Credentialing
BEFORE ACTIVATION MAKE SURE TO REVIEW AND VERIFY THE CREDENTIALS PAGE IN CTM
Credentials Page Completed and Verified
• License Verification – Do this before you contact your lead/prospect! Make sure no Disciplinary Action! If there is Disciplinary Action, that’s a red flag, consult with your Supervisor/Manager! “Reqs Complete” should be the First Credential Date.
• Advance Certifications
BLS – Nurses (Required)
CPR and First Aid – CNAs (Required)
Food Handler’s – CNAs (Required)
Pre Service Dementia – CNAs in OR (Required)
Dementia and Mental health Training CNA WA – good to have
Nurse Delegation (Core/Diabetes) – good to have
CPI – For Providers who work/intend in Behavioral Setting
• Human Resources
Driver’s License
SS Number/SS Card
WATCH (WA State Patrol) – Good for a year. In case of a Ding in the BG Check Result, please consult with your Supervisor/Manager. “Reqs Complete” is the date you run the WATCH and expiration date is a year thereafter.
Actriv Badge
Application – Make sure you have sufficient work history for CNAs in WA for OBRA. Watch out for Self – Disclosures of a history in their background/malpractice/etc., please consult with your
Supervisor/Manager if you see self disclosures.
DSHS Authorization Form – Send the Link and sample PDF Form and instruction on how to download/save the PDF Form via Email. We need the PDF Form with the Code at the upper righthand corner. Code is good for 90 days. If Provider has an Alias/Previous Name include this information when you run WATCH Criminal BG Check. In case of self - disclosure of a pending case/prior conviction, consult with your Supervisor/Manager. The said Pending case/prior conviction could be a Disqualifying Negative Action that disqualifies the Provider from
unsupervised direct care of vulnerable adults/minors.
Nursys – Applies to Nurses (LPNs and RNs). This is another Form of License Verification for Nurses that covers all States. If you see a disciplinary action in a license other than in our region (past and present), it’s a red flag! Consult with your Supervisor/Manager. Good for one year. “Reqs Complete” is the date you run the Nursys and expiration date is a year thereafter.
OBRA – Omnibus Budget Reconciliation Act. This applies to CNAs in WA ONLY! When hiring a CNA WA, Recruiters should send an inquiry report to OBRA complete with work history for at least 2 years. OBRA wants to make sure that all CNAs is WA are not only licensed but are
working. OBRA replies within the day from the time you send the inquiry. OBRA Active Status is good for 2 years. Compliance should resubmit/update OBRA inquiry for a Provider before the 2 years expires. If the CNA is separated or terminated or no longer works for Actriv, Compliance should send a report to OBRA RE: separated/terminated Employee (CNA-WA).
Office of the Inspector General (OIG) – Make sure your Provider is not Disqualified/Excluded. Good for one year. “Reqs Complete is the date you run OIG and it expires a year thereafter.
OR CRIMs Authorization Form – This is the ORCHARDS (OR Criminal History & Abuse Records Database System). We send the ORCHARDS
Form to the Provider which should be completed and signed. If Provider has an Alias/Previous Name include this information when you run OR State Police Criminal BG Check. In case of self - disclosure of a pending case/prior conviction, consult with your Supervisor/Manager.
The said Pending case/prior conviction could be a Disqualifying Negative Action that disqualifies the Provider from unsupervised direct care of vulnerable adults/minors.
OSP Background – OR State Police Criminal BG Check. In case of a Ding in the BG Check Result, please consult with your Supervisor/Manager. “Reqs Complete” is the date you run the OSP and expiration date is a year thereafter.
Offer Letter – Sent via Rippling.
Quarterly Evaluation – We need one every 90- days while Provider is employed with Actriv. Four Quarterly Evaluations need to be
completed before scheduling a meeting for Pay increase/s.
System for Award Management (SAM) – Make sure your Provider is not Disqualified/Excluded. Good for one year. “Reqs Complete is the
date you run SAM and it expires a year thereafter.
Sex Offender – Make sure your Provider is not in the Sex Offender List.
Good for one year. “Reqs Complete is the date you run Sex Offender and it expires a year thereafter. There are facilities that also require
that we run a State Sex Offender.
Universal BG Check – This applies to Providers who have multiple licenses and have lived in multiple states or have moved from another
state. Corporate Compliance has access to this. If you need to run a Universal BG Check, send to Corporate Compliance. Good for one year.
“Reqs Complete is the date you run the Universal BG Check and it expires a year thereafter.
Work Authorization - Employment Authorization Document/EAD.
Notice of Receipt of Application for Renewal of EAD provides automatic extension which has been extended to 540 days from the expiration on the card.
Permanent Resident Card
• Medical
Covid Test Results – When necessary and required.
Covid 19 Vaccination Record. Since we no longer accept Covid Vax
Exemptions, Covid Vax Record is required.
