/2015/06/11-94.pdf Retrieved on: April 22, 2017 Regulation date: All Staff Requirements TITLE 11 DEPARTMENT OF HEALTH CHAPTER 94 SKILLED NURSING/INTERMEDIATE CARE FACILITIES 11-94-9 Dental services. (d) Nursing staff shall receive inservice training in oral hygiene and denture care at least annually. MDS 3.0 Section L: Oral/Dental Status QIS Dental Status and Services 11-94-11 Dietetic services. (4) Food service. (H) If the food service is directed by a person other than a qualified dietitian, there shall be frequent and regularly scheduled consultation by a dietitian or public health nutritionist. This consultation shall be given in the facility at the rate of four hours per every twenty-five patients per month and shall not be less than six hours per month. Consultation, training, and inservice education shall be appropriate to staff and patient needs and shall be documented. Dining Experience Food Preparation and Safe Food Handling Hydration Needs: Assessment and Care MDS 3.0 Section K: Swallowing and Nutritional Status New Dining Standards of Practice Nutritional Care QIS Dining Observation QIS Hydration Status QIS Kitchen/Food Service Observation Understanding Diet Modifications for Certain Health Conditions

11-94-18 Inservice education. (a) There shall be ab staff inservice education program that includes: (3) Inservice training which shall include annually: prevention and control of infections, fire prevention and safety, accident prevention, patient's rights, and problems and needs of the aged, ill, and disabled. Provision shall be made for training appropriate personnel in cardiopulmonary resuscitation and appropriate first aid techniques. prevention and control of infections Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations fire prevention and safety Fire Safety Environmental Safety Introduction to Safety accident prevention Introduction to Safety Fall and Restraint Reduction Patient Safety: Prevention of Medical Errors Environmental Safety patient's rights Elder Justice Act Ethics

HIPAA HITECH: What All Employees Need to Know Home Care Bill of Rights Implementing HIPAA and HITECH QIS Abuse Prohibition Right on target: Respecting Residents Rights Vulnerable Adult: Freedom fromm Abuse, Neglect and Exploitation problems and needs of the aged, ill, and disabled Activities of Daily Living (ADLs) Advanced Pain Management in Long Term Care Age Specific Creating a Personalized Activity Program Ergonomics Hydration Needs: Assessment and Care Nutritional Care Mental Health in Older Adults Parallels of Time: A History of Developmental Disabilities Pressure Ulcer Determination and Management Restorative Care/ ROM Safe Resident Handling for Housekeepers: Ergonomics for the Prevention of MSDs Understanding the Aging Process Understanding Diet Modifications for Certain Health Conditions Understanding MDROs Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation Wandering: Elopement Prevention

Skilled Nursing Idaho Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://adminrules.idaho.gov/rules/current/16/0302.pdf Retrieved on: April 20, 2017 Regulation date: last updates March 16, 2002 16.03.02 - RULES AND MINIMUM STANDARDS FOR SKILLED NURSING AND INTERMEDIATE CARE FACILITIES 105. PERSONNEL. 01. Personnel Policies. Personnel policies shall be developed and implemented and shall include: c. Continuing in-service training for all employees which is consistent with patients /residents needs and services offered. A minimum of twenty-four (24) hours of training per year shall be provided to nursing staff; *Please also see Skilled Nursing Federal Education Requirements 153. DENTAL SERVICES. The facility shall develop and implement written policies and procedures which reflect the satisfactory arrangement for assisting patients/residents to maintain good oral health and hygiene 03. Oral Care and Hygiene. The facility shall ensure that patients/residents receive care in the facility which promotes a healthy mouth through: c. In-service training for staff regarding oral hygiene MDS 3.0 Section L: Oral/Dental Status 200. NURSING SERVICES. QIS Dental Status and Services New Dental Lesson 01. Director of Nursing Services. A registered nurse currently licensed by the state of Idaho and qualified by training and experience shall be designated Director of Nursing Services in each SNF and ICF and shall be responsible and accountable for:

g. Planning and coordinating orientation programs for new nursing and auxiliary personnel, as well as a formal, coordinated in-service education program for all nursing personnel; *Please also see Skilled Nursing Federal Education Requirements

Skilled Nursing Illinois Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://www.ilga.gov/commission/jcar/admincode/077/077003000c06500r.html Retrieved on: April 20, 2017 Regulation date: August 30, 2012 Section 300.650 Personnel Policies f) Orientation and In-Service Training 1) All new employees, including student interns, shall complete an orientation program covering, at a minimum, the following: general facility and resident orientation; job orientation, emphasizing allowable duties of the new employee; resident safety, including fire and disaster, emergency care and basic resident safety; and understanding and communicating with the type of residents being cared for in the facility. In addition, all new direct care staff, including student interns, shall complete an orientation program covering the facility's policies and procedures for resident care services before being assigned to provide direct care to residents. This orientation program shall include information on the prevention and treatment of decubitus ulcers and the importance of nutrition in general health care. Resident safety Fall and Restraint Reduction Patient Safety: Prevention of Medical Errors Safe Resident Handling for Caregivers Safe Resident Handling for Manager Fire and disaster Introduction to Safety Fire Safety Environmental Safety Emergency care EMTALA Heimlich

