Part III. Personnel
22VAC40-73-110. Staff general qualifications.
All staff shall:
1. Be considerate and respectful of the rights, dignity, and sensitivities of persons who are aged or infirm or who have disabilities;
2. Be able to speak, read, understand, and write in English as necessary to carry out their job responsibilities; and
3. Meet the requirements specified in the Regulation for Background Checks for Assisted Living Facilities and Adult Day Centers (22VAC40-90).
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018; amended, Virginia Register Volume 40, Issue 24, eff. August 14, 2024.
22VAC40-73-120. Staff orientation and initial training.
A. The orientation and training required in subsections B and C of this section shall occur within the first seven working days of employment. Until this orientation and training is completed, the staff person may only assume job responsibilities if under the sight supervision of a trained direct care staff person or administrator.
B. All staff shall be oriented to:
1. The purpose of the facility;
2. The facility's organizational structure;
3. The services provided;
4. The daily routines;
5. The facility's policies and procedures;
6. Specific duties and responsibilities of their positions; and
7. Required compliance with regulations for assisted living facilities as it relates to their duties and responsibilities.
C. All staff shall be trained in the relevant laws, regulations, and the facility's policies and procedures sufficiently to implement:
1. Emergency and disaster plans for the facility;
2. Procedures for the handling of resident emergencies;
3. Use of the first aid kit and knowledge of its location;
4. Handwashing techniques, standard precautions, infection risk-reduction behavior, and other infection control measures specified in 22VAC40-73-100;
5. Confidential treatment of personal information;
6. Requirements regarding the rights and responsibilities of residents;
7. Requirements and procedures for detecting and reporting suspected abuse, neglect, or exploitation of residents and for mandated reporters, the consequences for failing to make a required report, as set out in § 63.2-1606 of the Code of Virginia;
8. Procedures for reporting and documenting incidents as required in 22VAC40-73-70;
9. Methods of alleviating common adjustment problems that may occur when a resident moves from one residential environment to another; and
10. For direct care staff, the needs, preferences, and routines of the residents for whom they will provide care.
D. Staff orientation and initial training specified in this section may count toward the required annual training hours for the first year.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-130. Reports of abuse, neglect, or exploitation.
A. All staff who are mandated reporters under § 63.2-1606 of the Code of Virginia shall report suspected abuse, neglect, or exploitation of residents in accordance with that section.
B. The facility shall notify the resident's contact person or legal representative when a report is made relating to the resident as referenced in subsection A of this section, without identifying any confidential information.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-140. Administrator qualifications.
A. The administrator shall be at least 21 years of age.
B. The administrator shall be able to read and write and understand this chapter.
C. The administrator shall be able to perform the duties and carry out the responsibilities required by this chapter.
D. For a facility licensed only for residential living care that does not employ an administrator licensed by the Virginia Board of Long-Term Care Administrators, the administrator shall:
1. Be a high school graduate or shall have a General Education Development (GED) Certificate;
2. (i) Have successfully completed at least 30 credit hours of postsecondary education from a college or university accredited by an association recognized by the U.S. Secretary of Education and at least 15 of the 30 credit hours shall be in business or human services or a combination thereof; (ii) have successfully completed a course of study approved by the department that is specific to the administration of an assisted living facility; (iii) have a bachelor's degree from a college or university accredited by an association recognized by the U.S. Secretary of Education; or (iv) be a licensed nurse; and
3. Have at least one year of administrative or supervisory experience in caring for adults in a residential group care facility.
The requirements of this subsection shall not apply to an administrator of an assisted living facility employed prior to February 1, 2018, who met the requirements in effect when employed and who has been continuously employed as an assisted living facility administrator.
E. For a facility licensed for both residential and assisted living care, the administrator shall be:
1. Licensed as an assisted living facility administrator or nursing home administrator by the Virginia Board of Long-Term Care Administrators pursuant to Chapter 31 (§ 54.1-3100 et seq.) of Title 54.1 of the Code of Virginia; or
2. Authorized to temporarily practice pursuant to § 54.1-2408.4 of the Code of Virginia.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018; amended, Virginia Register Volume 41, Issue 4, eff. November 6, 2024.
