25CRW018_-_Exhibit_A-1.pdf

California Department of Veterans Affairs Agreement Number: 25CRW018 Exhibit A-1 – Service Specification TBD

TEMPORARY/RELIEF REGISTERED DIETICIAN, FOOD SERVICE TECHNICIAN AND COOK SPECIALIST

SERVICES

1. PROVIDER’S QUALIFICATIONS

A. Providers assigned to CalVet must have the minimum experience/education outlined below.

1. Registered Dietician:

a. Minimum of 12 continuous months of experience within the last three (3) years performing services similar in scope to those defined herein, in a public or private institution is preferred.

b. Education: graduation from an accredited institution providing an education degree focused on nutrition and dietetics such as a bachelor's degree with course work approved by the Academy of Nutrition and Dietetics' Accreditation Council for Education in Nutrition and Dietetics.

c. Knowledge of: principles, practices, and theories of nutrition and dietetics, including medical nutrition therapy; methods of planning, preparing, and serving food to a large number of persons;

and the special dietary requirements of mentally or developmentally disabled persons, patients, pediatric and geriatric populations, and other client or patient groups.

d. Ability to: apply the principles and practices of nutrition and dietetics, including medical nutrition therapy; assess nutrition status and develop nutrition care plans; communicate nutrition concerns and recommendations with the interdisciplinary team; and analyze situations accurately and adopt an effective course of action.

e. Sympathetic understanding of and willingness to work with the client or patient population of a

State institution; possess good personal hygiene; flexible; able to work well independently; able to work cooperatively within a team; and freedom from communicable diseases.

f. Demonstrate experience with Minimum Data Set, Care Plans, and electronic charting.

2. Food Service Technician:

a. Experience: six months of experience in an institution, hotel, or restaurant, serving, cleaning food service areas, or assisting with the preparation and service of foods and beverages. (Completion of the eighth grade may be substituted for the required experience.)

b. Knowledge of: methods of cleaning and preparing foods for cooking and storing food; proper methods of arranging dining room furniture, setting tables, and serving meals; various types of food service utensils and equipment and their uses; methods of cleaning and maintaining food service areas, utensils, and equipment; sanitation and safety measures in food service areas;

general pantry work.

c. Ability to: portion servings; follow directions and keep simple records; communicate at a level appropriate to the classification.

d. Sympathetic understanding of and willingness to work with the resident population of a State institution; personal cleanliness, good sense of smell and taste; and freedom from communicable disease.

3. Cook Specialist:

a. Experience: One year of experience personally preparing and cooking various food items in a restaurant, fast food outlet, or any other business with a food service operation.

b. Knowledge of: Principles, procedures, and equipment used in the storage, care, preparation, cooking, and dispensing of food in large quantities; kitchen sanitation and safety measures used in the operation, cleaning, and care of utensils, equipment, and work areas; food handling sanitation; food accounting and keeping records and preparing reports.

c. Ability to: Prepare and cook all food groups and use appropriate equipment; prepare and follow menus, recipes, and formulas; determine food quantities necessary for groups pf varying size;

follow directions; keep records; analyze situations accurately and adopt an effective course of action.

d. Sympathetic understanding of and willingness to work with the client or patient population of a

State institution; possess good personal hygiene; flexible; able to work well independently; able to work cooperatively within a team; and freedom from communicable diseases.

B. All Providers must have the required licenses, permits, and/or certifications noted herein. (Refer to Exhibit

A-1, Section 2 – Licenses, Permits, and Certification Requirements for details.)

C. Resident health care is of paramount importance. Accuracy in communications is critical to ensure timely, correct care is provided. Therefore, any Provider(s) providing services through this Agreement must be able to communicate effectively with CalVet.

D. The Registered Dietician must have a Medicare NPI number and a Medicare billing number, or be willing to complete the necessary paperwork to perform Medicare billing.

E. Any Provider(s) who fails to meet the minimum qualifications shall not be permitted to perform service. The Home’s Contract Manager, or designee, shall state in writing the reason(s) the Provider does not meet minimum qualifications. After notification of failure to meet minimum qualifications has been provided, CalVet shall not pay the Contractor for additional hours worked by the Provider identified as not meeting the minimum qualifications.

2. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, Contractor shall:

A. Ensure that each Provider shall possess and maintain all current and valid licenses, permits, and certifications throughout the term of this Agreement for each classification noted below:

1. Registered Dietician:

a. Required: current and valid license issued by the Commission on Dietetic Registration of the American Dietetic Association in order to practice Dietetics in the State of California.

b. Provider must be linked to Medicare, MediCal / DentiCal, and all other applicable insurance vendors.

B. Provide copies of any required license(s), permits, and/or certification(s) for each Provider to the Home’s

Contract Manager, or designee, to be kept on file at the Home throughout the term of this Agreement.

Contractor shall ensure that all required licenses, permits, certifications, and any other requirements outlined herein are current and in effect at all times during the term of this Agreement.

C. Provide current/renewed license(s), permit(s) and/or certification(s) to CalVet not less than thirty (30) calendar days prior to their expiration. If, during the course of this Agreement, any of the licenses and/or requirements are found to be inactive or not in compliance, CalVet may withhold payment for services rendered during the expiration period and/or immediately terminate this Agreement.

D. Assume responsibility for verifying, through the appropriate licensing boards, that no current or unresolved adverse actions have been taken by the State licensing authorities against any Provider(s) assigned to

CalVet, and that all licenses are active and void of misconduct. CalVet may, at its discretion, verify the current status of Provider(s) assigned.

E. Maintain current Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS) certification for each

Provider at Contractor’s expense.

3. PROVIDER’S RESPONSIBILITIES

Under the direction of the Contract Manager, or designee, Provider shall provide services as permitted within the scope of practice for Registered Dietician and Food Service Technician Services in accordance with CalVet /Home policies and procedures.

A. Duties/Responsibilities shall include, but are not limited to:

1. The Registered Dietician shall:

a. Assess the nutritional needs of residents at the Home’s Skilled Nursing Facility (SNF) and the

Residential Care Facilities for the Elderly (RCFE) units upon resident admission and quarterly and as identified when a change in condition or change in level of care occurs. Staff shall develop systems for Individual Nutritional Assessments and quality assurance of nutritional care in accordance with the most current regulations, Clinical Records guidelines and professional dietetic practices.

b. Plan and assess regular and special therapeutic diets for nutritional adequacy for residents’ specific needs. This will include review of menus, diet spreadsheets, monitoring of tray line/distribution of food, food and supplies stock, resident education.

c. Interpret Physician orders for special diets and prepare chart documentation/reports as required.

This will include the daily meals and/or nutritional snacks as ordered. Evaluate resident modified diet acceptance; provides consultation for all technical aspects of preparation, service and interpretation of requirements for modified diets.

d. Monitor monthly, weekly, and daily weights, providing medically approved interventions nutritional alerts, and goal-oriented care plans. This will include working as a member of the Interdisciplinary Team (IDT) to educate and promote a team-oriented process for identifying issues, setting approaches, and defining time-oriented guidelines for obtaining identified goals.

e. Attend and participate in IDT meetings. Participate in department meetings, home committees, review /revision of diet manual, formulation of policies and procedures, and development and accomplishment of goals and objectives of the department.

f. Monitor therapeutic diets for conformance to diet orders and quality standards; utilize computerized database for resident meal planning, recipe, and nutrition analysis; maintain nutrition information in the Geri-Menu; receive diet order slips from fax, phone or computer in the kitchen office; process diet orders and review for accuracy; request clarification from the Dietitians and Unit staff. Enter diet order information in the Geri-Menu computer menu system as needed;

update daily preference and substitution lists; verify and/or correct Geri-Menu resident profile information; prepare and organize tray tickets.

g. Perform nutrition assessments for all assigned residents within specified time frames. Provides follow-up care as needed according to nutritional risk, nutrition care plan (NCP), and IDT meeting.

Identifies risk factors and nutrition-related problems, coordinates MNT for residents, communicates recommendations to appropriate health care team members and monitors response to plan of care. Accepts or transmits verbal or electronic orders from physicians, orders medical laboratory tests consistent with established protocols to implement MNT.

h. Monitor compliance of federal/state regulations, complete meal observations, monitor accuracy of tray assembly, and other quality assurance monitors as assigned to evaluate effectiveness of resident nutritional care and food service. Communicates with appropriate staff any problems, changes or recommendations found through meal observations; prepares meal patterns for complicated special diets as needed.

i. Provide billable Medical Nutrition Therapy, as required, in order to complete Medicare billing.

