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OREGON STATE BOARD OF NURSING

 

DIVISION 63

STANDARDS AND AUTHORIZED DUTIES FOR THE CERTIFIED NURSING ASSISTANT
AND CERTIFIED MEDICATION AIDE

851-063-0010

Purpose of Authorized Duties and Standards

(1) To identify the range of authorized duties which may be performed by the certified nursing assistant (CNA) and certified medication aide (CMA) in the process of assisting a licensed nurse;

(2) To serve as a guide to the Board to evaluate safe and effective assistance in nursing care; and

(3) To establish standards and conduct unbecoming for CNAs and CMAs.

Stat. Auth.: ORS 678.440, 678.442 & 678.444
Stats. Implemented: ORS 678.440, 678.442 & 678.444
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 3-2004, f. 1-29-04, cert. ef. 2-12-04; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0020

Definitions

(1) “Activities of Daily Living” means self-care activities which a person performs independently, when able, to sustain personal needs or to participate in society.

(2) "Assessment" means the systematic collection of data about a person for the purpose of judging that person's health/illness status and actual or potential health care needs.

(3) “Certified Medication Aide (CMA)” means a certified nursing assistant who has successfully completed additional training in administration of non-injectable medications, holds current Oregon CMA certification, and performs CMA authorized duties under the supervision of a licensed nurse.

(4) “Certified Nursing Assistant (CNA)” means an individual who holds current Oregon CNA certification; whose name is listed on the CNA Registry; and through their position as a CNA assists a licensed nurse in the provision of nursing care. The phrase certified nursing assistant and the acronym CNA are generic and may refer to a CNA 1, a CNA 2 or all CNAs.

(5) "Certified Nursing Assistant 1 (CNA 1)" means an individual who holds current Oregon CNA certification and who assists a licensed nurse in the provision of nursing care.

(6) "Certified Nursing Assistant 2 (CNA 2)" means a CNA 1 who has successfully completed additional training and competency validation in accordance with these rules.

(7) “Client” means the individual who is provided care by the CNA or CMA including a person who may be referred to as “patient” or “resident” in some settings.

(8) "CNA Registry" means the listing of Oregon certified nursing assistants maintained by the Board.

(9) “Community-Based Care (CBC) Setting” means a setting that does not exist for the purpose of providing medical and nursing service but where nursing service can be provided incidental to the setting. This is a setting where federal or state regulations do not require the presence of nursing personnel 24-hours a day. These settings include those identified in ORS 678.150(8).

(10) “Context of Care” means the cumulative factors which affect the manner in which nursing service is rendered. Factors include, but are not limited to, nursing role, job description, practice setting, organizational policy, regulations governing the setting, demographics of the population served, the surrounding environment, current community and industry standards, and the ability of the person to direct and to engage in their own care.

(11) "Hand Hygiene" means those measures recommended by the Centers for Disease Control (CDC) and used by the CNA or CMA to protect themselves and others from infection. Hand hygiene includes handwashing with soap and water, use of alcohol-based hand rubs and proper use of disposable gloves.

(12) “Health Care Team” means the team of people working with the client to achieve the client’s identified outcomes. The composition of the health care team is appropriate to the context of care and the practice setting.

(13) “Licensed Independent Practitioner (LIP)” means a licensed health care professional who is authorized by Oregon statute to independently diagnose and treat.

(14) “Licensed Nurse” means the licensed practical nurse (LPN) and registered nurse (RN) licensed under ORS 678.

(15) "Monitoring" means that a registered nurse assesses and plans for the care of the client, assigns or delegates duties to the nursing assistant according to the nursing care plan, and evaluates client outcomes as an indicator of CNA or CMA competency.

(16) “Nursing Assistant” means a person who assists licensed nursing personnel in the provision of nursing care per ORS 678.440(5).

(17) "Periodic Assessment and Evaluation" means that the RN, at regular intervals, assesses and evaluates the condition of the client and reviews, and modifies if necessary, the procedures and directions established for the provision of care. The interval shall be determined by the RN based on the condition of the client and the nature of the nursing care tasks being performed.

(18) “Person-centered Care” means to collaborate with the client regarding their health in a manner that is considerate and respectful of the client’s expressed wishes, choices, and health goals.

