Minnesota Administrative Rules

4668.0100 HOME HEALTH AIDE TASKS.

Subpart 1.

Home health aide tasks.

For a class A or C licensee, a registered nurse may delegate medical or nursing services as tasks or a therapist may assign therapy services as tasks only to a person who satisfies the requirements of subpart 5. These delegated or assigned tasks, as set forth in this part, include home care aide tasks as set forth in part 4668.0110. Class A licensees providing home care aide tasks must satisfy the training and supervision requirements of this part, and not part 4668.0110. These tasks include:

A.

administration of medications, as provided by subpart 2;

B.

performing routine delegated medical or nursing or assigned therapy procedures, as provided by subpart 4, except items C to H;

C.

assisting with body positioning or transfers of clients who are not ambulatory;

D.

feeding of clients who, because of their condition, are at risk of choking;

E.

assistance with bowel and bladder control, devices, and training programs;

F.

assistance with therapeutic or passive range of motion exercises;

G.

providing skin care, including full or partial bathing and foot soaks; and

H.

during episodes of serious disease or acute illness, providing services performed for a client or to assist a client to maintain the hygiene of the client's body and immediate environment, to satisfy nutritional needs, and to assist with the client's mobility, including movement, change of location, and positioning, and bathing, oral hygiene, dressing, hair care, toileting, bedding changes, basic housekeeping, and meal preparation. Oral hygiene means care of teeth, gums, and oral prosthetic devices.

Subp. 2.

Administration of medications.

A person who satisfies the requirements of subpart 5 may administer medications, whether oral, suppository, eye drops, ear drops, inhalant, topical, or administered through a gastrostomy tube, if:

A.

the medications are regularly scheduled;

B.

in the case of pro re nata medications, the administration of the medication is reported to a registered nurse either:

(1)

within 24 hours after its administration; or

(2)

within a time period that is specified by a registered nurse prior to the administration;

C.

prior to the administration, the person is instructed by a registered nurse in the procedures to administer the medications to each client;

D.

a registered nurse specifies, in writing, and documents in the clients' records, the procedures to administer the medications; and

E.

prior to the administration, the person demonstrates to a registered nurse the person's ability to competently follow the procedure.

For purposes of this subpart, "pro re nata medication," commonly called p.r.n. medication, means a medication that is ordered to be administered to or taken by a client as necessary.

Subp. 3.

Limitations on administering medications.

A person who administers medications under subpart 2 may not inject medications into veins, muscle, or skin.

Subp. 4.

Performance of routine procedures.

A person who satisfies the requirements of subpart 5 may perform delegated medical or nursing and assigned therapy procedures, if:

A.

prior to performing the procedures, the person is instructed by a registered nurse or therapist, respectively, in the proper methods to perform the procedures with respect to each client;

B.

a registered nurse or therapist, respectively, specifies, in writing, specific instructions for performing the procedures for each client;

C.

prior to performing the procedures, the person demonstrates to a registered nurse or therapist, respectively, the person's ability to competently follow the procedures; and

D.

the procedures for each client are documented in the clients' records.

Subp. 5.

Qualifications for persons who perform home health aide tasks.

A person may only offer or perform home health aide tasks, or be employed to perform home health aide tasks, if the person has:

A.

successfully completed the training and passed the competency evaluation required by part 4668.0130, subpart 1;

B.

passed the competency evaluation required by part 4668.0130, subpart 3;

C.

successfully completed training in another jurisdiction substantially equivalent to that required by item A;

D.

satisfied the requirements of Medicare for training or competency of home health aides, as provided by Code of Federal Regulations, title 42, section 484.36;

E.

satisfied subitems (1) and (2):

(1)

meets the requirements of title XVIII of the Social Security Act for nursing assistants in nursing facilities certified for participation in the Medicare program, or has successfully completed a nursing assistant training program approved by the state; and

(2)

has had at least 20 hours of supervised practical training or experience performing home health aide tasks in a home setting under the supervision of a registered nurse, or completes the supervised practical training or experience within one month after beginning work performing home health aide tasks, except that a class C licensee must have completed this supervised training or experience before a license will be issued; or

F.

before April 19, 1993, completed a training course of at least 60 hours for home health aides that had been approved by the department.

Subp. 6.

In-service training and demonstration of competence.

For each person who performs home health aide tasks, the licensee must comply with items A to C.

A.

For each 12 months of employment, each person who performs home health aide tasks shall complete at least eight hours of in-service training in topics relevant to the provision of home care services, including that required by part 4668.0065, subpart 3, obtained from the licensee or another source.

B.

Licensees shall retain documentation of satisfying this part and shall provide documentation to persons who have completed the in-service training.

C.

If a person has not performed home health aide tasks for a continuous period of 24 consecutive months, the person must demonstrate to a registered nurse competence in the skills listed in part 4668.0130, subpart 3, item A, subitem (1).

Subp. 7.

Documentation.

Class A licensees shall verify that persons employed or contracted by the licensees to perform home health aide tasks have satisfied the requirements of this part and shall retain documentation in the personnel records. Persons who perform home health aide tasks must provide documentation to the employing or contracting licensees of satisfying this part. Class C licensees shall retain documentation of satisfying this part.

Subp. 8.

Initiation of home health aide tasks.

Prior to the initiation of home health aide tasks, a registered nurse or therapist shall orient each person who is to perform home health aide tasks to each client and to the tasks to be performed.

Subp. 9.

Periodic supervision of home health aide tasks.

After the orientation required by subpart 8, a therapist or a registered nurse shall supervise, or a licensed practical nurse, under the direction of a registered nurse, shall monitor persons who perform home health aide tasks at the client's residence to verify that the work is being performed adequately, to identify problems, and to assess the appropriateness of the care to the client's needs. This supervision or monitoring must be provided no less often than the following schedule:

A.

within 14 days after initiation of home health aide tasks; and

B.

every 14 days thereafter, or more frequently if indicated by a clinical assessment, for home health aide tasks described in subparts 2 to 4; or

C.

every 60 days thereafter, or more frequently if indicated by a clinical assessment, for all home health aide tasks other than those described in subparts 2 to 4.

If monitored by a licensed practical nurse, the client must be supervised at the residence by a registered nurse at least every other visit, and the licensed practical nurse must be under the direction of a registered nurse, according to Minnesota Statutes, sections 148.171 to 148.285.

Statutory Authority:

MS s 144A.45; 144A.46; 144A.47; 144A.48; 144A.752

History:

17 SR 2454; 28 SR 1639

Published Electronically:

July 3, 2013