Placement on Minnesota’s Nursing Assistant Registry for Nurse ...

Placement on Minnesota's Nurse Aide Registry for Nurse Aides Working during the 1135 Waiver

PLANNING FOR TRANSITION UPON TERMINATION OF THE WAIVER

Effective March 1, 2020, under the Training and Certification of Nurse Aides 1135 Waiver, the Center for Medicare and Medicaid Services (CMS) waived some requirements to help with potential staffing shortages during the COVID-19 pandemic. CMS allowed people to work as nurse aides without active status on the registry. COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (). CMS waived the requirements at 42 CFR 483.35(d) (with the exception of 42 CFR 483.35(d) (1) (i)), which states that a skilled nursing facility and nursing facility may not employ any individual working in the facility as a nurse aide for more than four months unless they met the training and certification requirements under ? 483.35(d). To ensure the health and safety of nursing home residents, CMS did not waive 42 CFR ? 483.35(d)(1)(i), which requires facilities to not use any nurse aide for more than four months on a full-time basis, unless that person is competent to provide nursing and nursing-related services. CMS did not waive ?483.35(c), which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents' needs, as identified through resident assessments and described in the plan of care.

CMS 1135 Waiver

During the pandemic, nurse aides working in a Minnesota long-term care facility under the Training and Certification of Nurse Aides 1135 Waiver did not need evidence of being current or being on the Minnesota Nurse Aide Registry for the duration of the waiver. On April 7, 2022, CMS rescinded the waiver per QSO 22-15: Update to COVID-19 Emergency Declaration Blanket Waivers for Specific Providers (). The waiver will expire on June 6, 2022. For more information, see QSO 21-17: Updates to Long-Term Care (LTC Emergency Regulatory Waivers issued in response to COVID-19 (). On October 5, 2022, CMS gave Minnesota an extension to this waiver which will end on May 11, 2023. Once the waiver extension has expired, nurse aides will have the full 4-month time frame (until September 10, 2023) to come into compliance.

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PLACEMENT ON MINNESOTA'S NURSING ASSISTANT REGISTRY FOR NURSE AIDES WORKING DURING THE 1135 WAIVER

Options to Work as a Nurse Aide When the Waiver Ends

As of May 11, 2023, the 1135 waiver that allowed nurse aides to work in a nursing home or certified boarding care home without completing a training program will expire.

Nurse aides who wish to continue working must pass the competency evaluation and be added to the Minnesota Nurse Aide Registry by September 10, 2023.

There are three options available:

A. Waiver Checklist: Have your employer complete the Skills Checklist for Nurse Aides Working under the 1135 Waiver and pass the competency evaluation by September 10, 2023.

B. Challenge Exam: Register for and pass the competency exam by September 10, 2023.

C. Training Program: Enroll in and complete a NATCEP training program and pass the competency evaluation by September 10, 2023.

Option A: Waiver Checklist

Minnesota is allowing credit for time worked as a nurse aide during the public health emergency. The time worked will count towards the 75-hour training requirement for Nurse Aide Training and Competency Evaluation Program (NATCEP).

Employers must document the training and hours the individual completed on the Skills Checklist for Nurse Aides Working under the 1135 Waiver, which is included in the following document: Nurse Aides Working under the 1135 Waiver during a Public Health Emergency ()

Once the checklist is completed, the individual must enroll in a NATCEP program, which will verify that all training requirements are met and supplement any training requirements that have not been met.

The individual must then register for and pass the competency evaluation by September 10, 2023.

Approved training programs and testing sites are posted on the Nursing Assistant Training/Testing page (https:/health.state.mn.us/facilities/regulation/directory/natrainingsites.html) of the Nurse Aide Registry website.

Option B: Challenge Exam

Minnesota allows individuals to "challenge" the competency evaluation without completing a Minnesotaapproved training program. The "challenge" requires the person to complete the competency evaluation ? a knowledge and skills exam ? administered at an approved testing site. Candidates are allowed four chances to pass the knowledge test and three chances to pass the skills test to be placed on the Minnesota Nurse Aide Registry.

Candidates who want to challenge the test will need to complete the Candidate Challenge Form 1101, which can be found on the D&S ? Minnesota Nurse Aide () website. Once the form is complete and an account is created, they can contact an approved testing site, pay their testing fees, and be scheduled for a nurse aide exam.

