411-086-0310 Employee Orientation and In-Service Training (1) Orientation. The nursing facility shall ensure that each employee, temporary employee, and volunteer completes an orientation program sufficient to ensure that the safety and comfort of all residents is assured in accordance with facility policies (OAR 411-085-0210). Orientation to each task must be completed prior to the employee or volunteer performing such task independently. Orientation for nursing staff and nursing assistants in training shall be supervised by a registered nurse. The orientation shall include: (a) Explanation of facility organizational structure; (b) Philosophy of care of the facility, including purpose of nursing facility requirements as defined in these administrative rules; (c) Description of resident population; (d) Employee rules; (e) Facility policy and procedures; and (f) RESIDENTS’ RIGHTS. Residents' rights and the values of nursing facility care, including the Department-approved LGBTQIA2S+ trainings. (A) Effective December 31, 2024, all facility staff must have completed the required training. All new facility staff, hired on or after January 1, 2025, must complete the required training prior to beginning job responsibilities. (B) The Department-approved LGBTQIA2S+ trainings shall address the elements described in paragraph (3)(d) of this rule (2) Inservice. The Administrator or his/her designee shall coordinate all inservice training. Inservice training shall be designed to meet the needs of all facility staff in accordance with facility policy (OAR 411-085-0210). Each certified nursing assistant shall receive a minimum of three hours of in-service training each calendar quarter. Each calendar year the Inservice training agenda shall include at least the following: (a) Resident rights, including, but not limited to, those rights included in ORS 441.600-441.625; (b) Rules and statutes pertaining to abuse, including, but not limited to, ORS 441.630-441.675; (c) The transfer/discharge rules, including, but not limited to, the obligations of facility personnel to forward requests for conferences and hearings to the appropriate authorities; (d) Measures to prevent cross-contamination, including universal precautions; (e) Oral care, including oral screenings (required for nursing staff only); (f) Emergency procedures, including, but not limited to, the disaster plan; (g) Procedures for life-threatening situations, including, but not limited to, cardiopulmonary resuscitation and the life-saving techniques for choking victims (including abdominal thrust and chest thrust); (h) Application and use of physical restraints (required for nursing staff only); (i) Procedures to prevent residents from wandering away from the facility and how to deal with the wandering resident; (j) Restorative services, including benefits thereof (required for nursing staff only); (k) Activity program, including benefits thereof; (l) The social services program, including benefits thereof; (m) Accident prevention; (n) Alzheimer's disease and other dementias, including recognition of symptoms, treatments, and behavioral management; and (o) Other special needs of the facility population. (3) Biennial LGBTQIA2S+ training requires the following: (a) Administrators and employees shall be required to complete biennial training addressing LGBTQIA2S+ protections, as described in this section. The facility is responsible for the cost of providing this training to all facility staff. (A) Each facility shall designate two employees, one who represents management and one who represents direct care staff by July 1, 2024. It is acceptable for the designated employee representing management to generally be housed offsite, but the direct care representative must be onsite. (B) The designated employees shall serve as points of contact for the facility regarding compliance with the biennial training requirements. These individuals shall develop a general training plan for the facility. (b) Facilities must select the LGBTQIA2S+ training to be used by the facility by either: (A) Choosing to use the standard Department-approved biennial LGBTQIA2S+ training, or (B) Applying to the Department to request approval of a biennial LGBTQIA2S+ training to be developed and provided by the facility. (c) ORS 441.116 requires all LGBTQIA2S+ trainings address: (A) Caring for LGBTQIA2S+ residents and residents living with human immunodeficiency virus. (B) Preventing discrimination based on a resident’s sexual orientation, gender identity, gender expression or human immunodeficiency virus status. (C) The defined terms commonly associated with LGBTQIA2S+ individuals and human immunodeficiency virus status. (D) Best practices for communicating with or about LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including the use of an individual’s chosen name and pronouns. (E) A description of the health and social challenges historically experienced by LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including discrimination when seeking or receiving care at care facilities and the demonstrated physical and mental health effects within the LGBTQIA2S+ community associated with such discrimination. (F) Strategies to create a safe and affirming environment for LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including suggested changes to care facility policies and procedures, forms, signage, communication between residents and their families, activities, in-house services and staff training. (G) The facility, individual or entity providing the training must demonstrate a commitment to advancing quality care for LGBTQIA2S+ residents and residents living with human immunodeficiency virus in this state. (d) The proposal for training submitted by a facility, individual or entity shall include: (A) The regulatory criteria described in paragraph (c) of this section as part of the proposal. (B) The following elements must be included in the proposal: (i) A statement of the qualifications and training experience of the facility, individual or entity providing the training. (ii) The proposed methodology for providing the training either online or in person. (iii) An outline of the training. (iv) Copies of the materials to be used in the training. (C) The Department will review the materials and determine whether to approve or deny the training. No later than 90 days after the request is received, the Department will inform the facility in writing of the Department’s decision. (4) Contractors who provide services or supports directly to residents must complete the required LGBTQIA2S+ trainings outlined in paragraph (3)(c) of this rule. (a) Contractors who must be trained include, but are not limited to, RN and administrative consultants, housekeeping services, dietary services, beauticians, barbers, or other contractors who provide services or supports directly to residents. (b) Exempt from this training requirement are contractors who contract directly with the resident or the resident’s representative, and contractors who do not generally provide services or supports directly to residents, including but not limited to contractors for landscaping, pest control, deliveries and building repairs. (c) By December 31, 2024, facilities shall ensure that all contracts entered into with entities described in paragraph (a) of this section shall include language requiring contractors provide Department-approved LGBTQIA2S+ training to their employees within 12 months of entering into the contract with the facility and every two years thereafter. (d) For existing contracts in effect January 1, 2025, facilities shall require contractors to provide Department-approved LGBTQIA2S+ training to employees by December 31, 2025, and every two years thereafter. (e) For new contracts created after January 1, 2025, facilities shall require contractors to provide the Department-approved LGBTQIA2S+ training to employees within 12 months of entering into the contract with the facility, and every two years thereafter. (f) Facilities must inform contractors the cost of all LGBTQIA2S+ trainings for contracted employees shall be paid by the contractor. (5) Documentation. Inservice training, Biennial LGBTQIA2S+ training and orientation shall be documented and shall include the date, content, and names of attendees. Statutory/Other Authority: ORS 410.070, 410.090, 441.055 & 441.122 Statutes/Other Implemented: ORS 441.055, 441.116, 441.118 & 441.615 History: APD 57-2024, amend filed 09/23/2024, effective 09/25/2024 APD 17-2024, temporary amend filed 03/29/2024, effective 04/01/2024 through 09/27/2024 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90