STUDENT HANDBOOK · student as The IC CNA School student. This smock may be worn over a shirt. All students shall also be required to wear a name tag at all times while participating

STUDENT HANDBOOK

The Independence Center CNA School 7870 North Academy Blvd. Colorado Springs, CO 80920 www.the-ic.org/cna

Program Email: [email protected] Administrator: Katey Castilla, RN

Program Coordinator: Anita Pope, RN

The Independence Center CNA School 7870 North Academy Blvd., Colorado Springs, CO 80920 Phone: 719-648-1020 Email: [email protected] Website: the-ic.org/cna

Rev. 1/26/16 Copyright 2016 © Nurse Nancy LLC – Proprietary Use Only – DO NOT COPY Student Handbook Page 3

The Course is Intensive and Requires Work: This course requires a substantial amount of reading and study. The textbook reads at a 10th grade level and reading assignments occur daily. Pop-quizzes, multi-choice tests and homework assignments are also issued.

The Colorado Nurse Aide Practice Act

Colorado Nurse Aide Practice Act (NAPA): In the State of Colorado, the statutory legal basis governing Certified Nurse Aide (CNA) training requirements and subsequent “scope-of-practice” is defined by the Colorado Nurse Aide Practice Act (NAPA), designated as “CRS: Title 12, Article 38.1”. All Student Nurse Aides, Graduate Nurse Aides and Certified Nurse Aides should read NAPA in its entirety so that they develop a good understanding of what it says and what it requires. A copy of the NAPA can be downloaded from the Colorado State Board of Nursing web-site at http://www.dora.state.co.us/nursing/. CNA-GNA-SNA Designations: In accordance with the Colorado Nurse Aide Practice Act (Title 12, Article 38.1), “only a person who holds a certificate to practice as a Nurse Aide in this state. . . shall have the right to use the title ‘Certified Nurse Aide’ and its abbreviation, ‘C.N.A.’”. All persons are therefore prohibited by law from representing themselves as a CNA until they have taken and passed both the written and skills components the Colorado Nurse Aide Competency and Evaluation Program exam (also known as “NACEP exam” or “State Boards”). Only by passing the NACEP exam will the Colorado State Board of Nursing grant the “C” in CNA and only the State Board of Nursing is authorized to grant a person a CNA. Prior to the successful completion of The Independence Center (The IC) CNA School, all students enrolled in and attending The IC CNA School are technically designated as “Student Nurse Aides” (SNA). A SNA cannot submit an application to take the NACEP exams. Upon successful completion of The IC CNA School (PASS status), a student is technically designated as a “Graduate Nurse Aide” (GNA). Only GNAs are allowed to submit an application to take the NACEP exams. The Nursing Home Reform Act (CFR: Title 42, Chapter 7, Subchapter XVIII § 1396r, Section B.5.(F) (OBRA 1987)) states that the term “Nurse Aide” does not include an individual “who volunteers to provide such services without monetary compensation”. This means a volunteer cannot use the title of CNA, GNA or NA. Representation: At no time shall any student enrolled in The IC CNA School represent themselves as an employee of The Independence Center, The IC CNA School or the clinical site training facility; and no students enrolled in The IC CNA School shall be monetarily

http://www.dora.state.co.us/nursing/

http://www4.law.cornell.edu/uscode/42/usc_sup_01_42.html

http://www4.law.cornell.edu/uscode/42/usc_sup_01_42_10_7.html

http://www4.law.cornell.edu/uscode/42/usc_sup_01_42_10_7_20_XVIII.html



compensated (paid) for their participation in The IC CNA School, including time spent in clinical training. A Criminal Background Check is MANDATORY: Completion of a criminal background check (CBC) is mandatory for every enrolled student before they can participate in the clinical phase of the training. A CBC must be started by a student directly from our website at www.the-ic.org/cna and the results MUST be provided directly to The IC CNA School by the CBC agency or the approved sponsor NO LATER THAN THE ACTUAL 7TH SCHEDULED CLASS of the enrolled course. A CBC cannot be submitted to The IC CNA School by a student. Any student failing to complete a CBC will not be permitted to participate in the clinical phase of the training. If results show no conflict/problems with Acceptance Standards cited on the Enrollment Application Form, student will not be contacted regarding their results.

Negative Tuberculosis Determination is MANDATORY: Our primary concern shall always be for the safety and well being of the patients and residents at the clinical site, as well as the clinical staff, The IC CNA School staff or fellow students. In accordance with the law, every student must therefore provide a tuberculosis test result that confirms a NEGATIVE TB status or a chest x-ray that reads negative for TB. This test result must be signed by a licensed medical professional and performed/dated no more than 12 months prior to the start date of the course and must not expire prior to class completion. Failure to meet this 7th scheduled class deadline will result in being denied further training. Applicant must provide NEGATIVE TB test results prior to reinstatement into a future course. A "positive TB result" or any in-progress TB medication treatment (ABT) will result in denial of admission. There will be no exceptions to this requirement and no refunds will be granted. Also note that in-progress medication treatment for TB (ABT) DOES NOT equate to a negative TB determination as we have no guarantee of treatment compliance. If a negative TB determination is not received by the deadline, deferment to a future course may be possible, but only after the student has paid 100% of the balance due on their total enrollment cost (tuition) PLUS an additional $150 deferment fee, regardless of the payment option initially selected. In addition, readmission requires retesting results that CONFIRM A NEGATIVE TB STATUS.

