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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 556NURSE AIDES
RULE §556.3NATCEP Requirements

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

  (9) care of cognitively impaired residents, including:

    (A) techniques for addressing the unique needs and behaviors of a resident with a dementia disorder including Alzheimer's disease;

    (B) communicating with a cognitively impaired resident;

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

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

    (E) methods of reducing the effects of cognitive impairments;

  (10) basic restorative services, including:

    (A) training a resident in self-care according to the resident's abilities;

    (B) use of assistive devices in transferring, ambulation, eating, and dressing;

    (C) maintenance of range of motion;

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

    (E) bowel and bladder training; and

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

  (11) a resident's rights, including:

    (A) providing privacy and maintenance of confidentiality;

    (B) promoting the resident's right to make personal choices to accommodate their needs;

    (C) giving assistance in resolving grievances and disputes;

    (D) providing needed assistance in getting to and participating in resident, family, group, and other activities;

    (E) maintaining care and security of the resident's personal possessions;

    (F) promoting the resident's right to be free from abuse, mistreatment, and neglect and the need to report any instances of such treatment to appropriate facility staff; and

    (G) avoiding the need for restraints in accordance with current professional standards.

(q) If a trainee completes HHSC's 60-hour classroom training CBT, a NATCEP must accept proof of completion of the CBT in lieu of the 16 introductory hours of classroom training in subsection (p) of this section and the eight hours of infection control training in subsection (t) of this section. The NATCEP must ensure that the trainee:

  (1) only performs services for which the trainee has been trained and has been found to be proficient by a program instructor;

  (2) is under the direct supervision of a licensed nurse when performing skills as part of a NATCEP until the trainee has been found competent by the program instructor to perform that skill;

  (3) is under the general supervision of a licensed nurse when providing services to a resident after a trainee has been found competent by the program instructor; and

  (4) is clearly identified as a trainee during the clinical training portion of the NATCEP.

(r) A NATCEP that fails to accept proof of completion of the classroom training in accordance with subsection (n)(1)(B) of this chapter may be subject to §556.8 of this chapter (relating to Withdrawal of Approval of a NATCEP).

(s) A NATCEP must have a program director and a program instructor when the NATCEP applies for initial approval by HHSC in accordance with §556.7 of this chapter (relating to Review and Reapproval of a Nurse Aide Training and Competency Evaluation Program (NATCEP)) and to maintain HHSC approval. The program director and program instructor must meet the requirements of §556.5(b) - (d) of this chapter (relating to Program Director, Program Instructor, Supplemental Trainers, and Skills Examiner Requirements).

(t) Except as provided in subsection (q) of this section, a NATCEP must teach eight hours of infection control that includes the proper use of personal protective equipment (PPE) before a trainee has any direct contact with a resident.

(u) A NATCEP must verify that a trainee:

  (1) is not listed on the NAR in revoked status;

  (2) is not listed as unemployable on the EMR; and

  (3) has not been convicted of a criminal offense listed in Texas Health and Safety Code (THSC) §250.006(a) or convicted of a criminal offense listed in THSC §250.006(b) within the five years immediately before participating in the NATCEP.

(v) A NATCEP must ensure that a trainee:

  (1) completes the first 16 introductory hours of training (Section I of the curriculum) before having any direct contact with a resident;

  (2) only performs services for which the trainee has been trained and has been found to be proficient by a program instructor;

  (3) is under the direct supervision of a licensed nurse when performing skills as part of the NATCEP until the trainee has been found competent by the program instructor to perform that skill;

  (4) is under the general supervision of a licensed nurse when providing services to a resident after a trainee has been found competent by the program instructor; and

  (5) is clearly identified as a trainee during the clinical training portion of the NATCEP.

(w) A NATCEP must submit a NATCEP application to HHSC if the information in an approved NATCEP application changes. The NATCEP may not continue training or start new training until HHSC approves the change. HHSC conducts a review of the NATCEP information if HHSC determines the changes are substantive.

(x) A NATCEP must use HHSC Form 5497-NATCEP, Texas Nurse Aide Performance Record, to document major duties or skills taught, trainee performance of a duty or skill, satisfactory or unsatisfactory performance, and the name of the instructor supervising the performance. At the completion of the NATCEP, the trainee and the employer, if applicable, will receive a copy of the performance record. The NATCEP must maintain a copy of the performance record.

(y) A NATCEP must maintain records for each session of classroom training, whether offered in person or online, and of clinical training, and must make these records available to HHSC or its designees at any reasonable time.

  (1) The classroom and clinical training records must include:

    (A) dates and times of all classroom and clinical training;

    (B) the full name and social security number of each trainee;

    (C) a record of the date and time of each classroom and clinical training session a trainee attends;

    (D) a final course grade that indicates pass or fail for each trainee; and

    (E) a physical or electronic sign-in record for each classroom and clinical training session. An electronic sign-in must include a form of identity verification for the trainee conducted in compliance with the requirements of subsection (o)(2) of this section.

  (2) If a trainee completes the classroom training by successfully completing HHSC's CBT, a NATCEP must retain records that include a copy of the trainee's certification of completion for the CBT. The certificate of completion must be issued by HHSC and include the date the trainee completed the CBT.

  (3) A NATCEP must provide to HHSC, on the NATCEP application, the physical address where all records are maintained and must notify HHSC of any change in the address provided.

(z) A nursing facility must not charge a nurse aide for any portion of a NATCEP, including any fees for textbooks or other required course materials, if the nurse aide is employed by or has received an offer of employment from a facility on the date the nurse aide begins the NATCEP.

(aa) HHSC reimburses a nurse aide for a portion of the costs incurred by the nurse aide to complete a NATCEP if the nurse aide is employed by or has received an offer of employment from a nursing facility within 12 months of completing the NATCEP.

(bb) HHSC must approve a NATCEP before the NATCEP solicits or enrolls trainees.

(cc) HHSC approval of a NATCEP only applies to the required curriculum and hours. HHSC does not approve additional content or hours.

(dd) A new employee or trainee orientation given by a nursing facility to a nurse aide employed by the facility does not constitute a part of a NATCEP.

(ee) A NATCEP that provides training to renew a nurse aide's listing on the NAR must include training in geriatrics and the care of residents with a dementia disorder, including Alzheimer's disease.


Source Note: The provisions of this §556.3 adopted to be effective September 24, 2018, 43 TexReg 6326; amended to be effective August 8, 2021, 46 TexReg 4693; amended to be effective September 27, 2022, 47 TexReg 6201; amended to be effective March 17, 2024, 49 TexReg 1476

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