216-40-05 R.I. Code R. § 22.5

Current through June 20, 2024

Section 216-RICR-40-05-22.5 - General Requirements: Nursing Assistants and Medication Aides

A. No person shall be employed in this State as a nursing assistant or medication aide unless he or she holds a license as a nursing assistant in accordance with the provisions of the Act and this Part.

B. No person shall assume the title of "nursing assistant" or such similar title or use any abbreviations or any other words, letters, signs, figures, or devices to indicate that the individual using same is a nursing assistant as set forth in these Regulations, unless he or she holds a license as a nursing assistant issued by the Department. The only abbreviation that a nursing assistant may use in this State is "N.A."

C. All nursing assistants and medication aides shall assess patient pain in accordance with the Rules and Regulations Related to Pain Assessment promulgated by the Department of Health, Part 20-15-2 of this Title.

D. All nursing assistants and medication aides must notify the Department of all changes of home address and all changes of employment within ten (10) days of any such change. Failure to provide notice will result in sanctions.

22.5.1Supervision

A. Nursing assistants must be supervised by a licensed nurse, physician, or other appropriate health professional who is duly licensed and/or certified as required by law. The type of supervision, either direct or indirect, shall be determined by the licensed health care facility as defined in R.I. Gen. Laws § 23-17-2(8). Provided, however, those duties listed in §22.12.1(B) of this Part shall be discharged only under direct supervision of a licensed nurse, physician, or other appropriate health professional who is duly licensed and/or certified as required by law.

B. A medication aide must be supervised by a licensed nurse, physician, or other appropriate health professional who is duly licensed and/or certified as required by law. The type of supervision, either direct or indirect, shall be determined by the licensed health care facility as defined in R.I. Gen. Laws § 23-17-2(8), provided, however, those duties listed in §22.12.1(B) of this Part shall be discharged only under direct supervision of a licensed nurse, physician, or other appropriate health professional who is duly licensed and/or certified as required by law.

C. For the first three (3) months of employment, a licensed nurse designated by the health care facility, adult day services program, or assisted living residence, as appropriate, shall conduct and document monthly evaluations (in accordance with the evaluation checklist on the Department website) of a medication aide who administers medication. After the first three (3) months, the evaluation shall be conducted no less than quarterly. Copies of said evaluations shall be placed in the medication aides' personnel records.

D. Persons who are actively enrolled in a bachelor of science program in nursing, associate degree program in nursing, accredited licensed practical nursing program, or registered nurse course of study in a National League for Nursing Accrediting Commission, Inc., or a Commission on Collegiate Nursing Education (CCNE) accredited nursing program, and have completed two (2) clinical courses, including a Fundamentals of Nursing course, and who provide written documentation from the clinical supervisor indicating that the student is prepared to serve as a nursing assistant, are exempt from completing a Nursing Assistant Training Program and from sitting for the National Nurse Assistant Assessment Program Skills portion.

22.5.2General Requirements: Medication Aides

A. Persons licensed by the Department as medication aides may administer medications, as provided in this Part, in nursing facilities, adult day services programs, and assisted living residences.

B. Medication Aides may not administer medications to patients who reside at home.

C. In accordance with R.I. Gen. Laws § 23-17.9-2(3), a medication aide license may be issued to any person who meets the requirements established under the Act and this Part.

D. No person may serve as a medication aide without holding a valid medication aide license issued by the Department.

E. A medication aide applicant shall be required to furnish such information as the Department may prescribe, and simultaneously with the filing of said application, shall pay to the Department the required non-refundable fee as set forth in Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).

F. All licenses issued to medication aides shall be valid for a period of two (2) years and shall expire on the same date as the medication aide's nursing assistant license.

G. A medication aide shall wear a name tag that indicates the aide's name and the appropriate license designation.

22.5.3Qualifications for Applicants

A. An applicant seeking a license as a Nursing Assistant must demonstrate:

1. Successful completion of a department-approved nursing assistant training program; or be actively enrolled in a nursing program in accordance with §22.5.1(D) of this Part; and

2. Successful completion of the required nursing assistant examination; or

3. Possession of a current license as a nursing assistant in good standing in another State or jurisdiction that includes successful completion of a State-approved training program that meets or exceeds Rhode Island Nursing Assistant training program requirements, and successful completion of a State-approved nursing assistant exam, and provides documentation of the equivalent of three (3) months of full-time work experience as a nursing assistant; or

4. Successful completion of a one hundred (100) hour State-approved training program in another State or jurisdiction that includes a minimum of twenty (20) hours of practical clinical training under supervision, and successful completion of a nursing assistant examination.

B. An applicant seeking License as a Medication Aide shall:

1. Possess an active license as a nursing assistant in Rhode Island;

2. Be a high-school graduate or the equivalent;

3. Not have been convicted of any felony for crimes involving controlled substances (subject to waiver by the Department upon presentation of satisfactory evidence that such conviction does not impair the ability of the person to conduct the duties of a medication aide without endangering public health and safety);

4. Provide proof of successful completion of a Department-approved medication aide training program defined in this Part.