English Language Comprehension is MANDATORY: All participants in The IC CNA School MUST be able to communicate clearly using the English language due to its exclusive use by the instructors and its predominant use by medical teams and medical facilities. This includes the ability to understand written and spoken English plus the ability to be clearly understood, to read written English and to write clearly using the English language. All aspects of The IC CNA School use ONLY the English language including the textbook. The IC CNA School instruction proceeds at a pace that is roughly equivalent to a 9th or 10th grade



American educational level and relies heavily on textbook reading and comprehension. By enrolling in this course and signing the Enrollment Application Form, the student self-proclaims that their English language skills are proficient to meet the demands of the course and accepts sole responsibility for that decision.

Student Attire: Expected student dress during classroom and skills-lab instruction should reflect a clean, casual, and respectful workplace standard. In addition, any printed slogans or imagery that may be reasonably interpreted as vulgar, pornographic, racial or discriminatory are prohibited. As for footwear: work boots, high-heels, stilettos or any open-toed foot wear such as sandals or flip-flops are not allowed. Any student failing to comply may be asked to leave and/or have discretionary points deducted. (See the section entitled “Scoring by Instructor’s Discretionary Points” on page 7 of this handbook for an explanation of “Discretionary Points.” All students shall be assigned a red colored smock for the clinical training that identifies the student as The IC CNA School student. This smock may be worn over a shirt. All students shall also be required to wear a name tag at all times while participating in clinical training. The IC CNA School shall provide the name tag and a red colored loaner smock to each student with the understanding that the student shall return any such clothing to The IC CNA School at the end of the course or risk holding of their GNA. Physical Hygiene and Scents: It is expected that all enrolled students will maintain their personal hygiene in a manner that promotes mutual respect, including appropriate use of bathing, grooming, mouth care, deodorants and perfumes. The smell of cigarette smoke is easily detected and can be overwhelming to many people and even cause nausea to some (this also applies to perfume/cologne). This is especially true when studying, practicing or working in confined areas. Please take appropriate steps to reduce the smell via hand washing, breath mints, etc. Physical Requirements: Lifting and bending is required to complete The IC CNA School course. Students must be physically able to bend, kneel and lift at least 50 pounds. Any enrolled student attending The IC CNA School therefore does so at their own risk and indemnifies The IC CNA School and the Liberty Heights Skilled Nursing Center from any liabilities.

PASS Requirements and Scoring PASS Requirements: Achieving a passing status in The IC CNA School is dependent on seven major requirements that each enrolled student MUST meet:



1) A minimum of 75 hours of technical instruction must be received with no absences during Day 1 or during the clinical phase of the training (only 7 hours of pre-clinical training can be missed), and;

2) Student must attain a minimum score of 215 points out of the 250 possible points on the final skills demonstration exam (86%) and;

3) Student must attain a minimum score of 215 points out of the 250 possible points on the final written exam (86%) and;

4) Student must attain a minimum Overall Program Score of 860 points out of the 1000 possible total points for the entire course (86%) and;

5) Student must demonstrate proficiency in the Seven Expected Terminal Competencies as determined by the Program Coordinator’s professional nursing judgment (see below) and;

6) 100% of the total program cost must be paid in full (excluding students participating under an approved “Agency Sponsorship”). Please note that The IC CNA School retains the right to deny participation in the clinical phase of the training by any student if the student has failed to pay-in-full the outstanding balance due prior to the clinical training.

The Expected Terminal Competencies: Seven TERMINAL COMPETENCIES form the “core” of The IC CNA School teaching curriculum. All enrolled students must demonstrate understanding and proficiency in these seven terminal competencies as a PRECONDITION for successful completion of the course (see Pass Requirement No. 6 above):

1) Forming relationships, communicating and interacting competently on a one-to-one basis with clients (patients and residents), clinical staff, The IC CNA School staff and fellow students.

2) Demonstrating sensitivity to clients’ emotional, social, and mental health needs through skillful, directed interactions.

3) Assisting clients in attaining and maintaining independence.

4) Exhibiting behavior in support and promotion of clients’ rights.

5) Demonstrating observational and documentation skills needed in the assessment of clients’ health, physical condition and well-being.

6) Demonstrating an awareness of the Colorado Nurse Aide Practice Act.

7) Demonstrating competent team participation skills with fellow students, The IC CNA School staff and clinical staff.



Safety The safety of our patients, residents, clinical staff, The IC CNA School staff and fellow IC CNA SCHOOL students is a priority. Any enrolled student who exhibits unsafe working behavior will be expelled from the program. Scoring by Student Attendance (212 points): This course provides 87 hours of technical instruction. A minimum of 75 hours of technical instruction must be obtained by each and every student to pass the course with no absences during Day 1 or during the clinical phase of the training. Each student begins each course with the full 212 attendance points. Deductions are then made for absences which are calculated to the nearest 0.25 day. Any late arrival or early departure to/from class that exceeds 30 minutes shall be counted as absent to the nearest 0.25 day. A “no call/no show” absence results in a major deduction of attendance and discretionary points. A second “no call/no show” automatically terminates the Student Enrollment Contract. Students must therefore notify the instructor in advance of an anticipated absence. Exceptions shall be made for medical emergencies or jury duty if backed by official dated documentary proof. Scoring by Instructor’s Discretionary Points (68 Points): Active participation and professional conduct are expected, monitored, and contribute to each student’s final program score. Each student begins each course with 38 pre-clinical and 30 clinical discretionary points. Points may then be deducted at the instructor’s discretion based on unprofessional conduct, bad attitude, late arrivals/early departures, poor attendance, repetitive disruption of classroom instruction, lack of active participation, and cell phone use/abuse during class. Active participation is defined as the active and respectful interaction with instructors and peers during classroom and skills-lab instruction, discussions and activities, and respectful interaction with the clinical staff and patients/residents during all clinical session activities. It also includes the expectation that students will participate in the on-site practice of nursing skills and not just stand around and watch. Scoring By Quizzes and Written Tests (220 points): Each student begins each course with 220 quiz and test points. During The IC CNA School training, a series of quizzes (10 points each) and three brief written tests (60 points each) will be given. Incorrect answers will result in points being deducted. Please note that cheating is grounds for immediate termination of the Student Enrollment Contract.

