STAFFING: MANAGING YOUR MOST VALUABLE ASSET

2

• Your staff are the key to your success!

• Impact on the “bottom line”

• Impact on resident satisfaction

HUMAN RESOURCES

3

• Size of community

• Universal workers

• Departmental assignments

GENERAL CONSIDERATIONS

4

Department Heads/Managers

• Administrator/Executive Director

• Nurse

• Activity director

• Business manager

• HR manager

• Marketing and sales manager

• Dining/food service manager

• Housekeeping manager

• Maintenance

COMMON ROLES, DUTIES, AND QUALIFICATIONS

Line Staff

• Caregivers

• Cooks

• Servers

• Housekeepers

• Maintenance

• Activity assistant

• Receptionist

5

Turnover

INDUSTRY TRENDS

Overall Nursing29.60%

29.80%

30.00%

30.20%

30.40%

30.60%

30.80%

31.00%

31.20%

31.40%

31.60%

Overall; 30.20%

Nursing; 31.40%

Source: NCAL 2012 Assisted Living Staff Vacancy, Retention, and Turnover Survey

6

Vacancy

INDUSTRY TRENDS

Overall Nursing3.30%

3.40%

3.50%

3.60%

3.70%

3.80%

3.90%

4.00%

4.10%

Overall; 3.60%

Nursing; 4.00%

Source: NCAL 2012 Assisted Living Staff Vacancy, Retention, and Turnover Survey

7

Federal and State Agencies

8

• State and federal agencies

• Department of Labor

• IRS

• Employment Development Department (EDD)

• US Citizenship and Immigration Services

• Cal/OSHA

OTHER AGENCIES INVOLVED

9

• COBRA

• FLSA

• FMLA

• OSHA

• Wage Order 5

KEY EMPLOYMENT LAWS

10

• Fair Labor Standards Act

• Standards for the basic minimum wage and overtime pay

• Restricts the hours that children under age 16 can work and forbids the employment of children under age 18 in certain jobs deemed too dangerous.

• Learn more: www.dol.gov/compliance/laws/comp-flsa.htm

FLSA

11

• Published by the California Department of Industrial Relations

• Regulates the wages, hours, and working conditions in certain industries or occupations

• www.dir.ca.gov/iwc/wageorderindustries.htm

WAGE ORDER 5

12

• Consolidated Omnibus Budget Reconciliation Act (COBRA)

• Gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods

• Under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events

• Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.

• Generally applies to group health plans sponsored by employers with 20 or more employees in the prior year.

• Learn more: www.dol.gov/dol/topic/health-plans/cobra.htm

COBRA

13

• Family and Medical Leave Act

• Up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible, covered employees for the following reasons:

• Birth and care of the eligible employee's child, or placement for adoption or foster care of a child with the employee

• Care of an immediate family member (spouse, child, parent) who has a serious health condition

• Care of the employee's own serious health condition.

• At least 50 employees

• Learn more: www.dol.gov/compliance/laws/comp-fmla.htm

FMLA

14

• Occupational Safety and Health (OSHA) Act

• “Assure safe and healthful working conditions for working men and women"

• Created the Occupational Safety and Health Administration (OSHA) at the federal level

• States can run their own programs as long as those programs were at least as effective as the federal program

• Learn more: www.dol.gov/compliance/laws/comp-osha.htm

OSHA

15

The Employment Lifecycle

16

HUMAN RESOURCES

Identify Needs

Recruit

Screen and Interview

Hire

Manage

Terminate

17

Recruiting and Hiring Staff

18

• Advertising

• Classifieds

• Online

• Word of mouth

• Refer a friend programs

• Local schools/colleges

WHERE TO FIND QUALITY STAFF?

19

• ________________________________________

• ________________________________________

• ________________________________________

• ________________________________________

HOW DO YOU BECOME A PREFERRED EMPLOYER?

