CNA and Home Health Aide Responsibilities and Tasks
The certified nursing assistant (C.N.A.) and the home health aide shall:
(1) Be limited to assisting a patient in accordance with Section 400.506(6)(b), F.S.;
(2) Be responsible for documenting services provided to the patient or client and for filing said documentation with the nurse registry on a regular basis. These service logs will be stored by the nurse registry in the client’s file. The service logs shall include the name of the patient or client and a listing of the services provided;
(3) Be responsible for observing appearance and gross behavioral changes in the patient and reporting these changes to the patient’s health care surrogate or other person designated by the patient and the nurse registry or to the responsible facility employee if staffing in a facility;
(4) Be responsible to maintain a clean, safe and healthy environment, which may include light cleaning and straightening of the bathroom, straightening the sleeping and living areas, washing the patient’s dishes or laundry, and such tasks to maintain cleanliness and safety for the patient;
(5) Perform other activities as taught and documented by a registered nurse, concerning activities for a specific patient and restricted to the following:
(a) Assisting with the change of a colostomy bag, reinforcement of dressing;
(b) Assisting with the use of devices for aid to daily living such as a wheelchair or walker;
(c) Assisting with prescribed range of motion exercises;
(d) Assisting with prescribed ice cap or collar;
(e) Doing simple urine tests for sugar, acetone or albumin;
(f) Measuring and preparing special diets;
(g) Measuring intake and output of fluids; and,
(h) Measuring temperature, pulse, respiration or blood pressure.
(6) Be prohibited from changing sterile dressings, irrigating body cavities such as giving an enema, irrigating a colostomy or wound, performing gastric irrigation or enteral feeding, catheterizing a patient, administering medications, applying heat by any method, or caring for a tracheotomy tube.
(7) For every CNA, a nurse registry shall have on file a copy of the person’s State of Florida certification.
(8) For every home health aide registered with the nurse registry since May 4, 2015, a nurse registry shall have on file a certificate or documentation of successful completion of at least forty hours of home health aide training, pursuant to Section 400.506(6)(a), F.S., from a public vocational technical school or a non-public postsecondary career school licensed by the Commission on Independent Education, Florida Department of Education.
(9) Individuals who earn their CNA certificate in another state must contact the Florida Certified Nursing Assistant office at the Department of Health to inquire about taking the written examination prior to working as a CNA in Florida, pursuant to Chapter 464, Part II, F.S.
(10) Home health aides registered with the nurse registry since the effective date of this rule who complete their training in another state must provide a certificate of completion of home health aide training from a public vocational technical school or a career education school that is licensed in that state.
(11) CNAs and home health aides referred by nurse registries must maintain a current cardiopulmonary resuscitation (CPR) certification from an instructor or training provider that is approved to provide training by the American Heart Association, the American Red Cross, or the Health and Safety Institute, and that provides CPR training in which the student is required to demonstrate, in person, that he or she is able to proform cardiopulmonary resuscitation.
(12) Licensed practical nurses and registered nurses that are licensed in Florida or another state may work as home health aides. Also, persons who have completed the licensed practical nurse or registered nurse training from a public school, college, or university or a licensed nonpublic career education school or college in Florida who are not yet licensed may work as home health aides.
(13) A certified nursing assistant may work as a home health aide.
(14) C.N.A.s and home health aides referred by nurse registries may assist with self-administration of medication as described in Section 400.488, F.S.
(a) Home health aides and C.N.A.s assisting with self-administered medication, as described in Section 400.488, F.S., shall have received a minimum of 2 hours of training covering the following content:
1. Training shall cover state law and rule requirements with respect to the assistance with self-administration of medications in the home, procedures for assisting the resident with self-administration of medication, common medications, recognition of side effects and adverse reactions and procedures to follow when patients appear to be experiencing side effects and adverse reactions. Training must include verification that each C.N.A. and home health aide can read the prescription label and any instructions.
2. Individuals who cannot read shall not be permitted to assist with prescription medications.
(b) Documentation of training on assistance with self-administered medication from one of the following sources is acceptable:
1. Documentation of 2 hours of training in compliance with subsection 59A-8.0095(5), F.A.C., from a home health agency if the home health aide or C.N.A. previously worked for the home health agency;
2. A training certificate for assisted living facility staff in compliance with Section 429.52(6), F.S.
3. A training certificate for at least 2 hours of training from a career education school licensed pursuant to Chapter 1005, F.S., and Rule Division 6E, F.A.C., by the Department of Education, Commission for Independent Education.
4. Documentation of at least 2 hours of training by a provider approved by the Florida Board of Nursing, Department of Health.
(c) Documentation of the training must be maintained in the file of each home health aide and C.N.A. who assists patients with self-administered medication.
(d) In cases where a home health aide or a C.N.A. will provide assistance with self-administered medications as described in Section 400.488, F.S., and paragraph (e) below, a review of the medications for which assistance is to be provided shall be conducted by a registered nurse or licensed practical nurse to ensure the C.N.A. and home health aide are able to assist in accordance with their training and with the medication prescription and the medication is not required to be administered by a nurse. If the patient will not consent to a visit by the nurse to review the medications, a written list with the dosage, frequency and route of administration shall be provided by the patient or the patient’s health care surrogate, family member, or person designated by the patient to the home health aide or CNA to have reviewed by the nurse. The patient or the patient’s surrogate, guardian, or attorney in fact must give written consent for a home health aide or C.N.A. to provide assistance with self-administered medications, as required in Section 400.488(2), F.S.
(e) The trained home health aide and C.N.A. may also provide the following assistance with self-administered medication, as needed by the patient and as described in Section 400.488, F.S
1. Prepare necessary items such as juice, water, cups, or spoons to assist the patient in the self-administration of medication;
2. Open and close the medication container or tear the foil of prepackaged medications;
3. Assist the resident in the self-administration process. Examples of such assistance include the steadying of the arm, hand, or other parts of the patient’s body so as to allow the self-administration of medication;
4. Assist the patient by placing unused doses of solid medication back into the medication container.
(15) The nurse registry is not obligated to monitor, manage or supervise a certified nursing assistant or home health aide pursuant to Section 400.506(19), F.S. The nurse registry is not obligated to review patient or client records per Section 400.506(20), F.S., but the nurse registry is not prohibited from reviewing records and may do so. In the event of violation of Section 400.488, F.S., or other state laws that comes to the attention of the nurse registry, the nurse registry shall take the actions specified in Section 400.506(19), F.S. Rule-making Authority 400.488, 400.497, 400.506 FS. Law Implemented 400.488, 400.497, 400.506 FS. History–New 1-27-94, Amended 12-24-00, 8-10-06, 3-15-07, 5-4-15, 2-8-16.