Minnesota Administrative Rules

4664.0260 HOME HEALTH AIDE SERVICES.

Subpart 1.

Home health aide services.

A hospice provider must ensure that home health aide services are available and adequate in frequency to meet the needs of the hospice patient.

Subp. 2.

Competence.

A hospice provider must ensure that persons who perform home health aide services are competent in those services.

Subp. 3.

Delegated home health aide services.

Home health aide services are delegated nursing services or assigned physical therapy services under the direction and supervision of a registered nurse or physical therapist. A registered nurse may delegate nursing services or a physical therapist may assign therapy services only to a home health aide who possesses the knowledge and skills consistent with the complexity of the nursing or physical therapy service being delegated or assigned and only according to Minnesota Statutes, sections 148.171 to 148.285 or 148.65 to 148.78, respectively. The licensee must establish and implement policies to communicate up-to-date information to the registered nurse or physical therapist regarding the current home health aides and their training and qualifications, so the registered nurse or physical therapist has sufficient information to determine the appropriateness of delegating or assigning home health aide services.

Subp. 4.

Supervision.

A hospice provider must ensure that the home health aide services are supervised to verify that the services are adequately provided, identify problems, and assess the appropriateness to the patient needs. The hospice provider must ensure that a registered nurse or physical therapist visits the hospice patient's home site at least every two weeks or more frequently based on the plan of care. The home health aide may or may not be present at the time of the supervisory visit.

Subp. 5.

Written instructions.

A hospice provider must ensure that a registered nurse or physical therapist prepares written instructions for hospice patient care to be performed by a home health aide. The hospice provider must ensure that the registered nurse or physical therapist orients each home health aide to each hospice patient for the services to be performed.

Subp. 6.

Qualifications.

A hospice provider must ensure that persons who perform home health aide services:

A.

successfully complete 75 hours of training, as described in subpart 7, and a competency evaluation, as described in subpart 8; or

B.

successfully complete a competency evaluation, as described in subpart 8.

Subp. 7.

Training.

A.

If a hospice provider provides training for persons to perform home health aide services, the training must meet the requirements in this subpart.

B.

The home health aide training must combine classroom and supervised practical training totaling at least 75 hours, with at least 16 hours devoted to supervised practical training. The individual being trained must complete at least 16 hours of classroom training provided by a registered nurse before beginning the supervised practical training. "Supervised practical training" as used in this subpart means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual.

C.

The training of home health aides and the supervised practical portion of the training must be performed by or 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. Other individuals may provide instruction under the supervision of the qualified registered nurse. A mannequin may be used for training.

D.

Classroom and supervised practical training shall be based on an instruction plan that includes learning objectives, clinical content, and minimum acceptable performance standards.

Subp. 8.

Competency evaluation.

A hospice provider must ensure that a home health aide competency evaluation:

A.

is performed by a registered nurse;

B.

addresses each of the following subject areas:

(1)

communication skills;

(2)

observation, reporting, and documentation of patient status and the care or service furnished;

(3)

basic infection control procedures;

(4)

basic elements of body functioning and changes in body function that must be reported to an aide's supervisor;

(5)

maintenance of a clean, safe, and healthy environment;

(6)

recognizing emergencies and knowledge of emergency procedures;

(7)

physical, emotional, and developmental needs of and ways to work with the populations served by the hospice provider, including the need for respect for the patient, the patient's privacy, and the patient's property;

(8)

adequate nutrition and fluid intake;

(9)

reading and recording temperature, pulse, and respiration;

(10)

appropriate and safe techniques in personal hygiene and grooming, including bed bath; sponge, tub, or shower bath; shampoo in sink, tub, or bed; nail and skin care; oral hygiene; toileting; and elimination;

(11)

safe transfer techniques and ambulation;

(12)

normal range of motion and positioning; and

(13)

any other task that the registered nurse may choose to have the home health aide perform, including medication reminders, assistance with self-administration of medications, and administration of medications;

C.

uses evaluation after observation of the tasks identified in item B, subitems (9) to (12). Subject areas identified in item B, subitems (1) to (8) and (13), must be evaluated through written examination, oral examination, or after observation of the home health aide with a hospice patient. Assistance with self-administration of medications, administration of medications, and other nursing procedures must be competency evaluated according to part 4664.0265; and

D.

determines that a home health aide who is evaluated as satisfactory in all subject areas except one is considered competent. The aide is not allowed to perform the task in which the aide is evaluated as unsatisfactory, except under direct supervision of a registered nurse.

Subp. 9.

Training and competency.

A.

For each person who performs home health aide services, a licensee must comply with this subpart.

B.

For each 12 months of employment or contracted services, a person who performs home health aide services must complete at least 12 hours of in-service training in topics relevant to the provision of hospice services.

C.

A hospice provider must retain documentation that it has complied with this part and must provide documentation to persons who have completed the in-service training.

D.

If a person has not performed home health aide services for a continuous period of 24 consecutive months, the person must demonstrate to a registered nurse competence in the skills listed in subpart 8, item B.

Subp. 10.

Documentation.

A hospice provider must verify that persons employed or contracted to perform home health aide services have satisfied the requirements of this part and must retain documentation in the personnel records.

Subp. 11.

Fines.

For a violation of the following subparts, the stated fine shall be assessed:

A.

subpart 1, $300;

B.

subpart 2, $300;

C.

subpart 3, $350;

D.

subpart 4, $350;

E.

subpart 5, $300;

F.

subpart 6, $300;

G.

subpart 7, $300;

H.

subpart 8, $300;

I.

subpart 9, $300; and

J.

subpart 10, $50.

Statutory Authority:

MS s 144A.752

History:

28 SR 1639

Published Electronically:

October 11, 2007