Pre-Clinical Vitals Demonstration Exam (Pass/Fail Determination): Prior to participation in the clinical phase of The IC CNA School training, each student MAY be required to pass a pre-clinical vitals demonstration exam administered by the instructor. This exam will involve demonstration testing on: 1) measuring and recording blood pressure; 2) counting and recording radial pulse. A student must demonstrate proficiency to the instructor’s



satisfaction BEFORE they will be permitted to participate in the clinical phase of The IC CNA School training.

Scoring By Final Exams (500 points): On the final day of The IC CNA School training, a 250 point comprehensive written Final Exam (multi-choice) and a 250 point skills demonstration Final Exam (5 skills/25 minutes or less) will be given. Each student begins the Final Exams with all 500 points. Incorrect answers will result in points being deducted. These two Final Exams are comparable to the NACEP exams (State Boards). A minimum score of 215 points out of the 250 possible points is required to pass on each Final Exam (see Pass Requirements Numbers 2 and 3 on page 6).

Overall Program Score (OPS): At the end of the course and after the Final Exams have been graded, the Overall Program Score will be auto-calculated by computer using a combination of all scores achieved by each student (instructor’s discretionary points, student attendance points, quizzes, written tests, and Final Exams). Each student must attain a minimum overall cumulative score of 860 points out of the 1000 possible total points (86%) to earn a pass status for the course (see Pass Requirement No. 5 on page 6).

Re-Testing Standard for The IC CNA School Final Exams: If an enrolled student is notified that they failed one or both of The IC CNA School Final Exams on the final day of the course but their resulting Overall Program Score is 841 or higher, they are eligible for two additional opportunities to re-take either of The IC CNA School Final Exams. However, all re-testing must be completed within 45 days from the date the initial Final Exams were taken by that student. If a student is sponsored, it is expected that the student will pay the retesting fee out of their own pocket. If the student fails to complete all necessary retesting on Final Exams within 45 days from the Final Exam test date of their enrolled class, that student will automatically be issued a FINAL FAIL STATUS with notice issued to the Board of Nursing. If the student has failed both Final Exams but is eligible for retesting, retesting on the Final Written Exam must be completed first with a passing score before the student will be allowed to proceed with Final Skills Exam retesting. If the student fails retesting on the Final Written Exam, they will be issued a FINAL FAIL NOTICE. All Final Skills Exam retesting require that the student contact the Administrative Assistant to coordinate the retesting date and time. In most cases, six (6) hours of logged skills-lab practice will be required before retesting date will be set. It is solely the student's responsibility to follow through with contacting the Administrative Assistant. The IC CNA School will not initiate or pursue contact or coordination with any student who requires retesting. NOTE: At no time will any student needing to retest be given priority over the students in a "present/in-progress course."



Final Fail Notice If a student voluntarily drops-out of the program; is absent as a no call/no show for 2 or more days, or; at the end of the final day of the course has achieved a cumulative Overall Program Score that is 840 or lower, that student will be issued a FINAL FAIL NOTICE for the entire course and WILL NOT BE ELIGIBLE for any further retesting or participation with The IC CNA School. When that happens, the Student Enrollment Contract is terminated except for debt owed and that person cannot seek or accept any employment as a Graduate Nurse Aide nor can they submit an application to take the NACEP State Board Exams.

Affidavit of Completion The Independence Center Proof of Training Affidavit: Proof of a student’s successful completion (PASS status) of The IC CNA School is formally acknowledged by a signed diploma referred to as the "Affidavit of Completion" (AOC) issued to each Graduate Nurse Aide. This document must be picked up in person at the school and will not be mailed out. A separate "Proof of Training Affidavit" (POTA) is also issued by The IC CNA School to Pearson-Vue for all GNAs wanting to participate in State Board testing. THIS POTA EXPIRES AFTER 24 MONTHS so State Board testing must be completed by the GNA within 24 months of graduation. Any GNA pursuing “Regional Testing” must request this POTA in person at the school and attach it to their Pearson-Vue application form. It will not be mailed out. Student Review of The IC CNA School Quizzes, Tests and Exam Results: All quizzes, tests, exams and other testing resources (hardcopy) are the property of The IC CNA School and must remain on-site and under The IC CNA School’s possession and control at all times. They cannot be copied or permanently released to a student nor can they be removed from The IC CNA School training facility. However, a student may request a meeting to review any of the quizzes, tests, exams or other testing resources contained within their own student file. In fact, student review of their own Final Exam results is strongly encouraged to prepare for the State Boards.

Specific Nurse Aide Skills Instruction

Pearson-Vue has defined 22 specific nursing skills that must be learned by each enrolled student to become a CNA. Regardless of how a student may have been previously told or trained by any other person, nurse, program or employer, completion of The IC CNA School requires that the defined 22 specific nursing skills be learned and performed using the exact step-by-step procedures described in this Pearson-Vue Colorado Nurse Aide Candidate Handbook. If a specific procedure or task is not stated in writing in these step-by-step procedures, then it is not a required procedure or task.



