Nurse Aide Program: Starting or Maintaining a Nurse Aide Training Program

Please review the state and federal regulations that apply to Nurse Aide Training to determine if you are qualified to have a nurse aide training program. A successful program must be compliant with these regulations:

• 42 CFR Part 483
• Wisconsin Admin. Code ch. DHS 129
• Wisconsin Stat. ch. 146

Program designee

Wisconsin Admin. Code § DHS 129.05(1)(c) states "The program shall designate an individual who is responsible for the operation and compliance of the program with all applicable provisions of this chapter. The program shall note the designee on the application for approval."

The program designee is the main contact between the Department of Health Services (DHS) and the nurse aide training program. The program designee is the one who oversees the training program and is authorized to make changes to the program.

Primary instructor

Details on requirements for primary instructors is found in Wis. Admin. Code § DHS 129.06(1).

This can be the same person as the program designee if they meet the primary instructor requirements. A primary instructor is the lead teacher for the class. They must be a registered nurse (RN) for at least two years and have at least one year of experience as an RN in a nursing home or skilled nursing facility. Primary instructors also need to have completed a training course for primary instructors, commonly known as a "train the trainer" course. A program can have more than one primary instructor.

Classroom and lab

Wisconsin Admin. Code § DHS 129.07(2)(a)1 states "Programs shall ensure that classrooms and lab facilities are adequate to meet the needs of the program, based on the number of students enrolled and how the classroom space is used. Programs shall ensure that classroom and skills labs have adequate temperature controls, clean and safe conditions, adequate space to accommodate students, adequate lighting, and all training equipment needed, including audiovisual equipment and any equipment needed for simulating resident care. Lab equipment shall always be in the skill lab necessary for demonstration, practice, and student demonstration. Any area designated as a classroom or lab in a facility-based program shall be an area that is not designated for resident care."

Clinical site

These two directories may assist you in locating a clinical partner:

• Directory of nursing homes and skilled nursing facilities (PDF)
• Directory of Class C CBRF assisted living facilities (PDF)

Once you have reviewed the regulations and have secured a classroom, clinical site, and primary instructor, you can begin the process of applying for a nurse aide program. You will need to have the following documents ready to upload before you start the online application.

Federal ID tax papers

You will be asked to enter your social security number (SSN) if applying as an individual or federal employee identification number (FEIN) if applying as an organization. This is needed to conduct the Department of Revenue (DOR) and the Department of Workforce Development (DWD) checks required in Wis. Stat. § 146.40. Please upload documentation from the IRS documenting your FEIN.

Performance record

Wisconsin Admin. Code § DHS 129.07(2)(e)3. requires programs to provide a copy of the student's performance record at the conclusion of the student's training.

Record retention policy

Wisconsin Admin. Code § DHS 129.07(2)(f) requires programs to provide a copy of the student's performance record at the conclusion of the student's training. It also requires records be kept for at least three years after the student completes training. Please include provisions for how a student would access their records if the program should close.

Program evaluation policy

Wisconsin Admin. Code § DHS 129.05 requires students be given the opportunity to evaluate the program.

Primary instructor resume

Wisconsin Admin. Code § DHS 129.06(1)(d) states that a primary instructor shall:

• Provide to the program a resume documenting the instructor’s education and clinical experience in meeting clients’ psychosocial, behavioral, cognitive and physical needs
• Maintain the instructor’s resume on file
• Include a copy of the instructor’s resume with the program’s application for program approval

Primary instructor train-the-trainer certificate of completion

Wisconsin Admin. Code § DHS 129.06(1)(e) requires that primary instructors attend a training course for instructors that is approved by the department. See the accordion labeled Approved train the trainer programs for our list of approved training courses.

Successful program completion policy

Prepare a policy that identifies how a student would successfully complete your program. Consider these questions when designing your policy:

• How will you assess that the student has attained the necessary knowledge to pass the course? Quizzes? Tests? Will this include a final exam?
• What is a passing score for each quiz/test or to pass the course?
• How will final grades be calculated?
• Are things like attendance or class participation figured into the final grade?
• Can students retake a quiz or test if they do not pass? If yes, how many times? Is the highest grade counted or an average of the two?
• Will you round up grades?

Your policy should be very clear to answer questions like these to avoid misunderstandings.

Sample attendance record

Please ensure the record reflects the actual time (time in / time out) the student was in attendance, not just the hours the class is scheduled to meet. Document when and how any missed time was made up, if allowed. Clinical time must be made up with clinical time.

Classroom or lab floor plan

Floor plans do not have to be official blueprints but should include the location of the classroom in the building, the dimensions of the classroom and lab, and locations of handwashing sinks and restrooms in relationship to the beds in the lab. Handwashing sinks need to be in close proximity to the beds, just as it would be in a clinical setting as we do not want nurse aide students to get in the habit of leaving the care area without washing their hands.

DHS staff will need to conduct a pre-approval site visit for each classroom and lab location. The classroom and lab needs to be fully operational with all equipment and supplies needed to hold class at the time of the site visit.

Equipment supply list

You must upload the Basic Equipment List for Nurse Aide Training Programs, F-01726 (Word) form with items that the program will supply checked off.

Clinical site agreement(s)

Even if one organization is both the nurse aide training program applicant and clinical site, Wis. Admin. Code § DHS 129.07(2)(c)(1)(b) states, "The agreement between the program and the clinical setting shall be reviewed and renewed annually by the department and upon any change of facility or school administration. A copy of the agreement shall be submitted to the department."

