DHS 129.07(2)(c)1.1. Access to a clinical setting approved by the department that is adequate to meet the needs of the program. DHS 129.07(2)(c)1.a.a. Clinical settings shall be in compliance with state and federal law. The program designee or primary instructor and the health care provider with whom the program has contracted are responsible for verifying that the clinical facility is in compliance with state and federal law. This verification shall be documented in the program’s files and shall be available during the evaluation process. DHS 129.07(2)(c)1.b.b. The agreement between the program and the clinical setting shall be reviewed and renewed annually by the department and upon any change of facility or school administration. A copy of the agreement shall be submitted to the department. DHS 129.07(2)(c)1.c.c. During classroom and lab instructions, students shall be oriented to the various forms used to document resident information. Instructors shall supervise documentation on the appropriate flow sheets and forms during the clinical rotation. DHS 129.07(2)(c)1.d.d. Before a student begins a clinical rotation, the primary instructor shall evaluate and document that the student successfully demonstrated the ability to perform a skill. DHS 129.07(2)(c)1.e.e. Students may not give hands-on care to a resident who is not assigned to the student unless the student is under the direct supervision of the primary instructor. DHS 129.07(2)(c)1.f.f. Students who are under the general supervision of the primary instructor may be paired, during the student’s clinical rotation, with nurse aides who are employed by the health care provider. DHS 129.07(2)(c)1.g.g. Students shall maintain safe practices, infection control and respect resident rights at all times. DHS 129.07(2)(c)1.h.h. Students shall demonstrate knowledge regarding their assigned residents’ diagnoses and identified needs. DHS 129.07(2)(c)1.i.i. Students and instructors shall wear clothing that is in compliance with program policy and that is appropriate for performing resident care. The clothing shall include a nametag that designates the name of the nurse aide training program and the person’s status as a student or instructor. DHS 129.07(2)(c)1.j.j. The scheduled clinical hours shall provide experiences that meet expected outcomes outlined in the program curriculum. DHS 129.07(2)(c)1.L.L. A health care facility may serve as the site of clinical instruction for up to 2 nurse aide training programs at the same time, except that the department may decide to allow more than 2 programs at a single health care facility on a case-by-case basis in conjunction with the facility’s administrative staff. DHS 129.07(2)(c)1.m.m. The program shall not be used as a substitute for staff orientation or staff education programs. DHS 129.07(2)(c)2.2. An adequate number of primary instructors in the clinical setting to provide safe and effective supervision and assistance of students. DHS 129.07(2)(c)2.a.a. Primary instructors shall not function in another role while supervising students in the clinical setting. DHS 129.07(2)(c)2.b.b. A ratio of 6 to 8 students per instructor is considered to be adequate in most circumstances. DHS 129.07(2)(c)2.c.c. The primary instructor shall evaluate and document that a student demonstrated successfully the ability to perform a skill before the student begins a clinical rotation. DHS 129.07(2)(c)2.d.d. The primary instructor shall make all student clinical assignments with the approval of the health care provider. The instructor shall complete a review of each resident’s chart to retrieve pertinent information needed by the students to provide the required cares. Care plan information shall be reviewed at the beginning of each clinical experience and shall include new orders or changes in each resident’s status. DHS 129.07(2)(c)2.e.e. A student’s assignment shall be shared with the clinical setting to which the student is assigned before the student arrives at the clinical setting. DHS 129.07(2)(c)2.f.f. Each student shall be given an individual assignment. More than 2 students shall not be assigned to the same resident at the same time. i. Care of clients with varied levels of care needs.
ii. The opportunity to be evaluated on organizational skills and time management.
