Current through 2024-38, September 18, 2024
A.
Placement on the C.N.A.Registry
1.
No C.N.A. fee. The Department
may not charge an applicant or a C.N.A. a fee related to the application and
the biennial renewal for listing on the Maine Registry.
2.
Date of successful completion of the
C.N.A. competency test. The Registry shall document the date the
individual successfully completed the C.N.A.competency test.
a.
Failure to work as a C.N.A. during
24-month period from date of completion of test. In accordance with
Omnibus Budget Reconciliation Act of 1987 (OBRA 87), failure to notify the
C.N.A. Registry of at least eight hours of employment as a C.N.A. during the
24-month period from the date of completion of the competency test shall result
in the immediate removal of the C.N.A. from the list of active C.N.A.s. The
individual may not be employed as a C.N.A. until they successfully complete the
test for non-traditional C.N.A.s, the Department receives an application for
placement on the Registry and the Registry determines the individual is
eligible for placement on the Registry.
b.
Minimum employment
requirement. To comply with the above, the C.N.A. must submit documented
proof of qualified employment for monetary compensation for a minimum of eight
hours within the last 24 consecutive months under the supervision of a
registered professional nurse in a health care setting, in the capacity of a
C.N.A. on a full or part-time basis.
c.
Qualified employment.
Employment in a health care setting, under the supervision of a registered
professional nurse, is recognized as qualified employment that can be applied
to meet the minimum work requirement of eight hours within 24 consecutive
months.
3.
Date
approved for placement on the Registry. The Registry shall document the
date the individual is approved for placement on the Registry.
a.
Renewal term. The renewal
term will be 24 months. To remain on the Registry, a C.N.A. must submit a
completed renewal form and the required documents on or before their current
expiration date.
b. Failure to
submit a timely completed renewal form and required documentation shall result
in immediate removal from the Registry and bars future employment as a C.N.A.
until the C.N.A. takes appropriate action pursuant to this rule to be
reinstated on the Registry.
4.
Notification of listing. The
Registry shall notify the C.N.A. in writing when the Registry approves the
C.N.A. for placement on the list of active C.N.A.s on the Registry. This
notification shall include the approval date.
5.
Nursing school student on
Registry. A nursing school student currently enrolled in an educational
program in nursing that prepares persons for admission to a licensure
examination, or a former student who has terminated enrollment, who has been
issued a "Certificate of Equivalent Training" may be placed on the list of
active C.N.A.s on the Registry. Further testing is not required if the Registry
finds the individual is competent to function as a C.N.A.
B.
Training and competency programs for
C.N.A.s
1.
Training and testing
options. Training and testing options include the Maine C.N.A. training
program, educational preparation in a state other than Maine, and the
competency evaluation exam for non-traditional C.N.A.s.
a.
Maine C.N.A. Training
Program. The Maine C.N.A. training program includes the minimum number
of training hours required by the MSBON, including classroom instruction,
skills laboratory and correlated supervised clinical practice, and the MSBON
develops the prescribed curriculum utilized by training programs for C.N.A.s.
(See 02-380 CMR Ch. 5 (2)
Regulations Relating to Training Programs and
Delegation by Registered Professional Nurses of Selected Nursing Tasks to
Certified Nursing Assistants.)
i.
Student qualifications. Students applying for admission to a
C.N.A. training program must submit at a minimum, documentation in accordance
with 02-380 CMR Ch. 5:
1. Proof of completion
of the 9th grade of school. A high school diploma, or a high school equivalency
diploma, is preferred; and
2. Proof
of compliance with the minimum age requirement of 16 years; and
3. Demonstrated ability to read and write in
English.
ii.
Demonstration of competency. Each student must satisfactorily
complete both parts of the competency evaluation test:
1. The student must pass a written or an oral
examination; and
2. The student
must demonstrate an ability to successfully complete skills listed on the MSBON
curriculum checklist.
3. The
student will be allowed no more than three attempts to pass the Maine C.N.A.
test within 2years from the completion date of training, in accordance with CFR
title 42 § 483.154(f)(2). If this criterion is not met, the C.N.A.
training program must be retaken.
b.
Educational Preparation in a State
Other than Maine. A C.N.A. who has passed a nationally-certified C.N.A.
testing process which includes the evaluation of both theory and clinical
competence may be listed on the Registry, when the C.N.A. has:
i. Recently graduated from a C.N.A. program
outside of the State of Maine; or
ii. Has been employed as a C.N.A. outside of
the State of Maine for the last two years.
ii.