Code Response Information on CPR can be found in the Healthcare Academy lesson Code Response. Healthcare Academy recommends attending a class where the learner can practice their skills. Prevention and treatment of decubitus ulcers Acute and Chronic Wounds Etiology and Characteristics Body Positioning: A Welcome Change Pressure Ulcer Determination and Management QIS Pressure Ulcers Nutrition in general health care Dining Experience Food Preparation and Safe Food Handling Hydration Needs: Assessment and Care MDS 3.0 Section K: Swallowing and Nutritional Status New Dining Standards of Practice Nutritional Care QIS Dining Observation QIS Hydration Status QIS Nutrition QIS Kitchen/Food Service Observation Understanding Diet Modifications for Certain Health Conditions 2) All employees, except student interns shall attend in-service training programs pertaining to their assigned duties at least annually. These in-service training programs shall include the facility's policies, skill training and ongoing education to enable all personnel to perform their duties effectively. The inservice training sessions regarding personal care, nursing and restorative services shall include information on the prevention and treatment of decubitus ulcers. In-service training concerning dietary services shall include information on the effects of diet in treatment of various diseases or medical conditions and the importance of laboratory test results in determining therapeutic diets. Written records of program content for each session and of personnel attending each session shall be kept. Personal care Activities of Daily Living (ADLs) Body Positioning: A Welcome Change

Creating a Personalized Activities Program Ergonomics QIS Activities of Daily Living Restorative Care/ROM Nursing and restorative services shall include information on the prevention and treatment of decubitus ulcers Dietary services shall include information on the effects of diet in treatment of various diseases Acute and Chronic Wounds Etiology and Characteristics Body Positioning: A Welcome Change Pressure Ulcer Determination and Management QIS Pressure Ulcers Restorative Care/ROM Understanding Diet Modifications for Certain Health Conditions *Please also see Skilled Nursing Federal Education Requirements Section 300.1220 Supervision of Nursing Services 8) Supervising and overseeing in-service education, embracing orientation, skill training, and on-going education for all personnel and covering all aspects of resident care and programming. The educational program shall include training and practice in: activities and restorative/rehabilitative nursing techniques through out-of-facility or in-facility training programs. This person may conduct these programs personally or see that they are carried out. Activities Activities of Daily Living (ADLs) Creating a Personalized Activities Program QIS Activities QIS Activities of Daily Living Restorative/rehabilitative Pulmonary Rehabilitation Program QIS Rehabilitation and Community Discharge Restorative Care/ROM

Skilled Nursing Indiana Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://www.in.gov/legislative/iac/iac_title?iact=410 Retrieved on: April 25, 2017 Regulation date: last updated 2013 410 IAC 16.2-3.1-13 Administration and management (b) The licensee shall provide the number of staff as required to carry out all the functions of the facility, including the following: (2) A continuing in-service education and training program for all employees. (A) personnel assigned to the unit receive required in-service training; and (B) care provided to Alzheimer's and dementia care unit residents is consistent with: (i) in-service training; (ii) current Alzheimer's and dementia care practices; and (iii) regulatory standards. *Please also see Skilled Nursing Federal Education Requirements Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation

410 IAC 16.2-3.1-18 Infection control program (4) Provides orientation and in-service education on infection prevention and control, including universal precautions. Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations

Skilled Nursing Iowa Education Requirements Requirement Definition Potential HCA Lesson Retrieved from: https://www.legis.iowa.gov/docs/iac/chapter/481.58.pdf Retrieved on: April 20, 2017 Regulation date: June 8, 2016 481 58.9(135C) Administration. All Staff Requirements c. Be responsible for a monthly in-service educational program for all employees and to maintain records of programs and participants; (III) *Please also see Skilled Nursing Federal Education Requirements 481 58.11(135C) Personnel. 58.11(1) General qualifications. j. There shall be an organized ongoing in-service educational and training program planned in advance for all personnel in all departments. (II, III) *Please also see Skilled Nursing Federal Education Requirements 481 58.20(135C) Duties of health service supervisor. Every nursing facility shall have a health service supervisor who shall: 58.20(7) Plan and conduct nursing staff orientation and in-service programs and provide for training of nurse s aides; (III) *Please also see Skilled Nursing Federal Education Requirements 481 58.22(135C) Rehabilitative services. Rehabilitative services shall be provided to maintain function or improve the resident s ability to carry out the activities of daily living. (4) Present programs in the facility s in-service education programs. (III) Activities of Daily Living (ADLs) Body Positioning: A Welcome Change Coding and Documentation of Activities of Daily Living

