[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR483.154]



[Page 548-549]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 483_REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES--Table 

of Contents

 

 Subpart D_Requirements That Must Be Met by States and State Agencies: 

    Nurse Aide Training and Competency Evaluation, and Paid Feeding 

                               Assistants

 

Sec. 483.154  Nurse aide competency evaluation.



    (a) Notification to Individual. The State must advise in advance any 

individual who takes the competency evaluation that a record of the 

successful completion of the evaluation will be included in the State's 

nurse aid registry.

    (b) Content of the competency evaluation program--(1) Written or 

oral examinations. The competency evaluation must--

    (i) Allow an aide to choose between a written and an oral 

examination;

    (ii) Address each course requirement specified in Sec. 483.152(b);

    (iii) Be developed from a pool of test questions, only a portion of 

which is used in any one examination;

    (iv) Use a system that prevents disclosure of both the pool of 

questions and the individual competency evaluations; and

    (v) If oral, must be read from a prepared text in a neutral manner.

    (2) Demonstration of skills. The skills demonstration must consist 

of a demonstration of randomly selected items drawn from a pool 

consisting of the tasks generally performed by nurse aides. This pool of 

skills must include all of the personal care skills listed in Sec. 

483.152(b)(3).

    (c) Administration of the competency evaluation. (1) The competency 

examination must be administered and evaluated only by--

    (i) The State directly; or

    (ii) A State approved entity which is neither a skilled nursing 

facility that participates in Medicare nor a nursing facility that 

participates in Medicaid.

    (2) 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 competency evaluation program may be charged for any portion 

of the program.

    (3) 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 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.

    (4) The skills demonstration part of the evaluation must be--

    (i) Performed in a facility or laboratory setting comparable to the 

setting in which the individual will function as a nurse aide; and

    (ii) Administered and evaluated by a registered nurse with at least 

one year's experience in providing care for the elderly or the 

chronically ill of any age.

    (d) Facility proctoring of the competency evaluation. (1) The 

competency evaluation may, at the nurse aide's option, be conducted at 

the facility in which the nurse aide is or will be employed unless the 

facility is described in Sec. 483.151(b)(2).

    (2) The State may permit the competency evaluation to be proctored 

by facility personnel if the State finds that the procedure adopted by 

the facility assures that the competency evaluation program--

    (i) Is secure from tampering;

    (ii) Is standardized and scored by a testing, educational, or other 

organization approved by the State; and

    (iii) Requires no scoring by facility personnel.

    (3) The State must retract the right to proctor nurse aide 

competency evaluations from facilities in which the State finds any 

evidence of impropriety, including evidence of tampering by facility 

staff.

    (e) Successful completion of the competency evaluation program. (1) 

The State must establish a standard for satisfactory completion of the 

competency evaluation. To complete the competency evaluation 

successfully an individual must pass both the written



[[Page 549]]



or oral examination and the skills demonstration.

    (2) A record of successful completion of the competency evaluation 

must be included in the nurse aide registry provided in Sec. 483.156 

within 30 days of the date if the individual is found to be competent.

    (f) Unsuccessful completion of the competency evaluation program. 

(1) If the individual does not complete the evaluation satisfactorily, 

the individual must be advised--

    (i) Of the areas which he or she; did not pass; and

    (ii) That he or she has at least three opportunities to take the 

evaluation.

    (2) The State may impose a maximum upon the number of times an 

individual upon the number of times an individual may attempt to 

complete the competency evaluation successfully, but the maximum may be 

no less than three.