What Is Nurse Delegation in the Community Residential Setting?
The DSHS Nurse Delegation Program, under Washington State law, allows credentialed and trained Nursing Assistants and Home Care Aides working in DSHS Community-Based Residential Care settings to perform certain tasks. Examples include administration of medications and blood glucose testing which are normally performed only by licensed nurses. A Registered Nurse must teach and supervise the Nursing Assistant or Home Care Aide, as well as provide nursing assessments of the patient's condition. Registered Nurse delegation is governed by many laws, rules, and policy regarding licensing, credentialing, training, and for each setting.
Nurse Delegation Links
- Contractor Meeting notes
- HCS Management Bulletins
- 2026 Calendar of Events
- Skin Observation Protocol Resources
- RCW 18.79.260 Registered nurse—Activities allowed—Delegation of tasks
- WAC 246-840-910 - 970 Delegation of Nursing Care Tasks in Community-Based and In-Home Care Settings
- RCW 18.88A Nursing Assistants
- RCW 18.88B Long-Term Care Workers
- Aging and Long-Term Support Administration Long-Term Care Manual
- Developmental Disabilities Administration Nursing Services
- DOH Provider Credential Search
How to Become a Registered Nurse Delegator
DSHS HCS provides Registered Nurse Delegation Orientation 6-hour classes every other month for Registered Nurses who are interested in a DSHS contract to provide delegation to DSHS Medicaid clients. This orientation is held in different locations around the state. Locations are dependent on availability for class space. Most classes are limited to 30 participants and registration typically fills up fast.
This RN Delegation Orientation class is an introduction to nurse delegation in community based residential settings such as Adult Family Homes, In-Home, and Developmental Disabilities Certified Community residential services.
How Do I Find Classes?
Registered Nurse Delegation Orientation class is provided at no cost every other month in different locations in WA state. Registration is required and classes fill up fast. We are unable to keep a waiting list.
Please do not reach out to us to get signed up. If there is an open spot the registration link will open to the registration link.
Here is the link to the registration information page: Registered Nurse Delegation Registration
The class training material is available for viewing and downloading. It is available for any RN that wants to know about delegation and has resources for more information: Registered Nurse Delegation Orientation Handout
FREQUENTLY ASKED QUESTIONS:
How Can a Registered Nurse Contract with DSHS To Provide Nurse Delegation?
Registered nurses who wish to contract with DSHS are required to attend an all-day in-person training session provided by the DSHS Nurse Delegation program. The RN must also complete a contract packet which you will receive after attending the class.
What Is Required for a Registered Nurse to Provide Nurse Delegation?
All Registered Nurse’s in Washington State may delegate, however they may only do so according to the laws (RCW 18.79.260) and regulations (WAC 246-840-910 to 970) upheld by the Washington State Board of Nursing.
To delegate to DSHS Medicaid clients the RN must have an active DSHS ND contract.
How does an RN Contractor find clients?
DSHS does not automatically provide clients to the delegator; the delegator must market their services for themself. DSHS does distribute the current list of Contracted Nurse Delegators to DSHS Case Managers who authorize Nurse Delegation services for Medicaid clients qualified for services.
The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from Case Managers in Home and Community Living Administration and Developmental Disabilities Community Services. The contractor submits time through Health Care Authority and ProviderOne for payment of services.
How does the Nurse Delegator get paid for delegation services?
The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from Case Managers in Home and Community Living Administration and Developmental Disabilities Living Administration. The contractor submits time through Health Care Authority and ProviderOne for payment of services.
How Do I Get Nurse Delegation Forms?
You can download all mandatory forms at the Nurse Delegation Forms page. The forms provided are mandatory by contract.