42 CFR §483.152

Requirements for approval of a nurse aide training and competency evaluation program.

(a) For a nurse aide training and competency evaluation program to be approved by the State, it must, at a minimum—

(1) Consist of no less than 75 clock hours of training;

(2) Include at least the subjects specified in paragraph (b) of this section;

(3) Include at least 16 hours of supervised practical training. Supervised practical training means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse;

(4) Ensure that—

(i) Students do not perform any services for which they have not trained and been found proficient by the instructor; and

(ii) Students who are providing services to residents are under the general supervision of a licensed nurse or a registered nurse;

(5) Meet the following requirements for instructors who train nurse aides;

(i) The training of nurse aides must be performed by or under the general supervision of a registered nurse who possesses a minimum of 2 years of nursing experience, at least 1 year of which must be in the provision of long term care facility services;

(ii) Instructors must have completed a course in teaching adults or have experience in teaching adults or supervising nurse aides;

(iii) In a facility-based program, the training of nurse aides may be performed under the general supervision of the director of nursing for the facility who is prohibited from performing the actual training; and

(iv) Other personnel from the health professions may supplement the instructor, including, but not limited to, registered nurses, licensed practical/vocational nurses, pharmacists, dietitians, social workers, sanitarians, fire safety experts, nursing home administrators, gerontologists, psychologists, physical and occupational therapists, activities specialists, speech/language/hearing therapists, and resident rights experts. Supplemental personnel must have at least 1 year of experience in their fields;

(6) Contain competency evaluation procedures specified in § 483.154.

(b) The curriculum of the nurse aide training program must include—

(1) At least a total of 16 hours of training in the following areas prior to any direct contact with a resident:

(i) Communication and interpersonal skills;

(ii) Infection control;

(iii) Safety/emergency procedures, including the Heimlich maneuver;

(iv) Promoting residents' independence; and

(v) Respecting residents' rights.

(2) Basic nursing skills;

(i) Taking and recording vital signs;

(ii) Measuring and recording height and weight;

(iii) Caring for the residents' environment;

(iv) Recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor; and

(v) Caring for residents when death is imminent.

(3) Personal care skills, including, but not limited to—

(i) Bathing;

(ii) Grooming, including mouth care;

(iii) Dressing;

(iv) Toileting;

(v) Assisting with eating and hydration;

(vi) Proper feeding techniques;

(vii) Skin care; and

(viii) Transfers, positioning, and turning.

(4) Mental health and social service needs:

(i) Modifying aide's behavior in response to residents' behavior;

(ii) Awareness of developmental tasks associated with the aging process;

(iii) How to respond to resident behavior;

(iv) Allowing the resident to make personal choices, providing and reinforcing other behavior consistent with the resident's dignity; and

(v) Using the resident's family as a source of emotional support.

(5) Care of cognitively impaired residents:

(i) Techniques for addressing the unique needs and behaviors of individual with dementia (Alzheimer's and others);

(ii) Communicating with cognitively impaired residents;

(iii) Understanding the behavior of cognitively impaired residents;

(iv) Appropriate responses to the behavior of cognitively impaired residents; and

(v) Methods of reducing the effects of cognitive impairments.

(6) Basic restorative services:

(i) Training the resident in self care according to the resident's abilities;

(ii) Use of assistive devices in transferring, ambulation, eating, and dressing;

(iii) Maintenance of range of motion;

(iv) Proper turning and positioning in bed and chair;

(v) Bowel and bladder training; and

(vi) Care and use of prosthetic and orthotic devices.

(7) Residents' Rights.

(i) Providing privacy and maintenance of confidentiality;

(ii) Promoting the residents' right to make personal choices to accommodate their needs;

(iii) Giving assistance in resolving grievances and disputes;

(iv) Providing needed assistance in getting to and participating in resident and family groups and other activities;

(v) Maintaining care and security of residents' personal possessions;

(vi) Promoting the resident's right to be free from abuse, mistreatment, and neglect and the need to report any instances of such treatment to appropriate facility staff;

(vii) Avoiding the need for restraints in accordance with current professional standards.

(c) Prohibition of charges. (1) No nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide training and competency evaluation program may be charged for any portion of the program (including any fees for textbooks or other required course materials).

