Current through Reg. 49, No. 38; September 20, 2024
(a) A
home health aide may be used by an agency providing licensed home health
services if the aide meets one of the following requirements:
(1) a minimum of one year of full-time
experience in direct client care in an institutional setting (hospital or
nursing facility);
(2) one year of
full-time experience within the last five years in direct client care in an
agency setting;
(3) satisfactorily
completed a training and competency evaluation program that complies with the
requirements of this section;
(4)
satisfactorily completed a competency evaluation program that complies with the
requirements of this section;
(5)
submitted to the agency documentation from the director of programs or the dean
of a school of nursing that states that the individual is a nursing student who
has demonstrated competency in providing basic nursing skills in accordance
with the school's curriculum; or
(6) listed on the HHSC nurse aide registry
(NAR) with no finding against the aide relating to client abuse or neglect or
misappropriation of client property.
(b) A home health aide must have provided
home health services within the previous 24 months to qualify under subsection
(a)(3) or (4) of this section.
(c)
Assignment, delegation, and supervision of services provided by home health
aides must be performed in accordance with rules in this chapter governing the
agency's license category.
(d) The
training portion of a training and competency evaluation program for home
health aides must be conducted by or under the general supervision of an RN 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. The training program may
contain other aspects of learning, but must contain the following:
(1) a minimum of 75 hours as follows:
(A) an appropriate number of hours of
classroom instruction; and
(B) a
minimum of 16 hours of clinical experience, which will include in-home training
and must be conducted in a home, hospital, nursing home, or
laboratory;
(2)
completion of at least 16 hours of classroom training before a home health aide
begins clinical experience working directly with clients under the supervision
of qualified instructors;
(3) if
LVN instructors are used for the training portion of the program, the following
qualifications and supervisory requirements apply:
(A) an LVN may provide the home health aide
classroom training under the supervision of an RN who has two years of nursing
experience, at least one year of which must be in the provision of home health
care;
(B) LVNs, as well as RNs, may
supervise home health aide candidates in the course of the clinical experience;
and
(C) an RN must maintain overall
responsibility for the training and supervision of all home health aide
training students; and
(4) an assessment that the student knows how
to read and write English and carry out directions.
(e) The classroom instruction and clinical
experience content of the training portion of a training and competency
evaluation program must include, but is not limited to:
(1) communication skills;
(2) observation, reporting, and documentation
of a client's status and the care or service furnished;
(3) reading and recording temperature, pulse,
and respiration;
(4) basic
infection control procedures and instruction on universal
precautions;
(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
populations served by the agency including the need for respect for the client
and his or her privacy and property;
(9) appropriate and safe techniques in
personal hygiene and grooming that include:
(A) bed bath;
(B) sponge, tub, or shower bath;
(C) shampoo, sink, tub, or bed;
(D) nail and skin care;
(E) oral hygiene; and
(F) toileting and elimination;
(10) safe transfer techniques and
ambulation;
(11) normal range of
motion and positioning;
(12)
adequate nutrition and fluid intake;
(13) any other task the agency may choose to
have the home health aide perform in accordance with § 558.298 of this
chapter (relating to Delegation of Nursing Tasks by Registered Professional
Nurses to Unlicensed Personnel and Tasks Not Requiring Delegation);
and
(14) the rights of the
elderly.
(f) This section
addresses the requirements for the competency evaluation program or the
competency evaluation portion of a training and competency evaluation program.
(1) The competency evaluation must be
performed by an RN.
(2) The
competency evaluation must address each of the subjects listed in subsection
(e)(2) - (13) of this section.
(3)
Each of the areas described in subsection (e)(3) and (9) - (11) of this section
must be evaluated by observation of the home health aide's performance of the
task with a client or person.
(4)
Each of the areas described in subsection (e)(2), (4) - (8), (12), and (13) of
this section may be evaluated through written examination, oral examination, or
by observation of a home health aide with a client.
(5) A home health aide is not considered to
have successfully completed a competency evaluation if the aide has an
unsatisfactory rating in more than one of the areas described in subsection
(e)(2) - (13) of this section.
(6)
If an aide receives an unsatisfactory rating, the aide must not perform that
task without direct supervision by an RN or LVN, until the aide receives
training in the task for which he or she was evaluated as unsatisfactory and
successfully completes a subsequent competency evaluation with a satisfactory
rating on the task.
(7) If an
individual fails to complete the competency evaluation satisfactorily, the
individual must be advised of the areas in which he or she is
inadequate.
(g) If a
person, who is not an agency licensed under this section, desires to implement
a home health aide training and competency evaluation program or a competency
evaluation program, the person must meet the requirements of this section in
the same manner as set forth for an agency.
