home health aide
(3) (A) The agency must not use as a home health aide (on a full-time, temporary, per diem, or other basis), any individual to provide items or services described in section 1395x(m) of this title on or after January 1, 1990 , unless the individual— (i) has completed a training and competency evaluation program, or a competency evaluation program, that meets the minimum standards established by the Secretary under subparagraph (D), and (ii) is competent to provide such items and services. For purposes of clause (i), an individual is not considered to have completed a training and competency evaluation program, or a competency evaluation program if, since the individual’s most recent completion of such a program, there has been a continuous period of 24 consecutive months during none of which the individual provided items and services described in section 1395x(m) of this title for compensation. (B) (i) The agency must provide, with respect to individuals used as a home health aide by the agency as of July 1, 1989 , for a competency evaluation program (as described in subparagraph (A)(i)) and such preparation as may be necessary for the individual to complete such a program by January 1, 1990 . (ii) The agency must provide such regular performance review and regular in-service education as assures that individuals used to provide items and services described in section 1395x(m) of this title are competent to provide those items and services. (C) The agency must not permit an individual, other than in a training and competency evaluation program that meets the minimum standards established by the Secretary under subparagraph (D), to provide items or services of a type for which the individual has not demonstrated competency. (D) (i) The Secretary shall establish minimum standards for the programs described in subparagraph (A) by not later than October 1, 1988 . (ii) Such standards shall include the content of the curriculum, minimum hours of training, qualification of instructors, and procedures for determination of competency. (iii) Such standards may permit approval of programs offered by or in home health agencies, as well as outside agencies (including employee organizations), and of programs in effect on December 22, 1987 ; except that they may not provide for the approval of a program offered by or in a home health agency which, within the previous 2 years— (I) has been determined to be out of compliance with subparagraph (A), (B), or (C); (II) has been subject to an extended (or partial extended) survey under subsection (c)(2)(D); (III) has been assessed a civil money penalty described in subsection (f)(2)(A)(i) of not less than $5,000; or (IV) has been subject to the remedies described in subsection (e)(1) or in clauses (ii) or (iii) of subsection (f)(2)(A). (iv) Such standards shall permit a determination that an individual who has completed (before July 1, 1989 ) a training and competency evaluation program or a competency evaluation program shall be deemed for purposes of subparagraph (A) to have completed a program that is approved by the Secretary under the standards established under this subparagraph if the Secretary determines that, at the time the program was offered, the program met such standards. (E) In this paragraph, the term “home health aide” means any individual who provides the items and services described in section 1395x(m) of this title , but does not include an individual— (i) who is a licensed health professional (as defined in subparagraph (F)), or (ii) who volunteers to provide such services without monetary compensation. (F) In this paragraph, the term “licensed health professional” means a physician, physician assistant, nurse practitioner, physical, speech, or occupational therapist, physical or occupational therapy assistant, registered professional nurse, licensed practical nurse, or licensed or certified social worker.