CMS Final Rule – §483.95 Training Requirements

Post 19 of 108

Implementation Date: Phase 3 – November 28, 2018¹

This is a new section which sets forth training requirements, requiring a facility to develop, implement, and maintain an effective training program for all new and existing staff, persons providing service under contractual arrangements, and volunteers, consistent with the respective roles. Section 483.70(e) sets forth the assessment a facility uses to determine the amount and types of training needed.

Training topics include, but are not limited to the following:

Section (a) Communication requires a facility to train direct care staff in effective communications.

Section (b) Resident’s rights and facility responsibilities requires staff to be educated on rights of resident and facility responsibility for proper care of residents.

Section (c) Abuse, neglect, and exploitation requires staff training on:

(1)    Activities constituting abuse, neglect, exploitation, and misappropriation of resident property;
(2)    Procedures for reporting incidents of abuse, neglect, exploitation, or misappropriation of resident property; and
(3)    Dementia management and resident abuse prevention.

Section (d) Quality assurance and performance improvement (QAPI) requires mandatory staff training on the elements and goals of the QAPI program.

Section (e) Infection control requires mandatory staff training on written standards, policies, and procedures for the infection prevention and control program.

Section (f) Compliance and ethics program must include:

(1)    Effective way to communicate the standards, policies, and procedures through a training program or other practical manner; and
(2)    Annual training if organization operates five or more facilities.

Section (g) Required in-service training for nurse aides must include:

(1)    Ensure continuing competence for no less than 12 hours per year;
(2)    Dementia management and residence abuse prevention;
(3)    Address areas of weakness determined in performance reviews and facility assessment;
(4)    Nurse aides serving individuals with cognitive impairments also address care of such individuals.

Section (h) Required training of feeding assistants prevents a facility employing paid feeding assistants unless successfully completed a State-approved training program for feeding assistants.

Section (i) Behavioral health requires behavioral health training as required by §483.40 or as determined by facility assessment pursuant to §483.70(e).

While many of the requirements for this new section will not implemented until Phase 3 by November 28, 2018, several sections are implemented in Phase 1 beginning on November 28, 2016. Facilities will need to implement training for abuse, neglect, and exploitation; in-service training for nurse aides; and only hire paid feeding assistants that have successfully completed a State-approved training program. The Phase 1 changes will require prompt action to ensure that facilities comply with these sections slated for the November 28, 2016 implementation date.

By Denise Bloch

Denise Bloch








¹Section (c) Abuse, neglect, and exploitation, sections (g)(1),(2) & (3) Required in-service training for nurse aides, and section (h) Required training of feeding assistants will be implemented by November 28, 2016.

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