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Ohio Laws and Rules
(A) As used in this rule, “staff member” means a caregiver as defined in paragraph (F) of rule 3701-16-01 of the Administrative Code; the operator or residence manager; or any individual employed by or affiliated with the home who works in the home. “Staff member” does not include an individual staying temporarily in a community alternative home in the absence of staff members under paragraph (E) of this rule, or a volunteer.
(B) In addition to meeting the minimum staffing requirements of paragraph (C) of this rule, each community alternative home shall provide a sufficient number of staff members and appropriate scheduling of staff time to meet the care and supervisory needs of its residents in a timely manner and to provide necessary meal preparation, housekeeping, laundry, and home maintenance for the residents. The operator or residence manager shall establish a schedule for staff coverage that includes coverage during vacations, emergency situations, and long-term absences due to illness. The home shall not require a resident to supervise other residents, provide personal assistance, or manage the home.
(C) Except as provided in paragraphs (D) and (E) of this rule, each community alternative home shall ensure that at least one staff member who meets the conditions specified in paragraphs (G) to (L) of this rule is present in the home whenever a resident who meets any one of the following criteria is present:
(1) The resident requires assistance with walking and moving, bathing, toileting, dressing, or eating;
(2) The resident requires ongoing monitoring;
(3) The resident is nonambulatory as defined in paragraph (A)(6) of rule 3701-16-10 of the Administrative Code; or
(4) The resident requires assistance, as authorized by paragraph (D) of rule 3701-16-16 of the Administrative Code, with self-administrationof prescription medications that have been ordered on an as-needed basis.
A community alternative home shall ensure that a staff member is present in the home if the home is locked and the residents do not have keys.
(D) A community alternative home required by paragraph (C) of this rule to have a staff member in the home is exempt from that staffing requirement if all of the following conditions are met:
(1) The home and one or more other community alternative homes are owned by the same operator and all of the homes are located within two minutes or less response time from each other;
(2) At least one staff member meeting the conditions specified in paragraphs (G) to (L) of this rule is present and awake at all times when a resident is present in any of the homes, and makes periodic rounds of all the homes;
(3) When only one staff member is on duty to cover the homes, the homes shall designate another staff member who can be contacted immediately in case of emergency; and
(4) Each resident’s bedroom is equipped with a resident-activated call signal system that alerts the staff member or members of emergencies or resident needs in any of the homes. As used in this paragraph, “call signal system” means a set of devices that are connected electronically, by radio frequency transmission, or in a like manner and that effectively alert the staff member or members on duty of emergencies or resident needs.
(E) When a community alternative home is required by paragraphs (B) and (C) to have a staff member present in the home, the home may temporarily use an individual who is not a staff member to stay in the home. Such an individual shall not be left alone with residents for more than four consecutive hours, shall be capable of calling for emergency assistance and assisting residents in responding to an emergency, and shall be at least eighteen years of age. If an individual staying in a home under this paragraph provides personal assistance or supervision, he or she shall have received the training required by paragraph (I) of this rule.
(F) Each staff member of a community alternative home shall possess both of the following qualifications:
(1) Each staff member other than the residence manager shall be at least eighteen years of age. The residence manager shall be at least twenty-one years of age; and
(2) Each staff member shall demonstrate an ability to read, write, and understand directions in English. Caregivers shall demonstrate an ability to communicate in the predominant language of the residents.
(G) The provisions of this paragraph apply to all staff members, and all volunteers or temporary workers described in paragraph(E) that provide greater than ten hours of service in a community alternative home in any thirty day period. These individuals shall be tested for tuberculosis in accordance with the following:
(1) Prior to beginning employment, or when a volunteer or temporary worker attains ten hours of service in any thirty day period, the individual shall have a two-step Mantoux test for tuberculosis using five tuberculin units of purified protein derivative or, if the the individual has a documented history of a significant Mantoux test, a chest x-ray. Individuals subject to the provisions of this paragraph on the effective date of this rule shall meet the requirements of this paragraph within ninety days of the effective date of this rule. Only a single Mantoux test is required if an individual has documentation of either:
(a) A two-step Mantoux test with uninterrupted annual single Mantoux tests, the most recent single Mantoux test having been performed within one year of commencing work; or
(b) A two-step Mantoux test having been performed within one year of commencing work.
(2) No individual shall have any resident contact until after the results of the first step of the Mantoux test have been obtained and recorded in millimeters of induration. If the first step is nonsignificant, the second step of the Mantoux test shall be performed at least seven but not more than twenty-one days after the first step was performed.
