{"ref":"CA-HH-CS-02","title":"Skilled Nursing Services: Registered Nurse and Licensed Vocational Nurse Duties","category":"Clinical tasks","summary":"Sets out what registered nurses and licensed vocational nurses do for the Agency’s patients under 22 CCR §74707: the RN gives the initial nursing assessment before care begins and the ongoing assessment, notifies the practitioner of significant changes, coordinates services, documents, and teaches; the LVN may do everything except the assessment and coordination duties, and teaches only within the Vocational Nursing Practice Act. Both have one year of prior professional nursing experience; clinical notes are signed and incorporated into the record at least every seven working days; and nursing services are reviewed under the quality management program.","inShort":["Only a registered nurse does the first nursing assessment, ongoing assessments, and coordination of services.","LVNs may give care, document, and report changes, but they do not assess or coordinate, and they tell the RN about any change at once.","Call 911 first in an emergency, then the practitioner and your supervisor, unless a valid POLST or DNR says otherwise.","Write your note at the time of the visit. Notes must be signed and in the record within seven working days.","Only do the skills you have been checked as competent to do."],"primaryCitation":"22 CCR §74707","citations":["22 CCR §74707","22 CCR §74705","22 CCR §74703(a)","22 CCR §74697(d)","22 CCR §74701","22 CCR §74735(a)(5)","22 CCR §74742(b)(2)","Cal. Health & Safety Code §1727.5(c)","Cal. Bus. & Prof. Code §2725","Cal. Bus. & Prof. Code §2860.5","16 CCR §1443.5"],"federalCitations":["42 CFR §484.75","42 CFR §484.115(k)","42 CFR §484.60(d)"],"surveyorAsks":["Show me the initial nursing assessment for this patient. Who did it, and was it done before care was provided?","What does an LVN do for your patients, and what can an LVN not do?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (22 CCR §74707)","5. Duties of Registered Nurses and Licensed Vocational Nurses","6. Qualifications and Assignment","7. The Nursing Visit","8. Significant Changes in Condition","9. Coordination of Services","10. Supervision of Nursing Staff and Aides","11. Standardized Procedures","12. Clinical Notes and Documentation","13. Sufficient Nursing Services and Quality Review","14. Responsibilities","15. Records and Compliance Monitoring","16. Staff Training","17. References","18. Related Policies and Forms","19. Approval","20. Revision History"],"version":"1.0","sample":false,"pack":"ca-hha","state":"California","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}