DHS 129.07(2)(c)2.h.h. The RN primary instructor is responsible for supervising the clinical performance of each LPN program trainer. DHS 129.07(2)(d)(d) Nursing home-based program. Training of nurse aides may be performed under the general supervision of the director of nursing for a facility; however, the director of nursing may not act as the primary instructor or as a program trainer. Primary instructors shall not be involved in more than one role while supervising students in the clinical area. DHS 129.07(2)(e)1.1. The training program shall maintain a list of the required skills and competencies that a student will complete by the end of the training program. DHS 129.07(2)(e)2.2. On the list of skills, the primary instructor shall verify, by initialing and dating each individual skill, that the student has satisfactorily performed that skill. When a student has satisfactorily completed all required skills and competencies and attained the necessary knowledge, as well as achieved the stated course completion criteria, the trainee qualifies to enter a competency evaluation program. DHS 129.07(2)(e)3.3. The primary instructor shall provide a copy of the student’s performance record to the student at the conclusion of the student’s training. DHS 129.07(2)(f)(f) Record retention. The training program shall retain all records required by this section for a period of at least 3 years after a student completes the training program. DHS 129.07 HistoryHistory: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correction in (1) (e) 1. h. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; renumbering in (2) (c) 2. g. made under s. 13.92 (4) (b) 1., Stats., Register November 2008 No. 635; CR 16-088: am. (1) (intro.), cr. (1m), am. (2) (b) (title), 1., cr. (2) (bm), am. (2) (d), (e) 1. Register September 2017 No. 741, eff. 10-1-17; correction in (1m), (2) (b) made under s. 35.17, Stats., Register September 2017 No. 741; 2019 Wis. Act 1: am. (1) (a) 1. b. Register May 2019 No. 761, eff. 6-1-19; CR 20-068: am. (2) (a) 3. Register December 2021 No. 792, eff. 1-1-22; CR 21-087: r. and recr. (1) (title), (intro.), r. (1m), r. and recr. (2) (b) (title), 1., r. (2) (bm) Register June 2022 No. 798, eff. 7-1-22. DHS 129.08DHS 129.08 Standards for nurse aide competency evaluation programs. DHS 129.08(1)(1) Examiner qualifications. The examiner conducting the clinical competency program of a student shall be an RN with at least one year experience caring for the elderly or chronically ill of any age. DHS 129.08(2)(a)(a) The RN examiner will give each student instructions for the written or oral evaluation component. After the student’s written or oral evaluation has begun, the RN may designate another person to proctor the written or oral evaluation. DHS 129.08(2)(b)(b) The competency evaluation program shall develop a pool of test questions that addresses all 6 content areas and their components under s. DHS 129.07 (1). The test questions shall include enough questions to form 3 separate and complete examinations. DHS 129.08(2)(c)(c) The competency evaluation program shall develop written and oral examinations from the pool of test questions. The content of the written and oral examinations shall reflect the content and emphasis of the training program approved by the department. DHS 129.08(2)(d)(d) The competency evaluation program shall provide students with written and oral examinations in English. If the student will be working in a provider setting in which the predominant language is other than English, the program may not refuse to test in the language that is predominant in that work setting. DHS 129.08(2)(e)(e) The competency evaluation program may develop an oral examination for nurse aides with limited literacy skills. To do so, the program shall adapt the written examination for oral testing. The oral examination shall cover the same subject areas included in the original written examination adapted for oral testing, and shall include a component to determine the aide’s ability to read basic, objective, job-related information, such as reading a client’s name band or a client’s flow sheet. DHS 129.08(2)(f)(f) A minimum of 50 written or oral questions shall be asked in each examination. The questions shall cover at least the 6 care areas under s. DHS 129.07 (1) and shall be selected randomly from the following areas: DHS 129.08(2)(f)1.1. A minimum of 4 questions in the area of interpersonal communication and social interaction. DHS 129.08(2)(f)2.2. A minimum of 7 questions in the area of basic nursing skills. Of these 7 questions, at least one question shall address each of the following areas: DHS 129.08(2)(f)2.a.a. Observation, reporting and documentation of changes in client status and services furnished. DHS 129.08(2)(f)2.b.b. Recognizing and reporting change of client condition and status to supervisor. DHS 129.08(2)(f)5.5. A minimum of 5 questions in the area of client rights. Of these 