Home Health Aide Requirements in North Carolina

North Carolina has a high need for dedicated workers who provide in-home care for people who are elderly, frail, disabled, or convalescing. The job takes compassion and responsibility. The amount and type of training will depend on the agency’s licensing or certification and how complex the needs of the patient are. Some North Carolina agencies are classified as home health services. This term denotes agencies that can provide short-term and intermittent care that may be covered under federal programs. Some are classified as “home care only” even though in-home aides employed there may carry out nursing-related tasks under RN supervision.

Some positions require Nurse Aide certification. Other in-home positions require more basic training that does not require learning as many nursing-related tasks. In-home aides can choose to challenge themselves at different levels. Sometimes those extra skills translate into extra earnings. In a sense, North Carolina has created a career ladder.

Select a North Carolina Home Health Aide Topic:

North Carolina Home Care Agencies

Home care agencies provide two types of service: home management and personal care. North Carolina agencies may provide service plans for clients at four different levels, depending on the complexity of their needs. In-home aides can provide personal services at Level II or Level III. Level I care includes only relatively simple home management tasks like housekeeping, basic meal preparation, and food shopping. There is no personal care involved. The in-home aide could provide the client with transportation. Home care agencies that provide only this level and type of service are not required to be licensed. Home care agencies that provide personal care are.

Among the personal care tasks at Level II: assisting clients who are considered “ambulatory” to move around, assisting clients who have conditions that don’t affect swallowing in eating, providing skin care for clients without skin conditions, applying ace bandages, and assisting clients with basic hygiene and dressing. The total recommended training at this level is 58 hours. (This includes some basic concepts taught at Level I.)

Level II personal care can include tasks comparable to ones that a nursing assistant would carry out in a nursing home. Examples include ostomy care and IV fluid monitoring. At this level, an in-home aide would be able to shave a client who had a skin condition. He or she could assist the client with range of motion exercises. The recommended training for a person who provides personal care at Level III is 101 hours. The individual will have completed nurse aide training and gone through the nurse aide evaluation process.

Individuals who are qualified at a particular level may still provide services at a lower level.

Medicare-Certified Home Health Agencies and HHA Training Requirements in North Carolina

Medicare-certified agencies go through a different process. Medicare typically covers relatively short term care that is provided at ‘doctor’s orders’. The client may be receiving various services like skilled nursing and physical therapy. The state certifies Medicare facilities. The general expectation nationwide is that home health aides who work at Medicare-certified facilities will have at least 75 hours of training with 16 hours of clinical training. Some states have chosen to set this requirement higher; North Carolina has not.

The training will include a number of federally mandated concepts (https://www.law.cornell.edu/cfr/text/42/484.36). Among them are ambulation, infection control, basic body functions (and when changes in these functions require reporting), and appropriate grooming and hygiene techniques.

Nurse Aide Training in North Carolina

Some in-home care positions require nurse aide credentialing. The first step is approved training. The North Carolina Health Care Personnel Education and Credentialing Section has provided a list of state-approved nurse aide programs (https://www.ncnar.org/index1.jsp).

The National Nurse Aide Assessment Program (NNAAP) includes a skills evaluation and a written or oral examination; the oral examination is available in English and Spanish. All candidates will need to demonstrate proper handwashing technique. Other skills will be randomly selected. Examples of skills that may be tested include using a transfer belt for ambulation, counting and recording pulse, and dressing someone with a weak arm. Pearson VUE has provided a detailed candidate handbook (http://www.pearsonvue.com/nc/nurseaides/).

In order to keep status current, the individual will need to meet a modest work requirement at the Nurse Aide I level.

A geriatric nurse aide has completed an additional state-approved program that includes topics such as dementia.

Registry Status

The Healthcare Personnel Registry is used to ensure that healthcare organizations have safe, reliable workers who have not abused patients or committed inappropriate acts. The Nurse Aide Registry also records those who have completed the necessary training and evaluation. The Geriatric Aide Registry and Medication Aide Registry include workers who have met other sets of standards.

Career Outlook and Average Home Health Aide Salary in North Carolina

Home health aide employment levels have been projected to increase by 35% in North Carolina between 2014 and 2024.

North Carolina home health aides averaged $9.70 an hour in 2016. In-home direct care workers would, in some cases, be better described as personal care aides. North Carolina actually reported a slightly higher average salary — $10.01 — for personal care aides. Duties and salaries, though, overlap a good deal. 80% of the state’s home health aides made between $7.89 and $12.26 an hour. 80% of the state’s personal care aides made between $7.89 and $13.10.

Additional Resources

Information about requirements for in-home aides is available from North Carolina Health and Human Services (https://www.ncdhhs.gov/assistance/disability-services/in-home-aides).

Registry information is available from the North Carolina Health Care Personnel Education and Credentialing Section. The Nurse Aide I Registry can be reached at (919) 733-9764.

The North Carolina Division of Health Services Regulation has provided a list of home care and home health agencies by county (https://www2.ncdhhs.gov/dhsr/ahc/listings.html). Some are noted as also holding accreditation.