Wisconsin Nurse Aide Training and Nurse Aide
Directory Update - Termination of Nurse Aide Training "Deemed" and
"Grandparenting" Programs
PDF Version of BQA 99-077
(PDF, 25 KB)
Date: December 30, 1999 -- DSL-BQA-99-077
Supersedes BQA memos 93-022 and 93-023
From: Donna Cochems, Chief, Caregiver Regulation and Investigation Section
cc: Susan Schroeder, Director, Bureau of Quality Assurance
The purpose of this memo is to provide Bureau of Quality Assurance regulated providers
and nurse aide training programs with current information regarding Wisconsin Nurse Aide
Training Program and Nurse Aide Directory requirements, updated related forms, fact sheets
and publications. This memo replaces the sections of BQA Memo 93-022 and 93-023 that
pertain to Nurse Aide Registry (currently named the Wisconsin Nurse Aide Directory) Deemed
and Grandparenting Applications.
Termination of "Deemed" Nurse Aide Training
Program Effective January 1, 2000
Federal regulations specify that a skilled nursing facility must not employ any
individual as a nurse aide in the facility on or after January 1, 1991, for more than four
months unless that individual had completed a training and testing program approved by the
State (42 USCA § 1395i-3(5) Required training of nurse aides). States were
required to review and approve not later than January 1, 1989 those training and
competency evaluation programs that met this requirement (Subsection (e) (1)(A)).
States were allowed to waive the training and testing requirement for an individual who
had completed a nurse aide training and testing program prior to July 1, 1989 under the
process known as "Deemed." 42 CFR § 483.151 established the procedure for
review and approval of nurse aide training and competency evaluation programs. It further
established that no nurse aide training or competency evaluation program could be approved
for a period longer than two years, therefore requiring a review and approval of all
programs every two years. A state can withdraw any program if the state determines that
these programs do not meet any of the requirements of §§ 483.152 and/or 483.154.
BQA Memo 93-023 outlined the process of issuing retroactive approval to training
programs (known as "deeming"). Under federal laws, training programs conducted
and completed prior to December 31, 1989 are considered approved if they are substantially
the same as programs approved under HFS Administrative Code 129. Under state law, training
programs conducted and completed prior to October 1, 1990 have been considered approved.
The memo indicated that because of the difference in effective dates between state and
federal law, "state only" approval was given to programs in operation between
December 31, 1989 and October 1, 1990.
Although the specific nurse aide curriculum requirements have not changed, the degree
and level of clinical competence has changed substantially due to progressive changes in
health care. What was learned through the deemed training programs and tested through the
competency evaluation programs prior to December 18, 1989 is no longer sufficient to meet
the health care requirements of today.
A review of all "deemed" nurse aide training and competency evaluation
programs will be completed by December 31, 1999 to ensure all Wisconsin Nurse Aide
Directory practices are brought into Federal and State compliance.
Effective January 1, 2000, individuals will no longer be approved for placement on
the Wisconsin Nurse Aide Directory under the previously allowed "deeming"
procedure. Instead, all individuals wishing to be placed on the Wisconsin Nurse Aide
Directory must have completed a nurse aide training and/or competency evaluation program
approved by the State of Wisconsin.
Termination of "Grandparenting" Nurse Aide Training
Program Effective January 1, 2000
Federal regulations allowed states to waive the training and testing requirement for an
individual who worked as a nurse aide at one or more facilities of the same employer in
this state for at least 24 consecutive months before December 19, 1989 under the process
known as "Grandparenting," (42 CFR § 483.150(c) Waiver of requirements).
42 USCA § 1395i-3(5) Required training of nurse aides specifies that a skilled
nursing facility must not employ any individual as a nurse aide in the facility on or
after January 1, 1991, for more than four months unless that individual had completed a
training and testing program approved by the state. Further, it required that a skilled
nursing home must provide individuals used as nurse aides as of January 1, 1990 with a
competency evaluation program not later than October 1, 1990.
Section 146.40 (2) (am), Stats., states that a facility may not employ an individual as
a nurse assistant unless the individual had been employed as a nurse assistant between
October 1, 1985 and October 1, 1990, and had successfully completed a competency
evaluation program approved by the Department not later than December 31, 1991.
The intent of the Grandparenting program was to:
-
Provide a grace period to allow health care providers to be in compliance with federal
and state regulations when employing individuals as nurse aides;
-
Allow individuals working as nurse aides prior to January 1, 1991, to use work
experience in lieu of completing a nurse aide training program prior to completing a state
approved nurse aide competency evaluation program; and
-
Provide a grace period from January 1, 1990 to December 31, 1990 for individuals working
at that time to complete a state approved nurse aide competency evaluation program prior
to January 1, 1991.
Effective January 1, 2000, individuals will no longer be approved for placement on
the Wisconsin Nurse Aide Directory under the previously allowed "grandparenting"
procedure. Instead, all individuals wishing to be placed on the Wisconsin Nurse Aide
Directory must have completed a nurse aide training and/or competency evaluation program
approved by the State of Wisconsin.
Effective January 1, 2000, the following forms are now
obsolete:
Wisconsin Nurse Aide Directory Form and Publication
Update
[IMPORTANT - January 2003, please see Changes
to Nurse Aid Registry & Testing Services - the following forms
are no longer being used]
Attached with this memo are the following updated Wisconsin Nurse Aide Directory forms,
fact sheets and publications:
The updated forms and fact sheets reflect current Wisconsin Nurse Aide Directory
requirements, as well as changes that have resulted due to the Caregiver Program. The new
brochure, Wisconsin’s Nurse Aide Directory and Caregiver Program,
provides current information and requirements regarding the Wisconsin Nurse Aide Directory
and the Caregiver Program. [Information on ordering copies has been removed,
see Nurse
Aide Training and Registry Publications]
Introduction of Wisconsin Nurse Aide Directory and Nurse Aide
Training Program Web Site
The Department has created a web site for the Wisconsin Nurse Aide Directory and Nurse
Aide Training program. The most current documents that relate to the Nurse Aide Directory
and/or Nurse Aide Training program, such as forms, frequently asked questions, fact
sheets, and BQA Memos can be accessed at the following web site: www.dhfs.state.wi.us/caregiver/NATD/NATDintro.htm
For answers to further questions regarding the Nurse Aide Directory contact:
Wisconsin Nurse Aide Directory
Bureau of Quality Assurance
2917 International Lane, Suite 300
Madison, WI 53701-2569
(608) 243-2019
FAX: (608) 243-2020
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