22VAC40-73-150. Administrator provisions and responsibilities.
A. Each facility shall have an administrator of record.
B. If an administrator dies, resigns, is discharged, or becomes unable to perform his duties, the facility shall immediately employ a new administrator or appoint a qualified acting administrator so that no lapse in administrator coverage occurs.
1. The facility shall notify the department's regional licensing office in writing within 14 days of a change in a facility's administrator, including the resignation of an administrator, appointment of an acting administrator, and appointment of a new administrator, except that the time period for notification may differ as specified in subdivision 2 of this subsection.
2. For a facility licensed for both residential and assisted living care, the facility shall immediately notify the Virginia Board of Long-Term Care Administrators and the department's regional licensing office that the licensed administrator died, resigned, was discharged, or became unable to perform his duties and that a new licensed administrator has been employed or that the facility is operating without an administrator licensed by the Virginia Board of Long-Term Administrators, whichever is the case, and provide the last date of employment of the previous licensed administrator.
3. For a facility licensed for both residential and assisted living care, when an acting administrator is named, he shall notify the department's regional licensing office of his employment, and if he is intending to assume the position permanently, submit a completed application for an approved administrator-in-training program to the Virginia Board of Long-Term Care Administrators within 10 days of employment.
4. For a facility licensed for both residential and assisted living care, the acting administrator shall be qualified by education for an approved administrator-in-training program and have a minimum of one year of administrative or supervisory experience in a health care or long-term care facility or have completed such a program and be awaiting licensure.
5. A facility licensed only for residential living care may be operated by an acting administrator for no more than 90 days from the last date of employment of the administrator.
6. A facility licensed for both residential and assisted living care may be operated by an acting administrator for no more than 150 days, or not more than 90 days if the acting administrator has not applied for licensure, from the last date of employment of the licensed administrator.
7. An acting administrator may be granted one extension of up to 30 days in addition to the 150 days, as specified in subdivision 6 of this subsection, upon written request to the department's regional licensing office. An extension may only be granted if the acting administrator (i) has applied for licensure as a long-term care administrator pursuant to Chapter 31 (§ 54.1-3100 et seq.) of Title 54.1 of the Code of Virginia, (ii) has completed the administrator-in-training program, and (iii) is awaiting the results of the national examination. If a 30-day extension is granted, the acting administrator shall immediately submit written notice of such to the Virginia Board of Long-Term Care Administrators.
8. A person may not become an acting administrator at any assisted living facility if the Virginia Board of Long-Term Care Administrators has refused to issue or renew, suspended, or revoked his assisted living facility or nursing home administrator license.
9. No assisted living facility shall operate under the supervision of an acting administrator pursuant to §§ 54.1-3103.1 and 63.2-1803 of the Code of Virginia more than two times during any two-year period unless authorized to do so by the department.
C. The administrator shall be responsible for the general administration and management of the facility and shall oversee the day-to-day operation of the facility. This shall include responsibility for:
1. Ensuring that care is provided to residents in a manner that protects their health, safety, and well-being;
2. Maintaining compliance with applicable laws and regulations;
3. Developing and implementing all policies, procedures, and services as required by this chapter;
4. Ensuring staff and volunteers comply with residents' rights;
5. Maintaining buildings and grounds;
6. Recruiting, hiring, training, and supervising staff; and
7. Ensuring the development, implementation, and monitoring of an individualized service plan for each resident, except that a plan is not required for a resident with independent living status.
D. The administrator shall report to the Director of the Department of Health Professions information required by and in accordance with § 54.1-2400.6 of the Code of Virginia regarding any person (i) licensed, certified, or registered by a health regulatory board or (ii) holding a multistate licensure privilege to practice nursing or an applicant for licensure, certification, or registration. Information required to be reported, under specified circumstances includes substance abuse and unethical or fraudulent conduct.
