Oregon Bulletin
Rule
Caption: Rule amendments for Nursing
Assistant, Medication Aide, and CNA2 training programs.
Adm.
Order No.: BN 2-2011
Filed with Sec. of
State: 7-11-2011
Certified to be
Effective: 7-11-11
Notice Publication
Date: 5-1-2011
Rules Adopted: 851-061-0075
Rules Amended: 851-061-0020, 851-061-0030, 851-061-0040,
851-061-0050, 851-061-0080, 851-061-0090, 851-061-0110, 851-061-0130
Subject: These rules cover the standards for training programs
for Nursing Assistants (NA) and Medication Aides (MA). This rule amendment
includes language to permit on-line training for CNA2s and Medication Aides,
removes barriers in the director/instructor/preceptor qualifications for MA
training programs, increases the classroom/lab hours for MA training programs,
and adds student protections for NA and MA training programs.
Rules Coordinator: Peggy A. Lightfoot—(971) 673-0638
851-061-0020
Definitions
As used in these rules:
(1) “Assisted Living Facility” means a facility that is
licensed by the State of Oregon and as defined by the Oregon Department of
Human Services.
(2) “Board-approved Curriculum” means content required
in nursing assistant and medication aide training programs established by Board
policy.
(3) “Certified Medication Aide (CMA)” means a Certified
Nursing Assistant who has had additional training in administration of
noninjectable medication and holds a current unencumbered Oregon CMA
certificate.
(4) “Certified Nursing Assistant (CNA)” means a person
who holds a current Oregon CNA certificate by meeting the requirements
specified in these rules; whose name is listed on the CNA Registry; and who
assists licensed nursing personnel in the provision of nursing care. The phrase
Certified Nursing Assistant and the acronym CNA are generic and may refer to
CNA 1, CNA 2 or all CNAs.
(5) “Certified Nursing Assistant 1 (CNA 1)” means a
person who holds a current Oregon CNA certificate and who assists licensed
nursing personnel in the provision of nursing care.
(6) “Certified Nursing Assistant 2 (CNA 2)” means a CNA
1 who has met requirements specified in these rules for one or more of the CNA
2 categories.
(7) “Client” means the individual who is provided care
by the CNA or CMA including a person who may be referred to as “patient” or
“resident” in some settings.
(8) “Clinical Instructor” means a registered nurse
whose role is education of students in the skills laboratory or clinical site
and who may participate in classroom teaching under the direction of the
program director or primary instructor.
(9) “Clinical Preceptor” means a licensed nurse who
provides direct clinical supervision of students during their clinical
experience under the direction of the program director or a primary instructor.
(10) “Clinical Site” is a location or situation in
which hands on experience with actual clients is obtained.
(11) “CNA Registry” means the listing of Oregon
Certified Nursing Assistants maintained by the Board.
(12) “Competency evaluation” means the Board approved
process for determining competency.
(13) “Criminal History Check” means the Oregon Criminal
History Check and when required, a National Criminal History Check and/or a
State-Specific Criminal History Check, and processes and procedures equivalent
to the Department of Human Services (DHS) rules.
(14) “Direct supervision” means that the registered
nurse, clinical nurse specialist, or nurse practitioner is physically present
and accessible in the immediate client care area and is available to intervene
if necessary.
(15) “Facility-Based Program” means an approved nursing
assistant or medication aide training program in a licensed nursing facility.
(16) “Full-time” means at least 32 hours of regularly
scheduled work each week.
(17) “Independent Training Program” means an approved
nursing assistant or medication aide training program that is not a
facility-based program.
(18) “Instructor-directed” means an on-line training
that is managed, directed, and facilitated through interaction between learners
and identified instructor(s). Learning activities may occur through either
synchronous or asynchronous interaction between instructor and students and
among students.
(19) “Level 1 training” is the minimum training
required to prepare a graduate to take the state certification examination for
CNA 1.
(20) “Level 2 training” is training available to a CNA
1 to prepare them for a role in one or more of the Board approved category
areas.
(21) “Licensed Nursing Facility” means a licensed
nursing home or a Medicare or Medicaid certified long term care facility.
(22) “Nursing Assistant” means a person who assists
licensed nursing personnel in the provision of nursing care. ORS 678.440(4)
(23) “On-line program” means an interactive computer
based training program that provides at least the equivalent of the Board
required classroom, laboratory, and clinical hours under the supervision of a
Board approved instructor/preceptor.