Temporary listing. A C.N.A.
who received training in another jurisdiction that does not meet the
requirements of Section 2(B)(1)(b) may request temporary listing on the Maine
Registry, pending completion of a Department of Health and Human
Services-approved C.N.A. training program. The temporary listing shall be in
effect for a maximum of 4 months, and shall not be renewed.
c.
Test for non-traditional
C.N.A.s. Qualified C.N.A.s may take the test for non- traditional
C.N.A.s. Qualified C.N.A. includes, but is not limited to:
i. A C.N.A. trained in Maine who has not
worked as a C.N.A. for at least 8 hours in the preceding 24 months; or
ii. An individual trained as a
C.N.A., or its equivalent, while serving in the United States Armed Services
who completed training that is at least equal to the Maine minimum of approved
C.N.A. training required by these rules.
iii. If a non-traditional C.N.A. fails to
pass the test on their first attempt, they will be allowed no more than two
additional attempts to pass the test. If the C.N.A. does not pass the test
within two years from the date of the first scheduled exam, the C.N.A. must
complete and pass the full C.N.A. training program before being allowed to test
again.
2.
C.N.A.s employed by nursing facilities. Nursing facilities must
comply with the requirements of OBRA 87:
a.
Nursing facility prohibited from charging employee for C.N.A. training or
required competency evaluation. An individual who is employed by, or who
has received an offer of employment from, a nursing facility on or before the
date the individual begins a C.N.A. training program or competency evaluation,
may not be charged for any portion of the program (including any fees for
textbooks or other required course materials).
b.
Nursing facility reimburses training
costs. A C.N.A. who is employed by, or receives an offer of employment
from, a nursing facility not later than 12 months after successfully completing
a C.N.A. training program or competency evaluation must be reimbursed by the
nursing facility for the costs incurred for the training program or competency
evaluation.
c.
Nursing
facility in-service education for C.N.A.s. Nursing facilities must
provide C.N.A.s with no less than 12 hours per year of in-service education
(OBRA '87). Documentation of completed in-service education is given to the
C.N.A..
C.
C.N.A. application requirements
1.
All applicants. All
applicants must submit the Department-approved application or renewal form and
all required documentation. Required documentation includes but is not limited
to the following, as applicable:
a.
Documentation necessary to verify the identity of the individual, including:
i. Full name, including maiden name, and all
previously held names;
ii. Date of
birth;
iii. Current mailing
address; and
iv. Copy of current
driver's license or other suitable identification containing a photograph and
signature.
2.
C.N.A.s trained in Maine. In addition to the requirements of
2(C)(1),C.N.A.s trained in Maine must submit at least the following information
to determine eligibility for placement, or continued listing, on the Registry.
a. Training verification documentation
necessary to verify the training and evaluation testing of the individual,
including, as applicable:
i. A copy of the
Certificate of Training issued by the training program or equivalent
documentation of successful completion of the MSBON prescribed curriculum
training program on or after 10/9/91; or
ii. Documentation of successful completion of
a Maine Department of Education-approved training program prior to 10/9/91; or
iii. Documentation of successful
completion of the competency evaluation test; or
iv. A copy of a Certificate of Training or
equivalent documentation confirming that the training met then-existing MSBON
requirements at the time the course was taken; or
v. Documentation of 24 consecutive months of
employment for the same employer between 12/19/1987 and 12/19/1989 at one or
more Maine facilities, and documentation of current employment by that same
employer in one of the facilities; or
vi. Documentation of nursing assistant
training in Maine prior to 1975.
b. A copy of the criminal background check
secured by the training program as part of the admission process.
c. Documentation from former and current
employers verifying the dates and places (with full address) of employment as a
C.N.A. during the preceding two years.
3.
C.N.A.s trained in another
jurisdiction. In addition to the requirements of 2(c)(1),C.N.A.s trained
in another jurisdiction must submit documentation to determine eligibility for
placement, or continued listing, on the Maine Registry. Required documentation
includes but is not limited to the following, as applicable:
a. Information necessary to verify the
training and evaluation testing of the individual, including:
i. A copy of the official score report from
the testing company that conducted the competency evaluation, indicating a
passing score in both theory and clinical competence;
ii. A copy of the Certificate of Training
issued by the institution or agency conducting the training program; and
iii. Documentation from all
facilities where the individual was employed as a C.N.A. during the preceding
two years, including the dates and places of employment (with full address).
4.
