Bj 10-11 Property Use for Emergency Berm Project for Deepwater Horizon Oil Spill Response 1412

§10003. State Registration Requirements

A. Effective August 15, 2010, any nurse aide seeking employment with a nursing facility or hospital-based SNF shall be required to meet state registration and certification requirements.

B. The department will provide automatic registration of all certified nurse aides in the state, who according to the Louisiana Nurse Aide Registry, are employed with or contracted by a nursing facility or hospital-based skilled nursing facility (SNF) on August 15, 2010.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

Subchapter B. Training and Competency Requirements

§10013. Trainee Responsibilities

A. Each nurse aide trainee must be at least 17 years old.

B. Each nurse aide trainee should be clearly identified as a trainee during all clinical portions of the training. Identification should be recognizable to residents, family members, visitors and staff.

C. Trainees must take the competency evaluation (through skills demonstration and either written or oral examination) within 30 days after completion of the training program.

1. Trainees will be provided with a maximum of three opportunities within one year following completion of the training program to successfully complete the competency evaluation program.

D. Registered nurses (RNs) and licensed practical nurses (LPNs) who have completed online courses are required to provide an official transcript to determine eligibility to test.

E. If trained in another state, the trainee must test and certify to the registry in that state before transferring to Louisiana, or retrain and test in Louisiana.

F. Military personnel must provide a copy of their military transcript and other documentation needed to determine eligibility to certify to the registry.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2075 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

§10015. Training Curriculum

A. Each nurse aide training program shall provide all trainees with an orientation of the clinical training site that is a minimum of four hours long. This orientation is in addition to the total hours approved for the training program/school. The orientation shall include, but is not limited to:

1. - 5. …

B. Training Curriculum

1. Providers applying to have a training program after the effective date of this Rule must use one of the two state-approved curriculums.

a. …

2. Each additional unit objective added to the approved curriculum, above the minimum 80 hours, must be behaviorally-stated for each topic of instruction. Each objective must state performance criteria which are measurable and will serve as the basis for the competency evaluation.

a. The unit objectives will be reviewed with the trainees at the beginning of each unit so each trainee will know what is expected of him/her in each part of the training.

c. Any additional topics of instruction will require review and approval from the department.

C. Curriculum Goals and Content

1. - 3. …

D. The training program must be conducted to ensure that each nurse aide, at a minimum, is able to demonstrate competencies in the following areas:

1. basic nursing skills including, but not limited to:

a. - i. …

j. attaining and maintaining certification in cardiopulmonary resuscitation;

1.k. - 5.h. …

E. Program Approval

1. To get a nurse aide training program approved, the facility or school must submit to the department the application, completed in its entirety, which denotes the state-approved curriculum that will be used and all required documentation stipulated in the Nurse Aide Training packet.

a. - c. Repealed.

2. All schools applying for approval must identify the physical location used for classroom instruction and for clinical experience. Non-facility based programs must also submit clinical contracts.

3. Approval to provide nurse aide training is granted specifically for the provider who submitted the application. There is no provision for subcontracting the training program.

4. If an approved program ceases to provide a nurse aide training and competency evaluation program for a two year period, the program will be closed. The provider must reapply if they wish to provide training at a later date.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2075 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

§10017. Coordinators, Instructors and Trainers

A. …

1. The program coordinator must be a registered nurse (RN) with a current Louisiana license and must have the following experience and qualifications:

a. - b. …

2. The program coordinator may supervise no more than two nurse aide training programs simultaneously and must be on the premises where the program is being conducted for at least 50 percent of the duration of the program.

B. Instructors. Instructors may be RNs or LPNs and must hold a current Louisiana license. Licensed practical (vocational) nurses, under the general supervision of the coordinator, may provide classroom and skills training instruction and supervision of trainees if they have two years of experience in caring for the elderly and/or chronically ill of any age, experience in teaching LPN or RN students or have equivalent experience.

1. Such experience is normally obtained through employment in:

a. a nursing facility;

b. a geriatrics department;

c. a chronic care hospital; or

d. other long-term care setting.

e. - m. Repealed.

2. Experience in resident care, supervision and staff education is preferred.

3. The ratio of instructors to trainees in clinical training is 1:10 and the ratio of instructors to trainees in the classroom should not exceed 1:23.