(24) “On-line program provider” means a provider that
has a proven track record of successfully providing professional development,
training and educational programs in both classroom and on-line environments in
Oregon, either directly or in partnership, in the previous 24 months of
application, and meets all Board requirements.
(25) “Program” means a training program that prepares
graduates for certification as a nursing assistant level 1, level 2, or
medication aide. The terms “nursing assistant program, or “medication aide
program” as used in these rules, are synonymous with “Program.”
(26) “Representative of the Board” means the Nursing
Assistant Program Consultant or Board designee qualified to perform the
necessary responsibilities.
(27) “Residential Care Facility” means a facility that
is licensed by the State of Oregon and as defined by the Oregon Department of
Human Services.
(28) “Self-directed” means an on-line program in which
course materials, learning activities, communications, and assessment
activities are delivered and completed electronically. Learners engage in and
complete activities at their own pace.
(29) “Self-Evaluation” means a review of a basic
nursing assistant or medication aide training program conducted by the program
director using forms provided by the Board and submitted to the Board.
(30) “Site Visit” means that representative(s) of the
Board go to the location of a program for specified purpose(s) which may
include a survey for approval.
(31) “Standards for Approval” means authoritative
statements which set expectations for a program to achieve and maintain
approval status. (OAR 851-061-0080 through 0130).
(32) “Survey Visit” means that representative(s) of the
Board go to the location of a program to review the program for compliance with
Standards for Approval, and to prepare a report and recommendation regarding
approval status.
(33) “Waiver of Prohibition” authorizes a program to be
taught in but not by a facility that has had its approval denied or withdrawn
pursuant to OAR 851-061-0050(2).
Stat. Auth.: ORS 678.440, 678.442
& 678.444
Stats. Implemented: ORS 678.440,
678.442 & 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 1-2004, f. 1-29-04, cert. ef. 2-12-04; BN 11-2004, f. &
cert. ef. 7-13-04; BN 2-2008, f. & cert. ef. 2-25-08; BN 2-2011, f. &
cert. ef. 7-11-11
851-061-0030
Process for Program Approval
(1) Any person, partnership, association, corporation,
or limited liability company desiring to offer training other than just nursing
assistant or medication aide training to non-employed students will need to be
licensed through the Oregon Department of Education in addition to meeting the
Board’s standards as described in these rules.
(2) Any person, partnership, association, corporation,
or limited liability company desiring to offer only nursing assistant or
medication aide training without being licensed through the Oregon Department
of Education shall apply for an exemption of licensure from the Department of
Education.
(3) All nursing assistant or medication aide training
programs shall be Board-approved prior to being offered. Retroactive approval
shall not be granted.
(4) Application for Initial Approval of level 1, level
2, and medication aide training programs. A facility, agency, on-line program
provider, or individual wishing to establish a new nursing assistant or
medication aide training program shall make application to the Board at least
45 days in advance of expected start date. The application for initial approval
of a training program shall include:
(a) A completed form provided by the Board;
(b) Appropriate fees;
(c) Faculty names and qualifications;
(d) Names of classroom and clinical facilities;
(e) Name of person authorized to accept service of
notices issued by the Board;
(f) Program rationale, philosophy and purpose;
(g) Program outline:
(A) Objectives;
(B) Curriculum content divided into number and sequence
of didactic and clinical hours; and
(C) Teaching methodology.
(h) Evaluation method:
(A) Laboratory and clinical skills checklist approved
by the Board;
(B) Final exam; and
(C) In addition, for level 2 training programs, a Board
approved competency evaluation.
(i) Enrollment agreement and disclosure statement that
includes:
(A) Beginning and ending dates of the training;
(B) An outline of the instructional program as required
by these rules for which the student is enrolled;
(C) Fees, tuition, and other program costs (books,
clothing, etc.) itemized separately;
(D) A published cancellation and refund policy,
procedure, and schedule that is fully explained during orientation, prior to the
beginning of instruction, and requires no less than:
(i) If the training program discontinues after the fees
and tuition have been paid, the program provider must refund the tuition and
fees in full if the closure happens before the course is completed;
(ii) If the student cancels enrollment in writing three
days before the commencement of the first day of classes or three days before
they receive access to the online didactic training, all tuition and fees paid
to the program specific to the enrollment agreement, will be refunded, less a
cancellation fee that cannot exceed 10 percent of the tuition and fees paid;
and
(iii) Clearly stated reasons for which a refund will
not be granted; and
(E) Information about how the student can file a
complaint about the program with the Board.
