(a)

1. (1) Hospice aide services shall be available and adequate in frequency to meet the needs of the patient.

2. (2) A hospice aide is a person who meets at least one (1) of the following requirements:

   1. (A)

(i) Has at least one (1) year of experience in an institutional setting (home health agency, hospital, hospice, or long-term care facility).

1. (ii) This experience shall be verified by a previous employer;

   1. (B)

      1. (i) Has a certificate issued by the State of Arkansas for work in long-term care facilities.
      2. (ii) A copy of this certificate shall be available for review; or

   2. (C)

      1. (i) Has completed a forty-hour aide training course that meets requirements set forth in this part.
      2. (ii) In lieu of the requirement for completion of the hospice aide training course, a nursing student may qualify as a hospice aide by submitting documentation from the director of programs and/or the dean of a school of nursing that reflects the nursing student has demonstrated competency in providing basic nursing care in accordance with the school’s curriculum.

(b)

1. (1) Any aide who has not been employed as an aide in an institutional setting in the last twenty-four (24) months shall be observed by a registered nurse performing the skills required to care for a patient including:

   1. (A) Bathing;
   2. (B) Transferring;
   3. (C) Range of motion exercises;
   4. (D) Toileting;
   5. (E) Dressing;
   6. (F) Nail care; and
   7. (G) Skin care.
2. (2) The registered nurse shall observe the aide performing these skills on a person.

3. (3) Any other tasks or duties for which the aide may be responsible shall be evaluated by:

   1. (A) Written test;
   2. (B) Oral test; or
   3. (C) Observation.

4. (4) There shall be documentation by the agency to show evidence of this evaluation.

   1. (c)
5. (1) A registered nurse shall complete an aide assignment sheet for each patient receiving aide services.

6. (2) Each aide caring for the patient shall:

   1. (A) Receive a copy of the assignment sheet; and
   2. (B) Provide services as assigned.

7. (3) A copy of the assignment sheet shall be left in the patient’s:

   1. (A) Home; and

   2. (B) Medical record.

      1. (d) Each aide assignment sheet shall be individualized and specific according to the patient’s needs.

(e) The registered nurse shall conduct a visit to the patient’s place of residence at least every two (2) weeks to:

1. (1) Supervise the aide; and
2. (2) Update the aide assignment sheet.

(f)

1. (1) In no event shall a hospice aide receive or write verbal orders from a physician.

2. (2) A hospice aide shall not perform any:

   1. (A) Sterile procedure; or
   2. (B) Procedure requiring the application of medication requiring a prescription.

(g)

1. (1) Upon a request by a patient and/or family member for assistance with medications, the registered nurse may assign a hospice aide to assist with oral medications that are normally self-administered.

2. (2) Assistance shall be limited to:

   1. (A) Reminding a patient to take a medication at a prescribed time;
   2. (B) Opening and closing a medication container; and
   3. (C) Returning a medication to a proper storage area.

(h) Except as otherwise provided in this part, duties of the hospice aide may include:

1. (1)

   1. (A) Personal care.
   2. (B) Example. Bathing, grooming, feeding, ambulation, exercise, oral hygiene, and skin care, etc.;
2. (2) Assistance with medications ordinarily self-administered as assigned;
3. (3) Household services essential to health care in the home;
4. (4) Completion of records and reporting to appropriate supervisor;
5. (5) Taking and charting vital signs;
6. (6) Extension of therapy services; and

7. (7) Any duty consistent with the Arkansas State Board of Nursing Rules, 17 CAR pt. 120, on delegation of duties may be assigned by a registered nurse to meet the needs of the patient.

   1. (i)
8. (1) If the training is provided by the agency, the training program for hospice aides shall be conducted under the supervision of a registered nurse.

9. (2) The training program may contain other aspects of learning, but shall include the following:

   1. (A) A minimum of forty (40) hours of classroom and clinical instruction related particularly to the hospice setting;
   2. (B) Written course objectives with expected outcomes and methods of evaluation;

   3. (C) An assessment that the student knows how to:

      1. (i) Read;
      2. (ii) Write; and
      3. (iii) Carry out directions; and

   4. (D) Orientation to:

      1. (i) Hospice philosophy;
      2. (ii) Bathing;
      3. (iii) Ambulation and exercise;
      4. (iv) Personal grooming;
      5. (v) Principles of nutrition and meal preparation;
      6. (vi) Health conditions;
      7. (vii) Developmental stages and mental status;
      8. (viii) Household services essential to health care at home;
      9. (ix) Assistance with medication;
      10. (x) Safety in the home;
      11. (xi) Completion of appropriate records;
      12. (xii) Reporting changes to appropriate supervisor; and
      13. (xiii) At least four (4) hours covering Alzheimer’s disease and dementia to include:

(b) (b) Problem solving with challenging behaviors;

1. (c) (c) Assistance with daily living; and

   1. (d) (d) Explanation of Alzheimer's disease and other dementias.

(j)

1. (1) Aides shall receive a minimum of twelve (12) hours in-service training per twelve (12) months.
2. (2) The in-services provided shall address areas that directly relate to the patient care aspects of the aides’ job.