(2) If an individual who is not employed, or does not have an offer to be employed, as a nurse aide becomes employed by, or receives an offer of employment from, a facility not later than 12 months after completing a nurse aide training and competency evaluation program, the State must provide for the reimbursement of costs incurred in completing the program on a pro rata basis during the period in which the individual is employed as a nurse aide.

Extracted obligations

The nurse aide training and competency evaluation program must consist of no less than 75 clock hours of training. · training hours · 99%
The program must include at least the subjects specified in the curriculum requirements (paragraph (b)). · curriculum content · 99%
The program must include at least 16 hours of supervised practical training in a laboratory or other setting where the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or licensed practical nurse. · supervised practical training · 99%
The program must ensure that students do not perform any services for which they have not been trained and found proficient by the instructor. · student competency · 99%
The program must ensure that students who are providing services to residents are under the general supervision of a licensed nurse or a registered nurse. · student supervision · 99%
Nurse aide training must be performed by or under the general supervision of a registered nurse who has a minimum of 2 years of nursing experience, at least 1 year of which must be in the provision of long-term care facility services. · instructor qualifications · 99%
Instructors must have completed a course in teaching adults or have experience in teaching adults or supervising nurse aides. · instructor qualifications · 99%
In a facility-based program, training may be performed under the general supervision of the director of nursing, who is prohibited from performing the actual training. · instructor qualifications · 99%
Supplemental personnel from health professions who assist instructors must have at least 1 year of experience in their respective fields. · instructor qualifications · 99%
The program must contain competency evaluation procedures as specified in §483.154. · competency evaluation · 99%
The curriculum must include at least 16 hours of training in communication and interpersonal skills, infection control, safety/emergency procedures (including the Heimlich maneuver), promoting residents' independence, and respecting residents' rights — all completed prior to any direct contact with a resident. · curriculum content · 99%
The curriculum must include training in basic nursing skills: taking and recording vital signs; measuring and recording height and weight; caring for the residents' environment; recognizing abnormal changes in body functioning and reporting such changes to a supervisor; and caring for residents when death is imminent. · curriculum content · 99%
The curriculum must include training in personal care skills including bathing, grooming (including mouth care), dressing, toileting, assisting with eating and hydration, proper feeding techniques, skin care, and transfers, positioning, and turning. · curriculum content · 99%
The curriculum must include training in mental health and social service needs: modifying aide behavior in response to residents' behavior, awareness of developmental tasks of aging, how to respond to resident behavior, allowing residents to make personal choices consistent with their dignity, and using the resident's family as a source of emotional support. · curriculum content · 99%
The curriculum must include training in care of cognitively impaired residents: techniques for addressing unique needs and behaviors of individuals with dementia, communicating with cognitively impaired residents, understanding their behavior, appropriate responses to their behavior, and methods of reducing the effects of cognitive impairments. · curriculum content · 99%
The curriculum must include training in basic restorative services: training residents in self-care, use of assistive devices for transferring/ambulation/eating/dressing, maintenance of range of motion, proper turning and positioning, bowel and bladder training, and care and use of prosthetic and orthotic devices. · curriculum content · 99%
The curriculum must include training in residents' rights: providing privacy and confidentiality, promoting residents' right to make personal choices, assisting in resolving grievances and disputes, helping residents participate in resident and family groups and activities, maintaining care and security of personal possessions, promoting freedom from abuse/mistreatment/neglect and reporting such treatment to appropriate facility staff, and avoiding the need for restraints in accordance with current professional standards. · curriculum content · 99%
No nurse aide who is employed by, or has received an offer of employment from, a facility on the date the aide begins a nurse aide training and competency evaluation program may be charged for any portion of the program, including fees for textbooks or other required course materials. · prohibition of charges · 99%
If an individual who was not employed (or did not have an offer of employment) as a nurse aide when completing the program becomes employed by or receives an offer of employment from a facility within 12 months after completing the program, the State must provide for reimbursement of costs incurred in completing the program on a pro rata basis during the period in which the individual is employed as a nurse aide. · prohibition of charges · 99%

Source: eCFR 2024-12-31 · hash sha256:59b0613f71c13625bad3079dd63048731b6027f6e5fb95531792a05b423a943c