(3) If the Mantoux testing performed pursuant to paragraph (G)(2) of this rule is nonsignificant, a single Mantoux test shall be performed annually within thirty days of the anniversary date of initial testing.
(4) If either step of the Mantoux is significant, the individual shall have a chest x-ray and shall not have any resident contact until after the results of the chest x-ray have been obtained. A chest x-ray need not be performed if the individual has had a chest x-ray ninety days before the date of the significant Mantoux test. Unless a physician orders a repeat chest x-ray. Additional Mantoux testing is not required after one medically documented significant test.
(5) If the chest x-ray does not indicate active tuberculosis, but there is evidence of conversion to a significant Mantoux test, the individual shall not be permitted to work in the home without documentation of having started preventive treatment or documentation that treatment is medically contraindicated. The home shall require the individual to report promptly any symptoms suggesting tuberculosis. If symptoms are reported, the home shall not permit the individual to have any resident contact until appropriate tuberculosis testing and treatment is obtained. The home shall annually document the presence or absence of symptoms in such an individual and maintain this documentation on file. Such individuals shall not be required to have an annual chest x-ray.
(6) If active tuberculosis is found, the individual shall not enter the home until medication has rendered the individual noninfectious.
(H) The home shall ensure that each staff member, and volunteer with direct resident contact, completes the orientation and training prescribed by this paragraph. The home shall ensure that these individuals receive this orientation and training within three working days after beginning employment with the home and before any direct care is provided, or within thirty days after the effective date of this rule, whichever is later.
(1) Each individual shall have training in the home’s fire control and evacuation procedures and training in how to secure emergency assistance.
(2) Each individual shall have orientation and training applicable to the individual’s job responsibilities. The orientation and training required by this paragraph shall include at least orientation to the physical layout of the home, the individual’s job responsibilities, the home’s policies and procedures, and residents’ rights.
(3) Each individual shall have orientation and training in the physical and psycho-social aspects of aids and aids-related conditions.
(4) Each individual shall have training in the infection control principles pertaining to universal precautions.
(5) Each individual shall have training in the implementation of the infection control principles and procedures required by paragraph (H) of rule 3701-16-21 of the Administrative Code.
(I) In addition to meeting the requirements of paragraphs (F) to (H) of this rule, individuals who provide personal assistance or supervision in a community alternative home shall meet the following applicable training requirements:
(1) Each staff member shall have first-aid training evidenced by one of the following:
(a) Currently valid documentation of successful completion of the “American Red Cross standard first aid course”; or
(b) Documentation of successful completion, within the past three years, of first-aid training by a licensed physician or registered nurse, an emergency medical technician, or an instructor certified by the “American Red Cross.” This training shall include recognition and emergency management of bleeding, burns, poisoning, respiratory distress including choking, musculo-skeletal injury, wounds including animal and insect bites, sudden illness, shock, hypothermia, heat stroke and exhaustion, and frost bite; and
(2) Documentation that, prior to providing personal assistance without supervision in the home, each staff member and volunteer successfully completed training or orientation that covers the correct techniques of providing personal assistance and supervision to others. The training or orientation shall be sufficient to ensure that the individual can demonstrate an ability to properly provide the personal assistance and supervision required by the individual’s job responsibilities.
The documentation required by this paragraph shall be signed and dated by the provider of the training.
(J) All staff who prepare or handle food shall successfully complete training in food safety and sanitary practices provided by, or under the direction of, a dietitian licensed under Chapter 4759. of Revised Code, or a local health department.
(K) The operator or residence manager shall provide an annual evaluation to ensure that individuals working in the home maintain job competency. The residence manager shall receive continuing education on an annual basis, covering topics pertinent to operating a community alternative home.
(L) No individual shall work in a community alternative home under any of the following circumstances:
(1) During the communicable stage of a disease which may be transmitted in the performance of the individual’s job responsibilities;
(2) When the individual has exudative or other lesions or weeping dermatitis; or
(3) When the individual is under the influence of illegal drugs or is using alcohol or medications to the extent that the health or safety of any resident of the home is jeopardized.
R.C. 119.032 review dates: 01/09/2009 and 01/01/2014
Promulgated Under: 119.03
Statutory Authority: 3724.05
Rule Amplifies: 3724.03, 3724.05
Prior Effective Dates: 8/29/1988 (Emer.), 11/27/94, 2/13/99