(19) “Plan of Care” means the licensed nurse-generated document that identifies desired outcomes and the nursing activities selected to attain the desired outcomes.

(20) “Professional Boundaries” means the relationship limitations that promote professional and therapeutic interactions. Professional boundaries allow for safe and therapeutic interactions between the nursing assistant and the person, the nursing assistant and colleagues, the nursing assistant and society.

(21) "PRN" means as necessary.

(22) “Site” means the specific geographic location of the facility or institution.

(23) "Stable/Predictable Condition" means a situation where the client’s health and behavioral state is known, is not characterized by rapid changes, and does not require frequent reassessment and evaluation. This includes the client whose deteriorating condition is predictable such as the client receiving hospice services.

(24) “Supervision” means that the licensed nurse regularly observes, provides guidance, direction, oversight, and evaluation of the skills and abilities of the CNA or CMA to perform authorized duties.

Stat. Auth.: ORS 678.440, 678.442 & 678.444
Stats. Implemented: ORS 678.440, 678.442 & 678.444
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 3-2004, f. 1-29-04, cert. ef. 2-12-04; BN 11-2010, f. & cert. ef. 6-25-10; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0030

Authorized Duties and Standards for Certified Nursing Assistant 1 (CNA 1)

(1) Under the supervision and at the direction of a licensed nurse, the CNA may provide care and assist clients with the following tasks:

(a) Tasks associated with communication and interpersonal skills:

(A) Answering and placing call signals;

(B) Coaching and mentoring other nursing assistants;

(C) Communicating with clients and co-workers;

(D) Maintaining confidentiality;

(E) Reporting abuse, mistreatment, and neglect; and

(F) Utilizing de-escalation techniques.

(b) Tasks associated with person-centered care.

(c) Tasks associated with infection control and Standard or Transmission Based Precautions:

(A) Assisting with coughing and deep breathing;

(B) Bedmaking and handling of linen;

(C) Caring for the client’s environment;

(D) Handling and disposal of hazardous wastes;

(E) Handling of contaminated materials;

(F) Handwashing and hand hygiene;

(G) Implementing precautions associated with communicable and infectious diseases;

(H) Implementing neutropenic precautions;

(I) Maintaining client cleanliness and grooming; and

(J) Utilizing personal protective equipment.

(d) Tasks associated with safety and emergency procedures:

(A) Implementing bleeding, cervical, hip, and sternal precautions;

(B) Moving and transferring clients;

(C) Transporting clients in wheelchairs and specialized chairs;

(D) Turning and positioning clients;

(E) Using lifts and safe client handling devices;

(F) Turning oxygen on and off or transferring oxygen between wall and tank at pre-established flow rate for stable clients;

(G) Managing hazards in the workplace;

(H) Preventing burns;

(I) Preventing falls; and

(J) Performing cardiopulmonary resuscitation.

(e) Tasks associated with activities of daily living (ADL):

(A) Assisting with nutrition and hydration:

(i) Measuring and recording height and weight;

(ii) Measuring and recording intake and output;

(iii) Positioning clients for nutritional and fluid intake;

(iv) Preventing choking and aspiration;

(v) Preventing dehydration; and

(vi) Thickening liquids; and

(vii) Utilizing techniques for assisting with eating.

(B) Assisting with elimination:

(i) Administering bowel evacuation suppositories that are available without a prescription;

(ii) Administering enemas;

(iii) Assisting with the use of bedpan and urinal;

(iv) Assisting with toileting;

(v) Collecting specimens; sputum, stool, and urine including clean catch urine specimens;

(vi) Providing catheter care including the application of and removal of external urinary catheters;

(vii) Providing ostomy care for established, healthy ostomy including cleaning the ostomy site and emptying the ostomy bag or changing the dressing or ostomy appliance or bag; and

(viii) Providing perineal and incontinence care.

(C) Assisting with personal care:

(i) Bathing;

(ii) Providing comfort care;

(iii) Dressing and undressing;

(iv) Grooming to include: application and care of dentures, eye glasses, and hearing aids.