Background check for C.N.A. training programs. Training programs
for C.N.A.s must secure or pay for a background check on each individual who
applies for enrollment. Prior to enrolling an individual, a training program
for C.N.A.s must notify individuals that a background check will be conducted
and that certain disqualifying offenses, including criminal convictions, may
prohibit an individual from working as a C.N.A.
D.
Nursing facility verification of
out-of-state Registries. In addition to the requirements set out in
22
MRS §1812-G, nursing facilities must
make a reasonable effort to obtain information pertaining to an individual from
each State C.N.A. Registry which is likely to contain such information (OBRA
'87).
E.
C.N.A. Registry
administration. The Registry shall:
1.
Determine C.N.A. eligibility for placement on the Registry;
2. Determine C.N.A.'s eligibility to take the
C.N.A.Competency Evaluation test for non-traditional nursing
assistants;
3. Annotate the
applicant's or C.N.A.'s record on the Registry to include criminal convictions
in accordance with this rule ;
4.
Remove any criminal convictions considered a Class D or Class E criminal
offense under Maine law that are at least ten years old or older, provided the
conviction did not involve as a victim a patient, client, or resident of a
health care setting; and
5. Respond
to inquiries from the public, including but not limited to, health care
providers, individual C.N.A.s, health care consumers, the MSBON, and C.N.A.
Registries in other jurisdictions.
a. The
Registry must disclose, at a minimum, the following information about an
individual to all requesters:
i. Whether the
individual is on the list of active C.N.A.s and direct care workers on the
Registry, without disqualifying annotation.
ii. The date the individual C.N.A.
successfully completed the competency test.
iii. The date the individual was approved for
placement on the Registry.
iv.
Verification of employment as a C.N.A. during the preceding 24
months.
v. Whether the individual
is annotated on the Registry for any of the following:
1. Criminal convictions; or
2. Substantiated complaints of abuse, neglect
or misappropriation of property of a patient, client or resident, the nature of
the allegation, the evidence that led the State survey agency to substantiate
the complaint, the date of the hearing, if any, and the C.N.A.'s statement
disputing the allegation, if any.
b. The Department shall promptly notify any
C.N.A. when he or she is annotated on the Registry, and upon request by the
public .
1. The Department shall notify a
registered C.N.A. by mail within ten business days, when they are
annotated.
2. The notification
shall include information describing the individual's right to
appeal.
F.
C.N.A. Registry content. The
Registry must contain at least the following information for each applicant and
C.N.A.:
1. Identity verification
documentation;
2. Training
verification documentation;
3.
Documentation of successful completion of the C.N.A. competency evaluation must
be included on the Registry within 30 days of the date of successful
completion;
4. Employment
verification documentation;
5. The
Registry determination that it finds the C.N.A. is competent to function as a
C.N.A.;
6. Annotation of any
substantiated findings of abuse, neglect, or misappropriation of property of a
patient, client or resident on the Registry within 10 working days of final
agency action. Each annotation shall include:
a. Documentation of an investigation of a
certified nursing assistant or a direct care worker, including the nature of
the allegation and evidence supporting a determination that substantiates the
allegation of abuse, neglect or misappropriation of property of a client,
patient or resident;
b.
Documentation of substantiated findings of abuse, neglect or misappropriation
of property of a client, patient or resident;
c. If the certified nursing assistant or
direct care worker appealed the substantiated finding, the date of the hearing;
and
d. The statement of the
certified nursing assistant or direct care worker disputing the allegation of
abuse, neglect or misappropriation of property of a client, patient or resident
if the certified nursing assistant or direct care worker submitted such a
statement;
The information remains on the Registry permanently, unless
documentation demonstrates to the Department that the finding was made in
error, the individual was found not guilty in a court of law, or the Registry
is notified of the individual's death;
7. Disqualifying criminal
convictions;
8. Nondisqualifying
criminal convictions, except that an annotation is not required on the Registry
for Class D and Class E criminal convictions over 10 years old that did not
involve as a victim of the act a patient, client or resident;
9. Petitions filed by a certified nursing
assistant for removal of employment ban issued by the Department that were
based on a criminal conviction and the Department's review and
determination;
10. Information
received from C.N.A. Registries in other jurisdictions; and
11. The following eligibility and renewal
status information regarding placement on the Registry:
a. The date that the C.N.A. was added to the
list of active C.N.A. son the Registry.
b. The date the Registry approves a C.N.A.'s
completed renewal form for continued listing on the Registry.
G.
Denial or
removal from the C.N.A. Registry
1.
Misrepresentation, deceit, or fraud on application or renewal
form. The Department will either deny placement on the active Registry
list or remove a C.N.A. from the list, based on the following factors:
a.