Additional Nurse Aide Skills

In addition to the 22 Pearson-Vue defined nursing skills, additional skills and competencies are also commonly practiced by nurse aides. Some of these skills are listed below and are discussed and/or demonstrated during pre-clinical training (classroom and skills-lab). Many may also be taught and practiced during clinical training if opportunities permit (dependent upon client needs at time of clinical training). These and additional skills are also listed and logged in The IC CNA School Student Performance Tracking Log:

Observation/Charting/Documentation Skills

Promoting Patient’s Right–to–Choose (Clothing, Activities, Foods, Recreation)

Supporting and Promoting Patient Rights

Delivery and Distribution of Meal Trays, Foods or Water to Clients

Observing/Assisting Clinical Staff with Care Plans/Care–Tracker System

Ensuring Client’s Room or Space is Safe and Free from Potential Hazards

Assisting Clinical Staff with Care Activities in Locked Alzheimer Unit

Assisting Clinical Staff with Care of Clients with Cognitive Impairments

Assisting with Recreational Activities (Bingo, Dancing, Music, Singing)

Transferring Clients to Family Meetings, Group Activities, Meals

Making Unoccupied Beds

Use of Non–Mercury Thermometer or Digital Thermometer to Obtain Temp.

Promptly Reporting Unusual Measurement Values Pertaining to Vital Signs

Recognizing/Reporting Abnormal Signs/Symptoms Related to Client Health

Measurement and Recording of Food/Fluid Intake

Measurement and Recording of Bowel or Other Output

Showering/Shampooing/Grooming Techniques

Mouth Care for Unconscious/NPO Client

Mock Shaving with Razor

Proper Skin Care Techniques and Reporting of Abnormal Signs/Symptoms

Assisting Client with Toiletries (Using/Organizing/Cleaning/Storing)

Assisting with Meal Set-up/Arrangement as Needed

Cueing Impaired/Confused Clients Who Can Feed Self

Use of Assistive Feeding Devices

Use of Bedside Commode/Use of Urinal

Dressing Wholly Dependent Clients

Proper Wheelchair Operation (Brakes/Leg Extensions/Footrest)

Use of Assistive Device for Mobility (Walker, Cane or Crutches)



Positioning of Clients on Side; Fowler’s; Prone; Supine; Sims Positions

2-Person Repositioning of Client in Bed (Logrolling)

Caring For/Using Orthotic/Prosthetic Devices (Glasses/Hearing Aide/Etc.)

Observing Clinical Staff with Use of Patient Lift The Independence Center Harness

Observing Clinical Staff with Refilling of Oxygen Canisters

Use of TABS or Pressure Alarms and other Restraint Alternatives

Use of Biohazard and Sharps Containers

Disposal Protocols and Dirty Supplies Protocols

Clean up of Spills or Debris that Could Pose a Hazard

Participating as a Professional Member of a Medical Care Team

General Training Policies

Video Surveillance: For security reasons, CCTV video monitoring and recording is used by The IC CNA School, but ONLY in the meeting, teaching and learning areas. Enrollment and participation in The IC CNA School grants implied consent to be recorded on tape when present in any of these areas of The IC CNA School training facility. Missed Classroom or Clinical Training Due to Instructor's Stand-Down Order: Every student MUST have at least 75 hours of technical training to complete and pass this course. There will be no exceptions to this requirement. Therefore, if an instructor orders a student to leave classroom or clinical training due to illness, late arrival or any other reason, than at the Program Coordinator’s discretion, and dependent on the availability of space, the student MAY BE allowed to make-up missed training time by attending a day or evening course that is already in progress. However, it shall be the sole responsibility of the student to coordinate such arrangements with the Program Coordinator in person. All missed training must be completed within 45 days from the scheduled end date of the student’s initial enrolled course unless the Program Coordinator makes an exception in writing. If at the end of this 45 day period the missed training time has not been made up, than the student will automatically be issued a Final Fail Status and their Student Enrollment Contract shall be terminated. NOTE: At no time will any student needing to make-up any missed time or needing to retest be given priority over the students in a "present/in-progress course" Postponement Due to Adverse Weather: Unless there is a significant accumulation of snow or ice, always presume that classes will take place. The IC CNA School will close when police or highway patrol recommend against travel on highways and streets. When



necessary, The IC CNA School retains the right to postpone or delay a classroom, skills lab or clinical session when travel is deemed unsafe due to adverse weather conditions. When such a postponement or delay is deemed necessary, The IC CNA School shall post a notice to the website at www.the-ic.org/cna. The Independence Center shall then reschedule the classroom or clinical session to the earliest time that is convenient for the majority of the enrolled students. Remember, when weather conditions are really bad, it is the doctors, nurses, nurse aides, police and firemen that the public expects to report to work. Parking: Use of the Plaza at Chapel Hills Shopping Center parking lots or clinical training site parking lots is done at the Student’s own risk and The Independence Center shall not be held liable in any manner for any damages to or theft from the student or the student’s vehicle when crossing, entering, exiting, parking or parked in these parking lots, regardless of cause or reason. All enrolled students should park in the central island area or near the back entrance to the building and watch out for and escort each other when using the parking lots. DO NOT park directly in front of any occupied stores.

Student Prohibitions: For reasons of professional courtesy, the following items or activities are strictly prohibited during any classroom, skills-lab or clinical session activity conducted in connection with The IC CNA School: 1) Firearms or dangerous weapons of any type; 2) Illegal drugs or banned substances of any type; 3) Alcoholic beverages of any type; 4) Use of cellular telephones of any type unless prior arrangements have been made with The IC CNA School to accommodate use for emergency notifications. This includes texting with a cell phone while in class or clinical training; 5) Use of any computer, audio, photographic, video or recording devices, including laptop computers, PDAs, iPads, radio, CD, DVD or any other type of hand-held or portable music player or recording device; 6) No student shall be accompanied by any children, family members, or friends or pets while participating in any aspect of The IC CNA School unless such persons are also enrolled students.

Should the student be in violation of this prohibition policy, The IC CNA School retains the right to demand, without prior warning, that the student leave a classroom or clinical facility immediately and terminate the student’s Student Enrollment Contract immediately. Resultant termination of the Student Enrollment Contract shall constitute formal expulsion of the student from The IC CNA School. The Colorado State Board of Nursing will be notified immediately and local law enforcement shall be notified as deemed necessary.