Creating a Personalized Activities Program Ergonomics QIS Activities QIS Activities of Daily Living Restorative Care/ROM 481 58.23(135C) Dental, diagnostic, and other services. f. Dentists shall be asked to participate in the in-service program of the facility. (III) MDS 3.0 Section L: Oral/Dental Status QIS Dental Status and Services New Dental Lesson 481 58.28(135C) Safety. The licensee of a nursing facility shall be responsible for the provision and maintenance of a safe environment for residents and personnel. (III) b. In-service shall be provided to ensure that all employees are knowledgeable of the emergency plan. (III) Fire Safety Environmental Safety Authoring Tool 481 58.54(73GA,ch 1016) Special unit or facility dedicated to the care of persons with chronic confusion or a dementing illness (CCDI unit or facility). b. Licensed nurses, certified aides, certified medication aides, social services personnel, housekeeping and activity personnel shall have a minimum of six hours of in-service training annually. This training shall be related to the needs of CCDI residents. The six-hour training shall count toward the required annual in-service training. (II, III) Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults

Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation

Skilled Nursing Kansas Education Requirements Requirement Definition Potential HCA Lesson All Staff Requirements Retrieved from: http://www.kssos.org/pubs/kar/2009/2a004_28- Department%20of%20Health%20and%20Environment%20Articles%2036%20through%2040,%202009%20KAR%20Vol%202A.pdf Retrieved on: April 20, 2017 Regulation date: 2009 28-39-160. Other resident services. (7) The facility shall provide in-service training specific to the needs of the residents in the special care section to staff at regular intervals. Abuse Prevention in Residents with Dementia Alzheimer s Disease Alzheimer's Disease: The Facts Care of the Cognitively Impaired Caring for the Alzheimer s Client Client Behaviors: Assessment and Intervention in the Resident with Dementia Comprehensive View of Alzheimer s Disease Comprehensive View of Dementia Nursing Care of the Resident w/ Advanced Alzheimer s Disease Overview of Mental Illness Older Adults Parallels of Time: A History of Developmental Disabilities Understanding Dementia Vulnerable Adult: Freedom from Abuse, Neglect and Exploitation 28-39-161. Infection control.

(6) includes in the orientation of new employees and periodic employees in-service information on exposure control and infection control in a health care setting; Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations 28-39-163. Administration. (g) Staff development and personnel policies. The facility shall provide regular performance review and in-service education of all employees to ensure that the services and procedures assist residents to attain and maintain their highest practicable level of physical, mental, and psychosocial functioning. (3) The facility shall provide regular, planned in-service education for all staff. (A) The in-service program shall provide all employees with training in fire prevention and safety, disaster procedures, accident prevention, resident rights, psychosocial needs of residents, and infection control. (B) The facility shall provide direct care staff with in-service education in techniques that assist residents to function at their highest practicable physical, mental, and psychosocial level. (C) Direct care staff shall participate in at least 12 hours of in-service education each year. All other staff shall participate in at least eight hours of inservice education each year. (D) The facility shall maintain documentation of in-service education offerings. Documentation shall include a content outline, resume of the presenter, and record of staff in attendance.

Fire prevention and safety Introduction to Safety Fire Safety Disaster procedures Environmental Safety Accident prevention Fall and Restraint Reduction Patient Safety: Prevention of Medical Errors Introduction to Safety Environmental Safety Accident Prevention Resident s rights Elder Justice Act Ethics HIPAA HITECH: What All Employees Need to Know Home Care Bill of Rights Implementing HIPAA and HITECH Right on target: Respecting Residents Rights Vulnerable Adult: Freedom form Abuse, Neglect and Exploitation Psychosocial needs of residents Activities of Daily Living (ADLs) Advanced Pain Management in Long Term Care Age Specific Body Positioning: A Welcome Change Creating a Personalized Activities Program Ergonomics Ethics QIS Activities QIS Activities of Daily Living QIS Behavioral and Emotional Status Restorative Care/ROM Understanding the Aging Process

Resident Adjustment to Transfer Psychosocial Needs of the Resident Infection control Hand Hygiene Breaking the Chain of Infection Aseptic Technique C. Difficile for Nursing Assistants C. Difficile for Nurses Isolation Precautions: A Lesson in Infection Control Laundry Measures to Prevent the Spread of Infection Personal Protective Equipment (PPE) Interpretive Guidelines for LTC Facilities (Tag F441 Infection Control) Understanding Bloodborne Pathogens Safety with Sharps Understanding MDROs TB QIS: Infection Control & Immunizations