Nursing Delegation lets a licensed nurse formally delegate a clinical task, such as administering a medication via pen or performing a fingerstick blood glucose check, to non-licensed staff. It keeps the resident assessment, staff training, and signatures together in one auditable record. ALIS tracks each delegation's status and expiration for you, so you can see at a glance what is active, what is coming due, and what has expired.
Nursing Delegations is a Limited Release feature and is off by default. To enable it for your community, contact your Account Manager.
Before You Begin
Nursing Delegations must be enabled once per community before the workflow can be used. Setup happens in three steps:
ALIS turns on the feature behind an entitlement.
Staff security role permissions must be configured.
Assessment templates and delegation types must be added to Staff Settings.
For more detailed setup instructions, see How to Enable Nursing Delegations.
Who Completes Nursing Delegations?
Once a community is set up, completing a delegation is a shared workflow between two key roles:
- Nurses assess the resident, assign and train staff, and release the delegation for signature.
- Med techs (non-licensed staff) acknowledge and sign the delegations assigned to them.
This guide walks through the full process in the order it happens and which team member completes each step.
Access Nursing Delegations
This feature lives under the Staff menu. You can only work with delegations for communities you are assigned to on your staff profile. If you oversee more than one community, you can switch between them from inside the Delegations Center.
Don't see the Nursing Delegations option? It may not be enabled for your company yet, or your permissions may not include access. Contact your Account Manager for assistance.
Step 1: Open the Nursing Delegations Center (Nurse)
The Nursing Delegations Center is the nurse's home base for managing every delegation across the residents and staff they oversee. Open it from the Staff menu > Nursing Delegations.
If you cover more than one community, use the community toggle at the top to switch between them.
The Center is organized into tabs, similar to the Evaluation Center:
- Needs Attention flags anything that requires action: past-due delegations, in-progress items (an assessment or delegation you still need to finish), and delegations awaiting a med tech's signature. Rolling monthly bars show upcoming delegations due for renewal, so you can stay ahead of expirations.
- All Delegations is a resident-anchored list of every delegation. Filter by delegation type, resident, or staff member; sort by any column header. Toggle to include discontinued or rescinded records, and export the view to Excel or PDF.
- Staff Trainings shows the same information organized by staff member, useful for seeing a person's stacked training history.
- Audit is a log of every action taken in this area, mainly for troubleshooting.
Step 1: Start a delegation
A delegation links one resident to one delegated task. Start a new one from any of the Center's tabs.
- Click the blue + button (Start Delegation).
- In the pop-out window, choose the resident.
- Choose the delegation type (the medication or task being delegated).
- Click Start Delegation.
ALIS opens the delegation detail page for that resident and task. Everything you do from here is anchored to this one resident and task pairing.
From the detail page you also have:
- View Packet (top right) prints the nursing assessment plus all staff assignments as a single packet once they are complete, for example for a state surveyor.
- Back to Delegations returns you to the Center.
- Discontinue closes out the entire delegation for this resident and task (see Discontinue a delegation).
Step 2: Complete the resident assessment
The first action on the delegation detail page is the nurse's resident assessment. This documents that the resident has been assessed for the delegated task.
- Click Start Assessment.
- Fill out the assessment form in the pop-up window. Use the Next and Previous buttons to step through each field the nurse needs to complete (helpful while you're learning the form), or jump directly to any field once you're familiar with it.
- Add your assessment notes.
- Add your nurse signature and date.
- Click Save, then Close.
The assessment now shows as In Progress. If you were interrupted, click Continue to pick up where you left off. Your entries and signature are saved.
When the assessment is finished, click Complete. Completing the assessment unlocks the Staff Assignments area so you can begin assigning staff.
The resident assessment is tied to the resident's record and pre-populates when you renew the delegation or assign additional staff, so you don't re-enter it each time. ALIS surfaces a reminder when an assessment is getting stale (a yellow advisory banner on the delegation and a Stale Assessments item in Needs Attention) so it can be refreshed on cadence.
