Current through Register Vol. 49, No. 13, September 23, 2024
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