5 questions, at least one question shall address each of the following areas: DHS 129.08(2)(g)(g) To successfully complete the written or oral portion of the competency evaluation program, the student shall obtain satisfactory scores as identified in par. (f). DHS 129.08(3)(a)(a) The competency evaluation program shall develop a pool of skill demonstration scenarios. There shall be a sufficient number of skill demonstration scenarios to measure the individual’s ability to perform the required job tasks. Skills demonstration scenarios shall be randomly selected from the pool of skills to be demonstrated. The care areas of interpersonal communication and social interaction shall be integrated throughout the skills demonstration scenarios. DHS 129.08(3)(b)(b) The skills demonstration shall consist of a demonstration of at least 5 randomly selected items drawn from a pool consisting of the tasks generally performed by nurse aides. This pool of skills shall include all skills listed in s. DHS 129.07. DHS 129.08(3)(c)(c) The criteria for successful completion of a competency evaluation program shall include the passing scores in all required skills. DHS 129.08(4)(4) Examinations. To be included on the registry under s. DHS 129.09, a student shall successfully pass a Wisconsin-approved nurse aide competency evaluation examination within one year of completing an approved nurse aide training program. If a person fails to pass any component of the competency evaluation examination, the individual need only retake the failed component. The person may retake the component failed as many times as needed within the one-year time period. The competency evaluation program shall ensure that each repeat examination shall differ in content from any examination previously taken by the individual. DHS 129.08(5)(5) Program operation. The competency evaluation program shall maintain all of the following standards in operating the program: DHS 129.08(5)(b)(b) An adequate number of examiners to provide safe and effective supervision and assistance. DHS 129.08(5)(c)(c) Assurance that examiners do not test students they have trained. DHS 129.08(5)(d)(d) Skills demonstration exercise portions of the examination are conducted at a ratio of one examiner to one student. DHS 129.08(5)(e)(e) Competency evaluation facilities that are adequate to meet the needs of the testing program. DHS 129.08(5)(f)(f) Retention of all records required under this section for a period of at least 3 years. DHS 129.08(5)(g)(g) A system to prevent unauthorized disclosure of the pool of test questions and the results of the individual competency evaluations. DHS 129.08 HistoryHistory: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correction in (2) (g) made under s. 13.92 (4) (b) 7., Stats., Register May 2011 No. 665; CR 20-068: am. (5) (a) Register December 2021 No. 792, eff. 1-1-22. DHS 129.09(1)(1) Content of the registry. The department shall maintain information about a person on the registry, including: DHS 129.09(1)(a)(a) The person’s eligibility for employment in a department-approved or licensed health care provider. DHS 129.09(1)(g)(g) The date the aide completed a competency evaluation program, if applicable. DHS 129.09(1)(i)(i) The dates, if any, that indicate the aide’s employment status. DHS 129.09(1)(k)(k) The 2 character alphabetic postal code of any state other than Wisconsin in which a finding of abuse, neglect, or misappropriation has been placed on the registry against the aide. DHS 129.09(1)(L)(L) Any finding of abuse or neglect of a client or misappropriation of a client’s property made by the department under s. 146.40 (4r) (b), Stats., or, if appealed, by a hearing officer under s. 146.40 (4r) (d), Stats., and a brief rebuttal statement provided by the affected nurse aide under s. 146.40 (4r) (e), Stats., if the nurse aide disputes the finding. DHS 129.09(2)(a)(a) The department or the department’s contractor shall place an individual’s name on the registry within 30 days after an individual has satisfactorily completed the competency evaluation program. DHS 129.09(2)(b)(b) An individual who is eligible for inclusion in sub. (5) in the registry, but for whom notification is not required under par. (a), or a hospital, nursing home, facility for the developmentally disabled, home health agency or hospice on behalf of that individual, may apply to the department to include that individual in the registry. DHS 129.09(3)(a)(a) Upon receiving an application under sub. (2) (b), the department or its agent shall review the application and make any inquiries necessary to determine if the individual is eligible to be included in the registry. False eligibility information submitted to the department or its contractor shall result in denial of the application or, if the application had already been processed, shall result in the individual’s removal from the registry.
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