E. For a facility licensed only for residential living care, either the administrator or a designated assistant who meets the qualifications of the administrator shall be awake and on duty on the premises at least 40 hours per week with no fewer than 24 of those hours being during the day shift on weekdays, unless at least one of the following applies:
1. 22VAC40-73-170 allows a shared administrator for smaller facilities.
2. If the administrator is licensed as an assisted living facility administrator or nursing home administrator by the Virginia Board of Long-Term Care Administrators, the provisions regarding the administrator in subsection F of this section apply. When such is the case, there is no requirement for a designated assistant.
F. For a facility licensed for both residential and assisted living care, the administrator shall serve on a full-time basis as the onsite agent of the licensee and shall be responsible for the day-to-day administration and management of the facility, except as provided in 22VAC40-73-170.
G. The administrator, acting administrator, or as allowed in subsection E of this section, designated assistant administrator, shall not be a resident of the facility.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018; amended, Virginia Register Volume 36, Issue 2, eff. October 17, 2019.
22VAC40-73-160. Administrator training.
A. For a facility licensed only for residential living care that does not employ a licensed administrator, the administrator shall attend at least 20 hours of training related to management or operation of a residential facility for adults or relevant to the population in care within 12 months from the starting date of employment and annually thereafter from that date. At least two of the required 20 hours of training shall focus on infection control and prevention, and when adults with mental impairments reside in the facility, at least six of the required 20 hours shall focus on topics related to residents' mental impairments. Documentation of attendance shall be retained at the facility and shall include type of training, name of the entity that provided the training, and date and number of hours of training.
B. All licensed administrators shall meet the continuing education requirements for continued licensure.
C. Any administrator who has not previously undergone the training specified in 22VAC40-73-40 C shall be required to complete that training within two months of employment as administrator of the facility. The training may be counted toward the annual training requirement for the first year, except that for licensed administrators, whether the training counts toward continuing education and for what period of time depends upon the administrator licensure requirements.
D. Administrators who supervise medication aides, as allowed by 22VAC40-73-670 3 b, but are not registered medication aides themselves, shall successfully complete a training program approved by the Virginia Board of Nursing for the registration of medication aides. The training program for such administrators must include a minimum of 68 hours of student instruction and training, but need not include the prerequisite for the program or the written examination for registration. The training shall be completed prior to supervising medication aides and may be counted toward the annual training requirement in subsection A of this section, except that for licensed administrators, whether the training counts toward continuing education and for what period of time depends upon the administrator licensure requirements. The following exceptions apply:
1. The administrator is licensed by the Commonwealth of Virginia to administer medications; or
2. Medication aides are supervised by an individual employed full time at the facility who is licensed by the Commonwealth of Virginia to administer medications.
E. Administrators who have completed the training program specified in subsection D of this section and who supervise medication aides shall be required to annually have (i) four hours of training in medication administration specific to the facility population or (ii) a refresher course in medication administration offered by a Virginia Board of Nursing approved program. Administrators are exempt from this annual medication training or refresher course during the first year after completion of the training program noted in subsection D of this section. For unlicensed administrators of a facility licensed only for residential living care this annual medication administration training or course may be counted toward the annual training requirement specified in subsection A of this section. For licensed administrators, whether the training counts toward continuing education and for what period of time depends upon the administrator licensure requirements.
F. If a designated assistant administrator, as allowed in 22VAC40-73-150 E supervises medication aides, the requirements of subsections D and E of this section apply to the designated assistant administrator.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-170. Shared administrator for smaller facilities.
A. An administrator of a facility licensed only for residential living care, who is not licensed as an assisted living facility administrator or nursing home administrator by the Virginia Board of Long-Term Care Administrators, is allowed to be present at a facility for fewer than the required minimum 40 hours per week in order to serve multiple facilities, without a designated assistant, under the following conditions:
1. The administrator shall serve no more than four facilities.
2. The combined total licensed capacity of the facilities served by the administrator shall be 40 or fewer residents.
3. The administrator shall be awake and on duty on the premises of each facility served for at least 10 hours a week, six of which must be during the day shift.