Prohibited Conduct or Actions: The IC CNA School’s educational training services involve close interaction with actual patients and residents in a medical clinical facility operated by a professional medical staff. The health, safety and well-being of the patients and residents is top priority.



Therefore, the staff of The IC CNA School and the clinical facility’s Administrator, Assistant Administrator or any Registered Nurse retain the right to demand, without prior warning, that a student leave a classroom or clinical facility immediately should their conduct or actions: 1) violate any of the Student Prohibitions cited in this Handbook; 2) involve unsafe, abusive, illegal, impaired, unprofessional, disrespectful, disruptive, threatening, endangering, potentially violent or violent actions or gestures made toward self or any patient/resident or their family members, or toward any Clinical Site staff or The IC CNA School Staff members or fellow students of The IC CNA School; 3) exhibit a potential safety risk or danger to self or other persons 4) involve dishonest actions, including cheating, forgery or the false reporting of events that did not actually occur (lying). Violation of any of these prohibitions can result in immediate dismissal from classroom or clinical training and potential termination of the Student Enrollment Contract. Contagious Disease(s) or Illness: If a student has or exhibits signs of an apparent, possible or confirmed contagious disease or illness, The IC CNA School retains the right to immediately suspend the student from any further training to prevent the potential spread of such disease or illness to other students or people. The student will then be allowed to rejoin the training once a medical doctor has confirmed in writing that they are no longer potentially contagious. Alcohol: Consuming alcohol during any aspect of The IC CNA School training is strictly prohibited. The IC CNA School Staff retains the right to immediately terminate any student’s participation in The IC CNA School if alcohol impairment is suspected or witnessed.

Smoking During Training: Smoking is NOT permitted within the building or near the building’s front public entrance points at either the Plaza at Chapel Hills Shopping Center or at any of the clinical training sites. Please do not leave litter or cigarette butts near our entryway, on the sidewalk or in our front planter box.

Deferment due to Medical, Legal Or Immediate Family Emergency: Should any enrolled student determine that they will not be able to complete their enrolled course due to a medical, legal or immediate family emergency, then the student MUST: 1) Request in writing that a deferment to a future course be granted by the Administrator of The Independence Center while their original enrolled course is still in progress; 2) pay a $150 CASH or MONEY ORDER deferment fee to cover necessary administrative amendments,



and; 3) provide written verification (proof) signed by an MD or attorney or a copy of a death certificate. Please note that only one (01) course deferment per student will be granted and no deferment will be granted until a STUDENT’S TOTAL REMAINING BALANCE DUE has been PAID IN FULL (100%) prior to the end-date of their original enrolled course, regardless of the payment option initially selected. Every deferred student must then complete the program within 90 days from the date their deferment was granted. All deferments become null and void after this 90 day deadline. IMPORTANT – Refunds And Withdrawal From Program Course: Refunds shall only be made when a student withdraws 72 hours (3 days) prior to the first day of their enrolled course. In addition, no refunds will be granted if the applicant has provided false information on their Enrollment Application Form, or their criminal background check confirms a conviction for any crime listed in the Program Acceptance Standards. Refunds shall be for the amount paid minus applicable bank fees and charges.

Clinical Training Policies

Deferment of Clinical Training Only: Should an enrolled student miss clinical orientation or any scheduled clinical training session, they will need to request a deferment in accordance with the requirements stated on page 14. Please note that any student granted deferment for clinical training will not receive priority placement in any future clinical sessions, but rather, will be assigned to the first available clinical training seat as determined by their instructor. This could delay completion of the program up to 90 days. In addition, it shall be the student's responsibility to contact the Administrative Assistant. The IC CNA School will not initiate or pursue contact or coordination with any student who requires deferment scheduling of their clinical training. All deferments become null and void after this 90 day deadline. Clinical Training Requirements: The IC CNA School training involves hands-on training in an actual clinical facility. All enrolled students MUST attend the scheduled on-site clinical orientation and MUST participate in the scheduled clinical training session for their enrolled course. All enrolled students MUST be in compliance with the following clinical training requirements prior to their participation in any scheduled on-site clinical orientation or any participation in any scheduled clinical training session:

1) The criminal background check must be completed and received by The IC CNA School no later than the 7th scheduled day of the students enrolled course;



2) PROOF OF A NEGATIVE TB DETERMINATION made by a medical professional must be received by The IC CNA School no later than the 7th scheduled day of the students enrolled course;

3) the student must show that a HEP-B series has been started or completed, or, they have signed a written HEP-B waiver form no later than the 07th scheduled day of their enrolled course;

4) the student must be able to perform the required bending and lifting nurse aide skills; 5) the student must not have any communicable or contagious disease(s) or illness that

could knowingly be spread to the patients/residents or staff at the clinical facility; 6) the student must not exhibit a potential threat, safety risk or danger to any patient,

resident, clinical staff, The IC CNA School staff or fellow students; 7) The student’s outstanding balance due for enrollment must be paid in full prior to

participation in the clinical training.

Clinical Training Dress:

1) The red medical smock issued by The IC CNA School must be worn at all times. 2) The student nametag issued by The IC CNA School must be worn at all times 3) Hands and hair should be clean and odor free. 4) For safety/health reasons, all fingernails must be clean, well groomed and not

excessively long. 5) Appropriate closed toed shoes must be worn. 6) Exposed jewelry during clinical is prohibited with the exception of small post earrings

and wrist watches.

