Impact of the New Regulation on Licensed Vocational Nurses (LVNs)

The Respiratory Care Board (RCB) has established a new regulation at California Code of Regulations section 1399.365 that specifies the basic respiratory tasks and services LVNs may perform without conducting respiratory assessments. The regulation aims to enhance patient safety while expanding LVNs’ ability to support respiratory care within defined limits. This page details how these regulations impact your role and responsibilities in respiratory care.

What the Regulation Means for LVNs

• LVNs may perform defined basic respiratory tasks that do not require a respiratory assessment, such as pulse oximetry, medication administration by aerosol, and hygiene care related to respiratory devices.
• The regulation excludes advanced respiratory assessments and invasive procedures (e.g., tracheal suctioning, ventilator management) from the LVN scope of practice.
• LVNs must continue to work under the supervision of a licensed respiratory care practitioner, registered nurse, or physician, depending on the care setting.
• Delegation of basic respiratory tasks should be consistent with the LVN's competency, employer policies, and applicable laws and regulations.
• LVNs are encouraged to seek training and validation of competence for any delegated respiratory tasks to ensure patient safety and regulatory compliance.
• Additional opportunities to perform advanced tasks may become available through future regulatory exemptions in specific home health and community-based settings.

Frequently Asked Questions

• Can LVNs perform tracheostomy care under this regulation?

  Basic hygiene care such as replacing tracheostomy ties and cleaning stoma sites is permitted as a basic respiratory tasks, but invasive tasks such as suctioning or tube changes are excluded from an LVNs scope of practice.

• When will exemptions for LVNs in home health settings be available?

  The RCB is currently developing these regulatory exemptions. More information will be published when finalized.

• What respiratory tasks am I now allowed to perform under the new regulation?

  LVNs can perform basic respiratory tasks that do not require respiratory assessment (see subdivision (b) of section 1399.365), including tasks such as pulse oximetry, data collection, aerosol medication administration (without ventilator manipulation), and basic tracheostomy care (e.g., tie replacement and stoma cleaning).

• Are there plans to allow LVNs to perform more advanced respiratory tasks?

  Yes, the RCB is actively working on regulatory exemptions that would allow LVNs to perform certain respiratory tasks beyond basic tasks and services in home health agencies and specific home and community-based settings.

• Do I need additional training or certification to perform these basic tasks?

  Employers may require training or competency validation related to the basic tasks outlibed in the new regulation. The RCB supports establishing clear training standards to ensure safe performance.

• Can I perform ventilator management or suctioning under this regulation?

  No, tasks such as ventilator manipulation and tracheal suctioning are not included in the basic tasks and remain outside the LVN scope of practice unless future exemptions are approved.

• Who supervises my performance of respiratory tasks?

  Generally, supervision comes from a licensed respiratory care practitioner, registered nurse, or physician, depending on your work setting.

Need More Information?

Contact the RCB at (916) 999-2190 or rcbinfo@dca.ca.gov for questions.