Human Resources Duties of the Agency

Staff Application Pack

(For all disciplines)

(Minimum order 5 / discipline)

Ready to use, updated as required, only $ 2.59 each

Your License must be renewed every 2 years

Renew License Form: 60 days before to expiration date.    CLIA application form

Training In your Office

Every month your Agency must comply with the in-office training to your staff.

Staff Competency Program:

New CoPs:  HHA/CNA Competency  (new practical part)

Staff Agreement: Staff Agreement

Clinical Manager JD (Add to DON):  Job Description

QAPI staff Job Description:  Job Description    DON JD:    DON JD

Compliance Officer JD   Job Description

Administrator Clarification:  Administrator JD add (add to Administrator JD)

Job Descriptions:    Job Descriptions

Staff Chart Audit Form (at least Annually to all field and office staff):

Staff Chart Audit Form

Every year all the following reports must be completed under the supervision of the Agency's Administrator or Human Resources Manager.

ADMINISTRATOR/HR: Staff Chart Audit Result Report to BD (Quarterly):

Quarterly Report for Chart Audits presented to BD meeting  

Staff Chart Audit Report BD

If needed, to complete competencies for Professional Staff (PT, OT, ST, MSW), the Agency need a participation of a member of the same discipline, if no staff is available, the Agency must contract a same discipline member Consultant to do the competencies in any discipline needed:

Prof. Consultant Contract (External contract, if needed for competencies)

Initial prospective staff Interview                      Exit staff Interview

Initial Interview                                                Exit Interview

Disciplinary warning:  Staff warning   Software Secury:Software Security

Staff survey: Staff Survey  Staff Concern/report incident: Staff Concern

During Absence of Administrator Form               During Absence of DON Form

(This forms must be filed in each employee chart Administrator/DON and their alternates)

During Absence Administrator                        During Absence of DON

Position Change Staff Orientation                   New DON Orientation

(all staff in new position must be trained/oriented in their new duties)

Position Change Orientation                            DON Orientation

New Alt. DON Orientation                               

Alt. DON Orientation                                       

Supervisor Staff Training/Orientation          Staff anonymous complaint

Supervisior Training Form                               Staff Complaint

School Verification if Diploma not available (CHAP)

(CHAP Only, not necessary if it is prevented by your Policy)

School Diploma Verification                           Personnel Licensure Policy

STTAF EVALUATIONS:  

90 days/Probation Period        (Same for all disciplines)

90 Days/Probation period:  Probation period eval

Annual Evaluations:          

Executive Staff Evaluations:

Administrator Competency                            Alt. Administrator Competency

DON Evaluation                                              ADON Evaluation

Field Staff:

Registered Nurse or Licensed Practical Nurse      Home Health Aide (HHA or CNA)

RN or LPN Annual Evaluation                        HHA or CNA Annual Evaluation

Psychiatric/IV/Pediatric Nurse, you must add this competency (Initial/Annual):

Pshyc RN Compentency                                IV Therapy Compentency

Pediatric RN Compentency                            Chemotherapy Compentency

Physical Therapist or Assistant                       Occupational Therapist or Assistant

Physical Therapist or Assistant                       OT or OTA Annual Evaluation

Speech Therapist or Assistant                          Social Worker

ST or STA Annual Evaluation                          MSW Annual Evaluation

Glucometer Competency                          

 (Nursing Staff-Annual)       The patient's glucometer must be verified before to be used staff:                               

Glucometer 2 Competencies                       Glucometer use verification 

( Also must have literature about the Glucometer manufacturer guidelines)

CoaguChek PT-INR Tests (Nursing Staff-Annual)

 CoaguCheck Competency 1                         CoaguCheck Competency 2

Bag Technique Competency                 Hand Hygiene knowledge assessment

(Initial-Annual)                              (all field staff)                   (Initial-Annual)               

