Oklahoma 2023 2023 Regular Session

Oklahoma Senate Bill SB370 Introduced / Bill

Filed 01/15/2023

                     
 
 
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STATE OF OKLAHOMA 
 
1st Session of the 59th Legislature (2023) 
 
SENATE BILL 370 	By: Garvin 
 
 
 
 
 
AS INTRODUCED 
 
An Act relating to long-term care; amending 63 O.S. 
2021, Section 1-1950.1, which relates to criminal 
history background check for nurse aide; modifying 
time period of certain requirement ; modifying certain 
restrictions on employment; creating certain 
exemption from additional background check; amending 
63 O.S. 2021, Section 1-1950.3, which relates to 
nurse aides; adding exception to certain employment 
prohibition; broadening applicability of certain 
requirements; modifying requiremen t for direct 
contact with residents; specifying certain 
supervision requirements; allowing certified nurse 
aide to begin certain training immediately upon 
certification; authorizing certified me dication aide 
to administer oxygen under specified condition; 
directing promulgation of certain rules; amending 63 
O.S. 2021, Section 1-1951, which relates to 
certification, training, and registration of nurse 
aide; stipulating period of approval for training and 
competency programs; requiring, permitting, and 
prohibiting withdrawal of training program under 
specified conditions; providing for reapplication of 
withdrawn program; directing State Department of 
Health to administer competency examinations to 
certain nurse aides; authorizing certain contracts; 
directing certification of certain individu als; 
requiring provision of certain form; stating 
requirements for employer-based long term care aide 
training program; stipulating certain recertification 
procedures; clarifying applicability of certain 
provisions; directing promulgation of certain rules; 
updating statutory language; and providing an 
effective date. 
 
   
 
 
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BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: 
SECTION 1.     AMENDATORY     63 O.S. 2021, Section 1-1950.1, is 
amended to read as follows: 
Section 1-1950.1. A.  For purposes of this section: 
1. “Nurse aide” means any person who pr ovides, for 
compensation, nursing care or h ealth-related services to residents 
in a nursing facility, a specialized facility, a residential care 
home, continuum of care facility, assisted liv ing center or an adult 
day care center and who is not a licensed health professional.  Such 
term also means any person who provides such services to individuals 
in their own homes as an employee or contract provider of a home 
health or home care agency, or as a contract provider of the 
Medicaid State Plan Personal Care Program; 
2.  “Employer” means any of the following facilities, homes, 
agencies or programs which are subject to the provision of this 
section: 
a. a nursing facility or specialized facility as such 
terms are defined in the Nursing Home Care Act, 
b. a residential care home as such term is defined by the 
Residential Care Act, 
c. an adult day care center as such term is defined in 
the Adult Day Care Act,   
 
 
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d. an assisted living center as such term i s defined by 
the Continuum of Care and Assisted Living Act, 
e. a continuum of care facility as such term is defined 
by the Continuum of Care and Assisted Living Act, 
f. a home health or home care agency, 
g. the Department of Human Services, in its capacity as 
an operator of any hospital or health care institution 
or as a contractor with providers under the Medic aid 
State Plan Personal Care Program, 
h. any facility operated by the Oklahoma Department of 
Veterans Affairs, and 
i. any facility approved and annu ally reviewed by the 
United States Department of Veterans Affairs as a 
medical foster home in which care is provided 
exclusively to three or fewer veterans; 
3.  “Home health or home care agency” means any person, 
partnership, association, corporation or ot her organization which 
administers, offers or provides health car e services or supportive 
assistance for compensation to three or more ill, disabled, or 
infirm persons in the temporary or permanent residence of such 
persons, and includes any subunits or br anch offices of a parent 
home health or home care agency; 
4.  “Bureau” means the Oklahoma State Bureau of In vestigation; 
and   
 
