Pennsylvania · nursing homes
Pennsylvania nursing home staff requirements: what you have to hold on every person
A Pennsylvania nursing home has to hold thirty dated things on file for the people it employs. Twenty-eight of them are federal and are the same in every state. Two are Pennsylvania's own, and one of them is a yearly teaching list that names topics the federal list leaves out.
What Pennsylvania adds
Two things, on top of everything every nursing home in the country already holds. Each one names the section of Pennsylvania law it comes from, so you can read it yourself rather than take our word for it.
| What we track | How often | Where the rule comes from |
|---|---|---|
| A yearly in-service on Pennsylvania's own list, including fire safety, emergency planning and residents' rightsTwo of these overlap the federal topics and one does not. Fire safety is a Pennsylvania addition, and it is the one that goes missing when a building runs a federal training calendar unchanged. | Every year | 28 Pa. Code 201.20 |
| A TB check that follows the national approachPennsylvania points at the national 2019 guidance rather than writing its own schedule, so there is no yearly test here. | Once when they start. After that it is a set of questions rather than a repeat test, unless your own plan says otherwise. | 28 Pa. Code 201.22 |
Fire safety is the one to notice
Most state layers add a check or a test. Pennsylvania adds a teaching topic, and it adds one that the federal list does not carry.
A building that buys a training package built to the federal eleven topics gets abuse and neglect, residents' rights, infection control, quality, compliance, behavioral health, communication and emergency preparedness. It does not get fire safety as a named annual topic, because federally it is not one.
So the Pennsylvania gap is quiet. Nothing is missing from the package you bought, nothing has expired, and the row simply is not there. It only shows up when somebody compares your training calendar against 201.20 rather than against the federal list, and the person who usually does that first is a surveyor.
What Pennsylvania does not add
No state TB testing schedule beyond the national approach. No extra nurse aide hours. No repeat background check on a cycle. The PATCH check is a hiring check.
What every nursing home in the country holds
These twenty-eight are the same in Pennsylvania as they are everywhere else, and they are most of the job. Each one names a CMS tag, a piece of the federal code, or both. The guides go through the ones that get cited most.
Licences and certificates
| What we track | How often | Where the rule comes from |
|---|---|---|
| A current RN license | When it runs out. Most last 2 years. | F839 · 42 CFR 483.70(e) |
| A current LPN license | When it runs out. Most last 2 years. | F839 · 42 CFR 483.70(e) |
| Nurse aide certification, still active on the state list | When it runs out. Most last a year. | F728 · 42 CFR 483.35(d) |
| A current license for therapy, social work and pharmacy staff | When it runs out. Most last 2 years. | F839 · 42 CFR 483.70(e) |
| A current administrator license | When it runs out. Most last a year. | F836 · 42 CFR 483.70(a) |
| Proof the food service director is qualified, where no dietitian works full time | When it runs out. Most last 3 years. | F801 · 42 CFR 483.60(a)(2) |
| Proof the activities lead is qualified | When it runs out. Most last 2 years. | F680 · 42 CFR 483.24(c)(2) |
Checks you run on a person
| What we track | How often | Where the rule comes from |
|---|---|---|
| A look at the state nurse aide list before the first shift | Before their first shift, then every 2 years | F729 · 42 CFR 483.35(d)(4) |
| A check for any finding of abuse or neglect against them | Every year | F606 · 42 CFR 483.12(a)(3) |
Health and safety
| What we track | How often | Where the rule comes from |
|---|---|---|
| A first TB check: history, symptoms and a test | Once, in their first two weeks | CDC 2019 via 42 CFR 483.80(a)(2) |
| The hepatitis B shot offered free, and their answer written down | Once, within ten working days of starting | 29 CFR 1910.1030(f) |
| A mask fit test for anyone who wears an N95 | When it runs out. Most last a year. | 29 CFR 1910.134(f) |
| A current CPR card at the healthcare level | When it runs out. Most last 2 years. | F678 · 42 CFR 483.24(a)(3) |
Teaching and in-service
| What we track | How often | Where the rule comes from |
|---|---|---|
| Orientation, before they work on their own | Once, in their first week | F940 · 42 CFR 483.95 |
| Teaching on abuse, neglect and dementia care | Every year | F943 · 42 CFR 483.95(c) |
| Teaching on residents' rights | Every year | F942 · 42 CFR 483.95(b) |
