42 CFR 484.80 — Condition of Participation: Home Health Aide Services

What this rule requires your agency to do

• 1Aide supervision must ensure aides furnish care safely and effectively — following the plan of care, maintaining communication with the patient/representative/caregivers, demonstrating competency, complying with infection prevention and control policies, reporting changes in condition, and honoring patient rights; where aide services are provided under arrangement, the HHA remains responsible for the quality of care, supervision, and the aides' training/competency (subd. h).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 2The HHA must supervise aides on the required schedule: for patients also receiving skilled nursing/therapy services, a supervisory assessment by an RN or skilled professional no less than every 14 days (on-site, with no more than one virtual assessment per 60-day episode) plus an annual on-site observation of each aide; for patients not receiving skilled services, an on-site RN visit every 60 days plus a semi-annual on-site observation of each aide; and any noted concern or verified deficiency requires an on-site visit and completion of retraining and a competency evaluation for the deficient and related skills (subd. h).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 3All home health aide services must be provided by qualified aides who have successfully completed one of the specified pathways (a training and competency evaluation program, a competency evaluation program, an approved nurse aide training and competency evaluation program with current good-standing registry listing, or a qualifying state licensure program); an aide with a continuous 24-month lapse in furnishing services for compensation must complete another qualifying program before providing services (subd. a).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 4An individual may furnish home health services only after successfully completing an RN-conducted competency evaluation addressing all required subjects (with specified subjects evaluated by direct observation of the aide with a patient or pseudo-patient); an aide rated "unsatisfactory" in a task may not perform it without direct RN supervision until retrained and re-evaluated, and is not considered to have passed if rated unsatisfactory in more than one required area; documentation must be maintained (subd. c).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 5Each home health aide must receive at least 12 hours of in-service training during each 12-month period, supervised by a registered nurse, with documentation maintained (subd. d).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 6Home health aides must be assigned to a specific patient by an RN or other appropriate skilled professional with written patient care instructions, and may provide only services that are ordered by the physician/allowed practitioner, included in the plan of care, permitted under state law, and consistent with their training; aides must report changes in the patient's condition and complete records per HHA policy (subd. g).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 7An individual furnishing Medicaid personal care aide-only services on behalf of an HHA must meet all qualification standards established by the state before furnishing services and must demonstrate competency in the services the individual is required to furnish (subd. i).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)
• 8Home health aide training must include classroom and supervised practical training totaling at least 75 hours, of which a minimum of 16 hours of classroom training must precede a minimum of 16 hours of supervised practical training, and must address all required subject areas; the HHA must maintain documentation demonstrating compliance (subd. b).(42 CFR 484.80 — Condition of Participation: Home Health Aide Services)