Current through Bulletin 2024-06, March 15, 2024
(1) UNAR shall administer a NATCEP through a
contract with the Department of Health.
(2) An agency that conducts a NATCEP must be
UNAR-approved.
(3) Applicants for
approval of a NATCEP and all new NATCEP instructors must successfully complete
a background clearance.
(a) A NATCEP must
submit required information to UNAR to initiate a background clearance for each
applicant and instructor.
(b) UNAR
shall ensure:
(i) required information is
entered into the Direct Access Clearance System to initiate a clearance for
each applicant and instructor;
(ii)
each applicant and instructor signs a criminal background screening
authorization form which must be available for review by the
department;
(iii) each applicant
and instructor submits fingerprints; and
(iv) the Direct Access Clearance System
reflects the current status of the applicant and instructor.
(c) If the Department determines
an applicant or instructor are not eligible, based on information obtained
through the Direct Access Clearance System, the Department shall send a Notice
of Agency Action to UNAR and the individual explaining the action and the
individual's right of appeal as defined in R432-30.
(4) In accordance with this section, UNAR
shall review and render a determination of approval or disapproval of any
NATCEP when a Medicare or Medicaid participating nursing facility requests the
determination. UNAR at its option, may also agree to review and render approval
or disapproval of any private NATCEP.
(5) UNAR must, within 90 days of the date of
an application, either advise the requestor of UNAR's determination, or must
seek additional information from the requesting entity with respect to the
program for which it is seeking approval.
(6) UNAR shall approve a NATCEP that meets
the criteria specified in OBRA, the Centers for Medicare and Medicaid Service's
guidelines, guidelines designated by the Department of Health, and all UNAR
requirements.
(a) UNAR shall admit a student
who is at least 16 years old on or before the first day the student begins
class; and
(b) shall include an
orientation to the training program.
(7) The nurse aide training program must meet
certain content requirements to be UNAR-approved.
(a) NATCEP must consist of at least 100 hours
of supervised and documented training by a licensed nurse.
(b) The curriculum of the training program
must include the following subjects:
(i)
communication and interpersonal skills;
(ii) infection control;
(iii) safety and emergency
procedures;
(iv) promoting resident
independence;
(v) respecting
resident rights; and
(vi) basic
nursing skills.
(c) The
trainee must complete at least 24 hours of supervised practical training in a
long-term care facility, and complete all skill curriculum and skill
competencies before training in any facility. The skills training must ensure
that each nurse aide demonstrates competencies in the following areas:
(i) Basic nursing skills:
(A) taking and recording vital
signs;
(B) measuring and recording
height;
(C) caring for residents'
environment; and
(D) recognizing
abnormal signs and symptoms of common diseases and conditions.
(ii) Personal care skills:
(A) bathing that includes mouth
care;
(B) grooming;
(C) dressing;
(D) using the toilet;
(E) assisting with eating and
hydration;
(F) proper feeding
techniques; and
(G) skin
care.
(iii) Basic
restorative services:
(A) use of assistive
devices in ambulation, eating, and dressing;
(B) maintenance of range of motion;
(C) proper turning and positioning in bed and
chair;
(D) bowel and bladder
training;
(E) care and use of
prosthetic and orthotic devices; and
(F) transfer techniques.
(iv) Mental Health and Social Service Skills:
(A) modifying one's behavior in response to
the resident's behavior;
(B)
identifying developmental tasks associated with the aging process;
(C) training the resident in self-care
according to the resident's ability;
(D) behavior management by reinforcing
appropriate resident behavior and reducing or eliminating inappropriate
behavior;
(E) allowing the resident
to make personal choices, providing and reinforcing other behavior consistent
with the resident's dignity; and
(F) using the resident's family as a source
of emotional support.
(v) Resident's rights:
(a) providing privacy and maintaining
confidentiality;
(b) promoting the
resident's right to make personal choices to accommodate the resident's
needs;
(c) giving assistance in
solving grievances;
(d) providing
needed assistance in getting to and participating in resident and family groups
and other activities;
(e)
maintaining care and security of resident's personal possessions;
(f) providing care that keeps a resident free
from abuse, mistreatment, or neglect, and reporting any instances of poor care
to appropriate facility staff; and
(g) maintaining the resident's environment
and care through appropriate nurse aide behavior to minimize the need for
physical and chemical restraints.