(j) Tentative time schedule for initiating the program;
and
(k) Plan for what job placement assistance will consist
of from the training program.
(5) A site visit may be conducted by a
representative(s) of the Board;
(6) The program director will be notified of approval
or non-approval. Following receipt of notification from the Board of approval
or non-approval:
(a) A program that is approved may begin classes
according to the schedule submitted;
(b) A program that is not approved will be notified of
the deficiencies and will be re-evaluated after appropriate modifications are
made;
(c) A program denied approval may petition the Board
for reconsideration.
(7) An approved nursing assistant level 1 or medication
aide training program:
(a) Shall be required to demonstrate ongoing compliance
with the standards of approval at least every two years for continued approval.
(b) Shall be surveyed for consideration of continued
approval and may have a survey visit or interim self-evaluation report required
by the Board at any time.
(c) May be subject to scheduled or non-scheduled site
visits for continued approval or any other purpose at any time.
(d) Shall submit an interim self evaluation during the
intervening year or as requested by the Board on forms provided by the Board.
(e) Shall have records available for review.
(f) Shall have adequate financial support for the
stability and continuation of the program.
(8) An on-line provider shall have a proven track
record of successfully providing professional development, training and
educational programs in both classroom and on-line environments in Oregon,
either directly or in partnership, in the previous 24 months, and meet all
Board requirements prior to being approved.
(9) Following initial approval, level 2 training
programs remain approved unless specifically withdrawn by the Board.
(10) Program changes requiring Board approval:
(a) Change of program ownership:
(A) If the change only causes minor changes, there is
no need to seek new approval of the program.
(B) If the change causes a substantial difference as
determined by the Board through the impact on the students, faculty, or program
resources, an application and approval for the program shall be required.
(b) Changes in course content, lab/clinical skill
checklist, final exam, certificate of completion, program director, primary
instructor, clinical instructor, clinical preceptor, policies and procedures
related to attendance, course requirements, cancellation and refunds, or
classroom or clinical training sites shall be submitted to the Board for
approval.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 5-2002, f. & cert. ef. 3-5-02; BN 1-2004, f. 1-29-04, cert.
ef. 2-12-04; BN 7-2006, f. & cert. ef. 5-8-06; BN 2-2008, f. & cert.
ef. 2-25-08; BN 2-2011, f. & cert. ef. 7-11-11
851-061-0040
Inactive Status or Closure of a
Program
(1) Voluntary Inactive Status. A training program may
be granted temporary inactive status for up to two years:
(a) The program director shall notify the Board in
writing of the intended inactive date and the plan for allowing the currently
enrolled students to complete the program.
(b) The program shall be continued until the committed
class schedule of currently enrolled students is completed.
(2) Involuntary Inactive Status. A training program
shall be placed on temporary inactive status for up to one year for the
following reasons:
(a) To allow an opportunity for the program to take corrective
action; or
(b) After a period of 12 months during which no classes
were taught.
(3) Process to reinstate active status: A training
program may be reinstated subsequent to voluntary or involuntary inactive
status by submitting satisfactory evidence that the program meets Board
standards.
(4) Voluntary Closing. When a facility, institution or
individual considers closing a nursing assistant training program, the program
director shall:
(a) Notify the Board in writing of the intended closing
date and the plan for allowing the currently enrolled students to complete the
program.
(b) Continue the program until the committed class
schedule of currently enrolled students is completed.
(c) Provide for the custody of the records:
(A) If the nursing assistant or medication aide
training program closes but the educational institution or licensed health care
agency continues to function, the institution shall assume responsibility for
the records of the students and the graduates. The Board of Nursing shall be
advised of the arrangements made to safeguard the records.
(B) If the facility-based or independent training
program ceases to exist, the Board of Nursing shall be consulted about the
maintenance of student records.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.440
& 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 1-2004, f. 1-29-04, cert. ef. 2-12-04; BN 2-2011, f. & cert.
ef. 7-11-11
851-061-0050
Denial or Withdrawal of Program
Approval
(1) The Board may deny or withdraw approval if
standards for approval of new or existing nursing assistant level 1, level 2,
or medication aide training programs are not being met:
(a) Notice of the deficiency(ies) shall be given in
writing to the program director;
(b) The program director may submit evidence of
correction to the Board;
(c) The Board may withdraw program approval immediately
or prescribe the time within which the deficiency(ies) shall be corrected;
(d) The approval may be withdrawn, if the program fails
to correct the deficiency(ies) within the time specified;
(e) A program may request a hearing if the approval is
withdrawn; and
(f) The withdrawal may be effective after the last
currently enrolled student has completed the program.
