All nurse aide training programs must comply with the federal nurse aide training and competency regulations, promulgated pursuant to the Omnibus Budget Reconciliation Act of 1987, and with federal labor laws, including but not limited to minimum age requirements. Copies of these regulations may be obtained from the department.

(1) Testing service.
(a) The Department shall provide or contract for the provision of nurse aide testing services as follows:
1. Annual publication of testing schedules and sites.
2. Test sites shall be located so that no individual is required to drive farther than thirty (30) miles to reach a test site.
3. Scheduled tests shall be administered, except when no individual is scheduled to test at a particular test site.
4. The number of individuals passing and failing shall be published following each test.
5. The minimum passing grade for each test shall be seventy-five percent (75%) for the written or oral component. The performance demonstration portion of the test shall consist, at minimum, of five performance tasks, which shall be selected randomly for each registrant from a pool of skills evaluation tasks ranked according to degree of difficulty, with at least one task selected from each degree of difficulty. Registrants are required to pass a minimum of five (5) performance tasks.
6. Individuals who fail any portion of the test three (3) consecutive times shall repeat training prior to taking the test again.
(b) Applications to take the test shall be sent by the program coordinator to the appropriate testing agency postmarked no later than thirty (30) days prior to the test date. Requests for special testing needs shall be made to the testing agency at this time.
(c) The department shall provide the board with quarterly reports on the number of individuals passing and failing each test.
(d) A practical and written test will be developed to reflect that a trainee has acquired the minimum competency skills necessary to become a competent and qualified nurse aide. The Nurse Aide Advisory Committee, composed of twelve (12) members with at least three (3) members nominated by the Tennessee Health Care Association, will periodically review testing materials and set criteria for survey visits of the nurse aide programs.
(e) The test will be developed from a pool of questions, only a portion of which is to be used for grading purposes in any one test, not to exceed one hundred (100) questions. A system must be developed which prevents the disclosure of the pool of questions and of the performance demonstration portion of the test.
(2) Training program.
(a) Requests for approval of a nurse aide training program shall be submitted to the department and shall include the following:
1. Name, address and telephone number of the facility, institution or agency offering the program;
2. The program coordinator's name, address, license number and verification of a minimum of two (2) years nursing experience, at least one of which must be in the provision of long-term care facility services;
3. Statement of course objectives;
4. Description of course content specifying the number of hours to be spent in the classroom and in clinical settings; and,
5. In lieu of (3) and (4) above, the fact that the curriculum is previously department-approved.
(b) Notification of any change to any one of the above five (5) items or termination of the program must be submitted to the department within 30 days.
(c) Each training program shall have a pass rate on both written and performance exams of at least 70%. Annual reviews of Nurse Aide Training Programs shall include:
1. Letter of commendation for exceptional pass rate as evaluated by the department;
2. Letter of concern for programs having one year of test pass rates below 70%;
3. Request for plan of program improvement for programs with two consecutive years of test pass rates below 70%;
4. After the third year of consecutive test pass rates below seventy-percent (70%), the program shall be closed for no less than twenty-four (24) months. All students enrolled in the program shall be allowed to complete the course. Any program closed may appeal the closure to the Board pursuant to the Uniform Administrative Procedures Act compiled in Title 4, Chapter 5, Part 3.
(d) Each program coordinator shall be responsible for ensuring that the following requirements are met:
1. Course objectives are accomplished;
2. Only persons having appropriate skills and knowledge are selected to conduct any part of the training;
3. The provision of direct individual care to residents by a trainee is limited to appropriately supervised clinical experiences; a program instructor must be present or readily available on-site during all clinical training hours including direct patient care for the seventy-five (75) hour training program. All activities of daily living (ADL) skills, including but not limited to bathing, feeding, toileting, grooming, oral care, and perineal care, must be taught prior to student performing direct patient care;
4. The area used for training is well-lighted, well-ventilated and provides for privacy for instruction. Such requirements are not to exceed the requirements for physical space in a nursing facility;
5. Each trainee demonstrates competence in clinical skills and fundamental principles of resident care;
6. Records are kept to verify the participation and performance of each trainee in each phase of the training program. The satisfactory completion of the training program by each trainee shall be attested to on each trainee's record;
7. Each trainee is issued a certificate of completion which includes at least the name of the program, the date of issuance, the trainee's name and the signature of the program coordinator.
8. The program coordinator shall be responsible for the completion, signing and submission to the department of all required documentation.
(e) Student to teacher ratio must be as follows: 25:1 in classroom and 15:1 for direct patient care training.
(3) Nurse Aide Registry. A nursing home must not use any individual working in a facility as a nurse aide for more than four (4) months unless that individual's name is included on the Nurse Aide Registry. A facility must not use on a temporary, per diem, leased or any basis other than permanent, any individual who does not meet the requirements of training and competency testing.
(a) The nurse aide registry shall include:
1. The individual's full name, including a maiden name and any other surnames used;
2. The individual's last known home address;
3. The individual's date of birth; and,
4. The date that the individual passed the competency test and the expiration date of the individual's current registration.
(b) The name of any individual who has not performed nursing or nursing related services for a period of twenty-four (24) consecutive months shall be removed from the Nurse Aide Registry.
(4) Continued Competency. The facility must complete a performance review of each nurse aide employee at least once every 12 months and must provide regular in-service education based on the outcome of these reviews.


Tenn. Comp. R. & Regs. 1200-08-06-.15
Original rule filed September 4, 2003; effective November 18, 2003 Amendment filed March 27, 2015; effective 6/25/2015.

Authority: T.C.A. ยงยง 4-5-202, 4-5-204, 68-11-202, 68-11-204, 68-11-206, 68-11-207, 68-11-209, 68-11-210, 68-11-211, 68-11-213, and 68-11-804.

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