Licensing and Regulatory Affairs
It has been reported that some skilled nursing facilities are temporarily self-limiting or restricting access, including access by nurse aide training programs. We understand this access is needed by training programs to complete clinical hours in the skilled nursing facility.
At this time, we are temporarily allowing nurse aide students to practice and demonstrate clinical tasks in health care settings outside of a skilled nursing facility when necessary.
If your training program is experiencing this temporary restriction, it is our recommendation that you first attempt to secure a contract with another skilled nursing facility.
If you are unable to secure a contract with another skilled nursing facility, you may attempt to secure a temporary contract in another adult health care setting. If the program has an agreement with an alternative health care setting, a temporary contract is required. A temporary contract may be secured through December 31, 2020. Once you have submitted the temporary contract to the state agency, you may proceed with clinical training in the alternative health care setting. We hope this clarification is helpful.
The bureau is approving an alternative option to the in person, face to face classroom requirements for all state approved nurse aide training programs. Due to the current state of emergency, effective immediately the bureau is approving online, virtual classroom sessions for those programs that wish to offer an alternative to in person classroom education. Online classes must provide the opportunity for students to interact and engage with the instructor teaching the lesson. The nurse aide trainer must be present and available during this time. Each program that wishes to use online classes must track and audit classroom hours to ensure that they meet the minimum requirements of 34 hours. This audit must be maintained and available for review by the bureau. All laboratory and clinical requirements remain in effect. Please submit a nurse aide training program application, indicating a change, and then detail that change to your classroom hours in a separate piece of paper for approval by the bureau.
All Nurse Aide Training Programs must be approved and obtain a permit by the State of Michigan. To become a Nurse Aide Training Program, the prospective program must follow the State of Michigan Nurse Aide Training Curriculum Model and complete the State of Michigan Nurse Aide Training Program application. Please refer to the Code of Federal Regulations 483.151 and 483.152 regarding information on training programs and trainers.
In a facility applying for a nurse aide training program, the State of Michigan will not approve a program until it has been two years since the assessment of penalties (locked out) under 42 CFR 483.151 (b) (3). Do not apply for a nurse aide training program if you are a facility that does not qualify based on the conditions outlined under the Federal Code.
A facility may request that CMS waive the disapproval (removal of a nurse aide training program) when the facility has been assessed a civil monetary penalty of not less than $10,483, if the civil monetary penalty was not related to the quality of care furnished to residents in the facility.
As of February 19, 2018, all new Nurse Aide Training Programs will be required to pay a fee as part of their application. This fee is written into state law, Part 219 of the Michigan Public Health Code, Sections 333.21919.
Any new nurse aide training program will pay the fee at the time of application. If approved, the permit is good until the next renewal period. All Nurse Aide Training Program permits are on a two-year cycle of renewal in even years. They all will expire on July 31st of the even number year. For all training programs offered by a secondary education institution (high school or ISD) or a skilled nursing facility the fee is $100.00. For all others (proprietary school, community college, adult education) the fee is $300. These are for all new programs and renewals of all programs. These fees are to be paid at the time of application and renewal.
REFUNDS: No refunds of the fee associated with a nurse aide training program will be granted unless a request for withdrawal of the application is received by our office prior to being issued a permit.
Each Nurse Aide Training Program also now must submit a renewal form (Nurse Aide Training Program application) 30 days prior to the expiration date of the program permit. A program permit is good for two years before it must be renewed. The permit will expire on July 31st of an even number year. If renewed, it will be granted from August 1st of the even year until July 31st of the nest even number year. There is only one form for training programs, which is used for new programs, program changes and renewals.
Any program that no longer wishes to offer training should contact the Bureau at BCHS-CNA-Training-Program@michigan.gov and inform them of their closure in writing.
At some point between when your permit is renewed and before it is set to expire, an on-site inspection will be conducted for compliance with Federal and State law as well as administrative rules.
To make changes to a nurse aide training program or nurse aide trainer certification, you must complete and submit the respective application indicating the changes. These forms serve as both initial application, changes and renewals.
In order for an individual to be a certified nurse aide trainer and teach in a nurse aide training program in the State of Michigan, the individual must complete the Nurse Aide Trainer Application and their application must be approved by the state. Please refer to 42 CFR 483. 152 (a) (5) (i) when considering filling out the application. You must have two years of nursing experience as a registered nurse, one of which must be in the provision of long term care facility services in a Michigan(federally certified CMS facility-state licensed long term care facility).
Note: Effective May 7, 2018, the Bureau has expanded the experience portion to include: “A nurse aide trainer candidate must have at least 1 year of experience in providing skilled nursing care and related services to individuals that require non-hospital residential medical, nursing or rehabilitative services. Long term care facilities may include nursing homes, hospital long term care units, county medical care facilities, homes for the aged, assisted living facilities, hospice and other like provider types."