(2) Pursuant to Federal Regulations the Board shall
deny approval to a nursing assistant training program and shall withdraw
approval from a previously approved nursing assistant training program offered
by or in a licensed nursing facility or a skilled nursing facility which, in
the previous two years:
(a) Has operated under a waiver of the federal
requirement for nursing facilities and skilled nursing facilities to have 24
hour a day licensed nurse staffing with eight hour a day registered nurse
staffing when such waiver is in excess of 48 hours per week; or
(b) Has been determined by surveyors from the state
Seniors and People with Disabilities Division or federal Center for Medicare
and Medicaid Services to have conditions which pose an immediate threat to
resident health and safety; or
(c) Has been subject to an extended or partial extended
survey, a restriction of admissions or an impending restriction of admissions
for provision of substandard quality of care; or
(d) Was subject to a denial of payment under federal
law; or
(e) Has had its Medicare participation terminated under
federal or state law; or
(f) Was assessed a civil penalty of $5,000 or more, for
deficiencies in nursing facility standards, except if waived pursuant to 42 CFR
§ 483.151; or
(g) Has operated under trusteeship appointed to oversee
the operation of the nursing facility and to ensure the health and safety of
its residents; or
(h) As a result of state action terminated the
operation of the facility or was closed or has had its residents transferred.
(3) A program or facility that has had its approval
denied or withdrawn pursuant to OAR 851-061-0050(2) may apply for waiver of
prohibition if:
(a) The facility has received written notice from
Seniors and People with Disabilities Division’s Client Care Monitoring Unit
that it is in compliance with regulations governing licensure and/or
certification; and
(b) There is not another program within ten road-miles
from the facility submitting the request.
(4) The letter of request for waiver of prohibition
shall:
(a) Address the distance in road-miles from the
sanctioned facility to the closest program or facility that is willing and
eligible for approval to serve as a clinical site for the training program; and
(b) Include a written statement of compliance with the
standards for licensure and certification.
(5) The Board shall grant or deny the waiver based upon
information received from applicant and Seniors and People with Disabilities
Division’s Client Care Monitoring Unit.
(6) The Board may withdraw program approval of a
nursing assistant level 1 or medication aide training program if:
(a) The program cannot provide satisfactory evidence
that the standards for nursing assistant or medication aide training programs
are consistently maintained; or
(b) No classes have been taught for 24 consecutive
months; or
(c) The average pass rate for graduates of the program
falls below 85% over a two year period; or
(d) The clinical facility fails to permit a site visit
of the training program.
(7) The Board may withdraw program approval of a
nursing assistant level 2 training program if:
(a) Standards for program approval are not met as
determined by a survey visit or interim self evaluation report which may be
required by the Board at any time, for any purpose, and may be announced or
unannounced; and
(b) A site visit is not permitted or records are not
available for review.
(8) When program approval is withdrawn, the program
shall:
(a) Submit a plan to the Board within ten working days
for completion of the currently enrolled students;
(b) Allow students who have started a training program
from which approval has been withdrawn to complete the course; and
(c) Submit the required student information to the
Board, using the Board approved format, when the students have completed the
course.
(9) The Board may reinstate approval of the nursing
assistant or medication aide training program upon submission of satisfactory
evidence that the program meets the Board standards.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 1-2004, f. 1-29-04, cert. ef. 2-12-04; BN 6-2008, f. & cert.
ef. 6-24-08; BN 2-2011, f. & cert. ef. 7-11-11
851-061-0075
Standards for Approval:
Organization and Administration
(1) Training program policies and procedures shall be
in written form and shall be reviewed at least once every two years.
(2) Training programs implementing program changes
cannot require students who are currently enrolled to complete the requirements
of a revised program. Enrolled students are to be taught out under the program
identified in their most current signed enrollment agreement. Exceptions may be
allowed when and if the school and student mutually agree to the program
change(s) and a new or amended enrollment agreement is negotiated, accepted,
and signed by the student and school. Examples of program changes as used in
this rule include, but are not limited to, increase or decrease of hours
required, changes in the schedule of hours of instruction, adding or dropping course
requirements, increasing program costs or fees, or changes in the payment plan.
(3) Training program shall be financially viable for
the stability and continuation of the program.