(v) Nail care for fingernails and toenails of persons with uncompromised circulation;

(vi) Oral hygiene;

(vii) Personal care considerations for persons who have tubes or special equipment;

(viii) Shampooing and caring for hair;

(ix) Shaving; and

(x) Skin Care to include: application of non-prescription pediculicides; application of topical barrier creams and ointments for skin care; maintenance of skin integrity; prevention of pressure, friction, and shearing; and use of anti-pressure devices;

(D) Assisting with positioning devices and restraints;

(E) Assisting with restorative care:

(i) Ambulating;

(ii) Applying, turn on and off, sequential compression devices;

(iii) Assisting with and encouraging the use of self-help devices for eating, grooming and other personal care tasks;

(iv) Assisting with bowel and bladder training;

(v) Assisting with ADL programs;

(vi) Assisting with the use of crutches, walkers, or wheelchairs;

(vii) Assisting with warm and cold therapies;

(viii) Caring for, applying, and removing antiembolus stockings, braces, orthotic devices, and prosthetic devices;

(ix) Elevating extremities;

(x) Maintaining alignment;

(xi) Performing range of motion exercises;

(xii) Reinforcing task sequence by breaking down tasks into small, obtainable steps;

(xiii) Reinforcing the use of an incentive spirometer;

(xiv) Using footboards; and

(xv) Utilizing devices for transferring, ambulation, and alignment.

(f) Tasks associated with collaboration with health care team.

(g) Tasks associated with observation and reporting:

(A) Observing and reporting changes of condition to licensed nurse; and

(B) Measuring and recording:

(i) Temperature, apical and radial pulse, respiration and blood pressure (manual and electronic- forearm, lower leg, thigh, upper arm and orthostatic blood pressure readings);

(ii) Emesis;

(iii) Liquid stool;

(iv) Pain level using a facility approved pain scale;

(v) Pulse oximetry; and

(vi) Urinary output, both voided and from urinary drainage systems.

(h) Tasks associated with documentation.

(i) Tasks associated with end of life care.

(2) The CNA may, as an unlicensed person, provide care as delegated or assigned by a nurse in a CBC setting.

(3) ORS 678.440(5) defines the term “nursing assistant” as a person who assists licensed nursing personnel in the provision of nursing care. Consistent with that definition, a CNA must either:

(a) Be regularly supervised by a licensed nurse; or

(b) Work under licensed nurse monitoring in a CBC setting or other setting where there is no regularly scheduled presence of a licensed nurse provided there is periodic supervision and evaluation of clients.

(4) Under no circumstance shall a CNA work independently without supervision or monitoring by a licensed nurse who provides assessment of clients as described in OAR 851-063-0030(3)(a)(b).

(5) A CNA may accept verbal or telephone orders for medication from a licensed health care professional who is authorized to independently diagnose and treat only when working in the following settings under the specified administrative rule:

(a) When working in Adult Foster Homes, as permitted under OAR Chapter 411, division 50;

(b) When working in Residential Care Facilities, as permitted under OAR Chapter 411, division 54; and

(c) When working in Assisted Living Facilities, as permitted under OAR Chapter 411, division 54.

(6) Standards of Care for Certified Nursing Assistants. In the process of client care the CNA shall consistently:

(a) Apply standard precautions according to the Centers for Disease Control and Prevention guidelines;

(b) Use hand hygiene between episodes of care;

(c) Use appropriate body mechanics to prevent injury to self and client;

(d) Follow the care plan as directed by the licensed nurse;

(e) Use appropriate communication with client, client’s family and friends, and coworkers;

(f) Use alternatives to physical restraints, or apply physical restraints as directed by the licensed nurse;

(g) Determine absence of pulse or respiration, and initiate an emergency response;

(h) Report to the licensed nurse any recognized abnormality in client’s signs and symptoms;

(i) Record observations and measurements, tasks completed, and client statements about condition or care;

(j) Apply safety concepts in the workplace;

(k) Report signs of abuse, neglect, mistreatment, misappropriation or exploitation;

(l) Demonstrate respect for rights and property of clients and coworkers; and

(m) Maintain client confidentiality.

Stat. Auth: ORS 678.440, ORS 678.442, 678.444
Stats. Implemented: ORS 678.440, ORS 678.442, 678.444
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 3-2004, f. 1-29-04, cert. ef. 2-12-04; BN 11-2009, f. & cert. ef. 12-17-09; BN 11-2010, f. & cert. ef. 6-25-10; BN 1-2011(Temp), f. 6-6-11, cert. ef. 6-23-11 thru 12-20-11; BN 4-2011, f. & cert. ef. 10-6-11; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0035

Authorized Duties and Standards for Certified Nursing Assistant 2 (CNA 2)

(1) Under the supervision and at the direction of a licensed nurse, a CNA 2 may provide care and assist clients with the following:

(a) Tasks associated with communication and interpersonal skills including:

(A) Coaching and mentoring peers; and

(B) Crisis intervention.

