Page:United States Statutes at Large Volume 101 Part 2.djvu/981

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-187

January 1, 1990, for more than 4 months unless the individual— "(i) has completed a training and competency evaluation program, or a competency evaluation program, approved by the State under subsection (e)(l)(A), and '(ii) is competent to provide such services. "(B) OFFERING COMPETENCY EVALUATION PROGRAMS FOR

CURRENT EMPLOYEES.—A nursing facility must provide, for individuals used as a nurse aide by the facility as of July 1, 1989, for a competency evaluation program approved by the State under subsection (e)(1) and such preparation as may be necessary for the individual to complete such a program by January 1, 1990. "(C) COMPETENCY.—The nursing facility must not permit an individual, other than in a training and competency evaluation program approved by the State, to serve as a nurse aide or provide services of a type for which the individual has not demonstrated competency and must not use such an individual as a nurse aide unless the facility has inquired of the State registry established under subsection (e)(2)(A) as to information in the registry concerning the individual. "(D) RE-TRAINING REQUIRED.—For purposes of subpara-

graph (A), if, since an individual's most recent completion of a training and competency evaluation program, there has been a continuous period of 24 consecutive months during none of which the individual performed nursing or nursing-related services for monetary compensation, such individual shall complete a new training and competency evaluation program. "(E) REGULAR IN-SERVICE EDUCATION.—The nursing facility must provide such regular performance review and regular in-service education as assures that individuals used as nurse aides are competent to perform services as nurse aides, including training for individuals providing nursing and nursing-related services to residents with cognitive impairments. "(F) NURSE AIDE DEFINED.—In this paragraph, the term 'nurse aide' means any individual providing nursing or nursing-related services to residents in a nursing facility, but does not include an individual— "(i) who is a licensed health professional (as defined in subparagraph (G)), or "(ii) who volunteers to provide such services without monetary compensation. "(G) LICENSED HEALTH PROFESSIONAL DEFINED.—In this paragraph, the term 'licensed health professional' means a physician, physician assistant, nurse practitioner, physical, speech, or occupational therapist, registered professional nurse, licensed practical nurse, or licensed or certified social worker. "(6) PHYSICIAN SUPERVISION AND CUNICAL RECORDS.—A nursing facility must— "(A) require that the health care of every resident be provided under the supervision of a physician; "(B) provide for having a physician available to furnish necessary medical care in case of emergency; and

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