(a) Training program providers in assisted living,
licensed nursing, and residential care facilities licensed by the Department of
Human Services or the Health Authority and training programs licensed by the
Department of Education are exempt from demonstrating financial viability to
the Board.
(b) Training program providers not identified in OAR
851-061-0075(3)(a), will provide financial statements to demonstrate:
(A) Assets equal to or greater than liabilities;
(B) No operating loss in any year of more than 10% of
their net worth; and
(C) No operating loss of any amount for two consecutive
years.
(c) A training program that is unable to verify
financial viability may be required to carry a bond, get a letter of credit, or
escrow unearned tuition.
(4) All training program advertising, sales,
collection, credit or other business practices are conducted in a manner that
does not violate ORS 646.608.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.440
& 678.444
Hist.: BN 2-2011, f. & cert.
ef. 7-11-11
851-061-0080
Standards for Program Approval:
Faculty Qualifications and Responsibilities
(1) The training of nursing assistants level 1 shall be
by or under the supervision of a program director or primary instructor who has
at least one year of nursing experience in a licensed nursing facility.
(2) The program director shall hold a current,
unencumbered license to practice as a registered nurse in Oregon; and
(a) For a nursing assistant level 1 and level 2
training program, have at least three years of nursing experience, including at
least one year of working in direct patient care; and one of the following:
(A) One year of experience on a nursing faculty;
(B) One year of experience in staff development;
(C) Evidence of academic preparation for teaching
adults; or
(D) Evidence of equivalent experience.
(b) For a medication aide training program, have at
least three years of experience as a Registered Nurse, including at least one
year as a nurse educator or nurse administrator.
(3) The program director shall:
(a) Act as liaison with the Board related to the
program’s continuing compliance with the required elements of these rules;
(b) Implement and maintain a program that complies with
all Board standards;
(c) Assume the ultimate responsibility for the
implementation of the Board-approved curriculum;
(d) Have sufficient time provided for carrying out
administrative responsibilities. Number of faculty, students, classes in
progress, and locations utilized for classroom and clinical training are to be
considered in determining appropriate time allocated;
(e) Recruit, supervise, and evaluate qualified primary
instructors and clinical instructors or preceptors;
(f) Develop and implement written policies necessary
for the operation of the program, including those maintained under OAR
851-061-0110(1)(c)(G);
(g) Ensure that all students have initiated a criminal
history check prior to entering the program and that all students are eligible
pursuant to laws governing the clinical site facility to participate in the
program’s clinical experiences.
(h) Coordinate classroom and clinical sites and
activities;
(i) Ensure that the classroom, lab, and clinical
environment is conducive to teaching and learning;
(j) Assure that the clinical setting provides an
opportunity for the students to perform the skills taught in the curriculum;
(k) Ensure that a Board-approved primary instructor,
clinical instructor, or clinical preceptor is on the premises at all times
during scheduled clinical hours;
(l) Supervise or coordinate supervision of students in
the clinical setting or assign this responsibility to the primary instructor.
(m) Provide or arrange for the orientation of the
primary and clinical instructors or clinical preceptors to their role and
responsibilities.
(n) Assess students’ reactions to course content,
instructional effectiveness, and other aspects of the learning experience;
(o) Submit program data upon request of the Board on
forms provided by the Board;
(p) Submit required reports;
(q) Verify that the training facility in which the
training program is offered or utilized for the clinical experience is licensed
under the appropriate licensing agency and is in substantial compliance with
all standards for licensure;
(r) Verify that a facility utilized for out-of-state
clinical experience:
(A) Has not been found within the preceding two years,
by the state survey and certification agency, using the currently applicable
Center for Medicare and Medicaid Services regulations, to be categorized as
providing substandard quality of care;
(B) Is no more than 50 miles from an Oregon border; and
(C) Has given permission for site visit(s) by Board
staff.
(s) For medication aide training programs, determine
student eligibility by verifying that the applicant:
(A) Holds a current certificate to practice as a CNA 1
on the CNA Registry;
(B) Has graduated from an approved basic nurse aide
training program at least six months prior to enrollment in the medication aide
training program; and
(C) Meets the employment requirement of at least six
months of full time experience as a nursing assistant or the equivalent in part
time experience since graduation from a basic nursing assistant training
program unless the applicant is exempt under OAR 851-062-0090.
(4) The primary instructor shall hold a current,
unencumbered license to practice as a registered nurse in Oregon; and
(a) For a nursing assistant level 1 and level 2
training program, have two years experience as a registered nurse and teaching
experience or educational preparation for teaching adults.
