Nurse Aide Training and Competency Evaluation Programs (NATP or NATCEP)

The LDH-HSS (Health Standards Section) reviews and approves or disapproves nurse aide training and competency evaluation programs for the state of Louisiana.

Any person or entity who wishes to offer a NATP/NATCEP must receive approval from the LDH-HSS. 

 

The Nurse Aide Training Application, along with the information detailed below, are required for approval of an NATP/NATCEP.  You must read the instructions below prior to submission of the application.

 

What you need to know about the application process:

  • Incomplete applications will be returned, and will delay approval of your program
  • If the application contains errors or discrepancies, you will be notified and given an opportunity to make corrections. This will delay approval of your program
  • The federal regulations require the state respond to a request within 90 days of receipt of the application.  Although it will usually be processed well within that time frame, please allow at least 30 days from the date you mail your application before inquiring about the status
  • Proprietary schools must obtain approval from the Board of Regents prior to conducting nurse aide training. Please review the license application and fee process prior to submission of NAT application to LDH
  • Nursing facilities that have been subject to one or more of the following actions in the previous 2 years are not eligible to provide nurse aide training, and may not serve as a clinical training site for other programs:
  1. Waiver for nursing services;
  2. Extended or partially extended survey;
  3. Assessed civil money penalty greater than $10,483;
  4. Denial of payment for new Medicare/Medicaid admissions;
  5. Termination from Medicare/Medicaid;
  6. Operated under trustee appointment for resident safety; and/or
  7. Closure of facility or transfer of residents due to state action.

 

As a reminder to NATP's: Clinical training cannot be performed in a facility that is ineligible to conduct NAT due to any of the reasons as noted in CFR  483.151 (above).  The facility is not required to notify the NATP; therefore, it is the responsibility of the NATP  to ensure the facility is eligible to serve as a clinical training site.Nursing Home Directory

 

 

 

A Nurse Aide Training Program must include a minimum of:

  1. 40 hours of classroom training
    • must have at least 16 hours of lab (skills) training, which is considered part of the classroom instruction;
    • must denote the lab/skills time in curriculum, including the subject area to which it correlates
    • ALL CLASSROOM/SKILLS MUST BE COMPLETED PRIOR TO CLINICAL TRAINING
  2. 4 hours of orientation to the clinical training site (not included in program hours); and
  3. 40 hours of clinical training (hands-on resident care in a nursing home or skilled nursing facility)

 

Curriculum: 

Programs approved after June 2012 must use one of 2 approved textbooks:

  1. How to Be a Nurse Assistant, 4th (or subsequent) edition, by American Health Care Association
  2. Successful Nursing Assistant Care, 2nd (or subsequent) edition, by Hartman Publishing**

**Subsequent editions are titled Nursing Assisting: A Foundation in Caregiving

 

A proposed curriculum must be submitted with the application.  It must include the time allotted for each unit/subject, the time allotted to lab instruction, and should be consistent with the program hours submitted on the application.

The textbook must be used as the curriculum.

Per the CFR 483.152 (a) and (b), the curriculum must include:

  1. At least 16 hours of in the following areas prior to any direct contact with a resident:
    1. communication and interpersonal skills
    2. infection control
    3. safety/emergency procedures, including the Heimlich maneuver
    4. promoting residents’ independence
    5. respecting residents’ rights
  2. At least 16 hours of supervised practical training (lab/skills training) prior to clinical instruction
  3. Basic nursing skills
  4. Personal care skills
  5. Mental health and social service needs
  6. Care of cognitively impaired residents
  7. Basic restorative services
  8. Residents’ rights

Please click here for additional information and example.

Clinical Contract:

For non-facility based programs, a valid clinical contract (copy) must be submitted for each clinical site to be used.  All clinical instruction must be performed at a LA licensed long term care facility (nursing home or hospital-based skilled nursing facility). Click here for a list of nursing homes.  The school must verify the nursing home is eligible to serve as a clinical training site (see above).  The clinical contract shall:

  • Indicate the agreement is for the purpose of nurse aide training
  • Specify a beginning and expiration date of the contract
  • Include printed name and title of individuals entering into agreement
  • Include date and signature of individuals entering into agreement
  • If the signature page is separate, the name of the entities must be included

 

Policy and Procedure:

The program’s policies/procedures shall be submitted with the application.  Below are the minimum areas that must be addressed for approval.  Please see the requirements for each, as noted in the federal and/or state regulations. The policy must provide your program's procedure for assurance the requirements will be met.

Admission requirements shall include:

  1. right to review (ALL non-facility based programs); criminal background check (facility-based programs)                                                                                                           *See memo regarding Right to Review sent to all NATP's in September 2016.  
  2. national sex offender public registry check (nsopw.gov)                                                                                                                                                                                         *Not included with the right to review
  3. CNA registry check
  4. DSW registry check

Attendance policy (including make-up work/time, absences allowed, re-entry, etc.)

Instructor to Student ratio

Skills performance checklist

  • Please note that Prometric's "Clinical Skills Checklist" shall NOT be used as the skills proficiency record/check-off.  Students must be proficient in ALL skills listed in the regulations, not just the skills that may be included in the competency evaluation.
  • The "Clinical Skills Checklist" available from Prometric is NOT to be used as a PROCEDURE GUIDE.  It should be used as a TOOL, because it provides checkpoints that the Nurse Aide Evaluator (NAE) will use to compare with the candidate's performance.  The checkpoints are the steps that a MINIMALLY COMPETENT CNA would be expected to carry out when performing that skill. Therefore, the checklist may differ from the procedure guide presented in the textbook, because the competency is evaluating the MINIMUM competency required to function as a CNA
    • Example: If the textbook includes use of gloves during linen change of an occupied bed, but is not listed as a checkpoint on the skills checklist, the student will not be penalized for donning gloves.  HOWEVER, the student will be penalized on the "Standard Precautions" checkpoint if s/he contaminates themselves when removing the gloves. 

