HAR Chapter 89A – Nurse Aide

§16-89A-2
HAWAII ADMINISTRATIVE RULES
TITLE 16
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
CHAPTER 89A
NURSE AIDE
Subchapter 1 General Provisions
§16-89A-1 	Objective
§16-89A-2 	Definitions
§16-89A-3 	Requirements for nurse aide certification
§16-89A-4 	Maintenance requirements for recertification
§16-89A-5 	Implementation and maintenance of registry
§16-89A-6 	Removal of entries from registry
SUBCHAPTER 1
GENERAL PROVISIONS
§16-89A-1 	Objective. 	This chapter is intended to clarify and implement
chapter 457A, Hawaii Revised Statutes, thereby also implementing the provisions
of 42 United States Code sections 1395i-3 and 1396r, to the end that the provisions
thereunder may be best effectuated and the public interest most effectively served.
[Eff 2/12/09] (Auth: HRS §457A-3) (Imp: HRS §457A-2)
§16-89A-2 Definitions. As used in this chapter:
"Department" means the department of commerce and consumer affairs,
unless specified otherwise.
"Director" 	means 	the 	director 	of 	the 	department 	of 	commerce 	and
consumer affairs, unless specified otherwise. [Eff 2/12/09] (Auth: HRS §457A-3)
(Imp: HRS §§457A-2, 457A-3)
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§16-89A-3
§16-89A-3 	Requirements 	for 	nurse 	aide 	certification. 	(a) 	The
requirements for a person applying for certification as a nurse aide working in a
medicare or medicaid certified nursing facility shall consist of the successful
completion of:
(1) 	The nurse aide training program approved by the director of the
department of human services. 	No person shall be permitted to
take the nurse aide examination until that person has successfully
completed the training program; and
(2) 	The nurse aide examination approved by the director, with a
passing score of seventy per cent on the test, along with the
successful demonstration of certain skills. 	The examination shall
consist of either a written or oral test, at the election of the
applicant, along with a demonstration of skills by means of a skills
evaluation. 	The skills demonstration shall consist of five randomly
selected items drawn from a pool consisting of tasks generally
performed 	by 	a 	nurse 	aide; 	the 	person 	must 	successfully
demonstrate all of these skills. 	The pool of skills shall include all
personal care skills 	listed in 42 Code of Federal Regulations
(C.F.R.) §483.152(b)(3).
(b) 	The requirements for a person applying for certification as a nurse
aide working in state-licensed or state-certified health care settings shall consist of
the successful completion of:
(1) 	The nurse aide training program approved by the director of the
department of human services. 	No person shall be permitted to
take the nurse aide examination until that person has successfully
completed the training program; and
(2) 	The nurse aide examination approved by the director, with a
passing score of seventy per cent on the test, along with the
successful demonstration of certain skills. 	The examination shall
consist of either a written or oral test, at the election of the
applicant, along with a demonstration of skills by means of a skills
evaluation, as provided in subsection (a)(2).
(c) 	Reciprocity certification shall be granted to a qualified nurse aide
from 	another 	state 	whose 	requirements 	are 	comparable 	to 	the 	certification
requirements of this subchapter.
(d) 	Once a nurse aide has met all of the requirements for certification,
the director shall provide a certificate to the nurse aide.
(e) 	A person who is unsuccessful in attaining certification shall be
advised of the areas in which the person is deficient.
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§16-89A-4
(f) 	An individual whose application for certification has been denied
shall be given the notice and opportunity for a hearing pursuant to chapter 91,
Hawaii Revised Statutes. 	[Eff 2/12/09] (Auth: 	HRS §457A-3) (Imp: 	HRS
§§91-9, 457A-1, 457A-1.5, 457A-2, 457A-3, 457A-7, 457A-8)
§16-89A-4 	Maintenance requirements for recertification. 	(a) A nurse
aide's certification is valid for a limited period up to twenty-four months and shall
be renewed biennially. 	The certification of each nurse aide shall cease upon the
expiration of that nurse aide's current biennial certification period, as determined
by the department. 	A nurse aide's recertification application shall be received
by the department on or before the end of the business day that is one month
before the date the current certification expires. 	Each nurse aide shall be
responsible for renewing the certification in a timely manner and satisfying the
recertification 	requirements 	provided 	by 	law. 	Lack 	of 	notification 	by 	the
department shall not be a valid reason for a nurse aide's non-renewal. Each nurse
aide 	shall 	be 	responsible 	for 	ensuring 	timely 	renewal 	of 	that 	nurse 	aide's
certification.