20

SCREENING

Pre-Screen InterviewOffer of

employment

21

• Review resume/application

• CCL Form 995F

• Review the position

• Review pay range

• Help avoid “wasting time” with a full interview

PRE-SCREENING

22

LIC995 F

23

• Fill out an application first

• Include a statement on the application that you are an “Equal Opportunity Employer”

• Include a statement on the application that it does not constitute a promise or guarantee of employment

THE INTERVIEW

24

• Ask open ended questions

• Evaluate responses critically. Did the applicant answer the questions fully? 

• Do not make any promises or guarantees with regard to the job or future employment. For example, avoid comments such as “You are by far the strongest candidate I’ve interviewed.”

• Take notes on a piece of paper separate from the job application or resume.

THE INTERVIEW

Adapted from www.monster.com

25

• Questions to avoid

• Fair Employment and Housing (CA DFEH)

THE INTERVIEW

26

• Have more than one person interview each candidate.

• Check references!

• Avoid the costs of a bad hire!

THE HIRING DECISION

27

Hiring Process

28

• Contingencies:

• Criminal clearance

• Health screening

• Drug testing

• Offer letter

• Avoid promising specific shifts, days, schedules, etc.

OFFER OF EMPLOYMENT

29

• Effective January 1, 2012, California law requires offer letters for non-exempt employees

• Must include:

• The rates of pay and basis for those rates (e.g., whether the employee is paid by the hour, shift, day, week, salary, etc.)  including any rates for overtime, as applicable

• Allowances, if any, claimed as part of the minimum wage, including meal or lodging allowances

• The regular payday designated by the employer

• The name of the employer

• The physical address of the employer’s main office or principal place of business and a mailing address, if different

• The telephone number of the employer

• The name, address, and telephone number of the employer’s workers’ compensation insurance carrier

OFFER LETTERS

30

• Assists in explaining the job to applicants.

• Serves as a basis for writing of postings and developing a list of criteria for a successful candidate to meet.

• After the person has been hired, it gives the new employee a direction and basis from which to start.

• Serves as a tool in the measurement of performance.

• Provides information related to physical and emotional requirements of the job and to assist the health care provider in completion of Health Screening (LIC 503).

JOB DESCRIPTIONS

31

• Persons who must be cleared

• Exempt from criminal clearance requirements

• Timeframes for clearances

• Criminal clearance transfers

• Criminal record statements

• Penalties for violation

CRIMINAL CLEARANCE REQUIREMENTS

32

• Licensee

• Administrator, supervisors

• Any adults other than a client, residing in the facility

• Caregivers (some exceptions for home health, etc.)

• Any staff or volunteer who has contact with residents

• CEO and Officers of the board

WHO MUST BE CLEARED?

33

• Spouse or friend of a resident who visits

• Volunteers (must meet criteria)

• Third party contractor (must meet criteria)

• Licensed or certified medical professionals, not employed by the RCFE

• Home health and hospice staff

• Clergy

WHO IS EXEMPT?

34

• Must be completed “prior to working, residing or volunteering in a licensed facility”

TIMEFRAMES FOR CLEARANCE

35

CRIMINAL RECORD

STATEMENT

(LIC508)

36

CRIMINAL CLEARANCE PROCESS

Fingerprints Submitted

DOJ Conducts Background Check

No Criminal History

Clearance forwarded to individual and

CBCB

Criminal History

CBCB reviews transcript from DOJ

Exemption or denial

37

• Replaced ink fingerprint cards in 2005

• Done at CCL offices or other non-contracted sites

• Fees vary

• “Dummy” number: 3455 88888

LIVESCAN

38

CRIMINAL CLEARANCE FEES

DOJ Fee $42

FBI Fee $17

DOJ CACI Fee n/a

Livescan Fee (varies) $16

TOTAL $75

39

• All convictions other than minor traffic violations, including misdemeanors, felonies and convictions that occurred a long time ago require an exemption

• Serious crimes such as robbery, sexual battery, child abuse, elder or dependant adult abuse, rape, arson or kidnapping are not eligible for an exemption

CRIMINAL RECORD EXEMPTION

40

Health Screening

41

• All personnel

• A health screening by a physician

• Including a chest x-ray or an intradermal test (TB)

• Not more than 6 months prior to or 7 days after employment or licensure

HEALTH SCREENING

42

Managing Staff

43

• Paychex

• ADP

• Labor attorneys

• California Chamber of Commercewww.calchamber.com

DON’T DO IT ALONE!