 
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5.  “Completion of the sentence” means the last day of the 
entire term of the incarceration imposed by the sentence including 
any term that is deferred, suspended or subject to parole. 
B.  Before any employer makes an offer to employ or to contract 
with a nurse aide begins employment or a contract to provide nursing 
care, health-related services or supportive assistance to any 
individual, the employer shall provide for a criminal history 
background check to be made on the nurse aide pursuan t to the 
provisions of the Long-Term Care Security Act.  If the employer is a 
facility, home or institution which is part of a larger complex of 
buildings, the requirement of a criminal history background check 
shall apply only to an offer of employment or contract made to a 
person who will work pr imarily in the immediate boundaries of the 
facility, home, or institution. 
Where the provisions of the Lo ng-Term Care Security Act 
pertaining to registry screenin gs and national criminal history 
record check checks are not in effect pending an effective date 
established in rulemaking, an employer is authorized to obtain any 
criminal history background records maintained by the Bureau 
pursuant to the following: 
1.  The employer shall request the Bureau to conduct a criminal 
history background check on the nurse aid e and shall provide to the 
Bureau any relevant information required by the Bureau to conduct 
the check.  The employer shall pay a fee of Fifteen Dollars ($15.00)   
 
 
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to the Bureau for each criminal history back ground check that is 
conducted pursuant to such a request; 
2.  An employer may make an offer of temporary employment to a 
nurse aide pending the res ults of the criminal history background 
check.  The employer in such instance shall provide to the Bureau 
the name and relevant information relating to the pe rson within 
seventy-two (72) hours after t he date the person accepts temporary 
employment.  The employer shall not hire or contract with the nurse 
aide on a permanent basis until the results of the criminal history 
background check are received; 
3.  An employer may accept a criminal history backgr ound report 
less than one (1) year old of a person to wh om such employer makes 
an offer of employment.  The report shall be obtained from the 
previous employer or c ontractor of such person and shall only be 
obtained upon the written consent of such person; and 
4.  Every employer while subject to the provisions of this 
subsection shall inform each applicant for employment, o r each 
prospective contract provider, as app licable, that the employer is 
required to obtain a criminal history background record before 
making an offer of permanent employment or contract to a nurse aide. 
C.  1. If the results of a criminal history backg round check 
reveal that the subject person h as been convicted of, pled guilty or 
no contest to, or received a deferred sentence for, a f elony or 
misdemeanor offense for any of the following of fenses in any state   
 
 
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or federal jurisdiction, the employer shall not hire or contract 
with the person: 
a. abuse, neglect, or financial exploitation of any 
person entrusted to the care or possession of such 
person, 
b. rape, incest, or sodomy, or any crime that resulted in 
the person being registered on a sex offender regi stry 
at any time, 
c. child abuse, 
d. murder or attempted murder, 
e. manslaughter, 
f. kidnapping, 
g. human trafficking, 
h. aggravated assault and battery, 
h. i. assault and battery with a dan gerous weapon, or 
i. j. arson in the first degree. 
2.  If less than seven (7) five (5) years have elapsed sin ce the 
completion of sentence, and the results of a criminal history che ck 
reveal that the subject person has been convicted of, or pled guilty 
or no contest to, a felony or misdemeanor offense for any of t he 
following offenses, in any state or federal jur isdiction, the 
employer shall not hire or contract with the person: 
a. assault, 
b. battery,   
 
 
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c. indecent exposure and indecent exhibition, except 
where such offense disqualifies the applicant as a 
registered sex offender, 
d. pandering, 
e. burglary in the first or second degree, 
f. robbery in the first or second degree, 
g. robbery or attempted robbery with a dangerous weapon, 
or imitation firearm, 
h. arson in the second degree, 
i. unlawful manufacture , distribution, prescription, or 
dispensing of a Schedule I through V drug as defined 
by the Uniform Controlled Dangerous Substances Act, 
j. grand larceny, or 
k. petit larceny or shoplifting. 
D.  An employer shall not employ or continue employing a person 
addicted to any Schedule I through V drug as specified b y the 
Uniform Controlled Dangerous Substances Act unless the person 
produces evidence that the person ha s successfully completed a drug 
rehabilitation program. 
E.  All employment eligibility determination reco rds received by 
the employer pursuant to this s ection are confidential and are for 
the exclusive use of the State D epartment of Health and the employer 
which requested the information.  Except on court order or with the 
written consent of the person being investigated, the records shall   
 
