1. (a) For all applicants considered for employment, for all volunteers, for all independent contractors who will provide direct care or personal care services to residents or who will be unaccompanied by an employee while performing non-direct care or non-personal care services within the facility, and for all household members, the licensee shall:

   1. (1) Obtain and review a criminal records check in accordance with RSA 151:2-d, which shall include criminal history from the state of New Hampshire;
   2. (2) Review the results of the criminal records check in accordance with (b) below; and
   3. (3) Verify the qualifications prior to employment.

2. (b) Unless a waiver is granted in accordance with (c) below, the licensee shall not offer employment contract with, or engage a person for any position or allow a household member to continue to reside in the residence if the individual:

   1. (1) Has been convicted of a felony in this or any other state;
   2. (2) Has been convicted of a sexual assault, other violent crime, assault, fraud, abuse, theft, neglect, or exploitation in this or any other state;
   3. (3) Has a finding by the department or any administrative agency in this or any other state for assault, fraud, theft, abuse, neglect, or exploitation of any person; or
   4. (4) Otherwise poses a threat to the health, safety, or well-being of the residents.

3. (c) If the information identified in (b) above regarding any person in (a) above is learned after the

   1. (1) Cease employing, contracting with, or engaging the person, or not permit the household

      member to continue to reside in the residence; or

   2. (2) Request a waiver of (b) above.

   person is hired, contracted with, or engaged, or after the person becomes a household member, the licensee

   shall immediately notify the department and either:

4. (d) If a waiver of (b) above is requested, the department shall review the information and the underlying circumstances in (b) above and shall either:

   1. (1) Notify the licensee that the person cannot or can no longer be employed, contracted with, or engaged by the licensee, or the person cannot or can no longer reside in the facility if, after investigation, it determines that the person poses a threat to the health, safety, or well-being of a resident(s); or
   2. (2) Grant a waiver of (b) above if, reviewing the underlying circumstances, it determines that the person does not pose a current threat to the health, safety, or well-being of a resident(s).
5. (e) Upon hire and annually thereafter, the licensee shall check the names of the persons in (a) above against the bureau of adults and aging services (BAAS) state registry maintained pursuant to RSA 161-F:49 prior to employing and continuing to employ, contracting with, or engaging them, or prior to allowing or continuing to allow a household member to reside at the residence.
6. (f) The licensee shall not employ, contract with, engage, or allow to reside in the facility any person in (a) above who is listed on the BAAS state registry unless a waiver is granted by BAAS.

7. (g) If any person in (a) above is listed on the BAAS state registry, and it is learned after the person is hired, contracted with, engaged with, or after the person becomes a household member, the licensee shall immediately notify the department and either:

   1. (1) Cease employing, contracting with, or engaging the person, or not permit the household member to continue to reside in the residence; or
   2. (2) Request a waiver from BAAS of (f) above.
8. (h) In lieu of (a) and (e) above, the licensee may accept a signed statement from independent agencies contracted by the licensee or by an individual resident to provide direct care or personal care services, that the agency’s employees have complied with (a) and (e) above and do not meet the criteria in (b) and (f) above.

9. (i) For an SRHCF licensed for 17 or more beds, all administrators shall be at least 21 years of age and have one of the following combinations of education and experience:

   1. (1) A bachelor’s degree from an accredited institution and 2 years of relevant experience working in a health care setting;
   2. (2) A New Hampshire license as an RN, with at least 2 years of relevant experience working in a health care setting;
   3. (3) An associate’s degree from an accredited institution plus 4 years of relevant experience working in a health care setting; or
   4. (4) A New Hampshire license as an LPN, with at least 4 years of relevant experience working in a health care setting.

10. (j) For an SRHCF licensed for 16 or fewer beds, all administrators shall be at least 21 years of age and have one of the following combinations of education and experience:

    1. (1) A bachelor’s degree from an accredited institution and one year of relevant experience working in a health care setting;
    2. (2) A New Hampshire license as an RN, with at least one year of relevant experience working in a health care setting;
    3. (3) An associate’s degree from an accredited institution plus 2 years of relevant experience working in a health care setting;
    4. (4) A New Hampshire license as an LPN, with at least 2 years of relevant experience working in a health care setting; or

    5. (5) Be a high school graduate or have a GED with 6 years of relevant experience working in a

       health care setting with at least 2 of those years as direct care personnel in a long-term care setting within the last 5 years.

