Nurse Aide Registry
Frequently Asked Questions about NATCEPs
This FAQ was developed in response to several common questions about Nurse Aide Training and Competency Evaluation Programs (NATCEPs) received by the Nurse Aide Registry (NAR).
MDH recognizes Minnesota has a variety of diverse training programs that are offered throughout the state. We also recognize approved curricula may differ in delivery method to best serve the needs of their students. The Federal Nurse Aide Training Competency Evaluation Program (NATCEP) Resource (PDF) includes requirements for approved training programs with no pandemic allowances.
Training programs should refer to §483.152 Requirements for approval of a nurse aide training and competency evaluation program (ecfr.gov) for the complete requirements.
CMS has clarified that “individual” refers to an actual person, not a mannequin, for assessing tasks or skills. See 42 CFR 483.152 (a)(3) below.
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;
Perineal care and catheter care tasks will continue to be performed on a mannequin in a setting other than a long-term care facility.
Yes. Programs may choose to conduct supervised practical training (SPT) in a single setting, such as a laboratory or conduct training in a variety of settings. Some hours can be completed in the lab setting and some can be completed in a facility, such as a long-term care facility, assisted living facility, or hospital. The training program must ensure the minimum requirement of at least 16 hours has been met. They must identify dates, times, and locations where the SPT was conducted.
If supervised practical training is not conducted in a facility, tuberculosis (TB) testing and background studies are not required.
Training programs must be mindful about the separation of skills training (lab practice) and SPT. Skills training with candidates in the lab does not count toward the 16 hours of SPT required by federal regulation §483.152. These times must be identified separately. Tasks performed during SPT must be completed during skills training and deemed proficient by RN instructor prior to direct care on either the fellow student or resident.
Training programs are responsible for ensuring the RN instructor has knowledge of the curriculum and the program. They should be aware of how the program is functioning and where students are having difficulty. The RN instructor must be involved with any changes to the program and input to these changes. The RN instructor must ensure the students do not perform any services for which they have not been trained and found proficient by the instructor prior to completing the tasks during supervised practical training. The general supervision of the program should be identified in their job description.
§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—
(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;
(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;
Training programs are responsible for ensuring RN instructors are currently licensed and have the required licensed nursing experience. Long term care facility services is considered licensed nurse experience in a nursing home or assisted living facility. Licensed nursing experience that only includes provision of home care services in private homes is not considered to be long-term care facility services experience.
An instructor's licensed nursing experience can be as an LPN, but they must currently be practicing as a registered nurse (RN). Nurse aide employment does not count towards the nursing experience.
Training programs can review resumes for instructor experience in teaching adults or supervising nursing aides.
Training programs must ensure instructors implement the approved curriculum appropriately and a “Train the Trainer” component for instructors is an accepted standard for a training program to ensure this.
Most approved curricula require a Train the Trainer “or similar” component for instructors which is a requirement for approved training programs and not for curriculum approval.
A director of nurses (DON) may temporarily delegate their duties to provide nurse aide instruction.
Instructor approval letters will no longer be sent out by the registry; however, information about the instructor's qualifications must be available for the onsite review conducted by MDH.
The regulation §483.152 in part directs....
Requirements for approval of a nurse aide training and competency evaluation program.
(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;
Yes, if the approved training program has a written agreement with the long-term care facility identifying the qualified licensed nurse that will be functioning as the approved instructor for the training program and assures requirements are met.
The training program is responsible for ensuring the licensed practical nurse or registered nurse functioning as the instructor in the long-term facility meet instructor requirements and are supervising the nurse aide student as required at 483.152.
In part ...
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;
This is not permitted under 4658.1360. A waiver may be requested by a nursing home waiving these requirements.
In part ...
4658.0040 VARIANCE AND WAIVER.
Subpart 1. Request for variance or waiver.
A nursing home may request that the department grant a variance or waiver from the provisions of this chapter. A request for a variance or waiver must be submitted to the department in writing. Each request must contain:
A. the specific part or parts for which the variance or waiver is requested;
B. the reasons for the request;
C. the alternative measures that will be taken if a variance or waiver is granted;
D. the length of time for which the variance or waiver is requested; and
E. other relevant information necessary to properly evaluate the request for the variance or waiver.
In part ....
4658.1360 ADMINISTRATION OF MEDICATIONS BY UNLICENSED PERSONNEL.
Subpart 1. Authorization. The director of nursing services may delegate medication administration to unlicensed personnel according to Minnesota Statutes, sections 148.171, subdivision 15, and 148.262, subdivision 7.
Subp. 2. Training. Unlicensed nursing personnel who administer medications in a nursing home must:
A. have completed a nursing assistant training program approved by the department; and
B have completed a standardized medication administration training program for unlicensed personnel in nursing homes which is offered through a Minnesota postsecondary educational institution that includes, at a minimum, instruction on the following:
(1) the complete procedure of checking the resident's medication record;
(2) preparation of the medication for administration;
(3) administration of the medication to the resident;
(4) assisting residents with self-administration as necessary;
(5) documentation after administration of the date, time, dosage, and method of administration of all medications, or the reason for not administering the medication as ordered, and the signature of the nurse or authorized person who administered and observed the same; and
(6) the type of information regarding medication administration reportable to a nurse.
Subp. 3. Documentation of training course. A nursing home must keep written documentation verifying completion of the required course by all unlicensed nursing personnel administering medications.
Subp. 4. Medication administration. A person who completes the required training course, and has been delegated the responsibility, may administer medication, whether oral, suppository, eye drops, ear drops, inhalant, or topical, if:
A. the medications are regularly scheduled; and
B. in the case of pro re nata (PRN) medications, the administration of the medication is authorized by a nurse or reported to a nurse within a time period that is specified by nursing home policy prior to the administration.
The definition of postsecondary education includes “level that follows the successful completion of high school. Includes universities and colleges, as well as trade and vocational schools. Postsecondary education usually culminates with a diploma, certification or academic degree.”
Minnesota Statutes 124D.09 POSTSECONDARY ENROLLMENT OPTIONS ACT.
Subd. 3.Definitions. For purposes of this section, the following terms have the meanings given to them.
(a) "Eligible institution" means a Minnesota public postsecondary institution, a private, nonprofit two-year trade and technical school granting associate degrees, an opportunities industrialization center accredited by an accreditor recognized by the United States Department of Education, or a private, residential, two-year or four-year, liberal arts, degree-granting college or university located in Minnesota.