4. The administrator shall serve as a full-time administrator (i.e., shall be awake and on duty on the premises of all facilities served for a combined total of at least 40 hours a week).
5. Each of the facilities served shall be within a 30-minute average one-way travel time of the other facilities.
6. When not present at a facility, the administrator shall be on call to that facility during the hours he is working as an administrator and shall maintain such accessibility through suitable communication devices.
7. A designated assistant may act in place of the administrator during the required minimum of 40 hours only if the administrator is ill or on vacation and for a period of time that shall not exceed four consecutive weeks. The designated assistant shall meet the qualifications of the administrator.
8. Each of the facilities served shall have a manager, designated and supervised by the administrator. The manager shall be awake and on duty on the premises of the facility for the remaining part of the 40 required hours per week when the administrator or designated assistant is not present at the facility. The manager shall meet the following qualifications and requirements:
a. The manager shall be at least 21 years of age.
b. The manager shall be able to read and write, and understand this chapter.
c. The manager shall be able to perform the duties and to carry out the responsibilities of his position.
d. The manager shall:
(1) Be a high school graduate or have a General Education Development (GED) Certificate;
(2) (i) Have successfully completed at least 30 credit hours of postsecondary education from a college or university accredited by an association recognized by the U.S. Secretary of Education and at least 15 of the 30 credit hours shall be in business or human services or a combination thereof; (ii) have successfully completed a course of study of 40 or more hours approved by the department that is specific to the management of an assisted living facility; (iii) have a bachelor's degree from a college or university accredited by an association recognized by the U.S. Secretary of Education; or (iv) be a licensed nurse; and
(3) Have at least one year of administrative or supervisory experience in caring for adults in a residential group care facility.
e. Subdivision 8 d of this subsection does not apply to a manager of an assisted living facility employed prior to February 1, 2018, who met the requirements in effect when employed and who has been continuously employed as an assisted living facility manager.
f. The manager shall not be a resident of the facility.
g. The manager shall complete the training specified in 22VAC40-73-40 C within two months of employment as manager. The training may be counted toward the annual training requirement for the first year.
Exception: A manager employed prior to December 28, 2006, who met the requirements in effect when employed and who has been continuously employed as a manager.
h. The manager shall attend at least 20 hours of training related to management or operation of a residential facility for adults or relevant to the population in care within each 12-month period. When adults with mental impairments reside in the facility, at least six of the required 20 hours of training shall focus on topics related to residents' mental impairments and at least two of the required 20 hours on infection control and prevention. Documentation of attendance shall be retained at the facility and shall include title of course, name of the entity that provided the training, and date and number of hours of training.
9. There shall be a written management plan for each facility that describes how the administrator will oversee the care and supervision of the residents and the day-to-day operation of the facility.
10. The minimum of 40 hours per week required for the administrator or manager to be awake and on duty on the premises of a facility shall include at least 24 hours during the day shift on weekdays.
B. An administrator, who is licensed as an assisted living facility administrator or nursing home administrator by the Virginia Board of Long-Term Care Administrators, may be responsible for the day-to-day administration and management of multiple facilities under the following conditions:
1. The administrator shall serve no more than four facilities.
2. The combined total licensed capacity of the facilities served by the administrator shall be 40 or fewer residents.
3. The administrator shall serve on a full-time basis as the on-site agent of the licensee or licensees, proportioning his time among all the facilities served in order to ensure that he provides sufficient administrative and management functions to each facility.
4. Each of the facilities served shall be within a 30-minute average one-way travel time of the other facilities.
5. When not present at a facility, the administrator shall be on call to that facility during the hours he is working as an administrator and shall maintain such accessibility through suitable communication devices.
6. Each of the facilities served shall have a manager, designated and supervised by the administrator, to assist the administrator in overseeing the care and supervision of the residents and the day-to-day operation of the facility. The majority of the time, the administrator and the manager shall be present at a facility at different times to ensure appropriate oversight of the facility. The manager shall meet the qualifications and requirements specified in subdivision A 8 of this section.
