Federal regulation at 42 CFR 483.152(c)(1) states that "No nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide training and competency evaluation program may be charged for any portion of the program (including any fees for textbooks or other required course materials)." Also, the federal regulation states at 42 CFR 483.152(c)(2), that "If an individual who is not employed, or does not have an offer to be employed, as a nurse aide becomes employed by, or receives an offer of employment from, a facility not later than 12 months after completing a nurse aide training and competency evaluation program, the State must provide for the reimbursement of costs incurred in completing the program on a pro rated basis during the period in which the individual is employed as a nurse aide." Only Medicare/Medicaid facilities have to reimburse training costs. State regulations do not require licensed-only facilities to reimburse nurse aides for NATCEP. Only nurse aides who successfully pass the NATCEP may receive the reimbursement. What is covered by the reimbursement? NATCEP costs cover: All of the training coursework; fees for textbooks or other required course materials; registering individuals on the nurse aide registry; and any costs of giving or grading the examinations. When does the nurse aide have to be reimbursed for the training program? When a nurse aide pays for non-facility-based training costs and is hired within one year of successfully completing the NATCEP, the provider is expected to pay 100% of the costs. This can be paid at the time of hiring or can be prorated over a reasonable period of time. A reasonable period of time cannot be more than 12 months. Does a nursing facility have to pay for the class for a nurse aide working in their facility or at a community college? Yes. The nursing facility is responsible for paying for the class regardless of whether it's at the facility or at a community college, within the time frames as stated above. If the person does not pass the training program evaluation, does the facility have to reimburse the costs? No. If the person does not pass both the written or oral and the skills tests, the facility does not have to reimburse him/her. A person only becomes a certified nurse aide after passing both sections, and the facility should only reimburse people who become fully certified. Since the facility paid for the training, does the aide have to work for the facility for a certain amount of time? No. A facility cannot make a nurse aide work for a certain length of time. As long as the person passed the evaluations, he/she must be reimbursed for the training. How does the facility report the reimbursement costs? All costs that have to do with nurse aide training and competency evaluation programs (NATCEP) should be reported on Line 321 (NATCEP Costs) of the Medicaid Nursing Facility Financial Report. These costs include: (1) reimbursement made to nurse aides who personally paid for the cost of training classes, (2) wages for trainers, (3) costs from train-the-trainer classes, (4) training materials and supplies, and (5) costs for nurse aide testing. Wages for nurse aides while in training should not be reported on Line 321, but should be reported on Line 314 (Nurses Aides). How do I know if the nurse aide was reimbursed at a different facility? The nurse aide should only be reimbursed by one (1) facility per one (1) training program completed. It is theresponsibility of the facility to do an employee background check to see if the nurse aide has completed the training, and if a different facility has already reimbursed him/her for the cost of training. This might mean the facility has to contact previous employers
to find out if the new employee has already been reimbursed for his/her training program costs.