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Home care staff requirements in Rhode Island

Rhode Island's Department of Health licenses home nursing care providers and home care providers under one rule, 216-RICR-40-10-17. Workers with routine unsupervised patient contact need a national FBI fingerprint check started before or within one week of hire, plus a pre-employment health screening that includes TB testing and an annual flu vaccine. Homemakers need 25 hours of training, nursing assistants need a 120-hour program and a state license, and nursing assistants and homemakers must be supervised at least every three months.

Licenses

• A home nursing care provider delivers nursing by RNs or LPNs or licensed therapy services in the home (216-RICR-40-10-17.3).
• A home care provider delivers RN-supervised direct health care services in the home, including homemaker services, but not ongoing nursing care by an RN or LPN (216-RICR-40-10-17.3).
• Nursing assistants are licensed by the Department of Health, and licenses renew every two years on June 30 (216-RICR-40-05-22.5).

Background checks

• Anyone seeking a job with a home nursing care provider, home care provider or hospice that involves routine patient contact without other staff present must undergo a national criminal records check with fingerprints sent to the FBI by the Attorney General's Bureau of Criminal Identification (R.I. Gen. Laws 23-17-34(a)).
• The national check must be started before employment or within one week of starting (R.I. Gen. Laws 23-17-34(a)).
• If disqualifying information is found, the employer decides on continued employment after the employee shares the report (R.I. Gen. Laws 23-17-34(c)).
• Employers must keep evidence that national checks were started and their results on file for Department inspection (R.I. Gen. Laws 23-17-34(e)).
• Personnel files must include criminal records check findings and a reference check done before employment (216-RICR-40-10-17.5.3(G)).
• Agencies must electronically verify licenses of Department-licensed staff, such as nursing assistants, in the Department's license database (216-RICR-40-10-17.5.3(F)).

Training and competency

• Homemakers must complete a basic training program of 20 hours of classroom instruction plus at least 5 hours of practical experience, and pass a final exam (216-RICR-40-10-17.5.3(I)).
• Nursing assistant training programs must be at least 120 clock hours, including at least 40 hours of supervised practical training (216-RICR-40-05-22.7.1(D)(1)).
• Agencies must run ongoing in-service education, including orientation for direct care staff, covering infection control, HIPAA, and recognizing and reporting abuse, neglect, mistreatment and exploitation (216-RICR-40-10-17.5.3(D)).
• Personnel files must document orientation, required training and in-service education (216-RICR-40-10-17.5.3(G)).

Health screening

• Each worker with possible direct patient contact needs a pre-employment health screening before delivering services (216-RICR-40-10-17.5.3(K)).
• Health care workers must show immunity to measles, mumps, rubella and varicella and have one Tdap dose (216-RICR-20-15-7.6.1).
• Annual flu vaccination is required for health care workers, subject to the rule's refusal provisions (216-RICR-20-15-7.6.1(A)(4)).
• Before employment, workers need a negative two-step TB skin test or a negative TB blood test, with follow-up for positive results (216-RICR-20-15-7.6.1(A)(5)(a)).
• Follow-up TB testing for current workers must follow CDC health care setting guidelines (216-RICR-20-15-7.6.1(A)(5)(b)).
• Workers who are not in compliance must be kept away from patients until they meet the requirements (216-RICR-20-15-7.6(D)).

Also in the personnel file

• Nursing assistant services must be supervised by an RN or other licensed professional at least every three months, with an initial in-home assessment before service starts (216-RICR-40-10-17.6.6(B)).
• Homemaker services must be supervised by a nurse or a qualified bachelor's-level professional, with in-home assessments at least every three months (216-RICR-40-10-17.5.3(H)).
• Each employee needs an annual performance evaluation reviewed with and signed by the employee within 45 days (216-RICR-40-10-17.5.3(C)(1)).
• Each position needs a written job description (216-RICR-40-10-17.5.3(B)).
• Staff who examine, observe or treat patients must wear a photo ID badge showing first name, license status, languages spoken and position (216-RICR-40-10-17.5.3(J)(3)).
• Personnel files must include a birth certificate or I-9 or immigration papers, qualifications, license or certification, prior employment, health exam records, complaints and follow-up, and annual evaluations (216-RICR-40-10-17.5.3(G)).

Common questions

Some rules for Rhode Island weren't confirmed from an official source. Check with the state before relying on this page.

Sources

• R.I. Gen. Laws 23-17-34 (criminal records review, home nursing-care and home-care providers), RI General Assembly
• 216-RICR-40-10-17.3 (definitions), Cornell LII
• 216-RICR-40-10-17.5 (organization and management, personnel), Cornell LII
• 216-RICR-40-10-17.6 (patient care management, nursing assistant supervision), Cornell LII
• 216-RICR-20-15-7.6 (immunization and testing for health care workers), Cornell LII
• 216-RICR-40-05-22.5 (nursing assistant licensure), Cornell LII
• 216-RICR-40-05-22.7 (nursing assistant training programs), Cornell LII

This page summarizes state licensing rules in plain words, with links to the rules themselves. It is not legal advice, rules change, and your license type decides what applies: check the linked source and your licensing agency. Medicare-certified home health agencies also follow 42 CFR 484.80. Checked October 2026.

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