Exception: In regard to subdivision A 8 of this section, the reference to 40 hours is not relevant to a facility to which this subsection applies (i.e., a facility with a licensed administrator).
7. There shall be a written management plan for each facility that includes written policies and procedures that describe how the administrator shall oversee the care and supervision of the residents and the day-to-day operation of the facility.
C. This section shall not apply to an administrator who serves both an assisted living facility and a nursing home as provided for in 22VAC40-73-180.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-180. Administrator of both assisted living facility and nursing home.
A. Any person meeting the qualifications for a licensed nursing home administrator pursuant to § 54.1-3103 of the Code of Virginia may serve as the administrator of both an assisted living facility and a licensed nursing home, provided the assisted living facility and licensed nursing home are part of the same building.
B. Whenever an assisted living facility and a licensed nursing home have a single administrator, there shall be a written management plan that addresses the care and supervision of the assisted living facility residents. The management plan shall include the following:
1. Written policies and procedures that describe how the administrator will oversee the care and supervision of the residents and the day-to-day operation of the facility.
2. If the administrator does not provide the direct management of the assisted living facility or only provides a portion thereof, the plan shall specify a designated individual who shall serve as manager and who shall be supervised by the administrator.
3. The manager referred to in subdivision 2 of this subsection shall be on site and meet the qualifications and requirements of 22VAC40-73-170 A 8, A 9, and A 10.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-190. Designated direct care staff person in charge.
A. When the administrator, the designated assistant, or the manager is not awake and on duty on the premises, there shall be a designated direct care staff member in charge on the premises. However, when no residents are present at the facility, the designated staff person in charge does not have to be on the premises.
B. The specific duties and responsibilities of the designated direct care staff member in charge shall be determined by the administrator.
C. Prior to being placed in charge, the staff member shall be informed of and receive training on his duties and responsibilities and provided written documentation of such duties and responsibilities.
D. The staff member shall be awake and on duty on the premises while in charge.
E. The staff member in charge shall be capable of protecting the physical and mental well-being of the residents.
F. The administrator shall ensure that the staff member in charge is prepared to carry out his duties and responsibilities and respond appropriately in case of an emergency.
G. The staff member in charge shall not be a resident of the facility.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-200. Direct care staff qualifications.
A. Direct care staff shall be at least 18 years of age unless certified in Virginia as a nurse aide.
B. Direct care staff who are responsible for caring for residents with special health care needs shall only provide services within the scope of their practice and training.
C. Direct care staff shall meet one of the requirements in this subsection. If the staff does not meet the requirement at the time of employment, he shall successfully meet one of the requirements in this subsection within two months of employment. Licensed health care professionals practicing within the scope of their profession are not required to complete the training in this subsection.
1. Certification as a nurse aide issued by the Virginia Board of Nursing.
2. Successful completion of a Virginia Board of Nursing-approved nurse aide education program.
3. Successful completion of a nursing education program preparing for registered nurse licensure or practical nurse licensure.
4. Current enrollment in a nursing education program preparing for registered nurse or practical nurse licensure and completion of at least one clinical course in the nursing program that includes at least 40 hours of direct client care clinical experience.
5. Successful completion of a personal care aide training program approved by the Virginia Department of Medical Assistance Services.
6. Successful completion of an educational program for geriatric assistant or home health aide or for nurse aide that is not covered under subdivision 2 of this subsection. The program shall be provided by a hospital, nursing facility, or educational institution and may include out-of-state training. The program must be approved by the department. To obtain department approval:
a. The facility shall provide to the department's representative an outline of course content, dates and hours of instruction received, the name of the entity that provided the training, and other pertinent information.
b. The department will make a determination based on the information in subdivision 6 a of this subsection and provide written confirmation to the facility when the educational program meets department requirements.
7. Successful completion of the department-approved 40-hour direct care staff training provided by a registered nurse or licensed practical nurse.
8. Direct care staff employed prior to February 1, 2018, who only cared for residents meeting the criteria for residential living care, and who were therefore not required to meet this subsection prior to February 1, 2018, shall successfully complete a training program consistent with this subsection no later than January 31, 2019.