44

Employee Records

45

• Personnel record

• Health screening/TB test

• Criminal record statement

• Criminal clearance

• Administrator certificate, if applicable

• First aid card, if applicable

• Verification of education/experience

• Copy of driver’s license

• Training documentation

• SOC 341A

EMPLOYEE RECORDS

46

CCL STAFF RECORDS

CHECKLIST

47

LIC501

48

FORM I-9

49

FORM W-4

50

Staff Training

51

• Water safety certificate (80065)

• Appropriate on the job training (80065)

• Standard precautions

• Egress control devices (80065)

• Health-related services (80075)

• First aid (80075)

• Total care (80077.2)

• Restricted health conditions (80092.1)

ARF

52

• Caregiver orientation (AB1570, SB911)

• 10 hours now, 40 hours in 2016

• Dementia care added in 2016 (12 hours)

• Postural supports, restricted conditions, and hospice care added in 2016 (4 hours)

• LGBT

• Caregiver ongoing (4 hours now, 20 hours in 2016)

• CPR (AB2044)

RCFE

53

• Medications – 16+ residents (AB1570, SB911)

• 16 hours now

• 24 hours in 2016

• Medications – 0-15 residents (AB1570, SB911)

• 6 hours now

• 10 hours in 2016

• Medications – 0-15 residents (AB1570, SB911)

• 4 hours now

• 8 hours in 2016

RCFE

54

• Employee safety• Injury and Illness Prevention• Handwashing• Back safety• Workplace violence• Bloodborne pathogens• Personal protective equipment• Disaster, emergency, and fire safety

DON’T FORGET OSHA

55

Retaining Staff

Group Project!

56

• Working in small groups prepare a 5 minute presentation on the three most effective strategies you have utilized to become a preferred employer in your local job market

PREFERRED EMPLOYERS

57

TURNOVER, RETENTION, AND VACANCY

58

Performance Management

59

• 90 days

• Annually

• Important feedback tool

• Opportunity for pay increases

• Set measurable goals

PERFORMANCE REVIEWS

60

Terminating Staff

61

• Documentation is critical

• Performance reviews

• Opportunities for improvement

• Performance Improvement Plans (PIP)

• California is “At-Will” but still must maintain a paper trail

• Must provide final paycheck at termination

TERMINATING STAFF

62

Wage and Hour Requirements

63

• 8 hour shifts, 12 hour shifts or 24 hours shifts

• Staffing must be adequate to meet the needs of the resident population

• Utilization of shifts over 8 hours in a day will require payment of overtime wages.

• A staff person cannot be paid on an exempt basis in order to avoid overtime.

• Always refer to Wage Order 5 to guide your staffing decisions.

STAFFING PATTERNS

64

CALIFORNIA OVERTIME REQUIREMENTS

Rate Applies To

Regular rate of pay

• Up to eight hours in any workday• Up to 40 hours in a workweek

1.5 x regular rate of pay

• All hours worked in excess of eight hours up to and including 12 hours in any workday, and

• The first eight hours worked on the seventh consecutive day of work in a workweek

2 x regular rate of pay

• All hours worked in excess of 12 hours in any workday, and

• All hours worked in excess of eight on the seventh consecutive day of work in a workweek.

