Idaho Medicaid Provider Handbook, Home Health and Hospice Services § 4.2.2

Hospice aides are assigned to a specific patient by a registered nurse (RN) of the

interdisciplinary group, and provided written patient care instructions for services found in

the plan of care that are within the state’s allowed scope of practice and training. The aide’s

regular duties include:

•

Hands on personal care;

•

Simple procedures of therapy and nursing services;

•

Assistance with ambulation or exercises;

•

Assistance in administering self-administered medications; and

•

Reporting changes in medical, nursing, rehabilitative and social needs to the RN.

Hospice aides are also eligible to provide Personal Care Services and Homemaker services.

Hospice aides must receive their certified nurse aide (CNA) certification and complete a

training program and competency evaluation. Home health aides that haven’t provided

services in the past 24 months must complete a new training program and competency

evaluation. The program must include 75 hours of classroom and supervised practical training.

Practical training must be supervised by a RN, or licensed practical nurse (LPN) under the

supervision of an RN. The aide must complete 16 hours of classroom work before performing

16 hours of practical work. Aides must receive 12 hours of ongoing education in a year

Training must be provided by a RN with two years of experience, one of which must be in

homecare; or a person supervised by an RN. Training must include:

•

Communication skills to report clinical information;

•

Observation and documentation of patient status and services furnished;

•

Collecting temperature, pulse and respiratory data;

•

Basic infection control procedures;

•

Basic elements of bodily functions requiring reporting to a supervisor;

•

Maintenance of a clean, safe and healthy environment;

•

Recognizing emergencies and knowing emergency procedures;

•

The physical, emotional and developmental needs of the patient and techniques to

address;

•

Respect for the patient, their property and privacy;

•

Appropriate techniques for personal hygiene and grooming tasks, including:

o

Bed bath.

o

Sponge, tub, and shower bath.

o

Hair shampoo.

o

Nail and skin care.

o

Oral hygiene.

o

Toileting and elimination.

•

Safe transfer and ambulation;

•

Normal range of motion and positioning;

•

Adequate nutrition and fluid intake; and

•

Any other services designated by the hospice.

Competency evaluations can be performed by any organization except a home health agency

that has within the past two years:

•

Was out of compliance with home health aide requirements;

•

Had unqualified persons provide home health aide services;

•

Was the subject of an extended survey or determined to have provided substandard

care;

•

Received $5,000 or more in sanctions;

•

Had compliance findings that endangered the health and safety of the patient and had

temporary management appointed to oversee the agency;

•

Had Medicare payments suspended;

•

Found negligent by CMS or the State under law:

•

Had its participation in Medicare terminated;

•

Closed by CMS or the State or had its patients transferred by the State.

An annual assessment by an RN with in-person observation of the aide must occur annually

regardless of deficiencies. Ongoing supervision requires an RN make an onsite visit at least

every 14 days to assess the quality of care and services and ensure they meet the patient’s

needs. The aide does not need to be present for the biweekly visits. If a concern is noted, the

aide must be observed in person and any deficiencies evaluated for competency. Assessments

must include demonstrations of satisfactorily performing outcome criteria including, but not

limited to:

•

Following the plan of care for assigned tasks;

•

Interpersonal relationships with the patient and family;

•

Competency with assignments;

•

Compliance with infection control; and

•

Reporting on changes in patient’s condition.

(a)

References: Hospice Aide

(i) Federal Regulations

Condition of Participation: Hospice Aide and Homemaker Services, 42 CFR §418.76 (2021).

Government Printing Office, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-

B/part-418/subpart-C/subject-group-ECFR74797288a614803/section-418.76.