section .0500 – staff orientation, training, competency and continuing education

Link to law: http://reports.oah.state.nc.us/ncac/title 10a - health and human services/chapter 13 - nc medical care commission/subchapter g/10a ncac 13g .0501.html
Published: 2015

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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.