(b) Tasks associated with observation and reporting:

(A) Observing and collecting pain responses; and

(B) Relieving pain:

(i) Assisting with complementary therapies such as using pre-recorded audio/visuals for guided imagery; deep relaxation.

(ii) Planning activities in relation to pain;

(iii) Providing comfort measures;

(iv) Reporting to the nurse;

(v) Repositioning; and

(vi) Using touch to massage non-diseased tissue.

(C) Understanding the concept of Situation, Background, Assessment (Observation), Recommendation, and Read-back/Review (SBARR).

(c) Tasks associated with person-centered care:

(A) Embracing the friendship philosophy of care;

(B) Positively impacting the environment for person with dementia; and

(C) Cultural responsiveness.

(d) Tasks associated with technical skills:

(A) Adjusting oxygen rate of flow;

(B) Applying and removing delivery device and turning continuous positive airway pressure (CPAP) or bilevel positive airway (BiPAP) devices on and off;

(C) Bladder scanning;

(D) Clipping hair in preparation for surgical procedure;

(E) Discontinuing saline lock;

(F) Fingerstick capillary blood testing;

(G) Interrupting and re-establishing nasogastric (NG) suction;

(H) Obtaining nasal or rectal swab;

(I) Placing electrodes/leads and run electrocardiogram (EKG);

(J) Placing electrodes/leads for telemetry;

(K) Removing casts in non-emergent situations;

(L) Screening newborn hearing;

(M) Setting up traction equipment;

(N) Suctioning nose or oral pharynx;

(O) Testing stool for occult blood; and

(P) Urine dip stick testing.

(e) Tasks associated with infection prevention and control:

(A) Establishing and maintaining a sterile field;

(B) Obtaining urine specimen from port of catheter;

(C) Discontinuing Foley catheters;

(D) Measuring, recording and emptying output from drainage devices and closed drainage systems; and

(E) Changing wound vac canisters.

(f) Tasks associated with safety:

(A) Implementing preventive/protective strategies; and

(B) Minimizing safety risks.

(g) Tasks associated with promoting nutrition and hydration.

(A) Adding fluid to established post pyloric, jejunostomy and gastrostomy tube feedings;

(B) Changing established tube feeding bags; and

(C) Pausing and resuming established post pyloric, jejunostomy and gastrostomy tube feedings to provide personal care;

(h) Tasks associated with promoting functional abilities:

(A) Assisting persons in and out of continuous passive motion (CPM) machines;

(B) Performing range of motion on persons with complex medical problems: fragile skin, at risk for pathological fractures, spascity, and contractures;

(C) Therapeutic positioning in a variety of situations and considering a person’s condition including but not limited to bridging and proning; and

(D) Use of adaptive, assistive and therapeutic equipment:

(i) Ankle and foot orthotics;

(ii) Braces;

(iii) Established traction equipment: remove and re-apply;

(iv) Foot lifter; and

(v) Splints.

(i) Tasks associated with end-of-life care:

(A) Comfort care; and

(B) Removal of non-surgically inserted tubes and devices from post-mortem persons.

(j) Tasks associated with documentation.

(2) Standards of Care for CNA 2. In the process of client care the CNA 2 shall consistently apply standards set for CNA 1s and:

(a) Establish competency as a CNA 2;

(b) Maintain competency as a CNA 2;

(c) Perform only authorized duties for which the CNA 2 has established competency.

Stat. Auth.: ORS 678.440 & 678.442
Stats. Implemented: ORS 678.440 & 678.442
Hist.: BN10-2007, f. & cert. ef. 10-1-07; BN 2-2009, f. & cert. ef. 5-15-09; BN 11-2009, f. & cert. ef. 12-17-09; BN 11-2010, f. & cert. ef. 6-25-10; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0070

Authorized Duties and Standards for Certified Medication Aide (CMA)

(1) Under supervision by a licensed nurse, a CMA may administer:

(a) Oral, sublingual and buccal medications;

(b) Eye medications with the exception of eye medications to new post-operative eye clients;

(c) Ear medications;

(d) Nasal medications;

(e) Rectal medications;

(f) Vaginal medications;

(g) Skin ointments, topical medications including patches and transdermal medications;

(h) Medications by gastrostomy and jejunostomy tubes;

(i) Premeasured medication delivered by Aerosol/Nebulizer; and

(j) Medications delivered by metered hand-held inhalers.

