64B9-15.002. Certified Nursing Assistant Authorized Duties.

(1) A certified nursing assistant shall provide care and assist residents with the following tasks related to the activities of daily living under the general supervision of a registered nurse or licensed practical nurse:

(a) Tasks associated with personal care:

1. Bathing,

2. Dressing,

3. Grooming,

4. Shaving,

5. Shampooing and caring for hair,

6. Providing and assisting with oral hygiene and denture care,

7. Caring for the skin,

8. Caring for the feet,

9. Caring for the nails,

10. Providing pericare,

11. Bed making and handling linen,

12. Maintaining a clean environment.

(b) Tasks associated with maintaining mobility:

1. Ambulating,

2. Transferring,

3. Transporting,

4. Positioning,

5. Turning,

6. Lifting,

7. Performing range of motion exercises,

8. Maintaining body alignment.

(c) Tasks associated with nutrition and hydration:

1. Feeding and assisting the resident with eating,

2. Assisting the resident with drinking.

(d) Tasks associated with elimination:

1. Toileting,

2. Assisting with the use of the bedpan and urinal,

3. Providing catheter care,

4. Collecting specimens,

5. Emptying ostomy bags, or changing bags that do not adhere to the skin,

6. Bowel and bladder training.

(e) Tasks associated with the use of assistive devices:

1. Caring for dentures, eyeglasses, contact lenses, and hearing aids,

2. Applying or donning established or previously fitted and adjusted prosthetic and orthotic devices,

3. Applying or donning previously fitted and adjusted orthotic braces,

4. Applying previously fitted antiembolus stockings,

5. Assisting with wheelchairs, walkers, or crutches,

6. Using comfort devices such as pillows, cradles, footboards, wedges, and boots,

7. Assisting with and encouraging the use of self-help devices for eating, grooming, and other personal care tasks,

8. Utilizing and assisting residents with devices for transferring, ambulation, alignment, and positioning,

9. Using restraints.

(f) Tasks associated with maintaining environment and resident safety, including handling of blood and body fluid and cleaning resident care areas.

(g) Tasks associated with data gathering:

1. Measuring temperature, pulse, respiration, and blood pressure,

2. Measuring height and weight,

3. Measuring and recording oral intake,

4. Measuring and recording urinary output, both voided and from urinary drainage systems,

5. Measuring and recording emesis,

6. Measuring and recording liquid stool.

(h) Recognition of and reporting of abnormal resident findings, signs, and symptoms.

(i) Post mortem care.

(j) Tasks associated with resident socialization, leisure activities, reality orientation, and validation techniques.

(k) Tasks associated with end of life care.

(l) Tasks associated with basic first aid, CPR skills, and emergency care.

(m) Tasks associated with compliance with resident’s/patient’s rights.

(n) Tasks associated with daily documentation of certified nursing assistant services provided to the resident.

(o) Medication administration:

1. A certified nursing assistant that meets the training requirements of Section 464.2035(1), F.S., may be delegated medication administration to patients of a home health agency by a licensed registered nurse.

2. A certified nursing assistant who meets the requirements of Sections 464.2035(1) and 400.211(5), F.S. and is designated as a qualified medication aide, may be delegated the administration of medication and associated tasks to residents of a nursing home facility by a licensed registered nurse; however direct supervision by a nurse is required when providing these services.

(p) Tasks prior to medication administration to a patient of a home health agency by a certified nursing assistant that meets the training requirements of section Section 464.2035(1), F.S., or to a resident of a nursing home facility by a qualified medication aide, who has been delegated such tasks by a licensed registered nurse:

1. Reviewing prescription medication orders,

2. Reviewing medication administration records for the time of last previous dose administered,

3. Reviewing prescription medication labels for the prescriber’s name, patient’s name, medication, dose, route of administration, frequency of administration, and expiration date,

4. Reviewing non-prescription, over the counter medication orders and any special instruction from the heath care provider that ordered the medication,

5. Reviewing the manufacturer’s packaging and instructions for medication ingredients, dose, route of administration, frequency, warnings and adverse reactions,

6. Contacting a registered nurse with any questions or concerns regarding ordered medications or administration. A qualified medication aide may also contact a licensed practical nurse with any questions or concerns regarding ordered medications or administration.

(q) Tasks at the time of medication administration to a patient of a home health agency by a certified nursing assistant that meets the training requirements of Section 464.2035(1), F.S., or to a resident of a nursing home facility by a qualified medication aide, who has been delegated such tasks by a licensed registered nurse:

1. Identifying patient by name,

2. Informing patient of medication and dose being administered,

3. Administering medication as ordered.

(r) Tasks following medication administration to a patient of a home health agency by a certified nursing assistant that meets the training requirements of Section 464.2035(1), F.S., or to a resident of a nursing home facility by a qualified medication aide, who has been delegated such tasks by a licensed registered nurse:

1. Reviewing medication administration record to confirm that the correct medication and dose was adminstered by the correct route, 

2. Documenting name of medication, dose, route of administration, and time of administration immediately following administration,

3.  Documenting medications refused or withheld and the reason for not administering the medication,

4. Reporting any symptoms of adverse effects to registered nurse and documenting reporting,

5. Documenting any adverse effects of medication.

(s) Tasks associated with out of date or discontinued medication delegated to a certified nursing assistant for a patient of a home health agency or delegated to a qualified medication aide for a resident of a nursing home facility:

1. Identifying expired  medication,

2. Reviewing orders to discontinue medication,

3. Returning expired or discontinued prescription medications to the home health agency for disposal or destruction per the agency’s medication policy and procedure protocol or for the qualified medication aide, following nursing home facility policies and procedures with regard to pharmacy requirements for expired or discontinued prescription medications.

4. Disposing of  non-prescription, over the counter medication per the agency’s medication policy and procedure protocol, or for the qualified medication aide, following nursing home facility policies and procedures.

5. Documenting return or disposal of medications.

(t) Tasks that meet the criteria of Section 464.0156, F.S. delegated by a licensed registered nurse to a certified nursing assistant who the licensed registered nurse has determined to be competent to perform the assigned tasks.

(2) A certified nursing assistant shall perform all tasks with knowledge of and awareness of a resident’s/patient’s rights and developmental level.

(3) A certified nursing assistant shall not perform any task which requires specialized nursing knowledge, judgment, or skills.

(4) A certified nursing assistant may receive additional training beyond that required for initial certification and upon validation of competence in the skill by a registered nurse may perform such skills as authorized by the facility.

(5) A certified nursing assistant shall not work independently without the supervision of a registered nurse or a licensed practical nurse.

Rulemaking Authority 400.211(5), 464.202, 464.203, 464.2035 FS. Law Implemented 400.211(5), 464.202, 464.203, 464.2035, 464.2085 FS. History-New 9-21-06, Amended 9-11-14, 7-15-21, 3-13-24.