 
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not be released or otherwise disclosed to any other person or 
agency.  These record s shall be destroyed after one (1) y ear from 
the end of employment of the person to whom such records relate. 
F.  As part of the inspections required by the Nursing Home Care 
Act, Continuum of Care and Assisted Living Act, the Residential Care 
Act, and the Adult Day Care Act, the State Depar tment of Health 
shall review the employment files of any facility, home or 
institution required to obtain a criminal history background 
determination to ensure such facilities, homes or institutions are 
in compliance with the provisions of this section. 
G.  A nurse aide who has undergone a criminal history background 
check and been deemed eligible for employment by the Department and 
who is currently employed or contracted by a facility and works not 
less than one hundred sixty (160) hours per month for the facility 
may be employed or contracted by one or more secondary facilities 
without an additional criminal history background check if: 
1.  The criminal history record check is dated not more than one 
(1) year from the date the nurse aide begins employment or contract 
at each applicable secondary facility; 
2.  Each secondary facility has common ownership with the 
primary facility; 
3.  The nurse aide works a total of not more than eighty (80) 
hours per month in all secondary facilities combined ; and   
 
 
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4.  The determination of eligibility f rom the Department is on 
file at each secondary facility. 
The hours worked by a nu rse aide at a secondary fa cility shall 
be available upon by request by the Department for review or audit. 
SECTION 2.     AMENDATORY     63 O.S. 2021, Section 1-1950.3, is 
amended to read as follow s: 
Section 1-1950.3. A.  1.  A Except as provided by paragraph 2 
or 3 of this subsection, a nursing facility, specialized facility, 
continuum of care facility, assisted living center, adult day care 
or residential home, or facility operated by the Oklahoma D epartment 
of Veterans Affairs, shall not employ as a nurse aide, on a full -
time, temporary, per diem, or any other basis, any individual who is 
not certified as a nurse aide in good standing and is not eligible 
for placement on the nurse aide registry main tained by the State 
Department of Health. 
2.  The Department may grant a temporary e mergency waiver to the 
provisions of this paragraph 1 of this subsection to any nursing 
facility, continuum of care facility, assisted living center or, 
adult day care, or residential home which can demonstrate that such 
facility, home or institution has been u nable to successfully meet 
its staffing requirements related to the provisions of this 
paragraph 1 of this subsection. 
3.  Until November 1, 2026, to the extent allowed under federal 
regulations, a nursing facility, continuum of care facility,   
 
 
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assisted living center, adult day care, or residential home that 
utilizes an employer-based training and competency evaluation 
program approved by the State Department of Health may employ nurse 
aides who are not yet certified if the nurse aides are en rolled in 
the facility’s training and competency evaluation program. 
B.  Such The temporary emergency waiver described in paragraph 2 
of subsection A of this section or an employer-based training and 
competency evaluation program described in paragraph 3 of subsection 
A of this section shall require the foll owing: 
1.  An The individual who is employed as a nurse aide who is 
must be enrolled in a Department-approved educational-based or 
employer-based training and competency evaluation program for nurse 
aides and shall successfully complete such training and competency 
evaluations within four (4) months of entering the training program, 
after which time no employer may use as a nurse aid e an individual 
who has not completed the training and competen cy evaluation 
program. The Department may grant a trainee a one-time extension of 
the four-month training requirement if: 
a. such requirement causes an undue hardship for the 
trainee due to unusual circumstances or illness, 
b. the trainee has demonstrated a good faith effort to 
complete the training and competency evaluation 
program, and   
 
