Nurse aides' standards set HHS releases guidelines for competency.


To ensure the best possible care in the nation's nursing homes, the U.S. health and human services secretary has issued regulations that would require nursing homes for the first time to meet training and competency standards for nurse aides.

Under the regulations, published in today's Federal Register, states will have to establish registries of nurse aides who meet specified training and competency criteria, Secretary Louis W. Sullivan said.

Maryland and other states across the country were issued advisory guidance in 1989 on the nurse aide training and competency evaluation requirements and on establishing registries of nurse aides.

The registries also must include any findings that a nurse aide has abused or neglected patients or misappropriated patient property, Sullivan said.

"These regulations reflect continued movement toward improved quality of patient care in the nation's nursing homes," he said. "Only with properly trained and evaluated nursing home personnel can we be sure of that."

He stressed that nursing homes must comply with the "Nurse Aide Training and Competency Evaluation Program" (NATCEP) to be eligible for Medicare and Medicaid reimbursement programs.

The requirements are authorized by the Omnibus Budget Reconciliation Act of 1987, which provided for comprehensive reform of health, safety and quality standards for nursing homes caring for Medicare and Medicaid patients.

Effective Tuesday, nursing homes are prevented from employing nursing aides for more than four months who have not completed a state-approved NATCEP or competency evaluation program. Congress has allowed several exemptions to the requirement for nurse aides who meet certain standards of experience or prior training.

"Nursing homes must provide state-approved NATCEPs or CEPs for nurses aides without cost to their employees," said Gail R. Wilensky, administrator of the Health Care Financing Administration.

"The facilities also must provide continuing education programs to maintain and improve the capabilities of nurses aides," she said.

The new regulations require that nursing home facilities provide at least 12 hours of in-service education annually, conduct annual performance reviews of nurses aides and be available for annual on-site inspections and evaluations of nurse aides.

State-approved NATCEPs may be conducted in nursing homes or in educational institutions, such as community colleges. But, the states must determine the competency of nurse aides through a competency evaluation program consisting of a demonstration of skills and an oral or written examination, Sullivan said.

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