Utah Admin. Code R432-45-5 - Nurse Aide Training Program Requirements Under UNAR

(1)

(a) An applicant shall apply to UNAR on behalf of an entity, including a:

(i) Medicare or Medicaid certified nursing facility;

(ii) secondary or post-secondary educational institution; and

(iii) private business.

(b) An entity may not include an educational program offered to an incarcerated inmate in accordance with Subsection 64-13-48(8).

(2) Within 90 days of receipt of an application for a NATCEP, UNAR shall advise the applicant of UNAR's:

(a) approval;

(b) denial, including a summary of the reasons for denial; or

(c) request for any additional information.

(3) An entity may not operate a NATCEP without UNAR approval.

(4) A NATCEP shall ensure the program director and any NATCEP instructor or employee who has direct patient access successfully completes a background check in accordance with Rule R432-35.

(5) UNAR shall ensure DACS reflects the current status of each individual required to have a clearance.

(6) A NATCEP shall provide at least 100 hours of supervised and documented training by a licensed nurse using curriculum containing:

(a) basic nursing skills;

(b) comprehensive orientation to the training program and the nursing assistant's role on the healthcare team;

(c) communication and interpersonal skills;

(d) infection control;

(e) promoting resident independence;

(f) respecting resident rights; and

(g) safety and emergency procedures.

(7) A NATCEP shall ensure each candidate:

(a) completes at least 24 of the required 100 hours of supervised practical training in a nursing care facility; and

(b) completes the skill competencies and skill curriculum listed on the NAPP record before training in a facility.

(8)

(a) UNAR may approve a written request from a NATCEP to use a Type II assisted living facility for no more than eight of the 24 required hours of supervised practical training if the NATCEP:

(i) identifies the Type II assisted living facility the NATCEP wishes to use; and

(ii) provides documentation of the lack of availability of nursing care facility locations to fulfill eight of the required 24 hours of supervised practical training for each NATCEP candidate.

(b) A NATCEP may not continue supervised practical training in a Type II assisted living or nursing care facility if that facility's supervised practical training approval has been withdrawn by UNAR.

(c) A nursing care facility listed on the NATCEP loss list may not allow separately approved NATCEPs to utilize the facility as a site location for supervised practical training unless the facility:

(i) obtains an approved NATCEP loss waiver from OL; or

(ii) is reinstated following the mandatory two-year ban following placement on the NATCEP loss list.

(9) NATCEP shall ensure the skills training requires demonstration of competencies in:

(a) basic nursing skills, including:

(i) caring for a resident when death is imminent;

(ii) caring for a resident's environment;

(iii) measuring and recording weight and height;

(iv) recognizing abnormal changes in body functioning and the importance of reporting the changes to a supervisor; and

(v) taking and recording vital signs;

(b) basic restorative services including:

(i) bowel and bladder training;

(ii) care and use of prosthetic and orthotic devices;

(iii) maintenance of range of motion;

(iv) proper turning and positioning in bed and chair;

(v) transfer techniques;

(vi) training a resident in self-care according to the resident's ability; and

(vii) use of assistive devices in ambulating, dressing, eating, and transferring;

(c) care of cognitively impaired residents, including:

(i) appropriate responses to the behavior of a cognitively impaired resident;

(ii) communicating with a cognitively impaired resident;

(iii) methods for reducing the effects of cognitive impairments;

(iv) techniques for addressing the unique needs and behaviors of a resident with dementia or Alzheimer's; and

(v) understanding the behavior of a cognitively impaired resident;

(d) mental health and social service skills, including:

(i) allowing a resident to make personal choices and providing and reinforcing other behavior consistent with the resident's dignity;

(ii) awareness of developmental tasks associated with the aging process;

(iii) how to respond to resident behavior;

(iv) modifying the nurse aide's behavior in response to a resident's behavior; and

(v) using a resident's family as a source of emotional support;

(e) personal care skills, including:

(i) assisting with eating and hydration;

(ii) bathing;

(iii) dressing;

(iv) grooming that includes mouth care;

(v) proper feeding techniques;

(vi) skin care;

(vii) toileting; and

(viii) transferring, positioning, and turning;

(f) resident's rights including:

(i) aiding in getting to and participating in resident and family groups and other activities;

(ii) aiding in resolving grievances and disputes;

(iii) maintaining care and security of a resident's personal belongings;

(iv) promoting a resident's right to be free from abuse, mistreatment, or neglect and the requirement to report any instances of abuse, mistreatment, or neglect to the appropriate staff, Adult Protective Services, and OL;

(v) promoting a resident's right to be free from physical and chemical restraints, unless the use is required to treat a medical symptom and is not used for discipline or staff convenience;

(vi) promoting a resident's right to make personal choices to accommodate the resident's needs; and

(vii) providing privacy and confidentiality.