Step 3: Assign and train staff
With the assessment complete, assign the staff members who will carry out the delegated task. You can assign and train several people at once.
- In the Staff Assignments area, click Assign Staff.
- Select one or more staff members.
- Click Assign. Each assigned staff member appears in a row.
You can now complete each staff member's training form. Fill them out one at a time with Continue, or fill several at once with Bulk Fill:
- Select the staff members you trained together (or Select All).
- Click Bulk Fill. The selected assignments open in a row so you can move through them without re-opening each one.
- On each form, complete the nurse's portion: the date and time, the delegated task (the resident and medication pull in automatically), the evaluation of staff competence, and any re-evaluation details and future re-evaluation date.
- Add your nurse signature and date.
- Click Save to hold your progress, or Next to mark that form ready for the staff member to sign and move to the next person.
Each form locks fields to the correct role. The nurse can only fill the nurse's fields, and the med tech can only fill theirs. The third page of every delegation form is the instruction set for the delegated task. Use it to train your staff; it stays available on the paperwork for med techs to reference at any time.
Step 4: Release the delegation and set the expiration
Releasing sends the completed paperwork to the assigned med techs for their signatures.
- After completing the last staff form, click Save, then Release for Signature.
- Choose the expiration for these delegations from the list: 30, 60, or 90 days, 6 months, 1 year, or a specific date.
- Click Release for Signature.
Each delegation moves to a Pending / Awaiting Signature state until the med tech signs. The detail page shows the date started, the expiration date, and a per-staff history view of prior trainings.
The expiration window is locked at the moment of release. It does not extend if a med tech is slow to sign, so the regulatory clock stays accurate.
Step 2: Sign the Delegation (Med Tech)
Assigned staff sign from their own login. ALIS makes sure they don't miss it.
- When a med tech logs in, a pop-up lists the delegations waiting for their signature. They can:
- Sign it right away, or
- Snooze it (up to 24 hours). A snoozed item re-prompts them later; they can also reach it anytime from the bell icon at the top of the screen.
- On the signing form, the med tech reviews the information the nurse completed, then uses the Next buttons to jump to the fields they must complete.
- The med tech agrees to the attestation statements, types their name, and adds their signature.
- Click Complete and Next to move to the next document, or finish if it's their only one.
If a med tech has several documents, ALIS walks them through each in turn, using the same multi-signing flow the nurse used.
If a document is missing information the nurse should have entered, the med tech can skip it and follow up with the nurse, then sign the ones that are ready.
Once the med tech signs, refresh the nurse's delegation page to see the status update to complete.
Step 3: Manage an Active Delegation (Nurse)
From the delegation detail page, a nurse can manage each staff member's completed delegation using the actions on the right:
- Reevaluate re-trains and re-signs a staff member when their delegation is due for renewal. Reevaluation supports Bulk Fill too, so you can re-train a group in one pass. This walks back through the delegation instructions and re-collects signatures.
- Reassess completes a new resident assessment when the resident needs to be reassessed.
- Download downloads the completed paperwork for that staff member.
- Rescind removes a staff member from the delegation (for example, if they change roles or leave). Rescinded records remain visible under the "Include rescinded" filter.
- View history shows prior trainings and assessments for that staff member; each row links to the original signed PDF.
Step 4: Discontinue a Delegation (Nurse)
Discontinue closes out an entire delegation, meaning the resident assessment and every staff assignment, when the task is no longer needed (for example, the resident moves out).
- On the delegation detail page, click Discontinue.
- Enter a reason for the discontinuation.
- Click Discontinue.
The delegation and all its history move to a discontinued state. It no longer appears in your active lists, but you can find it in All Delegations by turning on Include discontinued.
If circumstances change, for instance the resident returns, you can reinstate the discontinued delegation to bring the whole record back, rather than rebuilding it from scratch.