11. (k) All administrators shall obtain and document in accordance with (v)(7) and (8) below, 12 hours of continuing education related to the operation and services of the SRHCF each annual licensing period.

12. (l) All direct care personnel shall be at least 18 years of age unless they are:

    1. (1) A licensed nursing assistant working under the supervision of a nurse in accordance with Nur 700; or
    2. (2) Involved in an established educational program working under the supervision of a nurse.
13. (m) The licensee shall inform personnel of the line of authority at the SRHCF.
14. (n) The licensee shall educate personnel about the needs and services required by the residents under their care.

15. (o) Prior to having direct care contact with residents, personnel, including volunteers and independent contractors, shall:

    1. (1) Submit to the licensee the results of a physical examination or a health screening performed by a licensed nurse or a licensed practitioner and the results of a 2-step tuberculosis (TB) test, Mantoux method, or other method approved by the Centers for Disease Control, both conducted not more than 12 months prior to employment, contract, or engagement;
    2. (2) Be allowed to work while waiting for the results of the second step of the TB test when the results of the first step are negative for TB;
    3. (3) Comply with the requirements of the Centers for Disease Control and Prevention “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings” (2005 edition), available as noted in Appendix A, if the person has either a positive TB test, or has had direct contact or potential for occupational exposure to M. tuberculosis through shared air space with persons with infectious tuberculosis; and
    4. (4) In lieu of (1) above, independent agencies contracted by the SRHCF or by an individual resident, to provide direct care or personal care services, may provide the licensee with a signed statement that their employees have complied with (1) and (3) above before working at the SRHCF.

16. (p) Prior to having contact with residents or food, all personnel shall receive a tour of and orientation to the facility that includes the following:

    1. (1) The residents’ rights in accordance with RSA 151:21;
    2. (2) The licensee’s complaint procedures;
    3. (3) The duties and responsibilities of the position;
    4. (4) The medical emergency procedures;
    5. (5) The emergency and evacuation procedures;
    6. (6) The infection control procedures as required by He-P 805.22;
    7. (7) The procedures for food safety for personnel involved in preparation, serving, and storing of food;
    8. (8) The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29;
    9. (9) The licensee’s policies and procedures specific to the duties and responsibilities of the staff position; and
    10. (10) Policies and procedures for medication administration for personnel involved with supervision, assistance, or administration of medications.

17. (q) The licensee shall provide all personnel with an annual continuing education or in-service education training, which at a minimum contains the following:

    1. (1) The licensee’s resident’s rights and complaint procedures required under RSA 151;
    2. (2) The licensee’s infection control program;
    3. (3) The licensee’s written emergency plan;
    4. (4) The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29;
    5. (5) Policies and procedures for medication administration for personnel involved with supervision, assistance, or administration of medications;
    6. (6) Procedures for food safety for personnel involved in preparation, serving, and storing of food; and
    7. (7) The licensee’s policies and procedures specific to the duties and responsibilities of the staff position.
18. (r) The licensee shall comply with all dementia training requirements pursuant to RSA 151:47-49.

19. (s) The training required in (r) above shall include new information on best practices in the treatment and care of persons with dementia and be provided for:

    1. (1) A minimum of 6 hours for initial training to covered administrative staff members and covered direct service staff members within the first 90 days of hire; and
    2. (2) A minimum of 4 hours of continuing training each calendar year.

20. (t) Pursuant to RSA 151:52, I(e) licensee’s seeking extensions for compliance with any specific provision of RSA 151:48, RSA 151:49, or RSA 151:50 shall submit a written request to the commissioner that includes:

    1. (1) A full explanation of why an extension is necessary;
    2. (2) A reasonable explanation of why the extension should be granted;
    3. (3) The period of time for which the extension is sought; and
    4. (4) What good faith efforts, as verified by documentation or other means, the licensee has made to comply with the requirements of RSA 151:50 but has been unable to do so.
21. (u) A request for extension for compliance with RSA 151:50 shall be granted if the commissioner determines that the alternative proposed does not negatively impact the health, safety, or well-being of the residents.