D. The facility shall obtain a copy of the certificate issued or other documentation indicating that the person has met one of the requirements of subsection C of this section, which shall be part of the staff member's record in accordance with 22VAC40-73-250.
E. The administrator shall develop and implement a written plan for supervision of direct care staff who have not yet met the requirements as allowed for in subsection C of this section.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018; Errata, 34:8 VA.R. 832 December 11, 2017.
22VAC40-73-210. Direct care staff training.
A. In a facility licensed only for residential living care, all direct care staff shall attend at least 14 hours of training annually.
B. In a facility licensed for both residential and assisted living care, all direct care staff shall attend at least 18 hours of training annually.
C. Training for the first year shall commence no later than 60 days after employment.
D. The training shall be in addition to (i) required first aid training; (ii) CPR training, if taken; and (iii) for medication aides, continuing education required by the Virginia Board of Nursing.
E. The training shall be relevant to the population in care and shall be provided by a qualified individual through in-service training programs or institutes, workshops, classes, or conferences.
F. At least two of the required hours of training shall focus on infection control and prevention. When adults with mental impairments reside in the facility, at least four of the required hours shall focus on topics related to residents' mental impairments.
G. Documentation of the type of training received, the entity that provided the training, number of hours of training, and dates of the training shall be kept by the facility in a manner that allows for identification by individual staff person and is considered part of the staff member's record.
Exception: Direct care staff who are licensed health care professionals or certified nurse aides shall attend at least 12 hours of annual training.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-220. Private duty personnel.
A. When private duty personnel from licensed home care organizations provide direct care or companion services to residents in an assisted living facility, the following applies:
1. Before direct care or companion services are initiated, the facility shall obtain, in writing, information on the type and frequency of the services to be delivered to the resident by private duty personnel, review the information to determine if it is acceptable, and provide notification to the home care organization regarding any needed changes.
2. The direct care or companion services provided by private duty personnel to meet identified needs shall be reflected on the resident's individualized service plan.
3. The facility shall ensure that the requirements of 22VAC40-73-250 D 1 through D 4 regarding tuberculosis are applied to private duty personnel and that the required reports are maintained by the facility or the licensed home care organization.
4. The facility shall provide orientation and training to private duty personnel regarding the facility's policies and procedures related to the duties of private duty personnel.
5. The facility shall ensure that documentation of resident care required by this chapter is maintained.
6. The facility shall monitor the delivery of direct care and companion services to the resident by private duty personnel.
B. When private duty personnel who are not employees of a licensed home care organization provide direct care or companion services to residents in an assisted living facility, the requirements listed under subdivisions A 2 through A 6 of this section apply. In addition, before direct care or companion services are initiated, the facility shall:
1. Obtain, in writing, information on the type and frequency of the services to be delivered to the resident by private duty personnel, review the information to determine if it is acceptable, and provide notification to whomever has hired the private duty personnel regarding any needed changes.
2. Ensure that private duty personnel are qualified for the types of direct care or companion services they are responsible for providing to residents and maintain documentation of the qualifications.
3. Review an original criminal history record report issued by the Virginia Department of State Police, Central Criminal Records Exchange, for each private duty personnel.
a. The report must be reviewed prior to initiation of services.
b. The date of the report must be no more than 90 days prior to the date of initiation of services, except that if private duty personnel change clients in the same facility with a lapse in service of not more than 60 days, a new criminal history record report shall not be required.
c. The administrator shall determine conformance to facility policy regarding private duty personnel and criminal history to protect the welfare of residents. The policy must be in writing. If private duty personnel are denied the ability to provide direct care or companion services due to convictions appearing on their criminal history record report, a copy of the report shall be provided to the private duty personnel.
d. The report and documentation that it was reviewed shall be maintained at the facility while the private duty person is at the facility and for one year after the last date of work.
e. Criminal history reports shall be maintained in locked files accessible only to the licensee, administrator, board president, or the respective designee.
f. Further dissemination of the criminal history record report information is prohibited other than to the commissioner's representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.