 
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c. the extension meets such conditions as may b e required 
by rules promulgated by the State Commissioner of 
Health; 
2.  The individual sh all obtain certification, and the 
Department shall place th e nurse aide on the registry within thirty 
(30) days after demonstration of competency; and 
3.  Any nursing facility, specializ ed facility, continuum of 
care facility, assisted living center, adult day care, or 
residential care home that employs an individu al who is in nurse 
aide training, as provided in this section, shall e nsure that the 
trainee shall: 
a. complete the required training and competency program 
as provided in rules specified by 42 CFR 483.152(b)(1) 
prior to any direct contact with a resident or client, 
b. not perform any service for w hich the trainee has not 
trained and been determined proficient by the 
instructor, and 
c. be supervised at all times by no less than a licensed 
practical nurse; and. 
4.  No employer may use as a nurse aide an individual who has 
not completed the nurse aide training and competency program within 
the required four-month period. 
C.  For purposes of this section, “four (4) months” means the 
equivalent of four (4) months of full-time employment as a nurse   
 
 
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aide by any employer in any nursing facility, specialized facility, 
continuum of care facility, assisted living center, adult day care 
or residential care home. 
D.  1.  The Department may grant a trainee a one-time extension 
of the four-month training requirement if: 
a. such requirement causes an undue hardship f or the 
trainee due to unusual circumstances or illness, and 
b. the trainee has demonstrated a good faith effort to 
complete the training and competency evaluation 
program. 
2.  The State Board of Health shall promulgate rules related to 
the review of and th e process and conditions for such an extension 
(1) if the facility is subject t o federal regulations 
governing supervision of nurse aides, the 
facility shall comply with the federal 
regulations, or 
(2) if the facility is not subject to federal 
regulations governing su pervision of nurse aides, 
the facility shall ensure that the trainee is 
assigned a certified nurse aide as a mentor.  A 
Licensed Practical Nurse or greater shall oversee 
the training program, shall conduct all 
evaluations of the trainee, and shall provide 
initial direction and perio dic inspection of the   
 
 
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trainee’s and mentoring certified nurse aide ’s 
work.  The plan of care shall not be altered by 
the trainee or mentoring certified nurse aide 
without prior consultation with and app roval of 
the supervising Licensed Practical Nurse or 
greater.  The supervising Licensed Practical 
Nurse or greater need not always be physically 
present or on the premises when the trainee is 
providing care for which the trainee has been 
found competent; however, except in cases of 
emergency, the Licensed Practical Nurse or 
greater shall be available for consultation with 
and direction of the trainee and mentoring 
certified nurse aide. 
E. C.  1. Certified nurse aides may begin an education-based or 
employer-based training and competency evaluation and examination 
program to become a ce rtified medication aide immediately after 
receiving certification as a nurse aide and being listed on the 
nurse aide registry. 
2. Certified medication aides, upon success ful completion of 
competency standards or pres cribed training courses, shall be 
eligible to distribute medications or treatments provided by 
paragraph 2 3 of this subsection within a:   
 
 
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a. correctional facility, as set forth in Section 623 of 
Title 57 of the Oklahoma Statutes, 
b. correctional facility ope rated by a contractor of the 
Department of Corrections, 
c. county or municipal jail, 
d. nursing facility, 
e. specialized facility, 
f. continuum of care facility, 
g. assisted living center, 
h. adult day care, 
i. residential care home, or 
j. facilities operated by the Oklahoma Department of 
Veterans Affairs. 
2. 3.  Certified medication aides may: 
a. perform fingerstick blood sugars, 
b. administer diabetic medications, including 
subcutaneous injections of insulin, provided that the 
certified medication aide has c ompleted a Department-
approved advanced training program on diabetes and the 
administration of diabetes medications, including 
injections, 
c. administer medications, first aid treatments and 
nutrition; by oral, rectal, vaginal, otic, ophthalmic,   
 
 
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nasal, skin, topical, transdermal, and 
nasogastric/gastrostomy tubes routes, and 
d. administer oral metered dose inhalers and nebulizers;, 
and 
e. administer oxygen as prescribed by a physician or 
other licensed practitio ner with the authority to 
prescribe oxygen. 
3. 4.  The State Board of Health Commissioner shall establish 
rules necessary to ensure the safety of medication administration by 
certified medication aides, including but not limited to: 
a. competency and pract ice standards for medication 
aides, 
b. maintaining a list of skills and function s that 
medication aides will be able to perform upon 
completion of certification course work, 
c. certification and recertification requirements for 
medication aides, 
d. development of criteria and procedures for approval or 
disapproval of training and comp etency evaluation 
programs, and 
e. procedures for denying, suspending, withdrawing, or 
refusing to renew certification for a medication 
aide;.   
 