j. Learn Medicare billing processes applicable to Registered Dietician Services to aid the Home in submitting claims for reimbursement to Medicare for services provided. Provider shall complete appropriate charge slips for all resident visits in order for Veterans Homes to be reimbursed for services provided.

k. Provide nutrition counseling, diet intervention, and resident education regarding disease/disability management, food-medication interactions, weight management, diabetes management, health promotion, wellness and other education as needed. Provide In-Service Training for staff as needed, and supervised practice experience for dietetic interns as applicable.

l. Fulfill dietary consults as ordered within timelines per policy for all Veterans Home units. Consults may include, but are not limited to:

i. Special diets

ii. Weight variance

iii. Skin issues

iv. Tube feeders

v. Resident preferences

vi. Other needs as identified by IDT members

m. Participate in the following meetings and / or committees as requested to include, but not limited to, the following:

i. Health & Safety

ii. QA Committee

iii. Inter-Disciplinary Team

iv. Weight Variance

v. Medicare triple check

vi. Food service meetings

n. Remain available for individual resident consultations as needed.

o. Interpret physician orders and prepare chart documentation/reports as required.

p. Inform or consult with the Contract Manager or designee regarding cases or situations of an unusual administrative or clinical nature.

2. The Food Service Technician I. shall:

a. Provide food preparation and waited meal services three (3) times a day, in accordance with 22CCR, §72325-72345, Departmental Policies and Procedures related to food handling and sanitation regulations.

b. Provide meals for employees, guests, and catered events; sanitation and cleaning, food and supply purchasing, and nutrition care support.

c. Assist in food service and related work in the kitchen, dining room and the facility; read menus for regular and modified therapeutic diets.

d. Assist in preparing and dispensing food in the proper portions for tray line and in the dining room;

load, transport, store and deliver food, supplies and equipment.

e. Set up assigned stations and salad bars with required serving equipment and utensils; replenish stations as needed; relieve and serve food from kitchen, including the preparation of beverages, desserts and salads.

f. Review and assist in putting away supplies.

g. Assist members at meal time.

h. Maintain proper sanitation and temperatures.

i. Perform simple cooking tasks (i.e. toasting bread, mixing batters, operating the grill).

j. Deliver and pick up meal carts.

k. Provide and replenish snacks and condiments.

l. Wash dishes, pots, pans, meal carts, dishwasher and disposal, and clean floors in related areas;

operate dish washing machines and other culinary equipment.

m. Clean and maintain utensils, equipment and work area; clean and wipe interior and exterior of all equipment; properly dispose of items in appropriate bins.

n. Participate in regular monthly staff meetings; assist co-workers with any special clean up or extra jobs as related. May be required to participate in special events as they pertain to the Dietetics Department; may act in the absence of Food Service Technician II as required.

3. The Cook Specialist shall:

a. Prepare and cook a variety of foods for all meals, following standardized recipes and methods of preparation.

b. May serve meals on the tray line or in the cafeteria as needed. Provide instruction and training to food service staff and Member Helpers.

c. Follow the work assignment schedule.

d. Check food items for color, appearance and taste to ensure that food quality is of the highest standard.

e. May assist with recipe development for the menus.

f. Portion food in correct amounts per meal orders.

g. Read and follow posted menus for regular and modified therapeutic diets. Comply with all applicable local, state, and federal food handling and food safety regulations.

h. In conjunction with designated food service staff and Member Helpers, clean and maintain culinary utensils, equipment, and work areas. Follow the cleaning schedule; maintain safety and sanitation standards. Report repair issues and maintenance needs to the supervisor.

i. In a lead capacity, assist with the supervision of food preparation and report on progress to the supervisor. In the absence of the Supervising Cook, act as lead person.

j. Requisition, receive, inspect, store, and inventory supplies, as required. Keep records and prepare reports.

k. Determine food quantities necessary for groups of varying sizes; assist with special resident meals and facility caterings as necessary. Attend meetings and in-service training as required.

B. Provider shall wear an identification badge which includes the name of the Contractor, the Provider’s name, and a photo ID. This badge shall be worn above the waist at all times while on grounds of the Home.

C. Provider shall ensure resident medical record information is maintained as “CONFIDENTIAL” and shall be held in trust and confidence. Information shall be used only for the purposes contemplated under this contract.

D. Provider shall obtain the approval and authorization from the primary care physician through the Contract

Manager, or designee, prior to referring resident to other health care/medical vendors/contractors.