65

LIVE-IN FORMULA AS OF JULY 1, 2014

8 hours X $9.00 $72.00

1 hour meal break relieved of all duties, unpaid $0.00

8 hours of sleep, unpaid as long as staff is uninterrupted $0.00

4 hours X $9.00 X 1.5 times rate (overtime) $54.00

3 hours X $9.00 X 2 times rate (overtime) $54.00

TOTAL DAILY RATE $180.00 per day

TOTAL WEEKLY RATE (Daily Rate X 5 days) $900.00 per week

Less Meals, $12.21 (3 meals daily) X 5 days - $61.05

Less lodging - $37.63

TOTAL FOR 5 DAYS COVERAGE $801.32 per week

TOTAL MONTHLY COVERATE (4.2 X weekly total) $3,365.55 per month

66

• Regulations only specify a ratio for night staff

• “Sufficient” staff

• Our business is 24/7/365

• Scheduling for weekends and holidays can be challenging

STAFFING PATTERNS AND RATIOS

67

• 4-on/2-off staffing patterns

• Weekday/weekend staffing

• Live-in staff

• Holiday pay

• Shift differentials

STAFFING/SCHEDULING IDEAS

68

Workers’ Compensation

69

• California law requires employers to have workers' compensation insurance if they have even one employee

• An employer cannot ask employees to help pay the insurance premium

• You must post the “notice to employees” poster in a conspicuous place at the work site

WORKERS’ COMPENSATION INSURANCE

70

• Provide a workers’ compensation claim form to them within one working day

• Return a copy of the completed form to the employee within one working day of receipt

• Forward the claim form, along with your report of occupational injury or illness, to the claims administrator within one working day of receipt

• Within one working day of receiving the employee’s claim, authorize up to $10,000 in appropriate medical treatment

• Provide transitional work (light duty) whenever appropriate

SICK OR HURT ON THE JOB

71

Cost of claims, claims administration, and risk control are 91% of workers’ compensation costs

Source: Marsh USA

CONTROLLING WORKERS’ COMP COSTS

91%

9%

72

• Involve everyone in workplace safety

• Safety committees

• Injury and Illness Prevention Programs

• Ongoing training

• Hazard communication

CONTROLLING WORKERS’ COMP COSTS

73

• Employers are required to have an effective written Injury and Illness Prevention Program (IIPP)

• An effective IIPP improves the safety and health in your workplace

INJURY AND ILLNESS PREVENTION PROGRAMS

74

Statement of management commitment and identification of responsible party

Hazard identification: The employer is required to identify any hazards that exist in the workplace, including a personal protective hazards assessment

Hazard correction and prevention: The employer must correct all existing hazards, and perform periodic walk-through of the facility to identify and correct any future hazards

System for reporting accidents, and investigation and correction of all accident situations

YOUR IIPP MUST INCLUDE

75

Hazardous substance safety procedures

Fire prevention training (including fire extinguisher operation)

Emergency response and first aid procedures

General office safety plan

Medical waste disposal plan

Infection control and Bloodborne pathogens training

Personal Protective Equipment training

ONGOING TRAINING FOR ALL EMPLOYEES

76

System for training employees on the proper use, labeling and storage of hazardous substances

System for notifying all employees of new hazardous materials brought into the workplace

“Globally Harmonized System”

Labels

Safety Data Sheets

HAZARD COMMUNICATION

77

Identification of all biohazard wastes and appropriate disposal methods

Training for all employees on the differences between “biohazard waste” vs. “regulated medical waste” and the appropriate disposal methods of each

Systems for disposal of regulated medical waste, if your Community generates such

EPA registration number and waste manifests, if your Community generates hazardous medical waste

Approved sharps containers

MEDICAL WASTE DISPOSAL PLAN

78

Appropriate action to be taken in the event of an emergency, fire, earthquake, explosion, or other disaster

Identification of evacuation procedures, emergency response personnel and locations of nearest hospital, fire stations or other emergency centers

Identification of personnel (if any) trained in CPR or emergency first aid procedures

Location of assembly points and evacuation checklists

Operation shut down procedures and responsible parties

EMERGENCY ACTION PLAN

79

Location of all fire extinguishers in the facility

Appropriate training of all personnel in fire extinguisher handling and fire prevention