Patient/Resident Refusal of Student During Clinical Training: Although the intent of The IC CNA School clinical training is for student Nurse Aides to gain “live person” experience performing nursing skills, it is not uncommon for a patient/resident to refuse such student practice or any service offered by a student. This is the patient’s right just as they have the right to privacy and all student Nurse Aides should respect these patient/resident rights. These skills may still be learned within the skills-lab training with one student participating as an actor while another student practices the actual step-by-step procedures of the skill (live person training). NHRA Residents’ Legal Bill of Rights: It is extremely important that all Nurse Aides be aware of the following legal rights for nursing home residents as placed into law by the Nursing Home Reform Act (OBRA 1987: 42 USC§ 1396r):

The right to freedom from abuse, mistreatment, and neglect;



The right to freedom from physical restraints;

The right to privacy;

The right to accommodation of medical, physical, psychological, and social needs;

The right to participate in resident and family groups;

The right to be treated with dignity;

The right to exercise self-determination;

The right to communicate freely;

The right to participate in the review of one's care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility; and

The right to voice grievances without discrimination or reprisal.

HIPAA (P.L.104-191) Privacy Rule/Confidentiality: The IC CNA School training involves close interaction with actual patients and residents during the clinical phase of instruction. The confidentiality of matters involving personal, financial, health, or other affairs of the medical facility staff and its patients/residents is a legal concern of The IC CNA School and the professional medical staff of the Clinical Site Training Facility. As a Nurse Aide student, you can be legally liable for the misuse or abuse of confidential information concerning the personal, financial, health, or other affairs of the medical facility staff and its patients/residents. This includes without limitation, medical records and charts which shall not be disclosed, disseminated, or otherwise revealed by the student, in whole or in part, in any manner whatsoever, either during or after The IC CNA School training to any other persons, firms or organizations, other than The IC CNA School instructors or the professional medical staff of the Clinical Site Training Facility. In addition, all patient information, charts, records, forms and documents used by Clinical Site Training Facility are the property of said facility and cannot be removed from the facility. Clinical Training Prohibitions: Because of liability concerns, certain activities are STRICTLY PROHIBITED when participating in the clinical phase of The IC CNA School training. In addition to those stated on page 13 of this Handbook, they include, but are not limited to, the following: 1) Never practice or perform any Nurse Aide skills or duties if the instructor has not specifically authorized such or is not in the building or “on the floor”; 2) Never attempt to physically lift a patient/resident out of bed, a bath, a wheelchair or a chair without prior approval AND assistance from the instructor or a member of the medical staff; 3) Never attempt to position a patient/resident on a bedpan or a commode without prior approval



AND assistance from the instructor or a member of the medical staff; 4) Never attempt to ambulate a patient/resident without prior approval AND assistance from the instructor or a member of the medical staff; 5) Never attempt to make an occupied bed without prior approval AND assistance from the instructor or a member of the medical staff; 6) Never give any patient/resident any food or drink (including water) without prior approval from the instructor OR a member of the medical staff, AND, without first verifying the patient/resident's identity; 7) Observe but never use, assist with or operate any “patient lift”; 8) Observe but never use, assist with or operate the fill/re-fill of oxygen tanks; 9) Never approach, inspect or touch any cart containing medications; 10) Never carry any medications in your hands or pockets, including inhalers, vitamins, antihistamines, Tylenol or aspirin; 11) Never give any patient/resident any gifts or tobacco products without prior approval from the instructor or a member of the medical staff; 12) Never offer any form of a medical diagnosis or assessment to a patient/resident or any of their family members; 13) Never perform or provide any service to a patient/resident for which you have not been trained unless such service is an integral component of the training process, performed with consent from the patient/resident, and is performed under direct supervision of the instructor; Violation of any of these prohibitions can result in immediate dismissal from clinical training AND potential termination of the Student Enrollment Contract. Open Door Policy: Student interaction with patients and residents during the clinical phase of the training may involve experience(s) with patients dealing with loneliness, disorientation, denial, frustration, arthritis, dementia, and Alzheimer’s, in addition to other ailments. More important, the student’s clinical experience may involve witness or knowledge of a stroke, seizure, heart attack, or the passing of a patient (death). These are all experiences that a CNA may need to deal with while working in a paid capacity. They may in fact happen as part of the learning process. For this reason, The IC CNA School shall set aside a brief period of time after each clinical session to discuss amongst all students the day’s events and the students’ experiences and observations. In addition, The Independence Center CNA School shall maintain an open-door policy to discuss such experiences with the student.

General Policies and Common Sense

No Guarantee: No guarantee, promise or warranty is made, expressed or implied by The Independence Center (The IC CNA School) that a student will successfully complete The IC CNA School; achieve a passing score on The IC CNA School Final Exams, or; achieve a PASS status for The IC CNA School course. No guarantee or warranty is made, expressed or implied by The Independence Center or The IC CNA School that a student will successfully pass the Colorado Nurse Aide Competency and Evaluation Program Exams (State Boards).



No guarantee or warranty is made, expressed or implied by The Independence Center or The IC CNA School that, having successfully completed and passed The IC CNA School, a graduate will attain or be offered paid-employment, or that the student will attain, or be offered, a specific wage or salary.

State Nurse Aide Competency and Evaluation Exam Applications: A company called Pearson-Vue holds the contract to process, schedule and administer the Nurse Aide Competency & Evaluation Program (NACEP) exams (State Boards) on behalf of the Board of Nursing. Only GNAs are allowed to submit an application and it must be accompanied by a signed PROOF OF TRAINING AFFIDAVID (POTA) issued by The IC CNA School. We will provide blank NACEP application forms and provide time and guidance for filling out these applications but it will be the student’s sole responsibility to make certain that the information entered onto these applications is accurate and that no required student information or signatures is missing. NOTE: Questions on the application form require a yes or no answer regarding charges, guilty pleas, convictions, deferred sentences, etc. for any felony or misdemeanor crimes, including DUI/DWI/DWAI. If a student must answer “yes” to any of these questions, then copies of the court papers containing an original court ink stamp or seal must be obtained directly from that court BY THE STUDENT (in person or by phone) and then placed by the student directly in the locked wall box located in the reception area (DO NOT GIVE TO INSTRUCTORS). These must be attached to the application along with a written letter of explanation signed by the student BEFORE it can be submitted.