(b) For a medication aide training program, have at
least three years of nursing experience, to include:
(A) One year as a nurse educator, a primary instructor
in a nursing assistant training program or as a nurse administrator, and
(B) One year working with the particular type of clientele
or providing clinical instruction in a setting with the particular type of
clientele with whom students will have their clinical experience.
(c) May be the director of nursing service in a long
term care facility only if there is evidence of formal arrangements for the
director of nursing position to be filled by another qualified nurse during the
period of instruction.
(5) The primary instructor shall:
(a) Implement the required Board-approved curriculum;
(b) Provide effective teaching strategies in an
environment that encourages student and instructor interaction;
(c) Supervise and be present in the classroom at least
75% of the time that classes are being taught, or for on-line programs, be
available for consultation and additional clarification at least every 72
hours;
(d) Evaluate competency of students; and
(e) In addition, for medication aide training programs,
the primary instructor shall:
(A) Obtain approval from a facility prior to using a
facility employee as a clinical preceptor. The facility has the right to refuse
such approval;
(B) Ensure that each student’s clinical experience
includes administration of medications by all approved routes of administration
and includes administration of a variety of medications; and
(C) Supervise the clinical experience for all
medication aide students. Clinical preceptors may be used as appropriate.
(6) Other personnel from the healthcare professions may
supplement the instructor in their area of expertise:
(a) For a nursing assistant level 1 and level 2
training program, the program director or primary instructor may:
(A) Involve as trainers for a specific portion of the
nursing assistant training, other licensed nursing personnel or other licensed
health care professionals who have at least one year of experience in their
field.
(B) Use an approved clinical instructor who shall:
(i) Hold a current, unencumbered license to practice as
a registered nurse in Oregon; and
(ii) Have the equivalent of one year full time
experience as a registered nurse.
(C) Use an approved clinical preceptor who shall:
(i) Hold a current, unencumbered license to practice
nursing in Oregon; and
(ii) Have the equivalent of at least one year of
experience as a licensed nurse.
(b) For a medication aide training program, the
clinical preceptor shall:
(A) Hold a current, unencumbered license to practice
nursing in Oregon;
(B) Have the equivalent of one year full time
experience as a licensed nurse and shall have three months’ nursing experience
in a facility licensed the same as the setting in which the medication aide
student will be passing medications;
(C) Provide direct supervision; and
(D) Have only the responsibility for clinical
precepting during the scheduled clinical experience.
(c) Certified medication aides, resident care managers,
and directors of nursing are prohibited from acting as clinical preceptors for
medication aide students.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.440
& 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 18-2002, f. & cert. ef. 10-18-02; BN 1-2004, f. 1-29-04,
cert. ef. 2-12-04; BN 11-2004, f. & cert. ef. 7-13-04; BN 7-2006, f. &
cert. ef. 5-8-06; BN 2-2008, f. & cert. ef. 2-25-08; BN 2-2011, f. &
cert. ef. 7-11-11
851-061-0090
Standards for Program Approval:
Curriculum
(1) Board-approved curriculum shall be used in approved
nursing assistant level 1 and medication aide training programs.
(2) A nursing assistant level 1 training program shall
consist of:
(a) At least 150 hours of instruction divided into 75
hours of classroom instruction and 75 hours of supervised clinical experience;
(b) At least 24 hours of supervised
classroom/laboratory instruction with return student demonstrations of learned
skills to determine comprehension and competency, in addition to facility
orientation, preceding the students’ care of clients; and
(c) At least 75 hours of supervised clinical experience
in a hospital, licensed nursing, residential care, or assisted living facility
that has a registered nurse on duty during all scheduled student clinical
hours, is in substantial compliance with all standards of licensure, and
provides an opportunity for the student to perform the skills taught in the
Board’s approved curriculum.
(3) An on-line nursing assistant level 1 training
program shall consist of:
(a) At least the equivalent of 51 hours according to
the nationally recognized standard of content to credit ratio;
(b) At least 24 hours of supervised laboratory
instruction provided no later than two weeks after the successful completion of
the on-line portion of the curriculum. The laboratory portion of the program
shall include return student demonstration of learned skills to determine
comprehension and competency, in addition to facility orientation, preceding
the students’ care of clients;
(c) At least 75 hours of supervised clinical experience
in a hospital, licensed nursing, residential care, or assisted living facility
that has a registered nurse on duty during all scheduled student clinical
hours, is in substantial compliance with all standards of licensure, and
provides an opportunity for the student to perform the skills taught in the
Board’s approved curriculum;
(d) Ongoing technical support service(s) to sustain the
electronically offered program including provisions for staffing, reliability,
privacy, and security; and
(e) Ongoing technical support service(s) for students
on each required educational technology hardware, software, and delivery
system.