Drug Screen – Does not expire. For New Hires, if a Non - Negative shows due to Prescription, ask Provider if we can have a copy of it and make sure Provider knows that we treat it as confidential/sensitive information and will be kept in confidence. For Active Providers, this is done if there is an incident or requested by a facility.
Respirator/Mask Fit Test – Does not expire.
TB/PPD – For New Hires, either, 2 Step TB (good for one year), TB
Chest Xray (good for five years), Quantiferon Gold Plus (Good for one year). For Active Providers, Single Step or either one of the above -
mentioned TB Tests is acceptable.
• Mobile Skills – Self Assessment of the Provider’s skills set. Does not expire.
• Mobile Tests
Comprehensive Core Competency Test – Does not expire. This test includes HiPAA, OSHA, Cultural Competence, Abuse and Neglect. This test is also considered as an acceptable compliance to the Abuse &
Neglect Training required by some facilities.
Coronavirus Covid 19 Training (Federal Requirement).
• Mobile Edocs
Criminal History Disclosure – Make sure no “Yes”/Self Disclosures. If
there is a Self - Disclosure, refer to your Supervisor/Management.
Actriv Handbook Acknowledgment – Does not expire.
Actriv Job Description – Does not expire.
Actriv Hep B – Make sure that if Providers declare that they’ve already had the HepB Series, the year they got it should be indicated in the form. If they DECLINE then make sure they also “initial” the item that says “that by declining the vaccine, they continue to be at risk of acquiring HBV.” If they select to request the series to be administered free of charge, please refer to your Supervisor/Manager. This does not expire.
Actriv New Hire – Does not expire.
Declination of Influenza – If declined, make sure the Provider selects a reason and it should show in the Form. If Provider declares that they’ve had the current Flu Shot done, then please get a copy of the record and upload it. If Provider does not have a copy of the record, then have them complete the form an select “Others” and provide the month and year of their most current flu shot on the blank provided for. Good for one year.
Pre - Hire Packet – Does not expire. This has the Employee Drug Testing Consent Form, The Authorization to Release Information,
Background Check Authorization and Release Form. Please make sure this Packet is signed before you do the drug screening, references call/s, and Criminal BG Check.
Statement of Health – Does not expire. Make sure Provider completes this Form correctly. If there is a “Yes”, an explanation on the blank/s
provided for that will show that there are no complications and Provider is ready and fit to work! There is a reiteration of Hep B series,
make sure the year is provided for as well as the MMR.
TB Questionnaire – If there is a “Yes”, please consult with your Supervisor/Manager. For Providers who submit a TB Chest XRAY, this Questionnaire should be done every year.
Respirator Training Program – Does not expire. Providers are given a reading material (by the system) when completing this Form which will
serve as training for them in relation to the Mask Fit Testing.
Covid 19 Risk Assessment – Does not expire.
OSHA Infor Packet – Does not expire. Make sure Provider completes all pages of this Form.
Gait Belt Agreement – Does not expire. This applies to CNAs only.
Info Page Completed and Verified
• Provider’s Name should be spelled correctly. Capitalize the first letters ONLY.
• Make sure the address indicates the correct zip code otherwise it will affect the Provider’s access to the calendar once they are activated if zip code is incorrect.
• Region should be where they have a License. For dual Licensed Providers who reside in one of the States that they hold a License, make the State which they have a License and where they reside as the “Region” and the other State that the Provider has a License as Shared Region. Remember: Region and Shared Region affect the Provider’s access to query for shifts using the Calendar/App.
• Certification must be properly assigned as it will have an impact on what the system will automatically assign in the Credentials Page. For CNAs particularly, make sure it’s set to CNA/NAC otherwise the system will not assign important items in the Credentials Page like the JD.
• Specialty – Select the appropriate specialty but more importantly if you are hiring a NAR or a CNA that does not have an “Active” Status in OBRA Registry, Specialty should be set to Assisted Living and Behavioral ONLY!
• Verify Emergency Contacts
• If the Provider is referred by someone, make sure to show/indicate that in the info page.
• Years of Experience
• SSN
• DOB
• Hire Date
• Pay rate Match in Rippling
• Under Staffing Notes create a little summary/story about the Provider that will include no. of years of experience, Preferences, when they can start working, current employer, if Provider is in Nursing school, etc.
Pay Page Completed and Verified
• (New) Contracts (Standard, Travel, Covid, Covid & Travel) are added in the pay page and set to enabled.
History Page Completed and Verified
• Work History
• Education
• Professional References at least 2 Supervisors/Managers
Rippling
• Offer Letter Accepted
• I-9 Verified Correctly
• E-Verify is automatically done by Rippling
• Child supporting is done by Rippling
• Verify Pay matches CTM
Final Step: Activate and Set to Worker (Info Page CTM)