Every training program needs a contract with a clinical partner, even if it is within the same organization. The agreement helps clarify what the training program is responsible for and what the facility is responsible for so there are no misunderstandings.

Clinical supervision policy

Wisconsin Admin. Code § DHS 129.07(2)(c)2.b. states in the clinical setting "A ratio of six to eight students per instructor is considered to be adequate in most circumstances."

If there are too many students per instructor at clinicals the student and resident may have to wait a long time for the instructor to be available to watch cares. That may lead to facility staff having to go ahead and provide the care leaving the student with a missed opportunity to practice their skills. With only 16 hours of clinical required, students cannot afford to miss any opportunities!

Sample of performance record

Include a sample record of student performance in your application. This sample record should clearly demonstrate how to identify student progress. The sample can include grades, assessments, attendance, or any other relevant indicators of performance.

See Wis. Admin. Code § DHS 129.07(2)(e)3. for requirement.

Sample skills checklist

Your sample checklist should include all skills found under Wis. Admin. Code § DHS 129.07 and have an area for the primary instructor to date and initial each skill. Make sure your sample checklist is clear, organized, and easy to read.

General course calendar

A course calendar will provide clear structure and expectations for participants and helps ensures all topics are covered.

Curriculum

A training program must include classroom and lab in at least the following six core areas:

• Interpersonal communication and social interaction
• Basic nursing skills
• Personal care skills
• Basic restorative skills
• Rights of clients
• Dementias

The training program must provide classroom instruction of at least 16 hours prior to a trainee's direct contact with a resident or client. It must include:

• Communication and interpersonal skills
• Infection control
• Safety / emergency procedures
• Promoting residents' independence
• Respecting residents' rights

Clearly identify the curricula you will use. Will you be using a textbook, purchased platform or in-house platform? If you are using an in-house platform you will need to describe the platform.

Clearly describe your classroom delivery method. Will the class be in-person, online, or hybrid?

Reasonable accommodations policy

See Wis. Admin. Code DHS § 129.05(2)(a)1.e and Wis. Admin. Code DHS § 129.07(2)(a)3 regarding reasonable accommodations. For your reasonable accommodation and bias-free policies, please include what process is in place should the student wish to request an ADA accommodation or file a concern regarding discrimination under the bias-free policy. Here are some examples of questions your policy should seek to answer:

• Who should the student contact?
• How must they present their concern? In writing? In person?
• How will the issue be addressed?
• When can the student expect a response?
• What if they do not agree with the findings?

Dress code policy

Dress code policy, Wis. Admin. Code DHS § 129.07(2)(c)1.i. states, "Students and instructors shall wear clothing that is in compliance with program policy and that is appropriate for performing resident care. The clothing shall include a nametag that designates the name of the nurse aide training program and the person's status as a student or instructor."

Clothing appropriate for resident care usually is scrubs, closed toed shoes, and name tag.

Policies governing your nurse aide training program should be clear to anyone reading them exactly what is required, allowed, or not allowed. For example, if your attendance policy states "Students may face disciplinary action for multiple tardies" it leaves room for interpretation. The student may think they wouldn't face disciplinary action until they are tardy five times while the instructor may think action should be taken after the third time the student is tardy. Is someone tardy if they miss several hours of class or does that count as an absence? And what would the disciplinary action be? It is best to state the consequences if a student does not follow the specific policy.

Make sure you are consistent in applying any disciplinary actions. If you give one student two verbal warnings before advancing to a written warning, you should do so for all students. Keep good documentation. Having these details spelled out in your policies will help you avoid issues down the road. Be specific what is considered an excused absence and what is not.

Many programs include a statement regarding the student must be free of alcohol and/or drugs during classroom, lab, and clinical attendance and state the student will be dismissed from the program should that occur, or they have a separate policy regarding it.

Your program should have a cell phone and electronic device policy. To avoid Health Insurance Portability and Accountability Act (HIPAA) violations, most cell phone policies state phones are only to be used at breaks. Having a cell phone on their person at a clinical site is often grounds for immediate dismissal. As with other policies, include what the consequences are if a student disregards this policy.

Your program should have a complaint and grievance policy. What is the order of steps that a student shall take if they have a complaint about something about the course?

These recommendations will further strengthen and improve the effectiveness of your program. You should also implement ongoing evaluation and refinement to ensure your program remains responsive to student needs and aligned with program goals.

These resources may help you preparing materials and gather information for completing your application.

• Nurse Aide Program: Training and Registry webpage
• Sign up for notifications via the GovDelivery service (request DQA Nurse Aide Training and Testing updates) which will help you stay up to date on the latest news regarding nurse aide training and registry topics. You can see previously sent messages on this webpage.
• Background checks
  • Offenses Affecting Caregiver Eligibility for Chapter 50 Programs, P-00274 (PDF)
  • Background Checks Program
  • UW-Oshkosh Caregiver Educational Events - Caregiver Background Checks
• Headmaster
  • How to enter and complete students (PDF)
  • How to enter students (PDF)
  • How to complete training (PDF)
• Facebook group has been formed by your colleagues for the purpose of sharing information about operating nurse aide training programs. The searchable Facebook group name is Wisconsin State Nurse Aide Instructor Networking Group. This group is not affiliated with any state agency. The content, views, and opinions shared in the group may not reflect the official policy or position of DHS.

The programs in the following list are approved train-the-trainer programs for Wisconsin Nurse Aide Training.