(2) Administration of PRN Medications. A CMA may administer PRN medications (including controlled substances) to stable clients according to physician's or nurse practitioner's orders in the following circumstances:

(a) In response to specific client requests:

(A) Client request must be reported to licensed nurse; and

(B) Client response must be reported to licensed nurse.

(b) At the direction of the licensed nurse, when:

(A) A licensed nurse assesses the patient prior to administration of the PRN medications; and

(B) A licensed nurse assesses the patient following the administration of the PRN medication.

(3) A CMA may:

(a) Administer regularly scheduled controlled substances;

(b) Jointly witness wasted controlled substances with a licensed nurse;

(c) Count controlled substances with a licensed nurse or another CMA;

(d) Perform capillary blood glucose (CBG);

(e) Turn oxygen on and off at predetermined, established flow rate;

(f) Add fluid to established jejunostomy or gastrostomy tube feedings and change established tube feeding bags; and

(g) Accept verbal or telephone orders for medication from a licensed health care professional who is authorized to independently diagnose and treat. Such acceptance can occur only when the CMA is working in the following settings under the specified administrative rules:

(A) Adult Foster Homes, as permitted under OAR Chapter 411, division 050;

(B) Residential Care Facilities, as permitted under OAR Chapter 411, division 054; and

(C) Assisted Living Facilities, as permitted under OAR Chapter 411, division 054.

(4) A CMA may not administer medications by the following routes:

(a) Central lines;

(b) Colostomy;

(c) Intramuscular;

(d) Intrathecal;

(e) Intravenous;

(f) Nasogastric;

(g) Nonmetered inhaler;

(h) Subcutaneous;

(i) Intradermal;

(j) Urethral;

(k) Epidural; or

(l) Endotracheal.

(5) A CMA may not administer the following kinds of medications:

(a) Barium and other diagnostic contrast media; or

(b) Chemotherapeutic agents except oral maintenance chemotherapy.

(6) A CMA may not administer medication by, nor assume responsibility for, medication pumps, including client controlled analgesia.

(7) A CMA may not act as a clinical teaching associate to a student in a medication aide training program.

(8) In a community-based care setting, a CMA may, as an unlicensed person, provide care as delegated or assigned by a licensed nurse.

(9) Standards of Care for a certified medication assistant. In the process of client care a CMA shall consistently apply standards set for CNAs and:

(a) Establish competency as a CMA;

(b) Maintain competency as a CMA;

(c) Perform within Authorized Duties;

(d) Follow written instructions of a LIP authorized to independently diagnose and treat as transcribed in the medication administration record (MAR); and

(e) Accurately record on the MAR medications administered, medications withheld or refused and the reason why a medication was withheld or refused.

Stat. Auth.: ORS 678.440, 678.442, 678.444 & 678.445
Stats. Implemented: ORS 678.440, 678.442 & 678.444
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 3-2004, f. 1-29-04, cert. ef. 2-12-04; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0080

Causes for Denial, Reprimand, Suspension, Probation or Revocation of CNA Certificate

Under the contested case procedure in ORS 183.310 to 183.550 the Board may impose a range of disciplinary sanctions including, but not limited to deny, reprimand, suspend, place on probation or revoke the certificate to perform duties as a CNA for the following causes:

(1) Conviction of the nursing assistant of a crime where such crime bears demonstrable relationship to the duties of a nursing assistant;

(2) Any willful fraud or misrepresentation in applying for or procuring a certificate or renewal thereof;

(3) Use of any controlled substance or intoxicating liquor to an extent or in a manner injurious to the certificate holder or others or to an extent that such use impairs the ability to conduct safely the duties of a nursing assistant;

(4) Violation of any provision of ORS 678.010 to 678.445 or rules adopted thereunder;

(5) Physical or mental condition that makes the certificate holder unable to perform the duties of a nursing assistant; or

(6) Conduct unbecoming a nursing assistant.