(b) 	The recertification requirements for a nurse aide working in a
medicare or medicaid certified nursing facility shall consist of the successful
completion of:
(1) 	An annual performance review completed by the facility at least
once every twelve months;
(2) 	Regular in-service training provided by that facility based upon
the outcome of the annual performance reviews;
(3) 	A completed renewal application on a form approved by the
department and postmarked or received by the department on or
prior to thirty (30) days before the biennial expiration date, as
determined by the department. 	The form shall be signed by the
medicare 	or 	medicaid 	certified 	nursing 	facility's 	director 	of
nurses, registered nurse, director of human services, physician or
designee 	recognized 	by 	the 	department 	of 	health 	or 	the
department 	of 	human 	services, 	who 	shall 	verify 	successful
completion of paragraphs (1) and (2) herein; and
(4) 	Verification 	that, 	for 	monetary 	compensation, 	the 	nurse 	aide
provided, at a minimum, one full day of nursing or nursing-related
services, in a medicare or medicaid certified nursing facility,
involving direct patient care within the prior twenty-four months.
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§16-89A-4
(c) 	The 	recertification 	requirements 	for 	a 	nurse 	aide 	working 	in
state-licensed or state-certified health care settings shall consist of the successful
completion of:
(1) 	A competency evaluation approved by the department of human
services;
(2) 	A completed renewal application, including applicable fees, on a
form approved by the department and postmarked or received by
the department on or prior to thirty (30) days before the biennial
expiration date, as determined by the department; and
(3) 	Verification 	acceptable 	to 	the 	department 	that, 	for 	monetary
compensation, the nurse aide provided, at a minimum, one full day
of nursing-related services, in a state-licensed or state-certified
health care setting, involving direct patient care within the prior
twenty-four months.
(d) 	If a nurse aide has not provided proof of completing a minimum
one 	full 	day 	of 	nursing 	or 	nursing-related 	services 	in 	a 	state-licensed 	or
state-certified 	health 	care 	setting 	involving 	direct 	patient 	care 	for 	monetary
compensation within the prior twenty-four months in either the facility or setting or
fails to meet renewal requirements, that nurse aide shall complete the certification
requirements of section 16-89A-3 anew. 	[Eff 2/12/09] (Auth: 	HRS §457A-3)
(Imp: HRS §§457A-1, 457A-2, 457A-3, 457A-7, 457A-8)
§16-89A-5 	Implementation 	and 	maintenance 	of 	registry. 	(a) 	The
department shall establish and maintain a registry of all nurse aides who have
been certified by the department as nurse aides to work in either a medicare or
medicaid nursing facility or in state-licensed or state-certified health care settings
or who have been deemed to meet the certification requirements by reciprocity
or the nurse aide has been deemed to have met the requirements pursuant to
42 C.F.R. §483.150(b). 	No charge for the maintenance of this registry shall be
imposed upon nurse aides working in a medicare or medicaid certified nursing
facility. The registry shall be sufficiently accessible to promptly meet the needs
of the public and health care providers. 	The record of successful certification
shall be included in the registry within thirty days.
(b) 	The registry shall contain the following information which shall
be considered confidential unless otherwise specified herein or as provided by
law:
(1) 	The nurse aide's full name;
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§16-89A-5
(2) 	The 	nurse 	aide's 	home 	address, 	home 	and 	work 	telephone
numbers, 	and 	social 	security 	number 	or 	other 	identifying
information, 	and 	verification 	that 	the 	nurse 	aide 	is 	at 	least
eighteen years of age;
(3) 	The nurse aide's place of employment;
(4) 	The date when the nurse aide became eligible for entry in the
registry by successfully completing certification or the date when
the nurse aide was deemed to have met the requirements pursuant
to 42 C.F.R. §483.150(b);
(5) 	Any substantiated finding of abuse, neglect, or misappropriation of
resident's property by the nurse aide documented and reported by
the department of health or the department of human services to
the registry within ten working days of that finding. 	If there is a
substantiated finding of resident abuse, neglect, or misappropriation
of resident's property from another state's registry against an
individual applying as a nurse aide in this State, that finding shall be
listed in this State's registry. 	Except as provided herein, only the
department of health or the department of human services may
formulate a substantiated finding for a nurse aide. 	The director's
role, with regard to disciplining nurse aides, shall be limited to
the placement of a substantiated finding and related information
in 	the 	registry. Any 	appeal 	regarding 	the 	reporting 	and
placement of a substantiated finding in the registry shall be made
to the department of health or the department of human services,
whichever department was responsible for reporting that finding
for placement in the registry. 	The substantiated finding shall
include:
(A) 	Documentation of the State's investigation, including the
nature 	of 	the 	allegation, 	the 	evidence 	that 	led 	the
department of health or the department of human services
to conclude that the allegation was valid, and any other
documentation of the department of health's investigation
or the department of human services' investigation as
deemed 	appropriate 	by 	the 	State 	or 	the 	nurse 	aide's
criminal conviction;
(B) 	The date of the hearing, if requested by the nurse aide,
and the outcome; and
(C) 	The nurse aide's statement disputing the allegation, if the
nurse aide chooses to make a statement; and
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§16-89A-5
(6) 	The information in paragraph (5) shall remain in the registry
permanently, unless the information is removed in accordance
with section 16-89A-6.