(4) A nursing assistant level 2 training program will
have Board approved:
(a) Standardized category curriculum that may vary in
training hours from other Board approved standardized category curricula; and
(b) Competency evaluation.
(5) Medication aide training program classroom and
clinical instruction hours:
(a) A medication aide training program shall consist of
at least 84 hours of instruction divided into at least 60 hours of
classroom/lab instruction and at least 24 hours of 1:1 supervised clinical
experience.
(b) All clinical hours shall be completed at one site
(licensed nursing facility, hospital, assisted living facility, or residential
care facility).
(c) All required clinical hours shall be in medication
administration related activities.
(6) Admission requirements for medication aide training
programs shall be:
(a) Current, unencumbered CNA 1 status on the Oregon
CNA Registry maintained by the Board;
(b) Documentation of graduation from an approved basic
nursing assistant level 1 training program at least six months prior to
enrollment in the medication aide training program; and
(c) Documentation of at least six months full time
experience as a nursing assistant level 1 or the equivalent in part time
experience since graduation from a basic nursing assistant training program.
(7) An on-line nursing assistant level 2 or medication
aide training program shall consist of:
(a) At least the nationally recognized standard of
content to credit ratio to meet the Board’s curriculum policy for the specific
training program;
(b) Supervised laboratory instruction that meets the
Board’s approved curriculum provided no later than two weeks after the successful
completion of the on-line portion of the curriculum. The laboratory portion of
the program shall include return student demonstration of learned skills to
determine comprehension and competency, in addition to facility orientation,
preceding the students’ care of clients;
(c) Supervised clinical experience in a hospital,
licensed nursing, residential care, or assisted living facility that has a
registered nurse on duty during all scheduled student clinical hours, is in
substantial compliance with all standards of licensure, and provides an
opportunity for the student to perform the skills taught in the Board’s
approved curriculum;
(d) Ongoing technical support service(s) to sustain the
electronically offered program including provisions for staffing, reliability,
privacy, and security; and
(e) Ongoing technical support service(s) for students
on each required educational technology hardware, software, and delivery
system.
(8) Classroom and clinical faculty/student ratios for
nursing assistant level 1, level 2, and medication aide training programs:
(a) Classroom:
(A) The ratio of students per instructor in the
classroom shall be such that each trainee is provided with registered nurse
assistance and supervision and be no more than 30 students per instructor for
nursing assistant level 1 training programs, 20 students per instructor for
medication aide training programs, and 32 students per instructor for CNA level
2 training programs.
(B) The amount of students assigned per instructor with
self-directed, on-line instruction shall be such that each trainee is provided
with consultation and additional clarification by a Board approved instructor
within 72 hours of a trainee’s inquiry.
(C) The ratio of students per instructor with
instructor-directed, on-line instruction shall be such that each trainee is
provided with consultation and additional clarification by a Board approved
instructor within 72 hours of a trainee’s inquiry, and the class size shall be
no more than 20 students per instructor per on-line classroom.
(b) Lab: The ratio of students per instructor in
nursing assistant level 1, level 2, and medication aide training programs shall
be no more than 10 students per instructor at all times during the lab
experience.
(c) Clinical:
(A) The ratio of students per instructor in a nursing
assistant level 1 training program shall be no more than 10 students per
instructor at all times during the clinical experience.
(B) The ratio of students per instructor in a nursing
assistant level 2 training program shall be no more than 8 students per
instructor at all times during the clinical experience.
(C) The ratio of students per instructor in a
medication aide training program shall begin with a ratio of one clinical
preceptor to one medication aide student during the first 24 hours of the
clinical experience. Less intensive supervision (either more students per
preceptor or less direct supervision by preceptor) may occur after the first 24
hours, with satisfactory evaluation and approval of the clinical preceptor and
primary instructor.
(9) Clinical experience and demonstration of competency
for nursing assistant level 1 and medication aide training programs:
(a) A clinical schedule shall be prepared for all
students prior to the beginning of the clinical experience, and provided to the
clinical facility director of nursing, the clinical instructor/preceptor, and
the student.
(b) Student practice and demonstration of competency
for nursing assistant level 1 and medication aide training programs:
(A) Students may provide direct client care within
their authorized duties under the supervision of an approved instructor.
