ReEducation Module HR HCR CHRC Personnel File Influenza

Re-Education Module - HR § § HCR CHRC Personnel File Influenza

HCR

Background § The Home Care Registry (“HCR”) is a web-based registry of home care workers such as personal care aides and home health aides. The HCR provides identifying information, certifications, past home care agency employment in New York, training, administrative findings (if any), and determinations of employability § The HCR makes this information available to both home care agencies and the general public § The HCR is located on the Health Commerce System

Workers § Only aides listed on the HCR may provide service to patients § In light of the above, the following should match upon reconciliation at any given point in time: HHA e. Xchange HCR List of PCAs and HHAs with a status of “Active”, “Inactive”, “Hold”, or “On Leave” List of “Active” aides List of PCAs and HHAs with a status of “Terminated” List of “Inactive” aides

Timeframes § There are strict timeframes related to HCR activities. They are as follows: Circumstance Deadline Entering of New Hire Information Within 10 business days of employment Inactivating a Worker Within 10 business days of termination Providing Access to a Worker’s Own Information Upon his/her request Correcting Information Incorrectly Entered (e. g. , gender, DOB, spelling of name) Within 10 business days of request

Transfers/Name Changes § If a worker has already been entered into the HCR by one All Metro branch and that worker subsequently transfers to or otherwise begins providing services through another All Metro branch, the receiving/second branch must enter the worker into the HCR as well within 10 business days of the worker’s first day of service for the receiving/second branch (i. e. , if the worker is working for both offices, he/she is entered under both PFIs; if, however, the worker is transferring completely, the original office enders a separation date and the new office enters a hire date) § If a worker who has already been entered into the HCR informs the branch of a name change his/her information must be updated within 10 business days of notification. The worker must provide proof of the name change (e. g. , certificate of marriage, decree of divorce, or other court order authorizing a person to change his or her name and a copy of the proof provide must be retained.

Importance Our HCR information is our representation to the outside world (e. g. , regulators, patients, potential patients, referrers) of who we have working for us. It is critically important to enter and update information timely.

CHRC

Subject Individuals “Subject Individuals”: § Are persons for whom All Metro Home Care is authorized to request a check of criminal history information § Includes any unlicensed individual employed by or used by All Metro Home Care to provide direct patient care or supervision, or who has access to a patient, his/her residence, or his/her property (e. g. , Personal Care Aides, Home Health Aides, and Home and Community Support Service workers) § Does not include professionals licensed under Title 8 of the New York State Education Law (e. g. , nurses, physicians, physical and occupational therapists, licensed clinical and/or master social workers, mental health practitioners, etc. ), Consumer Directed Assistance Program (“CDPAP”) personal attendants, volunteers, and unpaid students enrolled in a program leading to a professional license under Title 8

New Hire Process § At the time an employment application is completed, Subject Individuals will be informed of the agency’s requirement regarding criminal background checks through the Criminal History Record Check (“CHRC”). All Metro Health Care does not seek, directly or indirectly, compensation from the applicant in any form for the payment of the feed or the agency costs associated with obtaining the CHRC § All Metro obtains signed, informed consent of the applicant using the CHRC 102 form

Completion The Authorized Person for the branch must complete Section 3 of the CHRC 102

New Hire Process, Cont. § The criminal background check is initiated by submitting the CHRC 103 -e Form to the DOH via the Health Commerce System § The form must be submitted immediately/as soon as practicable once All Metro Home Care reasonably expects to hire, employ, or use the individual, but in no event can the submission be later than fifteen (15) calendar days of the date the employee is placed on the agency’s payroll § All Metro Home Care generally does not avail itself of the opportunity to assign Subject Individuals prior to receipt of the CHRC final determination. This may only occur if the VP – Patient Services has authorized that an exception be made

Determination Letters Below are examples of CHRC Legal Determination letters: § Hold in Abeyance (charged but not tried) § Not Held in Abeyance (charged but not tried, but even if convicted will be cleared to work) § Pending Denial § Final Non-Denial (employee is approved for employment) § Subsequent arrest information

Actions Needed All Metro Home Care must take the following steps: § Hold in Abeyance – The individual will be immediately removed from providing care. If the agency no longer plans to employ the individual an electronic termination will be submitted § Pending Denial – The individual will be immediately removed from providing care. To the extent warranted, the agency will explain to the individual that he/she has thirty (30) days to submit rehabilitation information to assist in making a final determination § Final Denial – The individual will be immediately removed from providing care and an electronic termination will be submitted.

