The short answer North Carolina licenses home care agencies under 10A NCAC 13J (DHSR). In-home aides must either be listed on the NC Nurse Aide I Registry or have RN-verified competency in core personal care skills; Medicare-certified home health aides follow the federal 75-hour standard with 12 hours annual in-service.
What North Carolina requires
North Carolina
Home care licensure. Home care agencies providing in-home aide, nursing, or other home care services are licensed by NC DHSR under 10A NCAC 13J.
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Aide competency rule. 10A NCAC 13J .1110 requires agencies to document that in-home aides are competent for assigned tasks; aides not listed on the NC Nurse Aide Registry must have an RN verify core competencies (mobility, ambulation, transfers, bed mobility, bathing/showering).
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Nurse Aide I registry. Nurse Aide I listing requires completion of a state-approved training program meeting the 75-hour federal minimum plus competency evaluation; NA I listing is also a prerequisite for NC's Home Care Specialty Training registry for nurse aides.
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HHA in-service. Home health aides at Medicare-certified agencies must receive at least 12 hours of in-service training during each 12-month period per 42 CFR 484.80.
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The federal baseline (applies in every state)
Federal
75-hour HHA training standard. Under 42 CFR 484.80(b), home health aides at Medicare-certified home health agencies must complete a training program of at least 75 hours, including at least 16 hours of classroom training completed before beginning at least 16 hours of supervised practical (hands-on) training.
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Competency evaluation / CNA pathway. 42 CFR 484.80(a) allows aides to qualify by completing the 75-hour training and competency evaluation program, by passing a competency evaluation alone, or by completing a state nurse aide training and competency evaluation program (CNA) and being in good standing on the state nurse aide registry.
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12-hour annual in-service. 42 CFR 484.80(d) requires home health aides to receive at least 12 hours of in-service training during each 12-month period, which may occur while the aide is furnishing care and must be supervised by a registered nurse.
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RN trainer requirements. Under 42 CFR 484.80(b)(3) and (c)(2), classroom and supervised practical training must be performed by or under the general supervision of a registered nurse with at least 2 years of nursing experience, at least 1 year of which must be in home health care; competency evaluations must likewise be performed by an RN in consultation with other professionals.
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Primary sources for this page
- https://info.ncdhhs.gov/dhsr/ahc/homecare.html
- http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20j/subchapter%20j%20rules.html
- https://ncnar.ncdhhs.gov/hcafaq.html
- https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-484/subpart-B/section-484.80
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