(8) Qualification of Instructors:
(a) a NATCEP must have a program coordinator
who is a registered nurse with a current and active Utah license to
practice;
(b) who is in good
standing with DOPL;
(c) with two
years of nursing experience, at least one of which is the provision of
long-term care facility services or caring for the elderly or chronically ill
of any age; and
(d) must have at
least three hours of documented consulting time per month with the respective
program.
(9) Nursing
facility-based programs:
(a) the program
coordinator in a nursing facility-based program may be the director of nursing
for the facility as long as the facility remains in full compliance with OBRA
requirements;
(b) the primary
instructor must be a licensed nurse with a current and active Utah license to
practice and must be in good standing with DOPL; and
(c) must have two years of nursing
experience, at least one of which is the provision of long-term care facility
services or caring for the elderly or chronically ill of any age.
(10) Before approval of a NATCEP,
the program coordinator and primary instructor must successfully complete a
UNAR-approved "Train-the-Trainer" program or demonstrate competence to teach a
CNA candidate who is at least 16 years old. All high school instructors must be
certified to teach in the classroom by completing a "Train the Trainer" program
or be certified to teach as defined by the Utah State Office of Education
before providing instruction in the classroom.
(11) Students who provide services to
residents must be under the direct supervision of a licensed nurse who is a
UNAR-approved clinical instructor and whose clinical time is separate from her
facility employment.
(12) Qualified
personnel from the health professions may supplement the program coordinator
and primary instructor. The program coordinator or primary instructor must be
present during all provided supplemental training.
(13) Qualified personnel include registered
nurses, licensed practical or vocational nurses, pharmacists, dietitians,
social workers, sanitarians, fire safety experts, nursing home administrators,
gerontologists, psychologists, physical and occupational therapists, activities
specialists, speech or language therapists, and any other qualified
personnel.
(14) UNAR requires
qualified personnel to have at least one year of current experience in the care
of the elderly or chronically ill of any age, or to have equivalent experience.
Qualified personnel must also meet current licensure requirements, whether they
are registered or certified in their field.
(15) A NATCEP must have a
student-to-instructor ratio of 12:1 for clinical instruction and shall not
exceed a 30:1 ratio for theory instruction. UNAR requires an instructor
assistant when the program has more than 20 students.
(16) A NATCEP must provide a classroom with
the following:
(a) adequate space and
furniture for the number of students;
(b) adequate lighting and
ventilation;
(c) comfortable
temperature;
(d) appropriate
audio-visual equipment;
(e) skills
lab equipment to simulate a resident's unit;
(f) clean and safe environment; and
(g) appropriate textbooks and reference
materials.
(17) Initial
post-approval and ongoing reviews:
(a) After
the initial approval of a NATCEP, UNAR grants a one-year probationary
period;
(b) During the probationary
period, UNAR may withdraw program approval if there is a violation of OBRA,
state, federal, or UNAR requirements;
(c) After the probationary period, UNAR shall
complete an on-site review and then complete subsequent on-site reviews at
least every two years;
(d) The CNA
training program shall submit a self-evaluation to UNAR during the interim year
that UNAR does not complete an on-site review;
(e) In the event that UNAR does not complete
an on-site review within two years, the CNA training program is responsible to
send a self-evaluation to UNAR for the applicable two-year period;
(f) If UNAR does not make an on-site visit
within two years and the CNA training program sends in a self-evaluation, UNAR
must make an on-site visit within one year of the self-evaluation.
(18) The training and evaluation
program review must include:
(a) skills
training experience;
(b)
maintenance of qualified faculty members for both classroom and skills portions
of the nurse aide training program;
(c) maintenance of the security of the
competency evaluation examinations;
(d) a record of complaints received about the
program;
(e) a record that each
nursing facility has provided certified nurse aides with at least 12 hours of
staff development training each year with the compensation for the
training;
(f) curriculum content
that meets state and federal requirements; and
(g) classroom facilities and required
equipment that meet state, federal, and UNAR requirements.