C. The requirements of subsections A and B of this section shall not apply to private duty personnel who only provide skilled nursing treatments as specified in 22VAC40-73-470 B.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-230. Staff duties performed by residents.
A. Any resident who performs any staff duties shall meet the personnel and health requirements for that position.
B. There shall be a written agreement between the facility and any resident who performs staff duties.
1. The agreement shall specify duties, hours of work, and compensation.
2. The agreement shall not be a condition for admission or continued residence.
3. The resident shall enter into such an agreement voluntarily.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-240. Volunteers.
A. Any volunteers used shall:
1. Have qualifications appropriate to the services they render; and
2. Be subject to laws and regulations governing confidential treatment of personal information.
B. No volunteer shall be permitted to serve in an assisted living facility without the permission of or unless under the supervision of a person who has received a criminal record clearance pursuant to § 63.2-1720 of the Code of Virginia.
C. The facility shall maintain the following documentation on volunteers:
1. Name.
2. Address.
3. Telephone number.
4. Emergency contact information.
5. Information on any qualifications, orientation, training, and education required by this chapter, including any specified relevant information.
D. Duties and responsibilities of all volunteers shall be clearly differentiated from those of persons regularly filling staff positions.
E. At least one staff person shall be assigned responsibility for coordinating volunteer services, including overall selection, supervision, and orientation of volunteers.
F. Prior to beginning volunteer service, all volunteers shall attend an orientation including information on their duties and responsibilities, resident rights, confidentiality, emergency procedures, infection control, the name of their supervisor, and reporting requirements. Volunteers shall sign and date a statement that they have received and understand this information.
G. All volunteers shall be under the supervision of a designated staff person when residents are present.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-250. Staff records and health requirements.
A. A record shall be established for each staff person. It shall not be destroyed until at least two years after employment is terminated.
B. All staff records shall be retained at the facility, treated confidentially, and kept in a locked area.
Exception: Emergency contact information required by subdivision C 9 of this section shall also be kept in an easily accessible place.
C. Personal and social data to be maintained on staff and included in the staff record are as follows:
1. Name;
2. Birth date;
3. Current address and telephone number;
4. Position title and date employed;
5. Verification that the staff person has received a copy of his current job description;
6. An original criminal record report and a sworn disclosure statement;
7. Documentation of qualifications for employment related to the staff person's position, including any specified relevant information;
8. Verification of current professional license, certification, registration, medication aide provisional authorization, or completion of a required approved training course;
9. Name and telephone number of person to contact in an emergency;
10. Documentation of orientation, training, and education required by this chapter, including any specified relevant information, with annual training requirements determined by starting date of employment; and
11. Date of termination of employment.
D. Health information required by these standards shall be maintained at the facility and be included in the staff record for each staff person, and also shall be maintained at the facility for each household member who comes in contact with residents.
1. Initial tuberculosis examination and report.
a. Each staff person on or within seven days prior to the first day of work at the facility and each household member prior to coming in contact with residents shall submit the results of a risk assessment, documenting the absence of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it.
b. The risk assessment shall be no older than 30 days.
2. Subsequent tuberculosis evaluations and reports.
a. Any staff person or household member required to be evaluated who comes in contact with a known case of infectious tuberculosis shall be screened as determined appropriate based on consultation with the local health department.
b. Any staff person or household member required to be evaluated who develops chronic respiratory symptoms of three weeks duration shall be evaluated immediately for the presence of infectious tuberculosis.
c. Each staff person or household member required to be evaluated shall annually submit the results of a risk assessment, documenting that the individual is free of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it.
3. Any individual suspected to have infectious tuberculosis shall not be allowed to return to work or have any contact with the residents and personnel of the facility until a physician has determined that the individual is free of infectious tuberculosis.
4. The facility shall report any active case of tuberculosis developed by a staff person or household member required to be evaluated to the local health department.
E. Record of any vaccinations and immunizations received as noted in 22VAC40-73-100 D.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-260. First aid and CPR certification.
