first of all, they may call them licensed, but unless they have taken a state certification test to be licensed they are certified. if they had a license the nurse would not be responsible if the gave a wrong med. most states allow "certified" people do give meds (those who have been "educated" and "proven" competent) under the license and direction of the rn. some places call them med techs or med aides. the "legality" depends on whether it is acute care, long term care or residential care.
the actual requirements do vary from state to state. if the facility wants to misrepresent who is passing meds as along as they don't call them "nurses" (which is protects in most states)...they can do what they want. i would, however, be curious how the public would feel about being duped that these people have licenses. medicare and the joint commission probably would be interested as well about calling certified nurses aides "licensed"
here is an example of the requirements for "unlicensed personnel"passing med in tn.
faq for med administration for unlicensed personnel coursefaq for med administration for unlicensed personnel course internet redesign template
as far as leveling nursing home the are leveled for acuity so regulations can be set for staffing. delaware in particular uses this terminology. to check out requirements by law......