Bag Technique Competency                        Hand Hygiene Knowledge    

 Handwashing (initial/Annual):  Handwashing Competency

Hand Hygiene Staff Survey      Hand Hygiene Staff Survey (annual)

Bag tech., Pt Assessment, Handwashing procedures documentation:

Bag Assesment/Handwashing   (share with your staff)           

Yearly BP Gauges Check Log          Vissual Inspection of BP Equipment

BP Gauges Check Log  (annual)                  BP equipment inspection

Cardiovascular Disease Best Practice Competency CVD Competency

TB risk assessment questionnaire:  TB risk assessment questionnaire

Non Clinical staff:

Office Staff (Non-Clinical Staff)                        Safety Culture  Survey (all staff)

Non-Clinical Annual Evaluation                   Safety Culture survey                      

After Survey Staff training form (generic form to be completed as proof of training received after defficiency noted during a survey)

Staff Training after Survey   (part of the Plan of correction (POC))

ADMINISTRATOR: Influenza Vaccine Rate Compliance Goal LOG

(must be posted in the Agency's Board)           (Initial-Annual)   

Influenza Vaccine Goal Log                       Influenza Staff data

ADMINISTRATOR/HR: Staff Influenza Declination Analyzes, Report to BD (Quarterly):

Influenze Declination Analyzes

CALENDAR of In-services (must be posted in the Agency's Board)

Calendar of In-services

STTAF VERIFICATIONS:  

Florida Verify License:  

(Prof. staff & referral physicians)   OIG (Office Inspector General

FL Prof. License   (hire/annual)   OIG Verify Medicare Exclusion (hire/annual)

Sex Offender: (at hire)                    AHCA  Background Screening         
Sex Offender Registry              AHCA Background Screening

E-Verify:  E-Verify (Legal Status)                           

Florida School Verification (Verify that the School is Licensed)

FL School Verification              

Live Scan Providers: Live Scan Providers (for background check)

Florida:  Alzheimer's Educator Registration App:         Alzheimer's Educator

Approved Schools/trainer: Alzheimer's Schools   HCAF Approved Training

Texas:                                                Pennsylvania:

TX Verify License                       PA Verify License

Driver License check:
FL Drive License Check             TX Background Screening          

TX Driver License Check           PA Background Check

 PA Drivers License Check

Disclaimer: Every template is only your Guide/Agenda to complete each report, your Agency Officials must assure that the meeting/evaluation occur, the quorum is acceptable, and every member had active participation in the discussion and confection of the Reports, Evaluations/Competencies, Documents.

The 24 hours must include two (2) hours on Prevention of Medical Errors. HIV/AIDS is now a one-time, 1-hour CE requirement to be completed prior to the first renewal. Domestic Violence (DV) CE is now a 2-hour requirement every third renewal. Since Domestic Violence (DV) is a 2-hour requirement, the licensee will have 26 hours of CE during the renewal period when DV is taken. For example, if you renew your license on July 31, 2008 and completed DV during the 2006-2008 licensure cycle, you are required to complete the Domestic Violence CE before the July 31, 2014 renewal.

CPR: must be with life person (not on-line)

All home health aides employed by home health agencies must complete an HIV/AIDS training course. They also are required to obtain and maintain a current certificate in cardiopulmonary resuscitation (CPR).  Home health aides employed by Medicare and Medicaid home health agencies are required to have a total of 12 hours of in-service training during each 12-month period (this can be a calendar year or based on the date of hire).  The HIV/AIDS training and CPR training may be counted toward meeting the 12 hours of in-service training.

All CNAs must complete a minimum of 12 hours of in-service training each calendar year. Every 2 years, in-service training hours shall include, but are not limited to, the following areas: Bloodborne Pathogens, Infection Control, Domestic Violence, Medical Record Documentation and Legal Aspects Appropriate to Nursing Assistants, Resident Rights, Communication with cognitively impaired clients, CPR skills, Medical Error Prevention and Safety