H.F. _____ 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 in 13 this state prior to certification. The department shall adopt 14 rules pursuant to chapter 17A to administer this section . 15 Sec. 2. Section 231C.8, subsection 1, Code 2021, is amended 16 to read as follows: 17 1. The department shall provide an assisted living program 18 an exit interview at the conclusion of a monitoring evaluation 19 or complaint investigation, and the department shall inform the 20 program’s representative of all issues and areas of concern 21 related to the insufficient practices. The department may 22 conduct the exit interview in person or by telephone, and 23 the department shall provide a second exit interview if any 24 additional issues or areas of concern are identified. The 25 program shall have two ten working days from the date of the 26 exit interview to submit additional or rebuttal information to 27 the department. 28 Sec. 3. MEDICATION ADMINISTRATION BY NURSING STUDENTS AND 29 GRADUATE NURSES IN NURSING FACILITIES. The department of 30 inspections and appeals, in cooperation with other appropriate 31 agencies, shall adopt or amend rules pursuant to chapter 17A 32 to allow a nursing student or a graduate nurse to administer 33 medications if the nursing facility documents that the nursing 34 facility has implemented training and supervision measures to 35 -1- LSB 1758YC (3) 89 pf/rh 1/ 4

H.F. _____ ensure the nursing student’s or graduate nurse’s competency in 1 safe medication administration. The rules shall not require 2 the nursing student or graduate nurse to complete a medication 3 course or challenge examination if the nursing facility meets 4 such requirements. 5 Sec. 4. CERTIFIED NURSE AIDE TRAINING —— RECIPROCITY. The 6 department of inspections and appeals shall adopt or amend 7 rules pursuant to chapter 17A to recognize a person who is 8 a nurse aide in another state and is able to demonstrate 9 competency in skills and techniques necessary to care for the 10 needs of residents in nursing facilities as required by 42 11 C.F.R. §483.35(c) and (d)(1)(k) to become certified in this 12 state without additional requirements for certification. The 13 rules shall provide for such persons to complete the direct 14 care worker registry application and to be included in the 15 direct care worker registry maintained by the department. 16 Sec. 5. ASSISTED LIVING PROGRAM MANAGER OR DELEGATING NURSE 17 —— NEW EMPLOYMENT —— CURRICULUM COMPLETION. The department 18 of inspections and appeals shall amend rules pursuant to 19 chapter 17A relating to an assisted living program manager 20 or delegating nurse to allow a new program manager or a new 21 delegating nurse to complete any required assisted living 22 management class or assisted living nursing class within 23 twelve months of employment rather than within six months of 24 employment. 25 Sec. 6. ASSISTED LIVING PROGRAM —— EXIT INTERVIEW TIMING 26 FOLLOWING MONITORING. The department of inspections and 27 appeals shall amend rules pursuant to chapter 17A relating to 28 the exit interview at the conclusion of a monitoring evaluation 29 or complaint investigation of an assisted living program to 30 extend the time frame for the program to submit additional or 31 rebuttal information to the department from two working days to 32 ten working days. 33 EXPLANATION 34 The inclusion of this explanation does not constitute agreement with 35 -2- LSB 1758YC (3) 89 pf/rh 2/ 4

H.F. _____ the explanation’s substance by the members of the general assembly. 1 This bill relates to regulatory provisions applicable to 2 care provided in health care facilities and assisted living 3 programs. 4 The bill amends Code provisions relating to certification 5 of medication aides in health care facilities to require the 6 department of inspections and appeals (DIA), in cooperation 7 with other appropriate agencies, to establish a procedure to 8 recognize the credentials of a person who is certified as a 9 medication aide in another state to become certified in this 10 state without additional requirements for certification, 11 including but not limited to the current requirement that 12 the person complete and pass both the certified nurse aide 13 competency examination and the certified medication aide 14 challenge examination. The bill requires DIA to adopt 15 administrative rules to administer this provision of the bill. 16 The bill also requires DIA, in cooperation with other 17 appropriate agencies, to adopt or amend rules pursuant to Code 18 chapter 17A to allow a nursing student or a graduate nurse to 19 administer medications if the nursing facility documents that 20 the nursing facility has implemented training and supervision 21 measures to ensure the nursing student’s or graduate nurse’s 22 competency in safe medication administration. The bill 23 provides that the rules shall not require the nursing student 24 or graduate nurse to complete a medication course or challenge 25 examination, as is currently required, if the nursing facility 26 meets such requirements. 27 The bill requires DIA to adopt or amend rules pursuant to 28 Code chapter 17A to recognize a person who is a certified 29 nurse aide (CNA) in another state and is able to demonstrate 30 competency in skills and techniques necessary to care for 31 the needs of residents in nursing facilities as required 32 under federal law to become certified in this state without 33 additional requirements for certification. The rules shall 34 also provide for such persons to complete the direct care 35 -3- LSB 1758YC (3) 89 pf/rh 3/ 4

H.F. _____ worker registry application and to be included in the direct 1 care worker registry maintained by DIA. Currently, these CNAs 2 must pass a challenge examination in order to be certified in 3 the state. 4 The bill requires DIA to adopt or amend rules to allow a 5 new program manager or a new delegating nurse to complete any 6 required assisted living management class or assisted living 7 nursing class within 12 months of employment rather than within 8 6 months of employment as is currently required. 9 The bill requires DIA to adopt or amend rules relating to the 10 exit interview at the conclusion of a monitoring evaluation or 11 complaint investigation of an assisted living program to extend 12 the time frame for the program to submit additional or rebuttal 13 information to DIA from 2 working days, as currently required, 14 to 10 working days. 15 -4- LSB 1758YC (3) 89 pf/rh 4/ 4