Licensed Nurse Assistant (LNA)

The Licensed Nursing Assistant (LNA) supports the delivery of Personal Care Services by meeting with clients in their homes or other approved community settings, gathering standardized information, observing functional abilities and safety needs, and documenting findings for review by the supervising licensed nurse. This position helps identify a client’s ability to complete activities of daily living and instrumental activities of daily living, available natural supports, environmental considerations, and changes that may affect service needs. The LNA does not independently perform the nursing assessment, determine medical necessity, establish eligibility, develop or approve the plan of care, or exercise nursing judgment reserved to a licensed nurse.

· Reports to and practices under the supervision of an RN, APRN, or LPN, consistent with New Hampshire law and agency policy.

· Uses only agency-approved forms, scripts, tools, and assessment-support procedures for which competency has been verified.

· Promptly reports findings, concerns, and changes in condition to the supervising nurse; does not interpret findings or make independent clinical conclusions.

· For New Hampshire Medicaid Personal Care Attendant services, the provider’s licensed RN must conduct the personal care assessment and develop and sign the plan of care. The LNA may collect supporting information and observations but may not substitute for the RN.

· Schedule and complete assigned client visits within required timeframes and communicate delays or access issues promptly.

· Verify client identity, explain the purpose and limits of the visit, obtain required acknowledgments, and protect client choice, privacy, dignity, and rights.

· Gather client-reported information and directly observe functional performance related to bathing, dressing, grooming, toileting, eating, mobility, transfers, positioning, medication self-management, meal preparation, housekeeping, laundry, shopping, and other approved tasks.

· Observe and document the home environment for accessibility, equipment use, fall or fire hazards, sanitation concerns, and barriers to the safe delivery of personal care services.

· Record the client’s current routines, preferences, strengths, limitations, ability to direct or participate in care, and the availability and role of family, friends, or other natural supports.

· Obtain and accurately record information requested by the supervising nurse regarding diagnoses, medications, equipment, nutrition, communication needs, and existing services without conducting medication reconciliation or making clinical determinations.

· Use objective, factual, complete, and timely documentation; distinguish direct observation from client or caregiver statements.

· Immediately report urgent concerns, including suspected abuse, neglect, exploitation, significant change in condition, unsafe living conditions, or risk of harm, in accordance with law and agency policy.

· Submit completed documentation to the supervising nurse for review, clarification, follow-up assessment, service authorization, and plan-of-care decisions.

· Participate in orientation, competency validation, quality review, case conferences, and continuing education as assigned.

· Maintain professional boundaries and comply with infection prevention, emergency preparedness, incident reporting, and confidentiality requirements.

· Travel safely throughout the assigned service area and maintain reliable communication with the agency.

· Current, unrestricted New Hampshire LNA license in good standing.

· Completion of a New Hampshire Board of Nursing-approved nursing assistant education program and demonstrated competency within the LNA scope of practice.

· Current CPR and first aid certification, if required by agency policy or contract.

· At least one year of experience in home care, long-term care, community health, or services for older adults or individuals with disabilities preferred.

· Successful completion of required background checks, exclusion screening, health screening, and other onboarding requirements.

· Valid driver’s license, reliable transportation, and automobile insurance when travel is an essential function.

· Ability to use electronic documentation systems and mobile technology securely and accurately.

The role requires regular travel and entry into varied home and community environments. The employee must be able to sit, stand, walk, bend, reach, use a computer or mobile device, and observe client movement and the home setting. The employee may occasionally assist with mobility demonstrations or other tasks that are within the LNA’s verified competency and specifically authorized by the supervising nurse and agency policy. Reasonable accommodations will be considered for qualified individuals.

· Accurate observation and documentation

· Clear, respectful, person-centered communication

· Recognition and escalation of changes in condition or safety concerns

· Understanding of professional boundaries and delegated duties

· Cultural responsiveness and respect for client preferences

· Organization, time management, and independent fieldwork

· Confidentiality and sound handling of protected health information

Important: This position description is designed for an LNA who supports the client-assessment workflow. It does not authorize the LNA to independently conduct a comprehensive nursing assessment, diagnose a condition, determine service eligibility or medical necessity, prescribe the type or amount of services, or create, approve, sign, or revise a plan of care. Those responsibilities must be completed by the appropriately licensed clinician as required by applicable New Hampshire law, program rules, payer requirements, and agency policy. The employer should obtain legal and clinical

compliance review before implementation and update this description when governing requirements change.