(10) A candidate may not perform any services that the candidate has not been trained and found proficient to conduct by an instructor.

(11) A NATCEP shall have:

(a) a program director who:

(i) is an RN with an active license to practice nursing and is in good standing with the Division of Professional Licensing;

(ii) has two years of nursing experience with at least one year providing nursing care facility services, caring for the elderly, or caring for the chronically ill of any age;

(iii) establishes policies to ensure a minimum of three hours consulting time with a NATCEP for a new program and can provide at least three hours consulting time per month at renewal application for an existing NATCEP;

(iv) may be the director of nursing in a nursing care facility-based NATCEP if the facility remains in compliance with OBRA requirements; and

(v) may be the instructor;

(b) one or more instructors, each of whom:

(i) holds an active license to practice nursing and is in good standing with the Division of Professional Licensing; and

(ii) has two years of nursing experience with at least one year of experience providing nursing care facility services, caring for the elderly, or caring for the chronically ill of any age.

(12) Before approval of a NATCEP, the program director and any instructors shall successfully complete a UNAR-approved train-the-trainer program or demonstrate competence to teach candidates.

(13) Each high school instructor shall complete the train-the-trainer program or become certified to teach as defined by the Utah State Board of Education before providing instruction in the classroom.

(14)

(a) A licensed UNAR-approved nurse instructor shall directly supervise each candidate who provides services to a resident.

(b) Each instructor's supervised practical training oversight time is solely for the direct oversight of a candidate and the instructor may not be used to perform other facility services simultaneously.

(15)

(a) Qualified personnel from the health professions may assist the program director and any instructor.

(b) The program director or any instructor shall be present during any training provided by another qualified professional.

(16)

(a) UNAR shall require qualified personnel to have at least one year of recent experience in the care of the elderly, in the care of the chronically ill of any age, or equivalent experience.

(b) Qualified personnel shall meet current licensure requirements regardless of whether they are licensed, registered, or certified in that person's field.

(17)

(a) A NATCEP shall maintain a candidate-to-instructor ratio of 12:1 for supervised practical training and may not exceed a 30:1 ratio for theory instruction.

(b) A NATCEP shall ensure there is an instructor assistant when the program has more than 20 candidates.

(18) A NATCEP shall provide a classroom that:

(a) has a comfortable temperature, ventilation, and lighting;

(b) has adequate seating;

(c) has appropriate audio-visual and other necessary technology support;

(d) has appropriate textbooks and reference materials;

(e) has skills lab equipment to simulate a resident's living unit; and

(f) is maintained in a clean and safe condition.

(19)

(a) UNAR shall place a newly approved NATCEP on a one year probationary period.

(b) UNAR shall withdraw program approval if a NATCEP fails to comply with each regulation, rule and UNAR policy at any time.

(c) A NATCEP shall submit a self-evaluation to UNAR during any year that the UNAR does not complete an on-site review.

(20) Each UNAR on-site visit and NATCEP self-evaluation shall include a review of:

(a) any complaint received about the program;

(b) documentation of candidate skill proficiency;

(c) documentation of required theory and supervised practical training hours;

(d) evidence that curriculum content meets the requirements of rule and UNAR policy; and

(e) files for the program director, each instructor, each instructor assistant, and qualified personnel used by the NATCEP since the last review date;

(f) whether any classroom facilities and equipment meet the requirements of rule and UNAR policy.

(21) UNAR shall require a plan of correction for a NATCEP that fails to comply with rule, UNAR policy, or any state or federal requirement.

(22) UNAR shall withdraw approval of a facility-based NATCEP that UNAR had approved within the last two years, if:

(a) the facility:

(i) has closed or has had residents transferred to other facilities in an emergency;

(ii) has been assessed a civil money penalty by CMS in an amount that compels approval withdrawal;

(iii) has been subject to a partial extended or extended survey;

(iv) has been subject to the enforcement remedy of a temporary manager;

(v) has been subject to the enforcement remedy of denial of payment for new admissions; or

(vi) has operated with an approved nurse staffing waiver; or

(b) otherwise directed by the SSA or CMS.

(23) Upon review of program performance standards, UNAR shall end a program that does not provide an acceptable plan to correct any deficiency.

Notes

Utah Admin. Code R432-45-5

Amended by Utah State Bulletin Number 2019-22, effective 10/17/2019 Amended by Utah State Bulletin Number 2025-10, effective 5/8/2025