C. Program Trainers. Qualified resource personnel from the health field may participate as program trainers as needed for discussion or demonstration of specialized core procedures.

1. Qualified resource personnel must have a minimum of one year of experience in their field and must be licensed, registered and/or certified, if applicable, and may include:

a. registered nurses;

b. licensed practical/vocational nurses;

c. pharmacists;

d. dietitians;

e. social workers;

f. sanitarians;

g. fire safety experts;

h. nursing home administrators;

i. gerontologists;

j. psychologists;

k. physical and occupational therapists;

l. activities specialists; and

m. speech/language/hearing therapists.

2. All program trainers must have a minimum of one year of current experience in caring for the elderly and/or chronically ill of any age or have equivalent experience.

3. The training program may utilize other persons such as residents, experienced aides and ombudsmen as resource personnel if these persons are needed to meet the planned program objectives or a specific unit of training.

D. Repealed.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2076 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

§10019. Training Program Responsibilities

A. The facility/school shall not accept a nurse aide trainee into a training program until the facility or school determines that the nurse aide trainee:

1. has not been convicted or found guilty by a court of law of:

a. abusing, neglecting or mistreating the elderly or infirm as defined by R.S. 40:2009.20 or

b. misappropriating a resident’s property; or

c. has not had a finding of abuse, neglect, mistreatment or misappropriation of a resident’s property placed on the Nurse Aide Registry or the Direct Service Worker Registry.

2. A criminal history back ground check shows no convictions or listing on the national sex offender public registry in accordance with R.S. 40:1300.53. Trainees may obtain a certified copy of their criminal history from the Louisiana State Police by requesting that a “right to review” be conducted.

3. Trainees shall not be prohibited from completing training due to criminal history that is not related to abuse, neglect or misappropriation.

B. For facility-based training programs, the facility shall assure that trainees do not perform any care and services for which they have not been trained and found proficient by the instructor. Trainees providing services to residents must be under the general supervision of a licensed nurse approved to work in a nurse aide training program.

1. Trainees enrolled in facility based training programs must complete training within 30 days of beginning the program.

2. A class roster, as well as the beginning and ending dates of each training class, shall be clearly documented and available for review at all times. This shall be available for both classroom and clinical instruction.

C. …

D. Repealed.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2077 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

§10023. Compliance with Federal and State Regulations

A. The department shall review all components of a training and competency evaluation program for compliance with federal and state regulations.

1. For facility-based programs, after initial approval of a training and competency evaluation program, the Department will conduct an initial one year post-approval review at the annual survey to determine the program’s implementation of and compliance with the requirements.

2. For non-facility based programs, the Department will conduct an initial one year post-approval review and thereafter will conduct a review every two years.

B. After the one year post-approval review, an on-site review of the program will be conducted at least every two years Programs not meeting the minimum requirements may be terminated if the program does not provide an acceptable plan for correcting deficiencies.

C. Programs not accessible or refusing to permit unannounced visits by the department will be terminated.

D. A program that has not conducted training or certified trainees to the registry within a two year period will be closed.

E. Operational Requirements

1. In order to be considered operational and retain approval to conduct a training program, providers must have at least one employee on duty at the business location during the hours of operation reported on the training program application submitted to the DHH Health Standards Section.

2. All nurse aide training providers (facility based and non-facility based) shall maintain a current, operational telephone number, fax number and e-mail address and shall keep the department informed of any changes.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2078 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

§10025. Nurse Aide Responsibilities

A. A certified nurse aide employed or contracted by a nursing facility or hospital-based SNF to provide nursing assistant services shall apply for registration with the department. Each application for registration of a certified nurse aide shall be submitted to the department on forms or other methods designated by the department, and shall contain such information required by the department. Any additional information required by the department shall be provided upon request.

B. In order to maintain certification, the certified nurse aide employed or contracted by a nursing facility or hospital-based SNF shall perform a minimum of 90 days or 720 hours of certified nurse aide duties in one nursing facility or hospital based SNF within a 120 day period each year.

1. The department shall confirm the completion of the required hours at least once every two years.

C. Nurse aides working in clinical settings other than nursing facilities or hospital based SNFs must perform at least eight hours of nursing or nursing related services in an approved setting during every consecutive 24 month period for pay after completion of a training and competency evaluation program to maintain certification.

