Legal and Ethical Behavior

Why it matters on this exam

Three items, and mostly discrete facts that either stick or do not. Study it briskly and late — it is five percent.

Key concepts

• The registry. Section 483.156 requires each state to maintain a nurse aide registry, and 483.154(e)(2) requires a record of successful completion to be entered within 30 days of a candidate being found competent. Under 483.154(a) the state must advise you in advance that your successful completion will be recorded there.
• Findings against you. The registry also records findings of abuse, neglect or misappropriation of resident property. A finding follows the aide between employers, which is the practical consequence that makes this area matter beyond the exam.
• Confidentiality. A resident's information is disclosed to those involved in their care and to nobody else. This overlaps with Client Rights, where 483.152(b)(7)(i) names privacy and confidentiality together.
• Misappropriation of resident property. Taking or misusing a resident's belongings, which connects to the duty at 483.152(b)(7)(v) to maintain the care and security of personal possessions.
• Mandatory reporting. The duty to report abuse, mistreatment and neglect to appropriate facility staff, at 483.152(b)(7)(vi).
• Accountability. Documenting accurately and honestly, including recording care that was not given and why.

Common mistakes

• Charting care that was not actually given. It is a falsification, and the exam treats it as a legal question rather than a paperwork one.
• Discussing a resident where others can hear. Confidentiality is breached by a conversation in a corridor as surely as by handing over a file.

Worked example

An aide notices a resident's ring is missing and another staff member suggests waiting to see if it turns up. The correct action is to report it through the facility's process, without delay and without investigating first. Misappropriation of resident property is recorded on the registry, and the duty at 483.152(b)(7)(v) and (vi) is to maintain security of possessions and to report instances of mistreatment — not to establish what happened before saying anything.