The Nurse Delegation Law

Nurse Delegation is a specific situation where a RN will come to your home and teaches our caregivers how to administer medication to you or your loved one, if it is considered safe for our caregiver to do so. Home Care Agency caregivers may not ever place medication in a client’s mouth, give a suppository, administer medicated ointment without nurse delegation happening in your home.

The law reads that a qualified registered nurse must delegate to each caregiver with each specific client. This means that even though the caregiver has taken the appropriate classes, each caregiver must meet with the RN with each client and learn how to provide the medication with that particular client. Which Caregivers? Caregivers must be either a Registered Nursing Assistant or Certified Nursing Assistant with a current license and have successfully completed two different classes: Fundamentals of Caregiving and Nurse Delegation. What clients qualify for nurse delegation? Clients who are in a predictable and stable condition who need the caregiver to place medications in their mouths, administer eye drops, place ointment on their skin, give rectal medication, or administer ear drops. There are many situations where this is appropriate. Some examples are people who have had strokes or paralysis, people who are very weak and can not feed themselves, people who are recovering from a surgery that prevents them from being able to assist with their medication administration, and end-of-life care. Why does the nurse have to come a teach the caregiver at my home with me and/or my loved one? The law reads that because a nurse is actually giving the caregiver permission to administer the medication under his/her registered nursing license, that the nurse must teach each caregiver with each client that the delegation happens. This process hopes to make this a safe situation where all questions are answered. The nurse has the opportunity to talk about the specific client’s needs and issues. It allows the nurse to place limits on how each medication is administered and under what specific conditions this is done. This practice hopes to provide the utmost of safety in supervising the caregiver as they take on this important task. What will it cost? At CareForce the cost is $75.00 per hour for the time the nurse spends doing nurse delegation duties. The nurses time varies in each situation. Sometimes it will be only 1-2 hours of his/her time; sometimes it will be as much as 8 hours of his/her time. It depends on how many caregivers are providing this care and need delegation services, and how long the delegation services lasts. The nurse must return to your home whenever there is a change in medication orders or at least every 60 days to observe the caregiver doing the delegation task. CareForce has a list of nurses who are trained in delegation and will arrange for this service. CareForce does all of the coordination of nurse delegation: making sure the caregivers are properly taught and supervised.

The hourly rate for caregivers who are delegated is $1.00 per hour more than our published rates.

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