Any individual employed by an agency to provide home health aide services directly or by contract must complete a nurse aide training and competency evaluation program or a competency evaluation program which meets the following:

1. The training program must total at least seventy-five clock hours, with at least sixteen of the seventy-five hours being devoted to classroom training prior to initiating the supervised practical training. At least sixteen hours of the total program hours must be devoted to supervised practical training.

a. The training, including supervised practical training, of home health aides must be performed under the general supervision of a registered nurse who possesses a minimum of two years of nursing experience, at least one year of which must be in the provision of home health care services. Other professionals may be used to provide instruction under the supervision of the qualified registered nurse.

b. The training program must, at a minimum, include the following topics:

(1) Communication skills; (2) Observation, reporting, and documentation of patient status and care or services furnished; (3) Reading and recording of temperature, pulse, and respiration; (4) Basic infection control procedures; (5) Basic elements of body functioning and changes in body function that must be reported to an aide's supervisor; (6) Maintenance of a clean, safe, and healthy environment; (7) Recognizing emergencies and knowledge of emergency procedures; (8) The physical, emotional, and developmental needs of and ways to work with the patients served; (9) Patient rights; (10) Appropriate and safe techniques in personal hygiene and grooming which include: (a) Bed bath; (b) Sponge, tub, or shower bath; (c) Shampoo, sink, tub, or bed; (d) Oral hygiene; and (e) Nail or skin care. (11) Safe transfer techniques and ambulation; (12) Normal range of motion and positioning;

1. (13) Adequate nutrition and fluid intake; and
2. (14) Any other tasks the agency may choose to have the home health aide perform.- c. The agency must maintain sufficient documentation to demonstrate that the requirements for the training of home health aides of this section are met.
3. d. Agencies that have had state or federal enforcement action, other than the citation of deficiencies, filed against them in the past two years are not eligible to operate a home health aide training program.- 2. An individual may provide home health aide services on behalf of the agency only after that individual has successfully completed a competency evaluation that consists of the following:
4. a. The competency evaluation must be conducted by a registered nurse.
5. b. The competency evaluation must address each of the items listed in subdivision b of subsection 1.
   1. (1) The items listed in paragraphs 3, 10, 11, and 12 of subdivision b of subsection 1 must be completed by observation of the aide's performance of the tasks with a patient or other live individual.
   2. (2) All other items listed in subdivision b of subsection 1 can be evaluated through written or oral examination or observation of the aide with a patient.
6. c. A home health aide is not considered to have successfully passed a competency evaluation program if the aide has an unsatisfactory rating in more than one of the required areas.
   1. (1) A home health aide cannot perform any task for which the aide is evaluated to perform unsatisfactorily unless under the direct supervision of a licensed nurse.
   2. (2) The home health aide must receive training in the areas determined unsatisfactory and pass a subsequent evaluation satisfactorily prior to performing the task without supervision.
7. d. The agency must maintain documentation that the competency evaluation requirements of this section have been met by each home health aide.

History: Effective January 1, 1998.

Law Implemented: NDCC 23-17.3-05, 23-17.3-08