2024 Oregon Long Term Care State Report www.ohca.com 12 Initial and Continuing Training Requirements Oregon has comprehensive training requirements for caregivers, clinicians, staff, and administrators in long term care service settings. For many long term care positions, Oregon has some of the highest training requirements of any state. These requirements include pre-service trainings as well as annual in-service continuing education. For example, certified nursing assistants (CNAs) in Oregon’s skilled nursing facilities are required to complete 105 hours of initial training. This includes 65 hours of classroom instruction and 40 hours of supervised clinical experience and a competency exam and additional, continued training required on a quarterly basis. The initial training requirement is more than the federal minimum requirement of 75 hours of initial training for CNAs in these settings. Assisted Living and Residential Care Communities The state exercises robust regulatory control over training requirements in all assisted living and residential care communities, which include memory care. Each facility must have a training program in place—and are held accountable for meeting training requirements through the state survey process—that includes methods to determine competency of direct care staff through evaluation, observation, or written testing as well as documentation of direct care staff’s demonstrated competency. Knowledge and performance that must be demonstrated within the first 30 days of hire by direct care staff that include: • The role of service plans in providing individualized resident care • Providing assistance with the activities of daily living • Changes associated with normal aging • Identification of changes in the resident’s physical, emotional, and mental functioning, as well as documentation and reporting on the resident’s changes of condition • Conditions that require assessment, treatment, observation, and reporting • General food safety, serving, and sanitation If the direct care staff person’s duties include the administration of medication or treatments, appropriate facility staff must document that they have observed and evaluated the individual’s ability to perform safe medication and treatment administration unsupervised. Further, pre-service dementia care training is required which must include the following subject areas: • The dementia disease process • Techniques for understanding, communicating, and responding to distressful behavioral symptoms, including reducing the use of anti- psychotic medications for non-standard uses • Strategies for addressing social needs of persons with dementia23 Specific aspects of dementia care and ensuring the safety of residents with dementia, including: • Identify and address pain • Provide food and fluids • Prevent wandering and elopement • Use a person-centered approach All staff must also undergo a preservice orientation, which includes these topics: • Residents’ rights and the values of community- based care • Abuse and reporting requirements • Infection control • Fire safety and emergency procedures
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