| Teaching on stopping infection spreading | Every year | F945 · 42 CFR 483.95(e) |
| Teaching on the quality program | Every year | F944 · 42 CFR 483.95(d) |
| Teaching on the compliance and ethics program, if your company runs five or more buildings | Every year | F946 · 42 CFR 483.95(f) |
| Teaching on mental health and behavior needs | Every year | F949 · 42 CFR 483.95(i) |
| Teaching on talking with residents, for hands-on staff | Every year | F941 · 42 CFR 483.95(a) |
| Teaching on what to do in an emergency | Every year | 42 CFR 483.73(d)(1) |
| Teaching on blood and needle safety | Every year | 29 CFR 1910.1030(g) |
| Teaching on the chemicals they handle | When they start, and again when a new chemical arrives | 29 CFR 1910.1200(h) |
| Twelve hours of teaching for each nurse aide | 12 hours every year, counted from their own start date | F947 · 42 CFR 483.95(g) |
| A written look at how each nurse aide is doing | Every year | F730 · 42 CFR 483.35(d)(7) |
| Teaching on keeping resident information private | When they start, and again whenever your privacy policy changes | 45 CFR 164.530(b)(1) |
Employment paperwork
| What we track | How often | Where the rule comes from |
|---|---|---|
| Form I-9, filled in and kept | Once, in their first three days of work | 8 CFR 274a.2(b)(1)(ii) |
Three more that nearly every building does anyway
These three are not on the tables above, and the reason is narrow: they rest on federal guidance or on a reporting program rather than on a rule with a section number. Almost every nursing home does all three, several state Medicaid programs have made the first one a condition of payment, and a page that called them law would be a page a surveyor would stop trusting.
- A check against the federal list of people barred from Medicare and Medicaid work. Every month. A name that was clear in January can be on it in February, so this is one to run on employees and contractors alike.
- Teaching on the signs of TB. Every year. What the signs are, who is at risk, and what to do about it. Teaching, not a test.
- A flu shot, or their reason for saying no. Every year. Their answer either way, written down. The count of who said yes is what goes in the yearly report.
What you still have to check yourself
Real in Pennsylvania, and not on the tables above, because we could not put a section number next to it without guessing. Guessing at a citation is worse than admitting the gap, because the guess is the thing somebody quotes back.
- The PATCH check through the State Police before somebody starts, plus an FBI check if they have lived in Pennsylvania for less than two years. The Department of Aging publishes the requirement. We could not pin the two-year residency line to a section number, so it is not in the table above.
Where the Pennsylvania rows came from
Read on .
Questions Pennsylvania buildings ask
What does Pennsylvania require in an annual in-service?
28 Pa. Code 201.20 names its own list, which includes fire safety, emergency planning and residents' rights. Two of those overlap what the federal rules already ask for. Fire safety does not, so a building running a federal training calendar straight out of the box is one topic short in Pennsylvania.
Does Pennsylvania require an annual TB test?
No. 28 Pa. Code 201.22 follows the national 2019 approach, which is one test when a person starts and a set of questions after that. Your own infection control plan can ask for more, and it is the plan a surveyor will read.
When does a Pennsylvania nursing home need an FBI check?
When the person has lived in Pennsylvania for less than two years. Otherwise the PATCH check through the State Police is the one. Two years is a shorter window than Ohio's five, so a building near a state line runs into it more often than you would expect.
Does Pennsylvania add nurse aide training hours?
No. The aide hours stay at the federal twelve a year, counted from each person's own hire anniversary. What Pennsylvania adds is topics on the yearly in-service, not a bigger hour count.
Do the Pennsylvania in-service topics apply to everybody?
The yearly in-service under 201.20 is a staff development obligation for the facility, so read it as covering the people it names rather than only the aides. Fire safety and emergency planning in particular are the topics that make no sense limited to clinical staff, because the kitchen and the maintenance shop are where they matter most.
Where to go next
- How Credolex works in a nursing home
- F730: annual in-service hours, the guide behind the tag Pennsylvania leans on
- What New Jersey asks for
- What New York asks for
- What Ohio asks for
- Every state we have read so far