Eligiblity to take competency exam

**Please note: the program does not submit student information to the Nurse Aide Registry.  Once the student successfully completes (passes) both portions of the competency exam, the student's information is submitted by Prometric for placement on the Registry.

Competency exam by Prometric. The school must explicitly identify the following in their policy: 

  1. Competency evaluation (written/oral and skills) will be performed by testing company Prometric.
  2. Whether application, testing fee, and retest fee is responsibility of student or the school (i.e., is the initial testing fee and/or retesting fee included with tuition or provided by program? Will school submit application to Prometric?)
  3. A student has 3 opportunities within 12 months to pass both portions of the exam. Specify whether tuition includes cost of retest (if required).
  4. If testing fee is included in tuition, school must submit application and test fees) to Prometric within 10 calendar days of completion of training
  5. If test (or retest) fee is not included in tuition (student must pay for test), school must provide Training Verification Form to student within 10 calendar days of completion of training. The specific cost of the competency exam must be included, if not included in tuition. 
  6. If retest is required, student is only required to retake the portion (written/oral or skills) that they failed.  The cost of each portion must be included.
  7. If student does not pass the competency evaluation after 3 attempts, student must retrain (take complete course again)
  8. Address what (if any) additional instruction will be provided for students who do not successfully complete the competency exam.
  9. If test (or retest) fee is not provided by school, the policy must include the current fees charged by Prometric. 
  10. Statement that identifies whether school is approved as an in-facility testing (IFT) site with Prometric.  If not, students must be notified that test date scheduling will be based on regional test site date availability.  

In addition to above, the following applies to facility based programs

  • Students cannot be charged for any portion of the program, including re-tests.  Students are allowed 3 opportunities within 1 year to pass both portions (written/oral and skills) of the competency evaluation.  A student is only required to retake the portion that they failed. If student is unsuccessful after 3 attempts, student must retrain.
  • Because of the new testing process, the state requirement that students of facility-based programs complete training and test within 60 days will not be enforced.  Instead, per the LTC federal regulation F728, 483.35 (d)(1), the nurse aide trainee must train and successfully complete the competency evaluation within 4 months of hire. (The state regulations will reflect this information with the next revision.)
  • The facility must submit the application, fee, and Training Verification Form to Prometric within 10 calendar days of completion of training. 

 

Program Coordinators and Instructors:

Each NATP must have an RN Coordinator, responsible for the general supervision of program.  Coordinators may serve as instructors (except DON). Instructors may be RN’s or LPN’s.

RN Coordinator(s):

  • In facility-based programs, the DON may serve as RN Coordinator, but is prohibited from performing actual training
  • May not serve as RN Coordinator for more than 2 programs simultaneously
  • Shall be on premises where program is conducted at least 50% of the duration of the program
  • Qualifications:
    1. Registered nurse with current, unencumbered license;
    2. Minimum of 2 years nursing experience, including at least 1 year in the provision of long term care facility services; and
    3. One of the following: VTIE, CTTIE, “train the trainer,” or master’s degree or above.

Instructor qualifications:

  1. Registered or Practical nurse with current, unencumbered license;
  2. Minimum of 2 years’ experience in the provision of long term care facility services; and
  3. one of the following: VTIE, CTTIE, “train the trainer,” or master’s degree or above.

 

Equipment List: 

Provide a list of all equipment to be used for training, including audio-visual, resident care simulation supplies, etc.  

You may wish to refer to the Prometric website, because the testing site application and the clinical skills checklist contain many, but not all, items that should be used in training. 

PLEASE NOTE:  The Prometric supplies required for approval as a testing site only lists those necessary to perform the skills that may be included on the Prometric skills competency evaluation.  As noted in the "Skills Performance Checklist" section above, students must be proficient in ALL skills noted in the regulations, not just those tested by Prometric. Therefore, submission of the testing site supply list only will not be sufficient for approval. 

 Click here for links to the regulations, train the trainers, and other information.

 

Other information:

  • Approval to provide nurse aide training is granted specifically for the provider who submitted the application. There is no provision for subcontracting the training program.
  • Non-facility based programs will be surveyed within one (1) year of initial approval, then every two (years) after.
  • Facility-based programs will be surveyed during the annual survey.
  • If an approved program ceases to provide nurse aide training for a two (2) year period, the program shall be closed.
  • Train the trainer classes are provided by instructors approved by the LDH only. You must contact an approved instructor to schedule a class.  A list of train the trainers may be found here.
  • The competency evaluation is conducted by Prometric.  The application, Training Verification Form, and payment must be submitted to Prometric in order to schedule.  (The program's policy should indicate the procedure for this)
  • Due to the changes with Prometric, the state regulation that students must complete training and test within 60 days will not be enforced.  However, the federal regulation that requires an individual must not work greater than 4 months unless they have successfully completed an approved nurse aide training and competency program is still applicable.  
  • Facility based programs must submit the application (with payment) and the Training Verification Form to Prometric within 10 days of completion of training. 
  • Trainees of non-facility based programs shall be provided the Nurse Aide Training (NAT) Verification Form so they may schedule the competency evaluation within 10 days of completion of training. The student may test 3 times within 12 months before retraining is required. The NAT Verification Form cannot be withheld due to non-payment of tuition.
  • NATCEP’s shall notify trainees of their responsibility to notify the Registry, either written or via LARS, of any changes in contact information (name, address, phone, email). Trainees shall also be provided the website of the LA Nurse Aide Registry, as the answers to most questions can be found there.  The address is http://www.ldh.la.gov/index.cfm/page/2257.