Stat. Auth.: ORS 678.442
Stats. Implemented: ORS 678.442
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 3-2004, f. 1-29-04, cert. ef. 2-12-04; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0090

Conduct Unbecoming a Nursing Assistant

A CNA, regardless of job location, responsibilities, or use of the title “CNA," whose behavior fails to conform to the legal standard and accepted standards of the nursing assistant profession, or who may adversely affect the health, safety or welfare of the public, may be found guilty of conduct unbecoming a nursing assistant. Such conduct includes but is not limited to:

(1) Conduct, regardless of setting, related to general fitness to perform nursing assistant authorized duties:

(a) Demonstrated incidents of violent, abusive, neglectful or reckless behavior; or

(b) Demonstrated incidents of dishonesty, misrepresentation, or fraud.

(2) Conduct related to achieving and maintaining clinical competency:

(a) Failing to conform to the essential standards of acceptable and prevailing nursing assistant performance of duties. Actual injury need not be established;

(b) Performing acts beyond the authorized duties except for as allowed for in these rules;

(c) Assuming duties and responsibilities for a person’s care without documented preparation for the duties and responsibilities and when competency has not been established and maintained; or

(d) Performing new nursing assistant techniques or procedures without documented education specific to the technique or procedure and supervised clinical experience to establish competency.

(3) Conduct related to client safety and integrity:

(a) Failing to take action to preserve or promote a person’s safety based on nursing assistant knowledge, skills, and abilities;

(b) Failing to implement the plan of care developed by the registered nurse;

(c) Failing to report changes in a person’s status from the last assessment made by the registered nurse;

(d) Jeopardizing the safety of a person under the CNA’s care;

(e) Leaving or failing to complete a nursing assistant assignment without properly notifying appropriate supervisory personnel;

(f) Failing to report through proper channels information or facts known regarding the incompetent, unethical, unsafe, or illegal practice of any health care provider;

(g) Failing to respect the dignity and rights of the person receiving nursing services, regardless of social or economic status, age, race, religion, sex, sexual orientation, national origin, nature of health needs, other physical attributes, or disability;

(h) Failing to report actual or suspected incidents of abuse, neglect, or mistreatment;

(i) Engaging in or attempting to engage in sexual misconduct with a client in any setting;

(j) Engaging in sexual misconduct in the workplace; or

(k) Failing to maintain professional boundaries.

(4) Conduct related to communication:

(a) Failing to accurately document nursing assistant activities and tasks;

(b) Failing to document nursing assistant activities and task implementation in a timely manner. This includes failing to document a late entry within a reasonable time period;

(c) Entering inaccurate, incomplete, falsified or altered documentation into a health record or into agency records. This includes but is not limited to:

(A) Documenting the provision of services that were not provided;

(B) Failing to document information pertinent to the person’s care;

(C) Filling in someone else’s charting omissions, or signing someone else’s name;

(D) Falsifying data;

(E) Altering or changing words or characters within an existing document to mislead the reader; or

(F) Adding documentation to a health record or agency record without recording the date and time of the event being recorded. This includes late entry documentation that does not demonstrate the date and time of the initial event being documented, the date and time the late entry is being placed into the record, and the signature of the nursing assistant placing the documentation into the record.

(d) Destroying an agency record, a person’s health record, or any document prior to the destruction date indicated for the type of recorded data or document;

(e) Directing another individual to falsify, alter or destroy an agency record, a person’s health record, or any document prior to the destruction date indicated for type of recorded data or type of document;

(f) Failing to communicate information regarding a person’s status to the supervising nurse or other appropriate member of the healthcare team in an on-going and timely manner and as appropriate to the context of care; or

(g) Failing to communicate information regarding the person’s status to individuals who are authorized to receive the information and need to know.

(5) Conduct related to interactions with the client’s family:

(a) Failing to respect the person’s family and the person’s relationship with their family;

(b) Using one’s title/position as a nursing assistant to exploit a person’s family for personal gain or for any other reason;

(c) Stealing money, property, services or supplies from the family;

(d) Soliciting or borrowing money, materials or property from the family; or

(e) Engaging in unacceptable behavior towards or in the presence of the client’s family. Such behavior includes but is not limited to using derogatory names, derogatory or threatening gestures, or profane language.