Other HR Processes § Transfers – A new CHRC process must be initiated even if the Subject Individual is already working for another branch § Terminations – A CHRC 105 Form must be submitted no later than thirty (30) days of termination

Record Retention All CHRC actions, including the following will be considered part of an employee’s record and retained: § Original signed CHRC 102 Form § The completed printout of the electronic submission form which indicates when the background check request was submitted § Employment Determination letters § Any legal notifications, including subsequent arrest notifications § A completed print out of the electronic termination form (CHRC 105 Form) All CHRC information is confidential and may be shared only with others at All Metro who have a role in the hiring/firing process.

Personnel File

Expectations § The Human Resource Coordinator or designee is responsible for ensuring that personnel files are complete § The contents of a personnel file must be maintained in a confidential manner § Authorized individuals are permitted to review an individual personnel file on a “need to know” basis § Under no circumstances may original personnel files leave the office § An individual staff person has the right of reasonable access to his/her own personnel file upon written request

Components The required components of an aide’s personnel file are reflected in the checklist presented on the following slide. It is critically important that: § Personnel files not contain patient information (e. g. , redact, as necessary from supervisory visit forms, etc. ) § All health-related documentation, annual health assessments, TB screening, immunization status reports, CHRC be maintained in a separate from file) IRS Form I-9 and Affirmative Action form must be maintained in the appropriate binders.

Personnel File, SECTION 1 SECTION 2 SECTION 3 Initial & (Annual) Competency Evaluation (Annual) Waiver Orientation Initial Orientation & (Annual) Re-Orientation Employee Handbook Receipt (print out) Attestation �Whistleblower, Employment Policy Acknowledgement, Code of Ethics, Transportation, Live-in Agreement, etc. Wage Rate Acknowledgment W-4 Exam �Answer Sheet Initial Waiver Orientation Home Care Registry (“HCR”) (print out) Certificate Conditional Offer AMHC staff should fill out AMHC Reference for legacy employees if their file is reviewed and you notice that there aren’t any adequate references References Acknowledgment signed and dated by employee (and supervisor; title is correct – depending on version) Annual NHTD & TBI Training and Competency signed/dated You do not need to file the quizzes annually. Initial quizzes should have been filed with all Initial Waiver documents. Form type corresponds with employee certification Interview Questions Emergency Contact Information Signed and dated Completed with Recommendation of Employment Completed by Associate Completed – information interviewing applicantmay be completed on the Employment Policy Acknowledgment depending on version of new hire packet Verified prior to employment: 2 Work References 1 Work References + 2 Character 3 Character References (NO FRIENDS OR FAMILY) Employee signs where it says, “Applicant Signature”. Witness (Associate) signs where it says, “Witness Signature”. *For work references – the full name and position of the reference was provided – has to be supervisor * ONLY accept Character References IF employee has NO work history or if previous employer charges for the provision of a reference Signed and dated by employee or (if by phone) signed and dated by supervisor VALID HHA/PCA Certificate with Registry Number Applicant shows you original or duplicate; you make a copy Listed as “active”; school and certification date match certificate – print Registrant Profile Once you add AMHC work history re-print and add to file. Basic, HCSS, and Respite Orientation signed/dated by employee; initialed by trainer TBI Certificate of Completion (AMHC required) 3 ½ hours NHTD Certificate of Completion 3 hours HCSS Certificate of Completion Job Description HCSS signed and dated Job Description Respite signed and dated Pre-questionnaire, Post-questionnaire, Boundaries Quiz Showing passing which is (x 4) 70% or above if Verification ofscore, Qualifications already certified; 80% or above if trained by AMHC Signed and dated with accurate range Signed and dated (Sections 8 – 10 completed by branch) Pre-populated with Corporate address EIN is Associate v. Field Employee specific so double check that the form is consistent with type of employee. Signed and dated by Employee and Associate Signed and dated by appropriate party/parties (depending on version of Attestation(s)) – Attestation condenses all these forms into 1 signature page, but all pages of the Attestation packet must also be filed in chart. Application NEW YORK PCA/HHA Guidelines (REVISED 5/2018)