Location of nearest fire department and appropriate notification procedures, including responsible parties

Identification of specific fire hazards in your facility, if any

Site Plan sketch, identifying location of fire extinguisher and any specific hazards, as well as evacuation routes

FIRE PREVENTION PLAN

80

Tuberculosis exposure control plan

Bloodborne Pathogens training, including offer of Hepatitis B vaccinations for all personnel with occupational exposure, or signed declination forms

Ergonomics training, with identification of potential problem areas, and corrective steps taken to eliminate or reduce repetitive motion injuries

SPECIALIZED TRAINING FOR HEALTHCARE FACILITIES

81

Harassment and Bullying in the Workplace

82

• Working in a “hostile environment” negatively affect productivity and decrease morale, it also can be extremely costly.

• California Assembly Bill 1825 requires that all supervisors are trained on sexual harassment every two years.

SEXUAL HARASSMENT TRAINING

83

• The California Fair Employment and Housing Act:

• Verbal Harassment

• Physical Harassment

• Visual Harassment

• Sexual Favors

CALIFORNIA LAW

84

Involves the use of epithets, derogatory comments or slurs including:

• Name-calling, belittling, or sexually explicit or degrading words used to describe someone

• Sexually explicit jokes

• Comments about an employee’s anatomy and/or attire

• Sexually oriented remarks or noises

• Questions about a person’s sexual practices

• Verbal abuse

• Graphic verbal commentaries about the body

VERBAL HARASSMENT

85

• Touching, patting, pinching, grabbing, brushing against, or poking another employee’s body

• An initiation or hazing event that involves a sexual component

• Requiring an employee to wear sexually suggestive clothing

PHYSICAL HARASSMENT

86

• Displaying sexual pictures, writings, or objects

• Obscene invitations or letters

• Unwanted notes or love letters

• Staring at an employee’s anatomy

• Leering

• Sexually oriented gestures

• Mooning

VISUAL HARASSMENT

87

Quid pro quo

• A Latin phrase which means “this for that” and refers to sexual harassment undertaken by a high-ranking employee, such as a manager or supervisor.

• Typically this involves a person of power demanding sexual favors of the employee who would in turn receive employment benefits such as

raises or promotions.

TYPES OF SEXUAL HARASSMENT

Hostile work environment

• When an employee has to

deal with unwanted sexual

advances, or visual, verbal or

physical conduct that is of a

sexual nature.

• Subjectively and objectively

unwelcome and was severe

and pervasive as to alter the

victim’s employment or create

an intimidating or offensive

work environment.

88

• AB 2053

• Beginning January 1, 2015

• Requires employers with 50 or more employees to include prevention of abusive conduct as a component of currently requirement harassment training

BULLYING (“ABUSIVE CONDUCT”)

89

• Repeated infliction of verbal abuse, such as the use of derogatory remarks, insults, and epithets

• Verbal or physical conduct that a reasonable person would find threatening, intimidating, or humiliating

• The gratuitous sabotage or undermining of a person’s work performance

WHAT IS ABUSIVE CONDUCT?

90

• Verbal

• Social

• Physical

• Work interference

TYPES OF BULLYING

91

• If you are an employer, co-worker, manager or supervisor you may be held liable for acts of sexual harassment.

• If you are an employer, you can be held liable for the inappropriate conduct of your managers, supervisors, as well as your coworkers, vendors, customers, and visitors.

YOUR RESPONSIBILITIES

92

• Co-workers

• Non-employees

• Staff provided by temporary employment agencies

• Independent contractors

• Other professional relationships

HARASSMENT LAWS ALSO APPLY TO…

93

1. Display the required posters and notices.

2. Develop and implement a sexual harassment policy that contains an effective complaint process.

• Communicate zero tolerance for sexual harassment.

• Adopt a policy regarding employee relationships.

3. Train supervisors and other non-supervisory employees.

4. Investigate and resolve complaints in a timely manner.

PREVENTING HARASSMENT

94

ANY QUESTIONS