(6) Conduct related to relationships with co-workers and health care team members:

(a) Engaging in violent, abusive or threatening behavior towards a co-worker; or

(b) Engaging in violent, abusive or threatening behavior that relates to the performance of safe care to a person.

(7) Conduct related to safe performance of authorized duties:

(a) Performing authorized duties when unable/unfit to perform nursing assistant activities or tasks due to:

(A) Physical impairment as evidenced by documented deterioration of functioning in the work setting or by the assessment of a LIP qualified to diagnose physical condition/status; or

(B) Psychological or mental impairment as evidenced by documented deterioration of functioning in the work setting or by the assessment of a LIP qualified to diagnose mental condition/status.

(b) Performing authorized duties when physical or mental ability to perform is impaired by use of a prescription or non-prescription drug, alcohol, or a mind-altering substance; or

(c) Using a prescription or non-prescription drug, alcohol, or a mind-altering substance to an extent or in a manner dangerous or injurious to the nursing assistant or others, or to an extent that such use impairs the ability to perform the authorized duties safely.

(8) Conduct related to other federal or state statutes/rule violations:

(a) Aiding, abetting or assisting an individual to violate or circumvent any law, rule or regulation intended to guide the conduct of the nursing assistant or other healthcare provider;

(b) Violating the rights of privacy, confidentiality of information, or knowledge concerning the person, unless required by law to disclose such information;

(c) Discriminating against a person on the basis of age, race, religion, gender, sexual preference, national origin or disability;

(d) Abusing a person;

(e) Neglecting a person;

(f) Failing to report actual or suspected incidents of abuse through the proper channels in the workplace and to the appropriate state agencies;

(g) Failing to report actual or suspected incidents of abuse to the appropriate state agency;

(h) Engaging in other unacceptable behavior towards or in the presence of the client. Such behavior includes but is not limited to using derogatory names, derogatory or threatening gestures, or profane language;

(i) Possessing, obtaining, attempting to obtain, furnishing or administering prescription or controlled drugs to any person, including self, except as directed by a LIP authorized by law to prescribe drugs;

(j) Unauthorized removal or attempted removal of any drugs, supplies, property, or money from any person or setting;

(k) Unauthorized removal of records, client information, or facility property from the workplace;

(l) Using one’s role or title as a nursing assistant to solicit or borrow money, materials, property or possessions from a client or the client’s family for personal gain or sale;

(m) Violating a person’s rights of privacy and confidentiality of information by accessing information without proper authorization to do so or without a demonstrated need to know;

(n) Failure to report to the Board the CNA’s arrest for a felony crime within ten days of the arrest; or

(o) Failure to report to the Board the CNA’s conviction of a misdemeanor or a felony crime within ten days of the conviction.

(9) Conduct related to certification violations:

(a) Resorting to fraud, misrepresentation, or deceit during the application process for licensure or certification, while taking the examination for licensure or certification, while obtaining initial licensure or certification or renewal of licensure or certification;

(b) Functioning as a certified nursing assistant without current certification as a nursing assistant;

(c) Functioning as a certified medication assistant without current certification as a medication assistant;

(d) Representing oneself as a CNA without current, valid CNA certification;

(e) Allowing another person to use one's nursing assistant certificate for any purpose;

(f) Using another licensee’s nursing license or nursing assistant certificate for any purpose;

(g) Impersonating any applicant or acting as a proxy for the applicant in any nursing assistant examination;

(h) Disclosing contents of the competency examination or soliciting, accepting or compiling information regarding the contents of the examination before, during or after its administration; or

(i) Altering a certificate of completion of training or nursing assistant certification issued by the Board.

(10) Conduct related to the certification holder’s relationship with the Board:

(a) Failing to fully cooperate with the Board during the course of an investigation, including but not limited to waiver of confidentiality, except attorney-client privilege.

(b) Failing to answer truthfully and completely any question asked by the Board on an application for certification, renewal of certification, during the course of an investigation, or any other question asked by the Board;

(c) Failing to provide the Board with any documents requested by the Board; or

(d) Violating the terms and conditions of a Board order.

