PROVISIONAL EMPLOYMENT and SUPERVISION
Q39. The Department's clarification of the "supervision" requirement contained in the FAQ, Volume 1 is overly burdensome for my agency. Please clarify theDepartment's position in regards to this requirement.
ANSWER:
The goal of supervision of provisionally-employed staff is to assure the health and safety of patients and residents throughout the provisional employment period. The Department requires weekly supervision. Covered operators may comply with the requirement as follows:
HOME CARE AGENCIES
Agencies can satisfy this requirement by alternating onsite supervisory evaluations by a licensed health care professional with offsite evaluations via phone call to the care recipient. The offsite evaluation may be performed by a senior aide, who meets the 1-year requirement of employment in home care.
For example, the first week’s supervision can be an onsite observation by a nurse. Week 2 supervision can be conducted through the above-referenced phone call. Since CHHA’s must perform the bi-weekly direct observation to comply with current federal requirements. In addition, the average turnaround time of CHRC reports to operators is currently less than 3 weeks. Therefore, the requirement of this regulation is not expected to place a significant burden on agencies.
NURSING HOMES
In the nursing home, direct supervision of the provisional employee is consistent with that required for nurse aide trainees when working with residents outside of the training program prior to certification. That is, the assigned supervisor/monitor must be on the same nursing unit as the provisional employee. The assigned supervisors/monitors for provisional employees do not necessarily have to be the line supervisor of the person. For example, an experienced certified nurse aide [who has been through the CHRC] may be assigned to provide supervision for a new provisionally-employed certified nurse aide. Each assigned supervisor/monitor must know the identity of the provisional employee(s) under their supervision and know their assignments and whereabouts in the facility at all times. The provisional supervision must be documented on a weekly basis. Therefore, with the exception of weekly documentation, we expect that, for many
facilities, current supervisory activities will satisfy the requirement. Also see Q40 below.
Q40. What would the documentation notes for supervision of provisional
employees entail? Is a note required each and every shift, weekly or is exception documentation be acceptable?
ANSWER: The results of the supervision of the provisional employee must be
documented at least weekly by the individual(s) assigned this responsibility. A notation in the employee record, signed by the monitor, will satisfy the documentation requirement. Documentation is limited to the purpose of provisional employment and does not have to include the individual’s competency with assigned tasks. Exception documentation is not acceptable.