| (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.
|
| Source Note: The provisions of this §558.701 adopted to be effective February 1, 2002, 26 TexReg 9159; amended to be effective June 29, 2003, 28 TexReg 4931; amended to be effective April 1, 2004, 29 TexReg 2383; transferred effective May 1, 2019, as published in the April 12, 2019 issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427 |