Personnel File, SECTION 4 Medical Confidential File Documentation checked prior to hire Section 1 & 2 to be completed by employee Section 3 to be completed by branch/agency (Associate) Needs to be printed for file CHRC 102 (and) CHRC 103 CHRC L 1 Enrollment Confirmation Appointment Letter from Fingerprint Vendor Completed ONLY if required by branch Signed/dated Completed by each employment anniversary date Includes non-habituation statement All “yes” answers are explained Documentation with one of the following: PPD with negative finding Quanti. FERON with negative finding PPD with positive result with clear chest x-ray and Annual PPD Reactor Form Exempt if born before 1/01/1957; Documentation for one of the following for those born after: Evidence of immunization (2 shots) Proof of immunity Statement from MD that the above is detrimental Documentation with one of the following: Evidence of immunization (1 shot) Proof of immunity Statement from MD that the above is detrimental Documentation with one of the following (choose one): Consent with Vaccination receipt Declination Required form every flu season/annual Completed for employee at least once over the past year Completed prior to annual performance evaluation Documented prior to assuming patient care duties Signed by provider and contains the MD’s name, address, license number stamp Includes “can work without restrictions” statement Includes non-habituation statement Signed and dated (choose only ONE option) Completed by each employment anniversary date – do not complete on day of hire! Form type corresponds with employee care-level Section II, “Counseling”, is addressed in completion Section III, “Goals”, is complete and includes work-related goals Signed and dated by employee and RN must complete Supervisory Visit prior to Performance Review Completed and In-Service Record filed completed annually: 8 hours of in-service for PCA (can count HCSS) 12 hours of in-service for HHAs (can count HCSS) Completed for employee within 90 days of hire date Drug Screening Clearance Drug Screening Consent “Reconsideration” box should be checked off if employee checked “declined” originally but received shot and provided a receipt afterwards. (Annual) Influenza Rubella (lab results preferred) Rubeola (lab results preferred) (Annual) Health Assessment MUST be signed by RN and they have to check off Employment Status box (Annual) PPD (Initial within 12 months of hire date) Hepatitis B Consent/Declination Pre-Employment Health Assessment (completed within past 12 months prior to hire date) *ALL patient information must be crossed out* (Annual) Supervisory Visits (Annual) In-Service Training Initial OSHA and Initial Waiver do NOT count towards In-Service hours! 90 -day Supervisory Visit * * Evaluation Ladder: VP/QI �DCS �Clinical Supervisor/Instructor �HHA/PCA Period of Review means the past year to current year and should be completed by your supervisor. (Annual) Performance Review

Charges/Convictions Affirmative Action questionnaire I-9 and e-verify Sections 1 and 2 *** #5 – 7 means employee CANNOT work as soon as you receive the letter *** Risk Assessment will be done by Corporate if there is a subsequent arrest after hire. Bring aide in for written statement regarding charges. *** Agency must submit electronic termination (CHRC 105) if agency no longer wishes to employ individual, especially if there is a final denial. Also, terminate in HCR and HHAe. Xchange. CHRC Legal Review Results (Employment Determination Letter) CHRC page with charge(s)/conviction(s) must be kept separate binder Results: 1. Non-ident: No hits or violation; no criminal history – hirable 2. No Conviction: Individual has never been convicted of any charges – hirable 3. NOT held in Abeyance – indicate the individual has charges that wouldn’t result in a negative determination – hirable 4. Final Non-Denial: agency can decide if they want to hire employee or not, BUT there has to be evidence of approval 5. Hold in Abeyance: can’t work; employee has 30 days to submit a plea to DOH 6. Pending Denial: Individual has criminal convictions; can’t work until letter received from DOH for non-denial – applicant has 30 calendar days to appeal to DOH 7. Final Denial: not hirable; if after hire – terminate ASAP (If Final Denial received AFTER employee is hired, branch has Completed with corresponding documents and/or edays to contact DOH and Corporate to notify them that verify 14 confirmation for Sections 1 and 2 printed the employee is still being considered for employment OR At least required portion completed to submit CHRC 105. ) 3. The only documents that should be completed annually are the ones that say Annual next to them. All other documents are only completed during New Hire. 2. Each branch may have their files organized in a different way, not necessarily the way I have it organized above, but as long as organization of the charts are consistent branch-wide that’s all that matters. 1. Please keep ONLY the documents on this grid filed in the chart. Anything not on this list (i. e. branch-specific documents) please keep in a separate alphabetized binder. Binders