Referral shall be made only to those health care/medical vendors/contractors set forth on the Home’s health care/medical vendor/contract list.

E. Prior Authorization Documentation shall include, but is not limited to the following:

1. Veterans Home rehabilitation referral process.

2. Resident progress notes/summary pertinent to reason for referral.

F. Equipment and/or supplies owned or customarily stocked by the Home and which are necessary for therapeutic services may be used by the Provider. If the lack of equipment and/or supplies creates a limitation to services requested, the Provider shall make a recommendation to the Contract Manager, or designee, identifying equipment or supplies necessary for treatment. The Provider will not procure equipment or supplies and expect reimbursement from the Home/CalVet.

4. PHYSICAL AND MENTAL REQUIREMENTS OF ESSENTIAL FUNCTIONS

A. Registered Dietician

Activity Not Required

Less than 25%

25% to 49%

50% to 74%

75% or More

VISION: Review charts and electronic communications;

assess resident’s physical appearance. X

HEARING: Answer telephone; communicate with residents, staff and visitors. X

SPEAKING: Communicate with staff, residents and the public in person and via telephone; interact in meetings. X

WALKING: Within the home to various unites; obtaining charts, interview residents, family, staff and visitors. X

SITTING: Work station; attend meetings; training. X STANDING: Use the copy machine; talk with others at the nursing stations. X

BALANCING: X

CONCENTRATING: During nutrition assessments, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation.

X

COMPREHENSION: Understand resident needs; laws, rules, regulations, policies, procedures; content of meetings, training, and work discussions.

X

WORKING INDEPENDENTLY: Able to work independently. X

LIFTING UP TO 10 LBS: X

LIFTING 10 – 25 LBS: X

LIFTING 25 – 50 LBS: X

FINGERING: Push telephone buttons, calculator keys, and computer keyboard. X

REACHING: Reach for charts; answer telephone; use a mouse; retrieve documents from the printer. X

CARRYING: Carry charts or binder. X CLIMBING: Stairs. X BENDING AT WAIST: Use copier; access low file drawers. X KNEELING: Access low file drawers. X PUSHING OR PULLING: Open and close file drawers. X HANDLING: Charts; papers. X DRIVING: Special events. X OPERATING EQUIPMENT: Computer, copier, telephone, printer, fax machine. X

WORKING INDOORS: Mainly inside the building. X WORKING OUTDOORS: Walk to domiciliary and other areas of the campus; special events. X

WORKING IN CONFINED SPACE: Small office, storage room, supply room, etc. X

B. Food Service Technician I.

Activity Not Required

Less than 25%

25% to 49%

50% to 74%

75% or More

VISION: Review charts and electronic communications;

assess resident’s physical appearance. X

HEARING: Answer telephone; communicate with residents, staff and visitors. X

SPEAKING: Communicate with staff, residents and the public in person and via telephone; interact in meetings. X

WALKING: Within the home to various unites; obtaining charts, interview residents, family, staff and visitors. X

SITTING: Work station; attend meetings; training. X STANDING: Use the copy machine; talk with others at the nursing stations. X

BALANCING: X

CONCENTRATING: During nutrition assessments, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation.

X

COMPREHENSION: Understand resident needs; laws, rules, regulations, policies, procedures; content of meetings, training, and work discussions.

X

WORKING INDEPENDENTLY: Able to work independently. X

LIFTING UP TO 10 LBS: X

LIFTING 10 – 25 LBS: X

LIFTING 25 – 50 LBS: X

FINGERING: Push telephone buttons, calculator keys, and computer keyboard. X

REACHING: Reach for charts; answer telephone; use a mouse; retrieve documents from the printer. X

CARRYING: Carry charts or binder. X CLIMBING: Stairs. X BENDING AT WAIST: Use copier; access low file drawers. X KNEELING: Access low file drawers. X PUSHING OR PULLING: Open and close file drawers. X HANDLING: Charts; papers. X DRIVING: Special events. X OPERATING EQUIPMENT: Computer, copier, telephone, printer, fax machine. X

WORKING INDOORS: Mainly inside the building. X WORKING OUTDOORS: Walk to domiciliary and other areas of the campus; special events. X

WORKING IN CONFINED SPACE: Small office, storage room, supply room, etc. X

C. Cook Specialist