 
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4. 5.  Each facility shall develo p policies and procedures that 
comply with the provisions of this subsection and rules promulgated 
by the State Board of Health Commissioner.  This policy shall be 
reviewed and approved by the facility Medical Director, Director of 
Nurses and/or Registered Nurse Consultant. 
F. D.  Any person convicted of violating any of the provision s 
of this section or Section 1-1950.1 of this title sha ll be guilty of 
a misdemeanor, punishable by a fine of not less than One Hundred 
Dollars ($100.00) nor more than Three Hu ndred Dollars ($300.00), 
imprisonment in the county jail for not more than thirt y (30) days, 
or by both such fine and imprisonment. 
E.  Not later than November 1, 2026, the State Commissioner of 
Health shall promulgate rules governing employer-based training 
programs including but not limited to rules that allow the 
employment of noncertified nurse aides enrolled in an employer-based 
training program, subject to the conditions allowed in such rules. 
SECTION 3.    AMENDATORY    63 O.S. 2021, Section 1-1951, is 
amended to read as follows: 
Section 1-1951. A.  The State Department of Health shall have 
the power and duty to: 
1. Issue certificates of training and competency for nurse 
aides; 
2.  a. Approve training and competency programs including, 
but not limited to, education -based programs and   
 
 
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employer-based programs, including those programs 
established pursuant to Section 223.1 of Title 72 of 
the Oklahoma Statutes. The period of approval shall 
be for the maximum duration allowed under federal 
regulation. 
b. The Department may withdraw approval of the program if 
the program or, in the case of an employer-based 
program, the program or facility, is in violation of 
rules promulgated by the State Commissioner of Health 
that govern the program. 
c. Until November 1, 2026, the Department shall 
immediately withdraw approval of an employer-based 
program if: 
(1) the facility’s temporary emergency waiver under 
paragraph 2 of subsection A of Section 1-1950.3 
of this title is withdrawn due to one or more 
deficiencies cited during an investigation or 
inspection; however, the Department shall not 
withdraw approval of the employer-based program 
if the facility’s temporary emergency waiver is 
withdrawn solely due to having a sufficiency of 
staffing that makes the facility ineligible for a 
temporary emergency waiver , or   
 
 
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(2) the facility is cited for one or more 
deficiencies of causing immediate jeopardy to 
resident health or safety. 
d. Until November 1, 2026, the Department shall not 
withdraw approval of an employer-based program solely 
on the basis of the amount of monetary penalties the 
facility has accrued unless the facility is assessed 
the maximum civil monetary penalty stipulated under 
federal regulation, in which case the Department shall 
immediately withdraw approval of the employer -based 
training program. 
e. Until November 1, 2026, if an employer-based program 
is withdrawn for any reason, the facility may reapply 
for approval of an employer-based program after 
completion of a plan of correction and certifi cation 
by the Department that the facility is in compliance 
with all applicable laws and r ules and the approval 
may be reinstated as provided by rules promulgated by 
the Commissioner; 
3.  Determine curricula and standards for training and 
competency programs.  The Department shall require such training to 
include a minimum of ten (10) hours of train ing in the care of 
Alzheimer’s patients;   
 
 
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4. Establish and maintain a registry for certified nurse aides 
and for nurse aide trainees; 
5.  Establish categories and standards for nurse aide 
certification and registration, including feeding assistants as 
defined in 42 CFR Parts 483 and 488; 
6.  Exercise all incidental powers as necessary and proper to 
implement and enforce the provisions of this section; and 
7.  Suspend or revoke any certification issued to any nurse 
aide, if: 
a. the nurse aide is found to mee t any of the 
requirements contained in subsection D of Section 1-
1947 of this title, 
b. the nurse aide is found to meet any of the 
requirements contained in subsection C of Section 1-
1950.1 of this title, or 
c. the nurse aide is found to have committed abu se, 
neglect or exploitation of a reside nt or 
misappropriation of resident or client property 
pursuant to the requirements contained in paragraph 7 
of subsection D E of this section.  The action to 
revoke or suspend may be included with the filing of 
any action pursuant to the requirements of pa ragraph 7 
of subsection D E of this section; and   
 
