The Centers for Medicare and Medicaid Services (CMS) reported that it was unable to verify in all but one case (from in-service training “sign-in sheets” and a master training list) that a randomly selected sample of CNAs in Texas had received the mandated performance reviews and in-service training. The CMS report, issued this past February, was based on its onsite review of Texas’ Nurse Aide Training and Competency Evaluation Program (NATCEP). As a result, the Texas Department of Aging and Disability Services (DADS) issued Provider Letter 06-14 on April 21, 2006, reminding facilities of the need to comply with the requirements of both 42 CFR 483.75(e)(8) [F-Tag 497] and 40 TAC ยง 19.1903(8) and to document activities in a manner that will facilitate surveyor verification of CNA performance reviews and in-service training. Both the federal and state regulations require that nursing facilities complete an annual performance review of every nurse aide and provide regular in-service education based on the outcome of the performance reviews. Nurse aides must receive a minimum of 12 hours per year in-service education.
As instructed by DADS, facilities should document and organize their information on nurse aide performance reviews and in-service education in a way that allows for ease in identification and tracking of data on individual nurse aides.