Personnel File, SECTION 1 SECTION 2 SECTION 3 Print out Office of Professions without Disciplinary Actions Verification of Credentials Nursing Diploma or Transcript (from university or college) Acknowledgment signed and dated by employee (and supervisor; title is correct – depending on version) Annual NHTD & TBI signed/dated You do not need to file the quizzes annually. Initial quizzes should be filed with all Initial Waiver documents. Initial Orientation & (Annual) Re-Orientation ** only for DCS and Clinical Supervisors ** (Annual) Waiver Orientation (required if nurse makes visits on HCSS cases) Signed and dated by appropriate party/parties (depending on version of Attestation(s)) – Attestation condenses all these forms into 1 signature page, but all pages of the Attestation packet must also be filed in chart. Signed and dated (with pre-populated Sections 8 – 10) Pre-populated with Corporate address EIN is Associate v. Field Employee specific so double check that the form is consistent with type of employee. Signed and dated by employee and Associate Attestation �Whistleblower, Employment Policy Acknowledgement, Code of Ethics, Transportation, Live-in Agreement, etc. Employee Handbook Receipt (print out) Acknowledgment W-4 Wage Rate Exam �Answer Sheet ** only for DCS and Clinical Supervisors ** Initial Waiver Orientation (required if nurse makes visits on HCSS cases or if they participate in Team Meetings) Current Nursing License Diploma showing Associate’s and/or Bachelor’s of Science/Nursing and any additional education and/or certification Transcript for LPN Basic, HCSS, and Respite Orientation signed/dated by employee; initialed by trainer TBI Certificate of Completion (AMHC required) 3 ½ hours NHTD Certificate of Completion 3 hours HCSS Certificate of Completion Pre-questionnaire Post questionnaire Boundaries Showing passing. Quiz score, which is 70% and above Verification of Qualifications (x 4) Signed and dated with accurate range Current Completed – information may be completed on the Employment Policy Acknowledgment depending on version of new hire packet Verified prior to employment: 2 Work References 1 Work References + 2 Character Employee signs where it says, “Applicant Signature”. Witness (Associate) signs where it says “Witness Signature”. * ONLY accept Character References IF employee has NO work history or if previous employer charges for the provision of a reference Signed and dated by employee or (if by phone) signed and dated by Associate Completed, signed, and dated CPR Nursing Skills Checklist Conditional Offer AMHC staff should fill out AMHC Reference for legacy employees if their file is reviewed and you notice that there aren’t any adequate references. References Emergency Contact Information Signed and dated Associate (office staff, full time, part time) completes Associate Application. Field Employee (per diem/shift) completes a Field Employee Application. Evidence of at least one year experience in home care, hospital, or nursing home Completed with Recommendation of Employment NEW YORK RN/LPN Guidelines (REVISED 5/2018) Interview Questions (Nurse-specific) Resume Application