The present cost of the NACEP exams is $123.00 and must be paid by a money order made out to Pearson-Vue (sponsored students should speak to the Administrative Assistant). The money order must be signed by the student, PLUS, the student’s name must be clearly printed somewhere on this money order. The student must also detach and keep their receipt. ALL money orders must be placed by the student directly in the locked wall box located in the reception area (DO NOT GIVE TO INSTRUCTORS). An envelope is not required. Any student wanting to test at a “regional test site” and not here at The IC CNA School must select the regional test site and test date from the Pearson Vue website and then process and submit their own application, money order and PROOF OF TRAINING AFFIDAVID (POTA) directly to Pearson-Vue without any involvement of The IC CNA School. Locked Wall Box: Mounted on the wall in the front reception area is a black colored locked wall box. All money orders, court papers and letters-of-explanation related to the NACEP exam application MUST be placed directly in this locked wall box by the student. DO NOT give these documents to instructors and DO NOT leave in an envelope on any desk, chair or floor. If they are not placed in this box, The IC CNA School will not be responsible for them!



Post-Graduation Skills-Lab Practice: The IC CNA School permits our GNAs and SNAs to practice in our skills-labs prior to taking the NACEP exams. This use is provided solely as a courtesy and not as a guaranteed right and may be restricted to certain hours or days. Such skills-lab practice is strongly encouraged by The IC CNA School as practice is by far the best way to master the specific step-by-step procedures required for successful performance of each of the 24 defined nursing skills that are taught and tested by The IC CNA School. All practicing students must sign in and sign out on the log sheets provided. A practicing student must not interfere with any on-site instructor’s teaching of any active class and all practice must be performed in a calm and quiet manner. The skills-lab(s) must be shared with other practicing students and it is imperative that the skills-lab(s) be left in a clean/tidy state upon completion of each practice session. No student shall be accompanied by any children, family members, friends or pets while practicing in the skills-labs unless such are also enrolled students. Written Recommendations: Only students achieving an Overall Program Score of 970 or higher are eligible for a “letter of recommendation” from the Program Coordinator. Please note that The IC CNA School cannot/will not respond to automatic internet based referral systems such as "skillsurvey.com" due to HIPAA and security reasons. QMAP: In strict accordance with the Colorado Nurse Aide Practice Act, a CNA cannot practice or work as a CNA while using a QMAP because CNAs are prohibited from providing any aspect of care that involves medications. A CNA can be granted a medication authority by the Colorado State Board of Nursing but it requires extensive supplemental training and is not the QMAP issued by the Colorado Department of Health. Contact the Colorado State Board of Nursing for more information or clarification about CNAs using QMAP. Respecting Diversity: If a resident/patient has items that are of religious significance (books, pendants, candles, prayer cloths, etc.), they should not be handled unless given permission. If they do need to be handled, treat them with the utmost respect. If a resident/patient has an unusual request to accommodate their customs or spiritual beliefs, politely refer their request to the doctor or nurse. In many cultures, it is considered impolite to question a person about their customs or spiritual beliefs. As a general rule, do not ask questions unless the resident/patient initiates the conversation, and only then with the utmost of discretion. Likewise, a resident/patient may also have items that are of personal significance, such as family heirlooms or gifts from family members or close friends. These too should be treated and handled with the same respect as the items of religious significance.



Respecting the Generation Gap: The vast majority of residents/patients who are living or cared for in long-term care facilities, nursing homes or assisted living centers will be over the age of 50. It is therefore important to remember that they often grew up at a time when life’s luxuries were harder to come by; when technology was not so prevalent; when education was much harder to obtain; when proper manners were not only expected, but considered part of everyday life. “Respect for your elders” was often considered the golden rule. In light of this fact, it is important to remember a couple of considerations when working with older residents/patients. First: jokes, political comments and stories that we think are humorous may often be offensive to an elderly resident/patient. Second: the use of “slang” terms or references to people or things may not be correctly understood by elderly residents/patients, or may even be interpreted in a completely different manner. Likewise, some elderly residents/patients may themselves use “slang” terms or references that are no longer used or understood by today’s youth. These may even seem offensive, impolite, or politically incorrect to the nursing assistant. Such use usually is not intended to be offensive, but rather, reflects the generation or environment in which they were raised. If you believe the comment was meant to be offensive, politely excuse yourself and report it to the doctor or nurse. Appropriate Place and Time: Knowing and understanding the concept of “appropriate place and time” is important. When entering a resident/patient’s room, pause to ensure that you are not invading a moment of privacy; announce your presence and request permission to enter; think before you speak so that your words are clear, accurate and understood in a manner that is neither offensive or invasive; use humor and kindness when appropriate, yet be serious and professional when the situation demands; if you have an observation or concern regarding a resident/patient’s health, welfare or safety, ask to speak privately with the doctor or nurse so that such information is not conveyed in the resident/patient’s presence. It is extremely important to remember that medical advice and diagnosis only be provided to the resident/patient by the doctor or the nurse. Gossip and Rumors: Even though it may sometimes be tempting, it is extremely unprofessional to participate in discussions that are clearly gossip or rumors. Word can travel fast and many a person’s reputation has been tarnished because they were associated with gossip or rumors, either directly or indirectly. It is therefore beneficial to keep in mind the age-old concept of “guilt-by-association” and avoid participation in any conversations or gatherings involving gossip or rumors. Situational Awareness: For your sake, for the doctors and nurses sake, and for the sake of the residents/patients, be aware of who is supposed to be present and who is not supposed



to be there. When observing a person involved in a suspicious activity, make note of their clothing or any other identifying features. If something or someone seems out-of-place, do not hesitate to share your thoughts and observations with a supervisor. Most important of all, stay out of harm’s way and do not attempt to confront the person in any manner.