 
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8.  Administer competency examinations to nurse aides who have 
completed a Department-approved employer-based training program.  
Until November 1, 2026, the Department shall offer both an online 
competency examination and an in-person competency examination. The 
Department may contract with on e or more vendors to administer 
either type or both types of competency examination . An individual 
who has received a passing sc ore on the competency examination and 
has met all other requirements for certification as a nurse aide 
including but not limited to training requirements shall be granted 
certification and shall be placed on the nurse aide registry .  The 
provisions of this paragraph shall not be construed to ex empt a 
nurse aide from in-person evaluation by a Licensed Practical Nurse 
before the nurse aide is eligible to take a comp etency examination.  
The Department shall provide a form appropriate for the care 
provided in each different type of licensed care fac ility for in-
person skills competency evaluation by no less than a Licensed 
Practical Nurse overseeing the training program . 
B.  The State Board Commissioner of Health shall promulgate 
rules to implement the provisions of this section and shall have 
power to assess fees. 
1.  Each person certified as a nurse aide pursuant to the 
provisions of this section shall be required to pay certification 
and recertification fees in amounts to be determined by the State   
 
 
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Board of Health Commissioner, not to exceed Fifteen Dollars 
($15.00). 
2.  In addition to the certification and recertification fees, 
the State Board of Health Commissioner may impose fees for training 
or education programs conducted or approved by the Department, 
except for those programs operated by the Oklahoma Department of 
Veterans Affairs. 
3.  All revenues collected as a result of fees authorized in 
this section and imposed by the Board Commissioner shall be 
deposited into the Public Health Special Fund. 
C.  Only a person who has qualified as a certified nurse aide 
and who holds a valid current nurse aide certificate for use in this 
state shall have the right and privil ege of using the title 
Certified Nurse Aide and to use the abbreviation CNA after the name 
of such person.  Any person who violates the provisions of this 
section shall be subject to a civil monetary penalty to be assessed 
by the Department. 
D.  A person qualified by the Department as a certified nurse 
aide shall be deemed to have met the requirements to work as a home 
health aide pursuant to the provisions of the Home Care Act and 
shall require no further licensure for performing services within 
the scope of practice of home health aid es.   
 
 
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E. 1.  The State Department of Health shall establish and 
maintain a certified nurse aide, nurse aide trainee and feeding 
assistant registry that: 
a. is sufficiently accessible to promptly meet the needs 
of the public and employers, and 
b. provides a process for notification and investigation 
of alleged abuse, exploitation or neglect of residents 
of a facility or home, clients of an agency or center, 
or of misappropriation of resident or client property. 
2.  The registry shall contain information as to whether a nurse 
aide has: 
a. successfully completed a certified nurse aide training 
and competency examination, 
b. met all the requirements for certification, or 
c. received a waiver from the Board. 
3.  The registry shall inc lude, but not be limited to , the 
following information on each certified nurse aide or nurse aide 
trainee: 
a. the full name of the individual, 
b. information necessary to identify each individual.  
Certified nurse aides and nurse aide trainees shall 
maintain with the registry curren t residential 
addresses and shall notify the registry, in writing, 
of any change of name.  Notification of change of name   
 