Personnel File, SECTION 4 Printed Completed with corresponding documents and everify confirmations for Section 1 and 2 printed At least required portion completed Criminal Background Check NPI I-9 and e-verify Sections 1 and 2 Affirmative Action questionnaire The only documents that should be completed annually are the ones that say Annual next to them. All other documents are only completed during New Hire. Please keep ONLY the documents on this grid filed in the chart. Anything not on this list (i. e. branch-specific documents) please keep in a separate alphabetized binder. ADP or Sterling Completed Release of Information Completed by each employment anniversary date Includes non-habituation statement All “yes” answers are explained Documentation with one of the following: PPD with negative finding Quanti. FERON with negative finding PPD with positive result with clear chest x-ray and Annual PPD Reactor Form Exempt if born before 1/01/1957; Documentation for one of the following for those born after: Evidence of immunization Proof of immunity (2 shots) Statement from MD that the above is detrimental Documentation with one of the following: Evidence of immunization Proof of immunity (1 shot) Statement from MD that the above is detrimental Documentation with one of the following: Consent with Vaccination receipt Declination Required form every flu season/annual Signed/dated Completed ONLY if required by branch Drug Screening Consent “Reconsideration” box should be checked off if employee checked “declined” originally but received shot and provided a receipt afterwards. (Annual) Influenza Rubella (lab results preferred) Rubeola (lab results preferred) (Annual) PPD MUST be signed by RN and they have to check off one of the Employment Status boxes (Annual) Health Assessment Hepatitis B Consent/Declination Pre-Employment Health Assessment (completed within past 12 months prior to hire date) Completed for employee at least once over the past year Completed prior to annual performance evaluation Documented prior to assuming patient care duties Signed by provider and contains the MD’s name, address, license number stamp Includes “can work without restrictions” statement Includes non-habituation statement Signed and dated (choose only ONE option) (Annual) Supervisory Visits *ALL patient information must be crossed out* Completed for employee within 90 days of hire date 90 -day Supervisory Visit * * Completed by each employment anniversary date – do not complete on day of hire! Period of Review means the past year Form type corresponds with employee care-level to current year and should be Section II, “Counseling”, is addressed in completion completed by your supervisor. Section III, “Goals”, is complete and includes work-related goals Evaluation Ladder: VP/QI �DCS �Clinical Signed and dated by employee and RN Supervisor/Instructor �Shift/Field RN/LPN RN must complete Supervisory Visit prior to Performance Review Waived Test Training Checklist Completed with DCS or Nursing Supervisor on hire (Annual) Performance Review Drug Screening Clearance Medical Confidential File Binder

Pre-Employment Physical • Direct care staff are required to produce a pre-employment physical examination that contains a “non-habituation statement” • No direct care staff person may be assigned unless he/she is free from a health impairment, which is of potential risk to the patient or which might interfere with the performance of his/her duties, including the habituation or addiction to depressants, stimulants, narcotics, alcohol or other substances that may alter his/her behavior

Pre-Employment Physical, Cont. The pre-employment physical examination requirement may be met utilizing the All Metro Home Care Health Status Assessment form or the health assessment form of another agency/school, so as long as it: a) has been completed within the twelve (12) months preceding the hire date; and b) includes at least the following: § Job Description (signed if HCSS, included somewhere for all other staff including nurses) § Physical Examination; § PPD testing or Tuberculosis screen (if proof of history of positive PPD, documentation of a negative chest x-ray); § Proof of immunity to Rubella (positive, negative/equivalent – 1 shot, or exempt with medical note); § Proof of immunity to measles (Rubeola) if born on or after January 1, 1957 (immune, negative/equivalent – 2 shots or exempt with medical note); § A health status assessment that documents that the individual is free from habituation/addiction from substances that alter behavior; § Documentation that the applicant can work without restrictions (or, with restrictions that the Branch Manager has determined are not disqualifying); and § MD signature (must be legible, date, and stamp). We can accept “outside” assessments as long as they meet agency requirements.

Pre-Employment Physical, Cont. The applicant is responsible for having all parts of the pre-employment physical examination completed and for obtaining medical clearance from his/her provider prior to start of employment.

Employment Application/References • Collecting the application and conducting reference checks are among the most important steps in the home care worker selection process. Since past performance is often the best indicator of future performance, references allow you to determine if the applicant being considered is suited for the role • Reference checks help confirm information an applicant provides on his/her application IN ORDER TO BE CONSIDERED ACCEPTABLE, THE APPLICATION AND REFERENCES MUST BE COLLECTED CONTEMPORANEOUS TO HIRE. LEGACY DOCUMENTATION CANNOT BE ACCEPTED NEW HIRES ONBOARDED THROUGH STRATEGIC ACQUISITION.

