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Direct Care Staff Supervisor
5055 I. 1-3Core Staffing Requirements(F328)
5055. I. 1-3Direct Care Staff Supervisor
Direct Care Staff Supervisor. The HCBS Provider shall designate and assign a direct care staff supervisorto monitor and supervisethe direct care staff.Thesupervisor shall be selected based upon the needs of client outlined in the ISP.AProvider may have more than one direct care staff supervisor.3.Staffin supervisor positions shall have annual training in supervisory and management techniques. This particular section of the deficient practice wascited the most in 2016.
Direct Care Staff Supervisor
This deficient practice was cited 47 times during the periodof January 1, 2016 through December 31, 2016.
So, why is this the case?
What can be done to help eliminate or minimize the citing of this deficiency?
BrainstormingWhat Can Providers Do To Prevent Deficiencies?
Possible Areas/Topics for Annual Supervisory and Management Training
Deficient Practice Related:Reviewing previous deficiencies cited during a survey and the Provider’s Plan of Correction with the Supervisors.Stressing the importance of notifying the Administrator of changes in the clients’ conditions which may require that the ISP be revised or updated, which may require an assessment by a RN, which may require a MD/Hospital visit, etc.Stressing the importance of ensuring that the current progress notes or equivalent documentation are maintained in the clients’ homes.
Possible Areas/topics for Annual Supervisory and Management Trainingcont’d
Deficient Practice Related:Stressing the importance of the oversight of client funds:For Example:Maintenance of receipts from all purchases with each receipt being signed by the client and the staff assisting the client with the purchase, or the staff assisting the client with the purchase and an independent staff when the client is not capable of verifying the purchase.5.Proper documentation of issues and retaining records: Documenting at the time of, or shortly following an incident. Don’t wait weeks or months to createdocumentation, Focuson the facts, not generalizations or subjective comments.
Possible Areas/topics for Annual Supervisory and Management Training cont’d
Others:6.Making sure the DSW Supervisors are aware of and know how to enforce the Provider’s Policies and Procedures. Examples may include: The Provider’s hiring practices, discrimination, attendance and leave, harassment, pay issues, proper disciplinary actions , retaliation, record/timekeeping .7.Proper documentation of employee misconduct and performance problems with clear expectations, don’t exaggerate or embellish, setting specific deadlines for follow-ups.8.Creating a positive work environment: Stress positive reinforcement, Recognition of DSWswho workwell with clients, DSWs with good attendance, giving the DSW an extra day off with pay.9.Dealing with difficultworkers--What’sthe best approach, conflict resolution, best actions to take, how to promote better communication and rapport with workers, team work, etc.
Direct CareSupervision
5055 J. 1-5Core Staffing Requirements(F330)
Most prevalent areas cited in this area
F330Cited mainly due to:Failure to conduct quarterly home visits to ensure the client’s ISP is adequate or needed to be revised/updated.Services not rendered in accordance with the ISP or the ISPwas not followed.In-person supervisory visits were not conducted within 60 days of hire and at least annually thereafter. Please NOTE: Supervisory visits shall be conducted more frequently if dictated by the client’s ISP, a worker’s performance may need to be addressed, achange inthe client’s statusand/or a change to ensureservices are being provided in accordance with the client’s ISP.Annual performance Evaluations were not conducted for each DSW.
Supervision is one of the most important things a provider can do to:Protect clientsPrevent deficienciesProtect the agency
The frequency of supervision should be determined based upon the client’s individual situation and needs and not just the minimum required by the regulations.
Clients receiving home and community based services must meet the same level of need as someone who is in a nursing home or facility for individuals with intellectual disabilities.Staff going into the client’s home are the eyes and ears who can report what is observed or heard that should be reported so that the client’s needs can be addressed in a timely manner. Some clients are non-verbal or have communication deficits and cannot convey whattheirneeds are.
Do your best to stay informed about what is going on in the client’s home.





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Direct Care Staff Supervisor -