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. DHS 129.09(3)(b)(b) Within 30 days after receiving an application, the department or its contractor shall approve the application and include the person in the registry, or deny the application. If the application for inclusion is denied, the department or its contractor shall give the individual, or the facility or agency that submitted the application on behalf of the individual, reasons, in writing, for the denial. DHS 129.09(4)(4) Release of registry information. The registry shall serve as an official record of persons who are qualified by training and testing, or experience, to work as a nurse aide or a medication aide. The department may use registry information in its surveys of facilities and agencies. With the exception of sub. (1) (b), the information included in the registry about nurse aides is public information. A written request for registry information shall be accompanied by a self-addressed, stamped envelope. DHS 129.09 NoteNote: Written requests for registry information may be sent to the Office of Caregiver Quality, P.O. Box 2969, Madison, WI 53701-2969.
DHS 129.09(5)(5) Eligibility for inclusion on the registry. An individual is eligible to be included in the registry only if at least one of the following is true: DHS 129.09(5)(a)(a) The individual has, within 120 days of beginning employment as a nurse aide, successfully completed a training program and a competency evaluation program for nurse aides that are approved by the department under s. 146.40, Stats. DHS 129.09(5)(b)(b) The individual has successfully completed an approved training program and a competency evaluation program in another state that meet criteria for acceptance in this state. DHS 129.09(5)(c)(c) The individual has completed a basic nursing course from a board-approved school for nursing under s. 441.01 (4), Stats., or has completed a basic nursing course approved in another state by that state’s board of nursing and the student nurse has successfully completed a competency evaluation program. DHS 129.09(6)(a)(a) State-licensed-only settings. Except as provided under sub. (7), a person included on the registry under any of the paragraphs in sub. (5), regardless of the title under which the person is employed, is eligible to be employed as a nurse aide by a health care provider. DHS 129.09(6)(b)(b) Federally-certified settings. Except as provided under sub. (7), regardless of the title under which a person is employed, a person is eligible to be employed by a health care provider if the person is included on the registry under sub. (5) (a), (b) or (c), and if the person has performed nursing or nursing-related services for monetary compensation at any time during the 24 consecutive months immediately before the individual’s employment in a health care provider’s setting would begin. If a person has not performed nursing or nursing-related services for monetary compensation at any time during the 24 consecutive months immediately before the person’s employment would begin, in order to be eligible to be employed by a health care provider, the person shall successfully complete a department-approved training and competency evaluation program, or a department-approved competency evaluation program for nurse aides. DHS 129.09(6)(c)(c) Student nurses. A person currently enrolled as a student nurse who has completed a basic nursing course at a school approved by the Wisconsin Board of Nursing under s. 441.01 (4), Stats., is eligible to be employed as a nurse aide in a hospital, facility for the developmentally disabled, or federally-certified intermediate care facility for individuals with intellectual disabilities even if that person is not included on the registry and even if that person has not successfully completed a competency evaluation program under sub. (5) (c). DHS 129.09(7)(7) Employment prohibitions. A federally-certified nursing home may not hire or continue to employ a nurse aide who has a finding of abuse, neglect or misappropriation entered on the registry as a result of an incident that occurred in a federally-certified nursing home. A federally-certified intermediate care facility for individuals with intellectual disabilities may not hire or continue to employ a nurse aide who has a finding of abuse, neglect or misappropriation entered on the registry. DHS 129.09(8)(8) Removing nurse aides from the registry. The name of a nurse aide who has not updated the nurse aide’s employment history on the registry in the previous five-year time period will be removed from the registry, except that the names of nurse aides with substantiated findings of caregiver misconduct as defined in s. DHS 13.03 (13) will remain on the registry. For any person whose name is removed from the registry, In order to be placed on the registry again, the person shall successfully complete another nurse aide training program and competency evaluation. DHS 129.09 HistoryHistory: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; renumbering in (6) (c) and correction in (8) made under s. 13.92 (4) (b) 1. and 7., Stats., Register November 2008 No. 635; 2019 Wis. Act 1: am. (6) (c), (7) Register May 2019 No. 761, eff. 6-1-19. DHS 129.10(1)(1) Subject of appeal. Except for the denial of an approval of a nurse aide training or competency evaluation program under 42 CFR 483.151 (b) (2) or (3) or the withdrawal of approval of a nurse aide training or competency evaluation program under 42 CFR 483.15(e)(1) or (3), a health care provider may appeal to the department of administration’s division of hearings and appeals any of the following:
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