Requirement • Checking references is required by regulation and by our accreditation • “Prior to patient contact, employment history from previous employers, if applicable, and recommendations from other people unrelated to the applicant if not previously employed, must be verified”

Policy • Policy #X-8 describes how reference checking by All Metro is to be conducted • The policy describes how only approved forms may be used for this purpose

Rule • Column A, Column B, or Column C must be verified prior to employment: Column A Two (2) work references Column B One (1) work reference and two (2) character references Column C Three (3) character references

Character References • A character reference is a recommendation provided by someone who knows the applicant and can speak to his/her character and abilities (e. g. , personality and people skills) • A character reference may only be obtained in place of a work reference if the applicant does not have work history (or if there is a fee associated with obtaining a work reference) • Character references may not be from friends or family (e. g. , boyfriends, girlfriends, spouse, etc. not permitted)

Character References, Cont. The following are examples of acceptable character references: • Teachers • Clergy • Physicians • Superintendents • Neighbor • Leaders/other members of an organization • Co-worker

Tips for Speaking with References • Identify yourself, your title, and All Metro and tell them you are calling about a reference for an applicant you are considering • Ask if now is a good time to talk or whether they would rather schedule a call at a later time • Make sure they understand that you have the consent from the applicant and that all responses will remain confidential • Give a brief description of the role the applicant is being considered for/what a home care worker job entails so that they can comment in context • Give them time to answer your questions. Let them respond, and do not cut them off or put words in their mouth You may only request a reference if the applicant has signed the reference form and a agency representative has signed as a witness

Handling 1. 2. Each applicant is asked to provide the names, addresses, and telephone numbers of references as part of the application process Either of the following takes place: • The reference form appropriate to the reference type (either the “Former Employee Reference Form” or the “Character Reference Form”) is mailed to the identified references for completion and return; or • A reference is contacted by phone and staff complete the reference form appropriate to the reference type on his/her behalf. In this case, the staff person must sign and date the form and note that the reference was verbal

Handling, Cont. If an applicant provides a reference letter on an unapproved form, it may only be accepted if the reference is verified using the “Former Employee Reference Form” or the “Character Reference Form”, as appropriate

Records All reference information must be: • Filed along with the employment application in the applicant’s file • Maintained as confidential

Influenza and Other Annuals

Influenza and Other Annuals § Influenza documentation (i. e. , vaccination or declination) must be updated every year so that the aides’ use of flu masks when around patients can be monitored by nurses during each flu season (i. e. , must be update every flu season) § All re-orientation, in-service training, and performance evaluations must be documented

Proof of Receipt If a new employee selects the box stating that he/she has received the vaccination for the current flu season, proof of receipt must be provided (it is not enough to just collect the form). The proof of receipt must include the date, name, and business address.

Performance Evaluation Each aide must have his or her performance evaluated annually. The performance evaluation must be based upon at least one (1) in-home supervisory visit conducted prior to the performance evaluation, consisting of the following: § Observation of the aide’s skill § Evaluation of aide’s ability to prioritize needs and problems § Review of all clinical documentation § Confirmation of adherence to the aide plan of care § Evaluation of the aide’s dependability, communication skills, knowledgebase, and judgment The supervision of the aide may be based upon the supervisory visit schedule of the patient (i. e. , q 90 days). However, if the patient’s date of supervision does not fall within the timeframe needed for the aide (i. e. , the aide has not had a supervision at the time of the performance evaluation), the nurse must conduct another visit.

Collaboration When a nurse conducts an in-home visit to observe performance in anticipation of an annual performance evaluation, he or she must consider any/all historical experience of the aide that the agency has on file (e. g. , reports from providers, complaints by patients/designees, counseling/ disciplinary matters, etc. ) and document that the historical experience was considered, even if the same problematic behaviors were not displayed during the visit and performance was determined acceptable. Therefore, it is important that HR and the clinical department collaborate to make performance evaluations as valuable as possible for both the agency and the aide