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PLACEMENT ON MINNESOTA'S NURSING ASSISTANT REGISTRY FOR NURSE AIDES WORKING DURING THE 1135 WAIVER

The individual must register for and pass the competency evaluation by September 10, 2023. Approved testing sites are posted on the Nursing Assistant Training/Testing page (https:/health.state.mn.us/facilities/regulation/directory/natrainingsites.html) of the Nurse Aide Registry website.

Option C: Training Program

Candidates may register for a NATCEP and complete the 75-hour training requirement, which includes a total of 59 hours of classroom training and 16 hours of supervised practical training. The individual must then register for and pass the competency evaluation by September 10, 2023. Approved training programs and testing sites are posted on the Nursing Assistant Training/Testing page (https:/health.state.mn.us/facilities/regulation/directory/natrainingsites.html) of the Nurse Aide Registry website.

Example Scenarios

Example A: Completing the Waiver Checklist

Employee A was hired during the waiver for employment in a nursing home. Employee A wants to continue employment as a nurse aide.

Employee A has their employer document their training and skills on the Skills Checklist for Nurse Aides Working under the 1135 Waiver, and registers for NATCEP to verify their training.

Employee A takes the knowledge and skills exam prior to the waiver ending and passes both exams. Employee A is placed on the registry. Employee A may continue working as a nurse aide, no further action is needed.

Example B: Challenging the Competency Evaluation Tests

Employee B was hired during the waiver for employment in a nursing home. Employee B wants to continue employment as a nurse aide but does not want to register with a NATCEP.

Employee B challenges the knowledge and skills exam on October 15, 2022, but fails the skills exam. Employee B tests for skills again on December 15, 2022, and fails for a second time. Employee B can work as a nurse aide, but must successfully pass the skills test before September 10, 2023, in order to continue working.

Example C: Failing the Competency Evaluation Tests

Employee C was hired during the waiver for employment in a nursing home. Employee C wants to continue employment as a nurse aide but does not want to register with a NATCEP.

Employee C challenges the knowledge and skills exam on November 22, 2022, but fails both exams. Employee C challenges the exams again on January 15, 2023, and fails both exams.

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PLACEMENT ON MINNESOTA'S NURSING ASSISTANT REGISTRY FOR NURSE AIDES WORKING DURING THE 1135 WAIVER

Employee C challenges the knowledge and skills exam for a third time on February 1, 2023, and passes the skills examination. Employee C challenges the knowledge exam for a fourth time on March 10, 2023, and fails.

Employee C challenges the skills exam for a third time on April 15, 2022, but fails again. Employee C may continue working as a nurse aide until September 10, 2023. To continue working as a

nurse aide after that, they will need to enroll in a NATCEP.

Issuance of Nurse Aide Certificate

MDH Nurse Aide Registry issues a nurse aide certificate when someone successfully completes the competency evaluation tests. The certificate does not indicate if a person has completed a Minnesotaapproved training program or has challenged the exam. 42 CFR ?483.156 - Registry of nurse aides ()

Items to Consider when Challenging the Exam

In Minnesota, nurse aides are considered "unlicensed personnel" who may only administer medication if they have completed the NATCEP and a medication administration training course. Candidates who challenge the exam without completing a NATCEP will not qualify to administer medications. For further information, see 4658.1360 ADMINISTRATION OF MEDICATIONS BY UNLICENSED PERSONNEL. ().

Nursing programs have varied prerequisites related to nurse aide training programs and registry placement. It is the responsibility of the nursing student to reach out to the desired nursing program to determine if this is a requirement for their program.

Information Related to Reimbursement

Nurse aides who complete an approved training program and/or pass the nurse aide competency exam and are hired by a nursing facility are eligible for reimbursement of training and testing costs in accordance with Minnesota Statutes 144A.611: 144a.611 Reimbursable expenses for nursing assistant training and competency evaluations. ()

Check the Registry

All persons on the Minnesota Nurse Aide Registry, active and inactive status, are listed in the online verification database. (Search using name at the time of registry placement.) How to Check the Nursing Assistant Registry ()

Minnesota Department of Health Health Regulation Division

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PLACEMENT ON MINNESOTA'S NURSING ASSISTANT REGISTRY FOR NURSE AIDES WORKING DURING THE 1135 WAIVER

P.O. Box 64900 St. Paul, Minnesota 55164-0900 651-201-4200 health.nar.coord@state.mn.us health.state.mn.us 03/27/2023 To obtain this information in a different format, call: 651-201-4200.

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