Denial. The Department will
deny placement on the active Registry list when an individual knowingly submits
an application or renewal form that contains misrepresentations concerning
qualification for listing on the Registry or in any way attempts to obtain
placement on the Registry by deceitful or fraudulent means; or
b.
Removal. The Department will
remove a C.N.A. from the active Registry list if it determines that the
individual gained such placement by knowingly submitting an application or
renewal form that contained misrepresentations concerning qualification for
listing on the Registry or in any way attempted to obtain placement on the
Registry by deceitful or fraudulent means.
2.
Nondisclosure of conviction is
misrepresentation . For the purpose of this rule, misrepresentation
includes, but is not limited to, the nondisclosure of criminal convictions by
an applicant or C.N.A. Nondisclosure occurs when an applicant or C.N.A. fails
to comply with this rule .
3.
Fraud or deceit in obtaining a Certificate of Training. An
individual who practices fraud or deceit in obtaining a Certificate of Training
as a nursing assistant shall not be eligible for placement on the Maine C.N.A.
Registry, in accordance with 02-380 CMR Ch. 5 Regulations Relating to Training
Programs and Delegation by Registered Professional Nurses of Selected Nursing
Tasks to Certified Nursing Assistants.
H.
D.C.W. Registry
administration. The Department places those D.C.W.'s on the Registry,
based on information regarding those D.C.W.'s criminal convictions from the
Maine Background Check Center and/or substantiated findings from
Department-licensing agencies or investigative entities.
I.
D.C.W. Registry content. Any
annotated D.C.W.s will be listed on the Registry. As a result, these annotated
D.C.W. names will include the disqualifying offense and the length of time that
the D.C.W. is ineligible for employment. The Registry will not list D.C.W.s in
good standing who are not annotated. The Registry contains the following
information for each annotated D.C.W. listed:
1.
Identity verification
documentation. Information necessary to verify the identity of the
individual, including:
a. Full name, including
maiden name, and all previously held names;
b. Date of birth; and
c. Current mailing address.
2.
Disqualifying criminal
convictions;
3.
Nondisqualifying criminal convictions, except that an annotation is not
required on the registry for Class D and Class E criminal convictions over 10
years old that did not involve as a victim of the act a patient, client or
resident;
4.
Substantiated
findings, including but not limited to the following information:
a. Documentation of an investigation of a
direct care worker, including the nature of the allegation and evidence
supporting a determination that substantiates the allegation of abuse, neglect
or misappropriation of property of a client, patient or resident;
b. Documentation of substantiated findings of
abuse, neglect or misappropriation of property of a client, patient or
resident;
c. If the direct care
worker appealed the substantiated finding, the date of the hearing;
d. The statement of the direct care worker
disputing the allegation of abuse, neglect or misappropriation of property of a
client, patient or resident if the direct care worker submitted such a
statement; and
e. Petitions filed
by a direct care worker for removal of an employment ban issued by the
Department that was based on a criminal conviction and the Department's review
and determination.
f. If the D.C.W.
was already annotated and listed on the Registry for other disqualifying
offenses, then the Department will add these most recent findings to the
D.C.W.'s record. A D.C.W. is added to the Registry only after he or she has
exhausted all of their rights to appeal under 10-144 MRS Chapter 1 with the
licensing or investigative entity reporting the substantiated
findings.
5.
Training of D.C.W.s. The employer or hiring entity is responsible
for verifying the credential(s), training, and certification of a
D.C.W.
J.
Notice
to annotated D.C.W.s. The Department shall notify an annotated D.C.W. of
his or her listing on the Registry by mail within ten business days of referral
from the Maine Background Check Center about criminal convictions, or referral
from another Department agency regarding high-severity substantiated findings
of abuse, neglect or misappropriation of property. The Department will add the
annotated D.C.W. to the Registry at the time of notification.
K.
Registry accessibility . The
Registry will be sufficiently accessible to meet the needs of the public,
including, but not limited to, health care providers, individual C.N.A.s,
health care consumers, and other state C.N.A. Registries. The Department must
disclose, at a minimum, the following information about an individual who is
listed on the Registry, to all requesters:
1.
The date that the individual was placed on the Registry; and
2. Whether the individual was annotated on
the Registry for:
a. Criminal convictions;
or
b. Substantiated findings of
abuse or neglect of a patient, client or resident; or
c. Substantiated findings of misappropriation
of property of a patient, client or resident.
3. Upon request, the Department shall
promptly provide all information about a particular D.C.W. listed on the
Registry to the requester.