(c) 	Except as provided by law, the department shall disclose to any
person all of the information provided in the subsections (b)(1), (3), (4), and
(5).
(d) 	The department of health or the department of human services, as
applicable, shall promptly provide a nurse aide, who is listed with the registry,
with all information in the registry when adverse findings are reported to and
placed in the registry and upon a nurse aide's request for information. A nurse
aide may correct any misstatements or inaccuracies in that nurse aide's entry in
the registry by making a request in writing to the department of health or the
department of human services, as applicable. 	If a nurse aide disagrees with the
department of health's or the department of human services' decision regarding
the correction of an entry for that nurse aide, the nurse aide may request a
contested case hearing in accordance with chapter 91, Hawaii Revised Statutes.
(e) 	A nurse aide may be removed from the registry in accordance with
section 16-89A-6. 	If, after removal from the registry, a nurse aide wishes to be
restored to the registry, that nurse aide shall complete the certification process as a
new applicant in accordance with section 16-89A-3.
(f) 	The department may contract the daily operation and maintenance
of the registry to a non-state entity, while the State retains accountability for
oversight of the registry. 	[Eff 2/12/09] (Auth: 	HRS §457A-3) (Imp: 	HRS
§§457A-1.5, 457A-2, 457A-3, 457A-7, 457A-8)
§16-89A-6 	Removal of entries from registry. 	(a) The registry shall
remove an entry for a nurse aide who has not performed nurse aide services for
twenty-four consecutive months, unless that entry includes documented findings of
abuse, neglect, or misappropriation of resident's property, in which case the entry
shall remain permanently in the registry unless removed in accordance with
subsection (b).
(b) 	In the case of a substantiated finding, made by the department of
health or the department of human services, against a nurse aide for abuse,
neglect, or misappropriation of resident's property the applicable department shall
remove 	that 	substantiated 	finding 	against 	the 	nurse 	aide's 	name 	upon 	the
determination that:
(1) 	The finding was erroneous, a court found the nurse aide not guilty,
or the State is notified of the nurse aide's death; or
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§16-89A-6
(2) 	The nurse aide's employment and personal history does not reflect
a 	pattern 	of 	abuse, 	neglect, 	or 	misappropriation 	of 	resident's
property; and
(3) 	The abuse, neglect, or misappropriation of resident's property
involved in the original finding was a singular occurrence. [Eff
2/12/09] (Auth: HRS §457A-3) (Imp: HRS §§457A-2, 457A-3)
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The new chapter 16-89A, Hawaii Administrative Rules, on the Summary
page dated December 24, 2008, were adopted on December 24, 2008, following a
public hearing held on December 24, 2008, after public notice was given in the
Honolulu Star-Bulletin, The Garden Island, Hawaii Tribune-Herald, West Hawaii
Today, and The Maui News on November 23, 2008.
They shall take effect ten days after filing with the Office of the Lieutenant
Governor.
/s/ Lawrence M. Reifurth
LAWRENCE M. REIFURTH, Director
Commerce and Consumer Affairs
APPROVED AS TO FORM: 	Date: 	1/8/09
/s/ James F. Nagle
Deputy Attorney General
APPROVED: 	Date: 	2/2/09
/s/ Linda Lingle
LINDA LINGLE
Governor
State of Hawaii
February 2, 2009
Filed
89A-9

DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Adoption of Chapter 16-89A
Hawaii Administrative Rules
December 24, 2008
SUMMARY
Chapter 16-89A, Hawaii Administrative Rules, entitled "Nurse Aide", is
adopted.
This material can be made available for individuals with special needs. Please call the Program Specialist,
Professional and Vocational Licensing Division, DCCA, at 586-2692, to submit your request.
Effective 2/12/09