Stat. Auth.: ORS 678.442
Stats. Implemented: ORS 678.442
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 9-2002(Temp), f. & cert. ef. 3-5-02 thru 8-1-02; BN 16-2002, f. & cert. ef. 7-17-02; BN 12-2009, f. & cert. ef. 12-17-09; BN 4-2010(Temp), f. & cert. ef. 4-19-10 thru 10-15-10; BN 15-2010, f. & cert. ef. 9-30-10; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0100

Conduct Unbecoming a Certified Medication Aide

A certified medication aide is subject to discipline as a CNA as described in these rules. In addition, a CMA is subject to discipline for conduct unbecoming a medication aide. Such conduct includes but is not limited to:

(1) Failing to administer medications as ordered by a LIP;

(2) Failing to document medications as administered, medications withheld or refused and the reason a medication was withheld or refused.

(3) Altering or falsifying medication administration record;

(4) Altering or falsifying CNA or CMA certificate;

(5) Diverting drugs for use by self or others;

(6) Accepting a verbal order or telephone order for medication from a LIP, except as allowed in authorized duties;

(7) Performing acts beyond the authorized duties for which the individual is certified;

(8) Working as a CMA without CMA Certification;

(9) Performing client care tasks other than authorized in these rules;

(10) Representing oneself as a CMA without current CMA certification; or

(11) Failing to conform to the standards and authorized duties in these rules.

Stat. Auth.: ORS 678.442
Stats. Implemented: ORS 678.442
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 3-2004, f. 1-29-04, cert. ef. 2-12-04; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

851-063-0110

Criminal Conviction History/Falsification of Application — Denial of Certification — Grounds for Discipline

(1) The Board has determined that the following crimes bear a demonstrable relationship to the role of a CNA and will issue a Notice to Deny Certification to an applicant for certification, renewal of certification or for reactivation of certification as a nursing assistant, following the provisions of the Administrative Procedure Act in contested case hearings, to persons who have been convicted as an adult, or found responsible except for mental illness, or adjudicated as a juvenile for the following crimes as set forth in Oregon law or comparable law in other jurisdictions:

(a) Aggravated Murder, as in ORS 163.095 and 115;

(b) First Degree Manslaughter, as in ORS 163.118;

(c) Second Degree Manslaughter, as in ORS 163.125;

(d) First Degree Assault, as in ORS 163.185;

(e) Second Degree Assault, as in ORS 163.175;

(f) First Degree Criminal Mistreatment, as in ORS 163.205;

(g) Second Degree Criminal Mistreatment, as in ORS 163.200;

(h) First Degree Kidnapping, as in ORS 163.235;

(i) First Degree Rape, as in ORS 163.375;

(j) Second Degree Rape, as in ORS 163.365;

(k) Third Degree Rape, as in ORS 163.355;

(l) First Degree Sodomy, as in ORS 163.405;

(m) Second Degree Sodomy, as in ORS 163.395;

(n) Third Degree Sodomy, as in ORS 163.385;

(o) First Degree Unlawful Sexual Penetration, as in ORS 163.411;

(p) Second Degree Unlawful Sexual Penetration, as in ORS 163.408;

(q) First Degree Sexual Abuse, as in ORS 163.427;

(r) Second Degree Sexual Abuse, as in ORS 163.425;

(s) Contributing to the Sexual Delinquency of a Minor, as in ORS 163.435;

(t) Sexual Misconduct, as in ORS 163.445;

(u) Child Abandonment, as in ORS 163.535.

(2) Any individual who applies for certification or renewal of certification as a nursing assistant or holds current certification, who has a history of arrests and convictions over an extended period of time, will be issued a Notice to Deny Certification following the provisions of the Administrative Procedure Act in contested case hearings.

(3) All other applicants or individuals with current nursing assistant certification, with conviction histories, other than those listed above, including crimes which are drug and alcohol related, will be considered on an individual basis.

(4) Any individual who applies for certification as a nursing assistant or holds current certification, and supplies false or incomplete information to the Board on an application for certification regarding the individual's criminal conviction record, may be issued a Notice to Deny Certification under the provisions of the Oregon Administrative Procedure Act in contested case hearings.

Stat. Auth.: ORS 678.442
Stats. Implemented: ORS 678.442
Hist.: BN 6-1999, f. & cert. ef. 7-8-99; BN 7-2014, f. 12-3-14, cert. ef. 1-1-15

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State Archives • 800 Summer St. NE • Salem, OR 97310