 
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shall require certified copies of any marriage license 
or other court document which reflects the change of 
name.  Notice of change of address or telephone number 
shall be made within ten (10) days of the effected 
change.  Notice shall not be accepted over the phone, 
c. the date the individual became eligible for placement 
in the registry, and 
d. information on any finding of the Departm ent of abuse, 
neglect or exploitation by the certified nurse aide or 
nurse aide trainee, including: 
(1) documentation of the Department’s investigation, 
including the nature of the allegation and the 
evidence that led the Departm ent to confirm the 
allegation, 
(2) the date of the hearing, if requested by the 
certified nurse aide or nurse aide trainee, and 
(3) statement by the individual disputing the finding 
if the individual chooses to make one. 
4. The Department shall include th e information specified in 
subparagraph d of paragraph 3 of this subsection in the registry 
within ten (10) working days of the substantiating finding and it 
shall remain in the registry, unless:   
 
 
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a. it has been determined by an administrative law judge, 
a district court or an appeal court that the finding 
was in error, or 
b. the Board Commissioner is notified of the death of the 
certified nurse aide or nurse aide train ee. 
5. Upon receipt of an allegation of abuse, exploitation or 
neglect of a resident or client, or an allegation of 
misappropriation of resident or client prope rty by a certified nurse 
aide or nurse aide trainee, the Department shall place a pending 
notation in the registry until a final determination has been made.  
If the investigation, or administrative hearing held to determine 
whether the certified nurse aid e or nurse aide trainee is in 
violation of the law or rules promulgated pursuant thereto, revea ls 
that the abuse, exploitation or neglect, or misappropriation of 
resident or client property was unsu bstantiated, the pending 
notation shall be removed within twenty-four (24) hours of receipt 
of notice by the Department. 
6.  The Department shall, after notice to the individuals 
involved and a reasonable opportunity for a hearing, make a finding 
as to the accuracy of the allegations. 
7.  If the Department after notice and opportunity for hearing 
determines with clear and convincing evidence that abuse, ne glect or 
exploitation, or misappropriation of resident or client property has 
occurred and the alleged perpetrator is the person who committed the   
 
 
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prohibited act, notice of the findings shall be sent to the nurse 
aide and to the district attorney for the c ounty where the abuse, 
neglect or exploitation, or misappropriation of resident or client 
property occurred and to the Medicaid Fraud Control Unit of the 
Attorney General’s Office.  Notice of ineligibility to work as a 
nurse aide in a long-term care facility, a residential care 
facility, assisted living facility, day care facility, or any entity 
that requires certification of nurse aides, and notice of any 
further appeal rights shall also be sent to the nurse aide. 
8.  In any proceeding in which the Departm ent is required to 
serve notice or an order on an individual, the Department may send 
written correspondence to the address on file with the registry.  If 
the correspondence is returned and a notation of the United States 
Postal Service indicates “unclaimed” or “moved” or “refused” or any 
other nondelivery markings and the records of the registry indicate 
that no change of address as required by this subsection ha s been 
received by the registry, the notice and any subsequent notices or 
orders shall be deeme d by the court as having been legally served 
for all purposes. 
9.  The Department shall require that ea ch facility check the 
nurse aide registry before hiring a person to work as a nurse aide.  
If the registry indicates that an individual has been found, a s a 
result of a hearing, to be personally responsible for abuse, neglect 
or exploitation, that individu al shall not be hired by the facility.   
 
 
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10.  If the state finds that any other individual employed by 
the facility has neglected, abused, misappropriated property or 
exploited in a facility, the Department shall notify the appropriate 
licensing authority an d the district attorney for the county where 
the abuse, neglect or exploitation, or misappropriation of resident 
or client property occurred. 
11.  Upon a written request by a certified nurse aide or nurse 
aide trainee, the Board Commissioner shall provide within twenty 
(20) working days all information on the record of the certified 
nurse aide or nurse aide trainee when a finding of abuse, 
exploitation or neglect is confirmed and placed in the registry. 
12.  Upon request and except for the names of residents and 
clients, the Department shall disclose all of the information 
relating to the confirmed determination of abuse, exploitation and 
neglect by the certified nurse aide or nurse aide trainee to the 
person requesting such information, and may disclose additional 
information the Department determines necessary. 
13.  A person who has acted in good faith to comply with state 
reporting requirements and this s ection of law shall be immune from 
liability for reporting allegations of abuse, neglect or 
exploitation. 
F.  Each nurse aide trainee shall wear a badge which clearly 
identifies the person as a nurse aide trainee.  Such badge shall be 
furnished by the faci lity employing the trainee.  The badge shall be   
 