22. (v) The SRHCF shall maintain a separate employee file for each employee, which shall include the

    1. (1) A completed application for employment or a resume;
    2. (2) Proof that the individual meets the minimum age requirements;
    3. (3) A statement signed by each individual that they have received a copy of and received training on the implementation of the licensee’s policy setting forth the residents rights and responsibilities as required by RSA 151:21;
    4. (4) A copy of the results of the criminal record check and BAAS state registry check;

    5. (5) A job description signed by the individual that identifies the:

       1. a. Position title;
       2. b. Qualifications and experience; and
       3. c. Duties required by the position;
    6. (6) Record of satisfactory completion of the orientation program required by (p) above;
    7. (7) Information as to the general content and length of all in-service or educational programs attended;
    8. (8) Record of satisfactory completion of all required education programs and demonstrated competencies that is signed and dated by the employee;
    9. (9) Documentation that the required physical examinations, health screenings, TB test results, and radiology reports of chest x-rays, if required, have been completed by the appropriate health professionals; and
    10. (10) The statement required by (w) below.

    following:

23. (w) All personnel shall sign a non-conviction attestation at the time the initial offer of employment is made and then annually thereafter stating that they:

    1. (1) Do not have a felony conviction in this or any other state;
    2. (2) Have not been convicted of a sexual assault, other violent crime, assault, fraud, abuse, neglect, or exploitation, or pose a threat to the health, safety, or well-being of a resident in this or any other state; or
    3. (3) Have not had a finding by the department or any administrative agency in this or any other state for assault, fraud, theft, abuse, neglect, or exploitation of any person.
24. (x) The licensee shall protect and store in a secure and confidential manner all records described in (v) above. Personnel records shall be retained for 4 years after termination.
25. (y) The licensee shall provide to its consenting employees annual immunizations against influenza in accordance with RSA 151:9-b.

26. (z) If the facility uses an electronic record storage system, it shall provide computer access to all

    personnel records for the purpose of verifying compliance with all provisions of RSA 151 and He-P 805 for the onsite inspection. Access shall include assistance navigating the database and printing portions of the record, if needed.

27. (aa) All personnel electronic records shall have security provisions to ensure confidentiality.
28. (ab) Personnel shall not be impaired while on the job by any substances including, but not limited to, legally prescribed medication, cannabis, or alcohol.

29. (ac) The licensee shall have a written policy, as described in RSA 151:41, establishing procedures for the prevention, detection, and resolution of substance abuse, misuse, and diversion, which shall apply to all personnel, and which shall be the responsibility of a designated employee or interdisciplinary team and include:

    1. (1) Education;
    2. (2) Procedures for monitoring the distribution and storage of controlled substances;
    3. (3) Voluntary self-referral by employees who are addicted;
    4. (4) Co-worker reporting procedures;
    5. (5) Drug testing procedures to include, at a minimum, testing where reasonable suspicion exists;
    6. (6) Employee assistance procedures;
    7. (7) Confidentiality;
    8. (8) Investigation, reporting, and resolution of controlled drug misuse or diversion as required per He-P 805.14(k); and
    9. (9) The consequences for violation of the controlled substance abuse, misuse, and diversion prevention policy.

30. (ad) The licensee shall maintain records, but not necessarily a separate file, for all volunteers and for all independent contractors who provide direct care or personal care services to residents that includes:

    1. (1) A signed and dated job description;
    2. (2) A record of satisfactory completion of the orientation program;
    3. (3) Documentation that the required physical examination, or health screening, and TB test have been completed;

    4. (4) A statement, which shall be signed at the time the initial contract or engagement is made, and then annually thereafter, stating that they:

       1. a. Do not have a felony conviction in this or any other state;
       2. b. Have not been convicted of a sexual assault, other violent crime, assault, fraud, theft, abuse, neglect, or exploitation, or pose a threat to the health, safety, or well-being of a resident in this or any other state; and
       3. c. Have not had a finding by the department or any administrative agency in this or any other state for assault, fraud, theft, abuse, neglect, or exploitation of any person in this or any other state;
    5. (5) A copy of the criminal records check;
    6. (6) A copy of the BAAS state registry check; and
    7. (7) A waiver as required per (b) above, if applicable.

Source. #8746, eff 10-25-06; ss by #10813, eff 4-21-15; ss by #13333, eff 1-25-22; ss by #14358, eff 8-28-25, EXPIRES: 8-28-35