(a) Initial training.
  (1) A facility must provide direct service staff with training in its fire, disaster, and evacuation procedures within three workdays after the start of employment and document the training in the facility records.
  (2) A facility must provide direct service staff a minimum of 18 hours of training during the first three months after the start of employment and document the training in the facility records.
  (3) The training provided in accordance with paragraph (2) of this subsection must include:
    (A) a nationally or locally recognized adult cardiopulmonary resuscitation (CPR) course or certification;
    (B) first aid;
    (C) orientation to health care delivery, including:
      (i) safe body function and mechanics;
      (ii) personal care techniques and procedures; and
      (iii) overview of the population served at the facility;
    (D) identification and reporting of abuse, neglect, or exploitation; and
    (E) basic infection prevention and control measures.
(b) Continuing training.
  (1) A facility must provide at least three hours of continuing training to direct service staff quarterly and document the training in the facility records. Training may include:
    (A) assisting clients with personal care services;
    (B) health conditions and diagnoses of clients in the facility and how they may affect provision of care;
    (C) safety measures to prevent accidents and injuries;
    (D) emergency first aid procedures, such as the Heimlich maneuver and actions to take when a client falls, suffers a laceration, or is experiencing a sudden change in physical or cognitive status;
    (E) managing dysfunctional, disruptive, or maladaptive behavior and de-escalation techniques;
    (F) client rights;
    (G) communication techniques for working with clients with hearing, visual, or cognitive impairment;
    (H) basic infection prevention and control measures; and
    (I) fall prevention.
  (2) A facility must practice evacuation procedures with staff and individuals at least once a month and document evacuation results in the facility records.
  (3) The facility must ensure that direct service staff maintain current certification in CPR.
(c) Policy for clients with Alzheimer's disease or a related disorder. A facility must adopt, implement, and enforce a written policy that:
  (1) requires direct service staff who provide care at the facility to a client with Alzheimer's disease or a related disorder to successfully complete training in the provision of care to clients with Alzheimer's disease or related disorders;
  (2) ensures the care and services provided by direct service staff to a client with Alzheimer's disease or a related disorder meet the specific identified needs of the client relating to the diagnosis of Alzheimer's disease or a related disorder; and
  (3) ensures the training required for direct service staff under paragraph (1) of this subsection includes information about:
    (A) symptoms and treatment of dementia;
    (B) stages of Alzheimer's disease;
    (C) person-centered behavioral interventions; and
    (D) communication with a client with Alzheimer's disease or a related disorder.

Source Note: The provisions of this §559.67 adopted to be effective July 10, 2024, 49 TexReg 4909