Home Health Aide Requirements in Nebraska

Nebraska’s home health aides help ill and disabled clients with many tasks, including some that go well beyond the traditional role of providing personal care, mobility assistance, nutrition, and household help. However, this doesn’t mean that all the state’s home health aides have expanded duties — or that all need to meet training and assessment requirements for the full set.

Nebraska’s basic HHA training requirement is at the minimum national standard with regard to program hours. However, the requirement applies to some individuals who would not be covered under national standards. The AARP has cited Nebraska as one of the top states in the nation with regard to duties that can be delegated by a nurse to a direct care worker in a home setting. Some tasks, though, do require specialized training. The individual may, for example, need to be credentialed as a medication aide.

Nebraska defines home health agency broadly. An agency qualifies if it exists to provide skilled nursing or one or more of a number of other therapies. Even the provision of home health aides could in some cases qualify an agency as home health. However, state code notes some exceptions; an agency other than a home health agency may engage in provision of basic personal care services.

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Home Health Aide Training and Evaluation in Nebraska

A Nebraska home health aide will either 1) complete a home health aide training program or 2) complete a nursing assistant program or equivalent nursing coursework and pass a home health aide competency evaluation.

Nebraska has set minimum training program requirements for home health aides. Generally, these echo federal standards for Medicare-certified facilities. The curriculum includes personal care tasks, mobility-related tasks, and health-related measurement and recording. It also includes concepts related to maintenance of a safe home environment, provision of fluids and nutrition, respect for client needs, and procedures for documentation, reporting, and handling of emergencies. Federal standards note, under personal care, that the trainee will learn to provide a bed bath and a tub, sponge, or shower bath; Nebraska standards reference sponge, bed, tub, and shower baths. Federal standards note provision of a tub, sink, or bed shampoo; Nebraska standards note provision of tub, sink, and bed shampoo.

Any organization can offer a home health aide program unless it has been disqualified. The organization must have adequate human resources: Training must be provided under a registered nurse’s general supervision.

Competency evaluation will consist of both skill demonstration and oral or written testing. The following skills will need to be tested on an actual patient or other human being:

  • Reading and recording of weight, respiration, and pulse
  • Safe transfer and ambulation
  • Bathing
  • Skin and nail care
  • Positioning and range of motion
  • Shampoo
  • Oral hygiene

Home health agencies are also required to assess competency for other care tasks that their HHAs will need to do on the job. A home health aide who receives an unsatisfactory on a task will be able to perform it only under direct supervision pending re-evaluation.

The following competencies are required in all cases and are assessed through oral or written means:

  • Communication skills
  • Infection control procedures
  • Basic body functions/ changes that need reporting
  • Observing, reporting, and documenting
  • Maintaining a safe, healthy, and clean environment
  • Adequate fluid and nutritional intake
  • Emergency recognition and related procedures
  • Needs of the population served and ways to work with this population

In many cases, care will be provided under order of a doctor. More basic services (personal care, assistance with activities of daily living) will not necessarily be doctor-ordered.

Supervision is ongoing. Generally, a home health aide will receive supervision by a registered nurse. If the client is receiving therapy (occupational therapy, speech therapy, physical therapy) but is not receiving skilled nursing, supervision may be provided by the appropriate therapist.

Meeting Requirements for Medication Aide

Some potentially allowable duties will require credentialing as a medication aide. Nebraska recognizes two levels of medication aide credentialing. ‘Medication Aide-40 hour’ is required of individuals who administer medication in certain settings; the list includes assisted living facilities as well as nursing homes. ‘Medication aide’ is adequate for many settings. Both classifications require the person to demonstrate proficiency in a range of state-identified competency areas; the ’40 hour’ classification requires (as the title implies) a 40-hour course.

The following are among the competencies:

  • Maintaining confidentiality
  • Providing complete documentation
  • Complying with patient medication refusal
  • Understanding and following directions
  • Giving the right dose of the right medication to the right person at the right time via the right route (aka “the five rights”)

The aide will be placed on a medication aide registry.

Sometimes a medication aide may be authorized to go a little beyond the norm. State code describes the protocol that will need to be followed.

Nebraska Long-Term Care Successes

Nebraska is well above the norm, according to the AARP, with regard to long-term services and supports for its disabled and elderly residents.

Average Nebraska Home Health Aide Salary and Career Outlook

Nebraska home health aides made, on average, $11.92 an hour, in 2016. Most made between $9.80 and $14.92. 10% made more; another 10% less.

Those classified as personal care aides had similar wages; the average was just $0.15 less.

Nebraska’s home health aide employment levels have been projected to increase by 33% between 2014 and 2024. Direct care employment levels as a whole are expected to increase; home health is increasing fastest percentage-wise.

Additional Information

Information about medication aide credentialing is available from the Nebraska Department of Health and Human Services (http://dhhs.ne.gov/publichealth/Pages/crlMedAideHome.aspx).