A. First aid.
1. Each direct care staff member shall maintain current certification in first aid from the American Red Cross, American Heart Association, National Safety Council, American Safety and Health Institute, community college, hospital, volunteer rescue squad, or fire department. The certification must either be in adult first aid or include adult first aid. To be considered current, first aid certification from community colleges, hospitals, volunteer rescue squads, or fire departments shall have been issued within the past three years.
2. Each direct care staff member who does not have current certification in first aid as specified in subdivision 1 of this subsection shall receive certification in first aid within 60 days of employment.
3. A direct care staff member who is a registered nurse, licensed practical nurse, or currently certified emergency medical technician, first responder, or paramedic does not have to meet the requirements of subdivisions 1 and 2 of this subsection.
4. In each building, there shall either be (i) at least one staff person at all times who has current certification in first aid that meets the specifications of this section; or (ii) an on-duty registered nurse, licensed practical nurse, or currently certified emergency medical technician, first responder, or paramedic.
B. Cardiopulmonary resuscitation (CPR).
1. There shall be at least one staff person in each building at all times who has current certification in CPR from the American Red Cross, American Heart Association, National Safety Council, or American Safety and Health Institute, or who has current CPR certification issued within the past two years by a community college, hospital, volunteer rescue squad, or fire department. The certification must either be in adult CPR or include adult CPR.
2. In facilities licensed for over 100 residents, at least one additional staff person who meets the requirements of subdivision 1 of this subsection shall be available for every 100 residents, or portion thereof. More staff persons who meet the requirements in subdivision 1 of this subsection shall be available if necessary to ensure quick access to residents in the event of the need for CPR.
C. A listing of all staff who have current certification in first aid or CPR, in conformance with subsections A and B of this section, shall be posted in the facility so that the information is readily available to all staff at all times. The listing must indicate by staff person whether the certification is in first aid or CPR or both and must be kept up to date.
D. A staff person with current certification in first aid and CPR shall be present for the duration of facility-sponsored activities off the facility premises, when facility staff are responsible for oversight of one or more residents during the activity.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-270. Direct care staff training when aggressive or restrained residents are in care.
The following training is required for staff in assisted living facilities that accept, or have in care, residents who are or who may be aggressive or restrained:
1. Aggressive residents.
a. Direct care staff shall be trained in methods of dealing with residents who have a history of aggressive behavior or of dangerously agitated states prior to being involved in the care of such residents.
b. This training shall include, at a minimum, information, demonstration, and practical experience in self-protection and in the prevention and de-escalation of aggressive behavior.
2. Restrained residents.
a. Prior to being involved in the care of residents in restraints, direct care staff shall be appropriately trained in caring for the health needs of such residents.
b. This training shall include, at a minimum, information, demonstration, and experience in:
(1) The proper techniques for applying and monitoring restraints;
(2) Skin care appropriate to prevent redness, breakdown, and decubiti;
(3) Active and active assisted range of motion to prevent contractures;
(4) Observing and reporting signs and symptoms that may be indicative of obstruction of blood flow in extremities;
(5) Turning and positioning to prevent skin breakdown and keep the lungs clear;
(6) Provision of sufficient bed clothing and covering to maintain a normal body temperature;
(7) Provision of additional attention to meet the physical, mental, emotional, and social needs of the restrained resident; and
(8) Awareness of possible risks associated with restraint use and methods of reducing or eliminating such risks.
3. The training described in subdivisions 1 and 2 of this section shall meet the following criteria:
a. Training shall be provided by a qualified health professional.
b. A written description of the content of this training, a notation of the entity providing the training, and the names of direct care staff receiving the training shall be maintained by the facility except that, if the training is provided by the department, only a listing of direct care staff trained and the date of training are required.
4. Refresher training for all direct care staff shall be provided at least annually or more often as needed.
a. The refresher training shall encompass the techniques described in subdivision 1 or 2 of this section, or both.
b. The refresher training shall meet the requirements of subdivision 3 of this section.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.