section .0500 – staff orientation, training, competency and
continuing education
10A NCAC 13G .0501 Personal care training and competency
(a) The facility shall assure that personal care staff and
those who directly supervise them in facilities without heavy care residents
successfully complete a 25-hour training program, including competency
evaluation, approved by the Department according to Rule .0502 of this
Section. For the purposes of this Subchapter, heavy care residents are those
for whom the facility is providing personal care tasks listed in Paragraph (i)
of this Rule. Directly supervise means being on duty in the facility to
oversee or direct the performance of staff duties.
(b) The facility shall assure that staff who perform or
directly supervise staff who perform personal care tasks listed in Paragraph
(i) of this Rule in facilities with heavy care residents successfully complete
an 80-hour training program, including competency evaluation, approved by the
Department according to Rule .0502 of this Section and comparable to the
State-approved Nurse Aide I training.
(c) The facility shall assure that training specified in
Paragraphs (a) and (b) of this Rule is successfully completed six months after
hiring for staff hired after July 1, 2000. Staff hired prior to July 1, 2000,
shall have completed at least a 20-hour training program for the performance or
supervision of tasks listed in Paragraph (i) of this Rule or a 75-hour training
program for the performance or supervision of tasks listed in Paragraph (j) of
this Rule. The 20 and 75-hour training shall meet all the requirements of this
Rule except for the interpersonal skills and behavioral interventions listed in
Paragraph (j) of this Rule, within six months after hiring.
(d) The Department shall have the authority to extend the
six-month time frame specified in Paragraph (c) of this Rule up to six
additional months for a maximum allowance of 12 months for completion of
training upon submittal of documentation to the Department by the facility
showing good cause for not meeting the six-month time frame.
(e) Exemptions from the training requirements of this Rule
are as follows:
(1) The Department shall exempt staff from the
25-hour training requirement upon successful completion of a competency
evaluation approved by the Department according to Rule .0502 of this Section
if staff have been employed to perform or directly supervise personal care
tasks listed in Paragraph (h) and the interpersonal skills and behavioral
interventions listed in Paragraph (j) of this Rule in a comparable long-term
care setting for a total of at least 12 months during the three years prior to
January 1, 1996, or the date they are hired, whichever is later.
(2) The Department shall exempt staff from the
80-hour training requirement upon successful completion of a 15-hour refresher
training and competency evaluation program or a competency evaluation program
approved by the Department according to Rule .0502 of this Section if staff
have been employed to perform or directly supervise personal care tasks listed
in Paragraph (i) and the interpersonal skills and behavioral
interventions listed in Paragraph (j) of this Rule in a comparable long-term
care setting for a total of at least 12 months during the three years prior to
January 1, 1996, or the date they are hired, whichever is later.
(3) The Department shall exempt staff from the
25 and 80-hour training and competency evaluation who are or have been licensed
health professionals or Certified Nursing Assistants.
(f) The facility shall maintain documentation of the
training and competency evaluations of staff required by the rules of this
Subchapter. The documentation shall be filed in an orderly manner and made
available for review by representatives of the Department.
(g) The facility shall assure that staff who perform or
directly supervise staff who perform personal care tasks listed in Paragraphs
(h) and (i), and the interpersonal skills and behavioral interventions listed
in Paragraph (j) of this Rule receive on-the-job training and supervision as
necessary for the performance of individual job assignments prior to meeting
the training and competency requirements of this Rule.
(h) For the purposes of this Rule, personal care tasks
which require a 25-hour training program include, but are not limited to the
following:
(1) assist residents with toileting and
maintaining bowel and bladder continence;
(2) assist residents with mobility and
transferring;
(3) provide care for normal, unbroken skin;
(4) assist with personal hygiene to include
mouth care, hair and scalp grooming, care of fingernails, and bathing in
shower, tub, bed basin;
(5) trim hair;
(6) shave resident;
(7) provide basic first aid;
(8) assist residents with dressing;
(9) assist with feeding residents with special
conditions but no swallowing difficulties;
(10) assist and encourage physical activity;
(11) take and record temperature, pulse,
respiration, routine height and weight;
(12) trim toenails for residents without diabetes
or peripheral vascular disease;
(13) perineal care;
(14) apply condom catheters;
(15) turn and position;
(16) collect urine or fecal specimens;
(17) take and record blood pressure if a
registered nurse has determined and documented staff to be competent to perform
this task;
(18) apply and remove or assist with applying and
removing prosthetic devices for stable residents if a registered nurse,
licensed physical therapist or licensed occupational therapist has determined
and documented staff to be competent to perform the task; and
(19) apply or assist with applying ace bandages,
TED's and binders for stable residents if a registered nurse has determined and
documented staff to be competent to perform the task.
(i) For the purposes of this Rule, personal care tasks
which require a 80-hour training program are as follows:
(1) assist with feeding residents with
swallowing difficulty;
(2) assist with gait training using assistive
devices;
(3) assist with or perform range of motion
exercises;
(4) empty and record drainage of catheter bag;
(5) administer enemas;
(6) bowel and bladder retraining to regain
continence;
(7) test urine or fecal specimens;
(8) use of physical or mechanical devices
attached to or adjacent to the resident which restrict movement or access to
one's own body used to restrict movement or enable or enhance functional
abilities;
(9) non-sterile dressing procedures;
(10) force and restrict fluids;
(11) apply prescribed heat therapy;
(12) care for non-infected pressure ulcers; and
(13) vaginal douches.
(j) For purposes of this Rule, the interpersonal skills and
behavioral interventions include, but are not limited to the following:
(1) recognition of residents' usual patterns of
responding to other people;
(2) individualization of appropriate
interpersonal interactions with residents;
(3) interpersonal distress and behavior
problems;
(4) knowledge of and use of techniques, as
alternatives to the use of restraints, to decrease residents' intrapersonal and
interpersonal distress and behavior problems; and
(5) knowledge of procedures for obtaining
consultation and assistance regarding safe, humane management of residents'
behavioral problems.
History Note: Authority G.S. 131D-2; 131D-4.5;
143B-165; S.L. 1999-0334;
Temporary Adoption Eff. January 1, 1996;
Eff. May 1, 1997;
Temporary Amendment Eff. December 1, 1999;
Amended Eff. July 1, 2000.