Student Communications and Follow-Through: If a student is in need of retesting or is in need of making up any missed classroom or clinical training time, it shall be the student's responsibility to initiate, coordinate and maintain communication with The IC CNA School staff and to know when important deadlines are scheduled to occur. This should be done in person or in writing using email or cell phone texting capabilities. In terms of deadlines, always check this handbook and check the classroom whiteboard calendars. During a typical week, The IC CNA School staff may work as many as 60 hours and our priority will always be on the present/in-progress students and class. We are human and we do make mistakes and sometimes forget to follow up with students on certain matters or even to return a phone call. If you suspect that is happening, by all means follow through and get in touch with us again.

Reimbursement Notice for Students

In the State of Colorado, a Certified Nurse Aide (CNA) that has paid for his/her own training and becomes employed or has had an offer of employment from a Medicare/Medicaid certified nursing home is eligible for prorated reimbursement of his/her training expenses within twelve months of having completed a State approved nurse aide training and competency evaluation program. The prorated reimbursement of an eligible Certified Nurse Aide is required under 42 CFR 483 Subpart D (Code of Federal Regulations) and under General Authority CRS 12-38.1-103(3) Chapter XI (Colorado Revised Statutes) and is provided by the employer and not by The IC CNA School.

42 CFR 483 Subpart D: Requirements That Must Be Met by States and State Agencies §483.152(c):

Section: (c) Prohibition of charges. (1) No nurse aide who is employed by, or who has received an offer of employment from, a facility on the date which the aide begins a nurse aide training and competency evaluation program may be charged for any portion of the program (including any fees for text-books or other required course materials.)

(2) If an individual who is not employed, or does not have an offer to be employed, as a nurse aide becomes employed by, or receives an offer of employment from, a facility not later than



12 months after completing a nurse aide training and competency evaluation program, the State must provide for the reimbursement of costs incurred in completing the program on a pro rata basis during the period in which the individual is employed as a nurse aide.

CRS 12-38.1-103(3) Chapter XI: 4.4. Pursuant to section 483.152(c) of the Federal Rules and Regulations related to Nurse Aide Training and Competency Evaluation Programs (NATCEP):

A. A long-term care facility ("facility") is prohibited from charging nurse aides it employs, or to whom it offers employment, for any portion of the NATCEP.

B. A nurse aide who pays for a NATCEP and becomes employed by a facility within 12 months of date of certification must be reimbursed by the facility, prorated for the portion of the 12-month period that the individual was employed at the facility.

This required reimbursement is provided by the State of Colorado through Medicaid per diem that is paid directly to Medicare/Medicaid certified nursing homes/long term care facilities. When a facility reimburses an eligible Certified Nurse Aide, the facility should record the pro rata reimbursement costs on their annual MED-13 report so that these costs are included in the computation of the facility’s per diem rate. All questions regarding these rules must be directed to the Colorado State Board of Nursing at (303) 894-2437 or (303) 894-7800. Notes for GNAs and CNAs from the Board of Nursing

1. If the GNA fails the NACEP exams after three attempts, the GNA must take an approved nurse aide training course over again from the start. 2. If a GNA accepts employment as a nurse aide, the GNA MUST take and PASS the NACEP exams within 120 days from the date they accepted the employment. 3. The CNA certificate is granted by the Colorado State Board of Nursing and not by The IC CNA School and then only after a GNA has passed the NACEP exams. A CNA certificate remains active for 24 months and then must be renewed. To renew a certificate, all CNAs are required to show proof that they have received monetary compensation for a minimum of eight hours during the prior twenty-four month period they have held a CNA. 4. Any person holding a CNA certificate is required to report any felony conviction to the Board of Nursing within forty-five days (45) of any such occurrence. Failure to comply may result in immediate termination of the CNA certification.



The IC CNA School

HEPATITIS B VACCINATION WAIVER FORM

I Waive My Right to Receive Hepatitis B Vaccine:

I, _____________________________________________, understand that due to my training exposure to blood or other potentially infectious materials during the clinical phase of The IC CNA School, I may be at risk of acquiring hepatitis B virus (HBV) infection. I understand that I can, at my own expense, obtain the opportunity to be vaccinated with hepatitis B vaccine, but I voluntarily decline the hepatitis B vaccination at this time. I understand that by declining this vaccine, I will continue to be at risk of acquiring hepatitis B, a serious disease, and herein accept sole responsibility for my decision to decline. By signing below, I herein indemnify and release from any and all liability the The Independence Center CNA School and the Liberty Heights Skilled Nursing Facility, including all of their owners and employed staff members. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series. ___________________________________________________________ _________________________________________________________

Print Student Name Student Signature

___________________________________________________

Date Signed (Month/Day/Year)



The IC CNA School

STUDENT HANDBOOK A Component of the Student Enrollment Contract

By signing below, I acknowledge that I have been given a copy of The IC CNA School Student Handbook; that The IC CNA School staff has reviewed this Handbook with our class on the first day of the course, and; that I have reviewed, understand and accept its content, including the attendance requirements and other program policies and the Handbook’s relationship to the Student Enrollment Contract. ___________________________________________________ _________________________________________________

Print Student Name Student Signature ___________________________________________________

Date Signed (Month/Day/Year)

Please Detach from Handbook and Submit to Administrator

STUDENT HANDBOOK · student as The IC CNA School student. This smock may be worn over a shirt. All students shall also be required to wear a name tag at all times while participating

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