5. Pass the Medication Aide Certification Exam.

C. Duties and Responsibilities of a Medication Aide A medication aide may perform only those tasks and duties for which he or she has been trained and for which there is documentation of proof of proficiency, as determined by his or her supervisor, but in no case shall those tasks and duties exceed what is permitted by Regulation, law, scope of practice, or as set forth in §22.12.3 of this Part.

D. License Application

1. Nursing Assistants

a. Application for a Rhode Island license as a nursing assistant shall be made on forms provided by the Department.

b. Such application must be accompanied by the following:

(1) Documented evidence of completion of a Department-approved nursing assistant training program;

(2) Documented evidence of successful completion of the required nursing assistant examination;

(3) The non-refundable processing fee in accordance with R.I. Gen. Laws § 23-17.9-5 and as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).

(4) If the nursing assistant is employed by a health care facility at the time of application and is continuously employed by the same facility for six (6) months after the license is issued, the fee required pursuant to R.I. Gen. Laws § 23-17.9-5 shall be directly refunded to the applicant by the facility or agency.

(5) Full Bureau of Criminal Investigation (BCI) check from the Rhode Island Attorney General's Office;

(6) If seeking registration under the provisions of §22.5.3(A)(3) of this Part, the applicant shall submit proof of an active license in good standing from the State or jurisdiction, written documentation from an employer attesting to no less than the equivalent of three (3) months of full-time work experience as a nursing assistant, as well as the items required in §§22.5.3(D)(1)(b) ((1)) through ((3)) of this Part.

(7) If seeking registration under the provisions of §22.5.3(A)(4) of this Part, the applicant shall submit written documentation of successful completion of a one hundred (100) hour State-approved training program (including the minimum of twenty (20) hours of practical clinical training under supervision) completed in another State or jurisdiction as well as the items required in §§22.5.3(D)(1)(b) ((2)) and ((3)) of this Part.

2. Medication Aides

a. Application for a Rhode Island license as a medication aide shall be made on forms provided by the Department.

b. Such application must be accompanied by the following:

(1) Documented evidence of completion of a Department-approved medication aide training program including a signed statement from the clinical supervisor or licensed nurse.

(2) The non-refundable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05 2 of this Title); and

(3) Full Bureau of Criminal Investigation (BCI) check from the Rhode Island Attorney General's Office.

22.5.4Licensure by Examination: Nursing Assistants

A. The nursing assistant written and practical examinations shall be selected and approved by the Director or designee.

B. All applicants shall be required to successfully complete the nursing assistant examinations within a period of one (1) year from the date that the applicant began the nursing assistant training program. If more than one (1) year has passed, the nursing assistant applicant shall be required to complete the nursing assistant training program again.

C. Nursing assistant applicants shall be given three (3) opportunities to successfully complete both the written and practical components of the nursing assistant examinations. After three (3) unsuccessful attempts to complete the nursing assistant examinations, the nursing assistant shall be required to repeat the nursing assistant training program.

D. Applicants for initial licensure as a nursing assistant by examination who have completed a nursing assistant training program in accordance with this Part, may be issued a one hundred twenty (120) day Temporary Permit authorizing the applicant to work under direct supervision of a licensed nurse or physician until the applicant has passed all required portions of the National Nursing Assistant Assessment Program or a nursing assistant written and practical examination selected and approved by the Director or his/her designee.

E. The training program shall provide ongoing assistance to candidates, as necessary and upon the candidate's request, to assure that testing date(s) are scheduled, and to facilitate the candidate's attendance and successful performance of the necessary tests. The availability of this assistance shall be communicated to all candidates prior to the conclusion of the training course. These efforts shall be documented and made available to the Department upon demand.

22.5.5Issuance and Renewal of License and Fee

A. The Department shall issue to applicants who have satisfactorily met the license requirements of this Part a license as a nursing assistant and/or medication aide. Unless suspended or revoked, this license shall expire biennially (every two (2) years) on June 30 of every other year following the date of issuance of the original registration.

B. Every nursing assistant and/or medication aide who wishes to renew his or her license shall file a renewal application with the Department together with the renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title) before June 15.

C. Upon receipt of such renewal application and payment of the fee, the Department shall renew the license effective July 1, and expiring June 30, two (2) years later unless the license is suspended or revoked.

D. Any nursing assistant and/or medication aide whose license lapses for a period of less than two (2) years may be reinstated by the Department upon submission of an application and payment of the renewal fee(s) as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title), unless the registration has been suspended or revoked.

E. A nursing assistant seeking renewal shall have been employed as a nursing assistant for at least eight (8) hours within the prior twenty-four (24) months and have completed twelve (12) hours of in-service training per year at the facility where employed; or have successfully completed a nursing assistant training program and passed the exam for licensure within the past twenty-four (24) months.