(B) Students shall be identified as students at all
times while in the clinical area.
(C) Students must not be counted as staff or utilized
as staff during the hours that are scheduled for clinical experience.
(D) Students may be on a unit, floor or wing of a
facility only under direct supervision of a qualified instructor.
(E) Students shall not be on a unit, floor, or wing
without a CNA or licensed nurse.
(F) Students shall provide care only to the level they
have been taught and determined competent by the approved clinical instructor.
(c) In addition, for medication aide training programs,
the clinical experience shall be progressive with the Board approved clinical
preceptor observing the medication administration and gradually increasing the
number of clients to whom the student is administering medications;
(10) Program completion:
(a) Completion of a nursing assistant level 1 or
medication aide training means that:
(A) The student has successfully completed 100% of the
required classroom and clinical hours and content in the curriculum;
(B) The student has successfully demonstrated the
required skills on the laboratory and clinical skills checklist;
(C) The student has achieved a score of 75% or higher
on the program’s final examination;
(D) The student has successfully completed the clinical
portion of the program no later than four months following the last date of
classroom instruction or within four months after the successful completion of
the on-line portion of the program; and
(E) In addition, for nursing assistant level 1 training
programs, the student has successfully completed current, adult CPR
certification in accordance with Board-approved curriculum.
(b) Completion of a nursing assistant level 2 training
means that:
(A) The student has successfully completed 100% of the
required classroom and clinical hours and content in the curriculum; and
(B) The student has successfully completed the
competency evaluation.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 15-2002, f. & cert. ef. 7-17-02; BN 1-2004, f. 1-29-04,
cert. ef. 2-12-04; BN 11-2004, f. & cert. ef. 7-13-04; BN 12-2005, f. &
cert. ef. 12-21-05; BN 7-2006, f. & cert. ef. 5-8-06; BN 2-2008, f. &
cert. ef. 2-25-08; BN 1-2009, f. & cert. ef. 5-15-09; BN 10-2009, f. &
cert. ef. 12-17-09; BN 2-2011, f. & cert. ef. 7-11-11
851-061-0110
Standards for Program Approval:
Records
(1) Nursing assistant level 1, level 2, and medication
aide training program records shall:
(a) Be maintained for a period of seven years;
(b) Be maintained in a secure and dry manner;
(c) Include the following program files that are dated
and contain:
(A) Faculty name and qualifications;
(B) Curricula, including the teaching methodology;
(C) Course schedules, including classroom and supervised
clinical hours;
(D) Laboratory and clinical skill checklists;
(E) Final exams;
(F) Documentation of Board approvals and re-approvals;
and
(G) Policies, including but not limited to attendance,
behavioral expectations, course requirements including satisfactory progress
standards, criminal history checks, dress code, cancellations and refunds, and
administration of examinations.
(d) Include student records that contain:
(A) Course start date;
(B) Document signed by student stating that they have
received, read, and understand the disclosure statement, enrollment agreement,
and program policies;
(C) Student progress record;
(D) Laboratory and clinical skills checklist;
(E) Attendance record;
(F) Examination scores;
(G) Proof of CPR certification (nursing assistant level
1 training program);
(H) Proof of the criminal history check;
(I) Date of completion; and
(J) Record of student completion:
(i) Facility-based and independent programs shall
maintain a copy of the student certificate of completion;
(ii) Community College and High School programs may
meet this standard by appropriate notation on student transcript.
(K) Date the student was employed (if applicable).
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.444
Hist.: BN 6-1999, f. & cert.
ef. 7-8-99; BN 1-2004, f. 1-29-04, cert. ef. 2-12-04; BN 11-2004, f. &
cert. ef. 7-13-04; BN 2-2011, f. & cert. ef. 7-11-11
851-061-0130
Interstate Programs
(1) Out-of-State Programs who seek to send student(s)
for clinical experience in Oregon shall meet the requirements established in
OAR 851-061-0090(8)(c) and 851-061-0090(9)(b).
(2) Programs with faculty and facilities located in
Oregon and approved by another state shall be required to obtain approval as a
program in Oregon.
Stat. Auth.: ORS 678.440 &
678.444
Stats. Implemented: ORS 678.444
Hist.: BN 1-2004, f. 1-29-04,
cert. ef. 2-12-04; BN 2-2011, f. & cert. ef. 7-11-11
Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.
2.) Copyright 2011 Oregon Secretary of State: Terms and Conditions of Use |