H.F. 549 Section 1. Section 135C.34, Code 2021, is amended to read 1 as follows: 2 135C.34 Medication aide —— certification. 3 The department of inspections and appeals, in cooperation 4 with other appropriate agencies, shall establish a procedure to 5 allow recognize the credentials of a person who is certified as 6 a medication aide in another state to become certified in this 7 state upon completion and passage of both the certified nurse 8 aide and certified medication aide challenge examinations, 9 without additional requirements for certification, including 10 but not limited to, completion and passage of both the 11 certified nurse aide competency examination and the certified 12 medication aide challenge examination or required employment 13 in this state prior to certification , if upon the request of 14 the person seeking certification, the department determines 15 that the other state in which the person is certified has 16 substantially similar certification requirements . The 17 department shall adopt rules pursuant to chapter 17A to 18 administer this section . 19 Sec. 2. MEDICATION ADMINISTRATION BY NURSING STUDENTS AND 20 GRADUATE NURSES IN NURSING FACILITIES. The department of 21 inspections and appeals, in cooperation with other appropriate 22 agencies, shall adopt or amend rules pursuant to chapter 23 17A to allow a nursing student or a graduate nurse with an 24 appropriate level of training to administer medications if 25 the nursing facility documents that the nursing facility has 26 implemented training and supervision measures to ensure the 27 nursing student’s or graduate nurse’s competency in safe 28 medication administration. The rules shall not require the 29 nursing student or graduate nurse to complete a medication 30 course or challenge examination if the nursing facility meets 31 such requirements. 32 Sec. 3. CERTIFIED NURSE AIDE TRAINING —— RECIPROCITY. The 33 department of inspections and appeals shall adopt or amend 34 rules pursuant to chapter 17A to recognize a person who is 35 -1- LSB 1758HV (4) 89 pf/rh 1/ 4

H.F. 549 a nurse aide in another state and is able to demonstrate 1 competency in skills and techniques necessary to care for the 2 needs of residents in nursing facilities as required by 42 3 C.F.R. §483.35(c) and (d)(1)(k) to become certified in this 4 state without additional requirements for certification. The 5 rules shall provide for such persons to complete the direct 6 care worker registry application and to be included in the 7 direct care worker registry maintained by the department. 8 Sec. 4. ASSISTED LIVING PROGRAM MANAGER WHO IS ALSO A 9 LICENSED NURSING HOME ADMINISTRATOR. The department of 10 inspections and appeals shall amend the administrative rules 11 pursuant to chapter 17A relating to an assisted living program 12 manager to allow a new assisting living program manager who 13 is currently licensed as a nursing home administrator to 14 complete any required assisted living management class within 15 twelve months of employment rather than within six months of 16 employment. 17 Sec. 5. ASSISTED LIVING PROGRAM —— EXIT INTERVIEW TIMING 18 FOLLOWING MONITORING. The department of inspections and 19 appeals shall amend rules pursuant to chapter 17A relating to 20 the exit interview at the conclusion of a monitoring evaluation 21 or complaint investigation of an assisted living program to 22 extend the time frame for the program to submit additional or 23 rebuttal information to the department from two working days to 24 ten working days. 25 EXPLANATION 26 The inclusion of this explanation does not constitute agreement with 27 the explanation’s substance by the members of the general assembly. 28 This bill relates to regulatory provisions applicable to 29 care provided in health care facilities and assisted living 30 programs. 31 The bill amends Code provisions relating to certification 32 of medication aides in health care facilities to require the 33 department of inspections and appeals (DIA), in cooperation 34 with other appropriate agencies, to establish a procedure to 35 -2- LSB 1758HV (4) 89 pf/rh 2/ 4

H.F. 549 recognize the credentials of a person who is certified as a 1 medication aide in another state to become certified in this 2 state without additional requirements for certification, 3 including but not limited to the current requirement that 4 the person complete and pass both the certified nurse aide 5 competency examination and the certified medication aide 6 challenge examination, if upon the request of the person 7 seeking certification, the department determines that the 8 other state in which the person is certified has substantially 9 similar certification requirements. The bill requires DIA to 10 adopt administrative rules to administer this provision of the 11 bill. 12 The bill also requires DIA, in cooperation with other 13 appropriate agencies, to adopt or amend rules pursuant to Code 14 chapter 17A to allow a nursing student or a graduate nurse with 15 the appropriate level of training to administer medications 16 if the nursing facility documents that the nursing facility 17 has implemented training and supervision measures to ensure 18 the nursing student’s or graduate nurse’s competency in safe 19 medication administration. The bill provides that the rules 20 shall not require the nursing student or graduate nurse to 21 complete a medication course or challenge examination, as 22 is currently required, if the nursing facility meets such 23 requirements. 24 The bill requires DIA to adopt or amend rules pursuant to 25 Code chapter 17A to recognize a person who is a certified 26 nurse aide (CNA) in another state and is able to demonstrate 27 competency in skills and techniques necessary to care for 28 the needs of residents in nursing facilities as required 29 under federal law to become certified in this state without 30 additional requirements for certification. The rules shall 31 also provide for such persons to complete the direct care 32 worker registry application and to be included in the direct 33 care worker registry maintained by DIA. Currently, these CNAs 34 must pass a challenge examination in order to be certified in 35 -3- LSB 1758HV (4) 89 pf/rh 3/ 4

H.F. 549 the state. 1 The bill requires DIA to adopt or amend rules to allow a new 2 assisted living program manager who is currently licensed as a 3 nursing home administrator to complete any required assisted 4 living management class within 12 months of employment rather 5 than within 6 months of employment as is currently required. 6 The bill requires DIA to adopt or amend rules relating to the 7 exit interview at the conclusion of a monitoring evaluation or 8 complaint investigation of an assisted living program to extend 9 the time frame for the program to submit additional or rebuttal 10 information to DIA from 2 working days, as currently required, 11 to 10 working days. 12 -4- LSB 1758HV (4) 89 pf/rh 4/ 4