CMS SOM App. PP, Tag F728

§483.35(e)(1) General rule.

A facility must not use any individual working in the facility as a nurse aide for

more than 4 months, on a full-time basis, unless—

(i) That individual is competent to provide nursing and nursing related services;

and

(ii) (A) That individual has completed a training and competency evaluation

program, or a competency evaluation program approved by the State as

meeting the requirements of §483.151 through §483.154; or

(B) That individual has been deemed or determined competent as provided

in §483.150(a) and (b).

§483.35(e)(2) Non-permanent employees.

A facility must not use on a temporary, per diem, leased, or any basis other than a

permanent employee any individual who does not meet the requirements in

paragraphs (e)(1)(i) and (ii) of this section.

§483.35(e)(3) Minimum Competency

A facility must not use any individual who has worked less than 4 months as a nurse

aide in that facility unless the individual—

(i) Is a full-time employee in a State-approved training and competency

evaluation program;

(ii) Has demonstrated competence through satisfactory participation in a State-approved nurse aide training and competency evaluation program or

competency evaluation program; or

(iii) Has been deemed or determined competent as provided in §483.150(a) and

(b).

DEFINITIONS

A “permanent employee” is defined as any employee the facility expects to continue

working on an ongoing basis.

GUIDANCE

Any individual who successfully completed either a nurse aide training or competency

evaluation program (NATCEP) or a competency evaluation program (CEP) or has been

deemed or determined competent as provided in §483.150(a) and (b) may be employed as

a nurse aide.

If an individual has not successfully completed a NATCEP program at the time of

employment, that individual may only function as a nurse aide if the individual is

currently in a NATCEP (not a competency evaluation program (CEP) alone) and is a

permanent employee in his or her first four months of employment in the facility.

PROCEDURES AND PROBES

• If there are concerns with a nurse aide’s competency or qualification determine

whether he/she successfully completed an approved NATCEP or a CEP. If not,

are these individuals’ permanent employees who have worked in the facility for 4

months or less enrolled in a NATCEP?

• Interview those aides to determine where they received their NATCEP training,

how long the training was and how long they have worked in the facility as a

nurse aide.

If you identify deficient care practices by nurse aides who do not have evidence of having

successfully completed a NATCEP/CEP, determine:

• If the aide is currently receiving training in a State-approved NATCEP; and

• If the aide has been trained, has demonstrated proficiency and determined to be

proficient for the tasks to which he or she is assigned. See §483.152 for specific

training that the aide is to receive.

For specific procedures for NATCEP/CEP refer to the State Operations Manual (SOM),

Chapters 4 and 7.