There are only two types of instructors, a Nurse Aide Trainer or a Supplemental instructor, mentioned in 42 CFR 483.152. A Nurse Aide Trainer is a Registered nurse, who possesses a minimum of 2 years of nursing experience, at least 1 of which must be in the provision of long term care facility services, i.e., a participating CMS facility. They also must have completed a course in teaching adults or have experience in teaching adults or supervising nurse aides. Any individual, training nurse aide candidates, must be a Nurse Aide Trainer or a Supplemental Instructor. The Nurse Aide Trainer must be on site, present, and overseeing the training 100% of the time in the classroom, lab or clinical site. The overall training of nurse aide candidates may not be delegated to someone else, nor can the overall training (classroom or clinical) be delegated solely to a supplemental instructor. A Licensed Practical Nurse or Registered Nurse (Supplemental Instructor), that is not a Nurse Aide Trainer approved by the State, may supplement the primary Nurse Aide Trainer (certified) in the lab for skills check off as well as clinical skills checks taught by the Nurse Aide Trainer. These Supplemental Instructors can be made up of licensed health professionals or other specialists and they must have at least 1 year of experience in their field. These supplemental instructors are not to be doing the overall training of nurse aides, but can supplement the instructor regarding their field of experience.
Effective February 19, 2018, Public Act 172 of 2017, Part 219, amended the Public Health Code giving additional oversight to the Bureau of Community and Health Systems regarding Nurse Aide Training Programs. Changes to the Public Health Code include fees associated with becoming and renewing a permit as a Nurse Aide Trainer. A permit is only good for two years. Previous to this new law, a Nurse Aide Trainer was known as a Train the Trainer and was given an indefinite expiration date and was not charged a fee. The new law requires a Nurse Aide Trainer to pay a fee of $40 for initial application and every two years thereafter for renewal and will be issued a permit. You will be issued a new nurse aide trainer number.
All Nurse Aide Trainer permits are tied to your professional license as a Registered Nurse. When your Registered Nurse license expires, so will your Nurse Aide Trainer Permit. These two renewals (professional license and Nurse Aide Trainer permit) are handled by two different Bureaus within the Michigan Department of Licensing & Regulatory Affairs. Your Registered Nurse license will be renewed with the Bureau of Professional Licensing and your Nurse Aide Trainer Permit will be renewed with the Bureau of Community and Health Systems. For all Nurse Aide Trainers with a current Train the Trainer Certificate, with an indefinite expiration date, you will need to fill out a renewal form listed on the Bureau’s web page for Nurse Aide Training Programs and pay the $40 fee, which needs to be mailed to the Bureau. For now, we only accept checks and these need to be made out to the “State of Michigan.” All Nurse Aide Trainers, that have a nursing license, will need to fill out the renewal/application form for Nurse Aide Trainers and pay the fee when they renew their nursing license.
Please refer to 42 USC 1395i-3 (f) (2) (C) when considering requesting a waiver of the 2-year "lock-out" prohibition. The waiver is for a nurse aide training program offered in, not by the facility. The facility is allowed to choose a non-facility affiliated contractor to train the facilities nurse aide candidates meet all conditions listed under (C). If the facility already has an outside training program in the facility at the time of the lock out, the facility must get a waiver for the outside program to continue to do the training if the facility is locked-out under the conditions listed under waivers. A nursing home may request a waiver of the 2-year Nurse Aide Training Prohibition by submitting the following information via BCHS-Nurse-Aide-Training-Program@michigan.gov.
A request will be reviewed if all of the above information is included. A request may be granted if the following conditions have been met. There must be no other nurse aide training program located within a reasonable distance of your facility (less than 5 miles).
The last condition is that the Bureau establishes that an adequate environment exists for operating the program in the facility, which can only be done by being in substantial compliance or having an approved Plan of Correction for any outstanding deficiency.
Within 90 days of receiving the waiver request, the Bureau will either approve or disapprove the waiver, in which case a letter will be sent, or additional information will be requested from the requesting entity.
Note: Any training program that is not offered by or in a facility, and only uses a facility to do their clinicals, does not need a waiver. If the facility is locked-out, this does not impact the training program that only uses the facility to do their clinicals and no waiver is needed.
Below are a list of state approved nurse aide training programs. Some of these programs that are run by or in a Long-Term Care Facility may be locked-out from conducting training due to federal requirements. Please verify with them that they can conduct training and are not locked-out.
Michigan Department of Licensing and Regulatory Affairs
Bureau of Community & Health Systems
611 W. Ottawa Street
PO Box 30664
Lansing, MI 48909