D. Nurse aides working in a nursing facility or hospital-based SNF and in any other approved setting simultaneously during the two year registration period, must comply with the requirement for 90 days or 720 hours of certified nurse aide duties in one nursing facility or hospital-based SNF within a 120 day period each year.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2078 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

Subchapter C. Nurse Aide Registry

§10033. General Provisions

A. The Department of Health and Hospitals shall develop and maintain a registry for individuals who have successfully completed a nurse aide training and/or competency evaluation program. Each individual listed on the registry will have the following information maintained and retrievable:

1. name;

2. address;

3. Social Security Number;

4. phone number;

5. e-mail address;

6. place of employment;

7. date of employment;

8. date employment ceased;

9. state certification number;

10. state registration number, as appropriate; and

11. documentation of any investigation, including codes for specific findings of a resident’s:

a. abuse;

b. neglect;

c. misappropriated property; and

d. an accurate summary of findings only after actions on findings are final.

B. The registry will renew certification in accordance with the provisions of §10025 of this Chapter.

C. …

D. If there is a final and binding administrative decision to place a finding on the registry or if there is a final conviction, guilty plea or no contest plea to a crime(s) by a nurse aide against the elderly, infirm or a nursing facility resident, the department shall place the adverse finding on the registry. Record of the occurrence and associated findings will remain permanently on the registry.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2078 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

§10035. Certification by Reciprocity

A. Nurse aides may become certified by reciprocity from other states. Applicants must, at a minimum, submit to the Nurse Aide Registry the following information:

1. his/her name;

2. his/her Social Security Number;

3. his/her e-mail address;

4. the certification number in the other state;

5. the address of the other state’s registry;

6. his/her former place of employment; and

7. the date of employment and termination.

B. …

C. Nurse aides granted reciprocity in Louisiana and who plan to be employed in a nursing facility or hospital-based SNF must also apply for state registration.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health

Services Financing, LR 32:2079 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

Subchapter D. Provider Participation

§10045. Training Program Responsibilities

A. A person cannot be employed as a nurse aide or nurse aide trainee by a nursing facility or hospital-based SNF for more than 30 days unless he/she has satisfactorily completed an approved training and competency evaluation program.

B. Prior to employing or contracting with a certified nurse aide, a nursing facility or hospital-based SNF unit shall verify through the Louisiana’s Certified Nurse Aide Registry that the certified nurse aide is currently certified and has a current state registration.

C. A person cannot be employed as a nurse aide or nurse aide trainee if there is a final administrative or judicial court decision that the nurse aide or trainee has:

1. committed abuse, neglect or mistreatment of the elderly, infirm or nursing facility resident; or

2. misappropriated a resident’s property.

D. The provider must complete and send the appropriate form to the Registry to notify the Registry of employment or termination of a certified nurse aide.

1. Failure to send notification to the Registry within five working days of employment or termination may result in further adverse action against the provider.

E. All facilities will continue to provide on-going training on a routine basis in groups and, as necessary in specific situations, on a one-to-one basis.

1. Each nurse aide must receive and be compensated for 12 hours of on-going training per year.

2. Training can be received in the unit as long as it is:

a. directed toward skills improvement;

b. provided by appropriately trained staff; and

c. documented.

F. When a change of ownership (CHOW) occurs, the new owner or the administrator/designee is responsible for ensuring that all reporting of employment and termination to the registry is current. In the event that a request for verification of work history is received after the CHOW occurs, the current owner is responsible for compliance.

G. The facility administrator/designee is responsible for reporting work history to the registry for nurse aides employed by staffing agencies. This shall be done at least monthly.

H. No nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide competency evaluation program may be charged for any portion of the program.

I. If an individual who is not employed, or does not have an offer to be employed as a nurse aide becomes employed by, or receives an offer of employment from, a facility not later than 12 months after completing a nurse aide competency evaluation program, the state must provide for the reimbursement of costs incurred in completing the program on a pro rata basis during the period in which the individual is employed as a nurse aide.

J. Providers shall issue a certificate of completion to nurse aides who successfully complete training and competency evaluation programs.

K. If a training program is facility-based, the administrator or their designee shall reconcile with the nurse aide registry at least monthly, their CNAs that are employed or have been terminated. Accuracy of information held by the registry is the responsibility of the facility. Failure to maintain current data shall result in adverse action by the department.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and P.L. 100-203.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:2079 (November 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:

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