 
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nontransferable and shall include the first and last name of the 
trainee. 
G.  1.  For purposes of this section, “feeding assistant” means 
an individual who is paid to feed residents by a facility or who is 
used under an arrangement with another agency or organization and 
meets the requirements cited in 42 CFR Parts 483 and 488. 
2.  Each facility that employs or contracts employment of a 
feeding assistant shall maintain a record of all individuals, used 
by the facility as feeding assistants, who have successfully 
completed a training course approved by the state for paid fee ding 
assistants. 
H. 1. Until November 1, 2026, an employer-based training 
program for long term care aides shall consist of at least eighty-
five (85) hours of training or the equivalent if the facility is 
subject to regulation by the Ce nters for Medicare and Medicaid 
Services.  Of the total required hours of training or the equivalent 
as specified in this paragraph, the program shall include : 
a. at least sixteen (16) hours of supervised practical 
training that is documented and signed by the nurse 
aide trainee, 
b. all of the curriculum specified in 42 CFR 483.152(b), 
and   
 
 
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c. pursuant to paragraph 3 of subsection A of this 
section, a minimum of ten (10) hours of training in 
the care of Alzheimer’s patients. 
2.  Until November 1, 2026, an employer-based training program 
for long term care aides shall consist of at least one hundred 
twenty (120) hours of training or the equivalent if the facility is 
not subject to regulation by the Centers for Medicare and Medicaid 
Services.  Of the total required hours of training or the equivalent 
as specified in this paragraph, the program shall include: 
a. at least sixteen (16) hours of supervised practical 
training that is documented and signed by the nurse 
aide trainee, 
b. all of the curriculum specified in 42 CFR 483.152(b), 
c. pursuant to paragraph 3 of subsection A of this 
section, a minimum of ten (10) hours of training in 
the care of Alzheimer’s patients, 
d. completion of a restorative nurse aide training 
program, and 
e. the following subjects: 
(1) ethics and ethical conduct, 
(2) social media behavior and privacy, 
(3) organizational structure of various care provider 
settings, 
(4) trauma informed care,   
 
 
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(5) basic legal statuses of residents or patients 
including but not limited to guardianship, power 
of attorney, advance directive, and living will, 
(6) understanding basic cultural competency and 
religious preferences , 
(7) resident sexuality in care settings, 
(8) understanding state rules and regulations for 
reportable incidents to the Department and the 
nurse aide registry, 
(9) personal liability, 
(10) possible career progression, and 
(11) professional soft skills including time 
management, problem solving, teamwork, stress 
management, decision making, critical thi nking, 
conflict management, receiving criticism, 
adaptability, and professionalism. 
I. 1.  The recertification requirements of the Department shall 
allow nurse aides to renew certification if the nurse aide works or 
volunteers the equivalent of a single eight-hour shift. 
2. For a nurse aide who volunteers, the nurse aide must have 
undergone a criminal history background check as provided by Section 
1-1947 of this title prior to volunteering and shall only be 
eligible for recertification if the nurse aide would not be 
disqualified for employment or contract based on the criteria of   
 
 
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subsection C of Section 1-1950.1 of this title. The facility may 
require a nurse aide who volunteers to pay the cost of his or her 
own criminal history background check. 
3.  The provisions of this subsection shall only apply to 
recertification procedures and shall not apply to in itial 
certification or employment by or contracting with a facility by a 
nurse aide. 
J.  Not later than November 1, 2026, the State Commissioner of 
Health shall promulgate rules governing employer-based training 
programs including but not limited to rules governing approval and 
withdrawal of employer-based training programs, administration of 
competency examinations to nurse aides who have completed a 
Department-approved employer-based training program, and employer-
based training program requir ements including but not limited to 
curriculum. 
SECTION 4.  This act shall become effective July 1, 2024. 
 
59-1-679 DC 1/15/2023 3:21:48 PM