F. A medication aide seeking renewal shall have been employed as a medication aide for at least eight (8) hours within the prior twenty-four (24) months and submit proof of four (4) Continuing Education Units; or have completed a medication aide training program and have passed the Medication Assistant Certification Exam within the past twenty-four (24) months.

G. A nursing assistant applicant seeking renewal shall have been employed as a nursing assistant in:

1. A Rhode Island-licensed health care facility licensed under the provisions of R.I. Gen. Laws Chapter 23-17;

2. An assisted living residence licensed under the provisions of R.I. Gen. Laws Chapter 23-17.4;

3. An adult day services program licensed under the provisions of R.I. Gen. Laws § 23-1-52; or

4. Employed by a nursing service agency licensed under the provisions of R.I. Gen. Laws § 23-17.7.1-1.

5. Private duty employment does not meet this employment requirement.

H. A medication aide applicant seeking renewal shall have been employed as a medication aide in:

1. A Rhode Island-licensed nursing facility licensed under the provisions o f R.I. Gen. Laws § 23-17-1;

2. An assisted living residence licensed under the provisions of R.I. Gen. Laws Chapter 23-17.4; or

3. An adult day services program licensed under the provisions of R.I. Gen. Laws § 23-1-52.

I. Any nursing assistant and/or medication aide whose license lapses for a period of two (2) years or longer, and who cannot provide proof of employment in accordance with §§22.5.5(G) and (H) of this Part, shall be required to successfully complete the nursing assistant training and/or medication aide training program, and all required examinations, prior to being reinstated as a nursing assistant and/or medication aide.

J. A nursing assistant applicant seeking renewal shall attest that he or she has been employed within the previous twenty-four (24) months when completing the online renewal form. Renewal applicants are subject to audit and must retain proof of completion of in-service hours and/or Continuing Education Units for a three (3) year period.

K. Continuing Education Requirements: Medication Aides

1. Every medication aide seeking renewal of a license under the provisions of the Act and this Part shall provide satisfactory evidence to the Department that in the preceding two (2) years the licensee has completed four (4) required continuing education hours as established in this section.

2. Continuing education hours related to medication administration will be accepted by the Board for course work that has been presented, accepted, or approved by recognized professional nursing organizations, schools of pharmacy, health care facilities, employing organizations, or other professional organization, labor organization, or accrediting agency as may be approved by the Board.

3. At the time of license renewal, each medication aide will be required to attest to the completion of the above continuing education requirements.

4. It shall be the sole responsibility of the individual medication aide to obtain documentation (e.g., course descriptions, proof of attendance) from the sponsoring organization, agency, or institution of his or her participation in a continuing education program and/or activity. These documents shall be retained by each licensee for no less than three (3) years and are subject to random audit by the Department.

5. Failure to produce satisfactory documentation of completion of the requirements of this section, upon request by the Board, constitutes grounds for disciplinary action under the provisions of the Act.

L. Removal of Name from Nurse Aide Registry

1. In the case of a finding of unprofessional conduct, as defined in this Part, a nursing assistant may petition the Department in writing to have his or her record of discipline removed from the registry upon a determination by the Department that the employment and personal history of the nursing assistant does not reflect a pattern of unprofessional conduct; and the conduct involved in the original finding was a singular occurrence.

2. A nursing assistant shall submit a written petition to:

Rhode Island Department of Health

Nursing Assistant Advisory Board

3 Capitol Hill, Room 104

Providence, RI 02908

3. Such petition shall request that the nursing assistant's offense be removed from the registry in accordance with the criteria stated in §22.5.5(L)(1) of this Part.

4. The nursing assistant's name and record of discipline shall remain on the registry for a period of two (2) years from the date on which the name was placed on the registry after which time the name may be removed if the petitioner's request is granted by the Department.

M. Reinstatement of Nursing Assistant License

1. A nursing assistant who has been licensed in Rhode Island in good standing, has let his or her license lapse, and has been working as a nursing assistant in another State or jurisdiction within the two (2) years immediately preceding the application for reinstatement and has completed twelve (12) hours of in-service per twelve (12) month period, may apply for reinstatement upon submission of the following:

a. Photocopy of active license/registration from the State or jurisdiction where employed as a nursing assistant;

b. Reinstatement processing fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title);

c. Attestation of employment as a Nursing Assistant for eight (8) hours within the past two (2) years (license must be current at the time of employment) in a nursing home, hospital, home care agency, assisted living residence, adult day services program, or employed by a nursing service agency;

d. Attestation of completion of twelve (12) hours per twelve (12) month period of in-service training;

e. Verification from current State of licensure that the applicant for reinstatement is and has been in good standing in that jurisdiction.

216 R.I. Code R. § 216-RICR-40-05-22.5

Adopted effective 5/21/2022
Amended effective 2/1/2023