175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision)

What this rule requires your agency to do

• 1The agency must verify and maintain records of the competency of all home health aides before the aide provides services in a patient's home, with competency evaluated by an RN through observation and written/oral examination; an aide receiving an unsatisfactory on a task must not perform it without direct supervision until retrained and re-evaluated as satisfactory (14-006.04G7a, 14-006.04G7c(2)-(4)).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 2The agency must provide RN-written direction (plan of care/assignment sheet) and RN supervision of home health aides, ensure an RN is available or on call during all hours aide services are provided, and provide four one-hour inservice programs per year with documentation (14-006.04G2, 14-006.04G3).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 3An RN must make an initial evaluation visit and devise a physician-approved written plan of care, review it at least every 62 days, and perform aide-supervision onsite visits (at least once every two weeks for basic therapeutic care, and per the specified intervals for personal care/ADL aide services); discipline-specific services (skilled nursing, PT, OT, speech, respiratory, social work, dialysis, IV therapy) must be provided by qualified licensed professionals per approved plans of care with the stated supervision standards (14-006.04F, 14-006.04G7d, 14-006.04H-N).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 4The agency must maintain a current employment record for each staff person, including position/qualifications/duties, evidence of licensure/certification, performance evaluations within six months of hire and annually thereafter, and post-hire/pre-employment health history screening (14-006.04B).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 5The agency must provide and document initial orientation for new staff (and re-assigned staff) covering job duties, organizational structure, patient rights, care and personnel policies, and abuse/neglect/exploitation reporting requirements; and must provide ongoing and specialized training with records maintained (14-006.04C, 14-006.04D1-D2).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 6The agency must not employ a person with an adverse finding on the Nurse Aide Registry regarding patient abuse, neglect, or misappropriation of patient property (14-006.04A1d).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 7The agency must employ only home health aides qualified under Neb. Rev. Stat. §§ 71-6601 to 71-6615, including completion of a 75-hour aide training course (or an equivalent qualifying pathway) and, for medication aides, listing on the Medication Aide Registry (14-006.04G1, 14-006.04G5).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))
• 8The agency must complete and maintain documentation of pre-employment criminal background and registry checks on each unlicensed direct care staff, checking the Nurse Aide Registry, Adult Protective Services Central Registry, Central Register of Child Protection Cases, and Nebraska State Patrol Sex Offender Registry (14-006.04A1, 14-006.04A1a-b).(175 NAC 14-006.04 — Standards of Operation, Care, and Treatment: Staff Requirements (Employment Eligibility, Background/Registry Checks, Orientation, Training, Home Health Aide Qualifications, Competency, and Supervision))