20 CAR pt. 403 | 20 CAR Part 403 — Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program

Chapter X

Subchapter A

Subpart 1

20 CAR § 403-101 Purpose {#sec-20-car-403-101 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-101}

20 CAR § 403-101. Purpose.

(a) The purpose of this part is to develop and approve training and competency evaluation programs for individuals who provide nursing or nursing-related services to residents in long-term care facilities and who are not licensed health professionals or volunteers who provide services without monetary compensations.

(b)(1) These requirements are designed to assist long-term care facilities and other educational institutions with training and competency programs for nursing assistants.

(2) The objective of the Long-Term Care Facility Nursing Assistant Training Program is the provision of quality services to residents by nursing assistants who are able to:

(A) Perform certified nursing-aide skills and to assist licensed practical nurses or registered nurses in direct resident care;

(B) Form a relationship, communicate, and interact competently on a one-to-one basis with the residents as part of the team implementing resident care objectives;

(C) Demonstrate sensitivity to residents’ emotional, social, and mental health needs through skillful, directed interactions;

(D) Assist residents in attaining and maintaining functional independence;

(E) Exhibit behavior in support and promotion of residents’ rights; and

(F) Demonstrate observational and documenting skills needed in support of the assessment of residents’ health, physical condition, and well-being.

(c)(1) The training program must:

(A) Teach skills to enhance knowledge in promoting healthy functioning of residents both physically and emotionally; and

(B) Focus on the restoration and maintenance of the resident.

(2) These attitudes and behaviors of staff must be demonstrated in the facility on a day-to-day basis.

20 CAR § 403-102 Definitions {#sec-20-car-403-102 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-102}

20 CAR § 403-102. Definitions.

The following words and terms, when used in this part, shall have the following meaning, unless the context clearly indicates otherwise:

(1) “Abuse” means the willful, knowing, or reckless act of mistreatment of a resident through words or physical action which results in physical, emotional, or mental injury to a resident;

(2)(A) “Act” means the Federal Nursing Home Reform Act, Subtitle C of the Omnibus Budget and Reconciliation Act of 1987, Pub. L. No. 100-203, and technical amendments of the Omnibus Budget and Reconciliation Act of 1989, Pub. L. No. 101-239, and the Omnibus Budget and Reconciliation Act of 1990, Pub. L. No. 101-508.

(B) “Act” may also refer to the Long-Term Care Aide Training Act, Arkansas Code § 20-10-701 et seq.;

(3) “Additional instructor” means a registered nurse (RN) or licensed practical nurse (LPN) who, under the general supervision of the primary instructor, may provide classroom and skills training;

(4) “Centers for Medicare and Medicaid Services” means the federal agency that oversees programs including Medicare, Medicaid, the Children’s Health Insurance Program, and the state and federal health insurance marketplaces;

(5) “Certified nursing assistant (CNA)” means individuals trained and certified to help nurses by providing nonmedical assistance to patients, such as help with bathing, dressing, and using the bathroom;

(6) “Competency examination” means an examination that includes manual (skills) and written (or oral component for those with limited literacy skills) evaluations;

(7) “Educational institution” means an institution that is licensed by the State Board of Private Career Education within the Division of Higher Education as defined by Acts 1989, No. 906 (examples include but are not limited to career colleges and proprietary schools);

(8) “Examination” means a competency examination that includes manual (skills) and written evaluations;

(9)(A) “Facility” means a long-term care facility or nursing facility (nursing home) licensed by the Office of Long-Term Care.

(B) A nursing facility that provides nursing care and supportive care on a twenty-four-hour basis to residents.

(10) “Facility-based program” means a nursing assistant training program offered by or in a long-term care facility;

(11)(A) “General nursing experience” means nursing experience which may include, but is not limited to:

(i) Employment;

(ii) Internship;

(iii) Externship; or

(iv) Other means including working in:

(a) A nursing assistant education program;

(b) A long-term care facility;

(d) A geriatrics department, excluding geriatric psychiatry;

(e) A long-term acute care hospital (recuperative care);

(f) Home healthcare;

(g) Hospice care; or

(h) Other long-term care setting;

(B) See Arkansas Code § 20-10-702(1);

(12) “Guest speaker” means a registered nurse, licensed practical nurse, or other licensed health professional who conducts specific classroom lectures based upon an expertise in a given subject area under the direct supervision of the primary instructor;

(13) “Licensed health professional” means a:

(A) Physician;

(B) Physician assistant;

(D) Physical, speech, or occupational therapist;

(E) Physical therapist assistant or occupational therapist assistant;

(F) Registered professional nurse;

(G) Licensed practical nurse; or

(H) Certified social worker;

(14) “Misappropriation of resident property” means the taking, secretion, misapplication, deprivation, transfer, or attempted transfer to any person not entitled to receive any property, real or personal, or anything of value belonging to or under the effective control of a resident or other appropriate legal authority, or the taking of any action contrary to any duty imposed by law prescribing conduct relating to the custody or disposition of property of a resident;

(15) “Neglect” means an act of omission or an act without due care which causes physical or emotional harm to a resident or adversely affects the resident’s health, safety, or welfare in any way;

(16)(A) “Nonfacility-based program” means a nursing assistant training program not offered by or in a facility.

(B) Examples include but are not limited to:

(i) Career colleges;

(ii) Community colleges;

(iii) Vocational or technical schools; and

(iv) Proprietary schools;

(17) “Nursing assistant” means an unlicensed nursing staff member who assists with basic patient care such as giving baths, checking vital signs, bed-making, and positioning to residents in a long-term care facility who has successfully completed a training or competency evaluation program and is competent to provide such services, but not an individual who is a licensed health professional or who volunteers to provide such services without monetary compensation;

(18) “Office” means the Long-Term Care Facility Nursing Assistant Training Program within the Division of Provider Services and Quality Assurance;

(19)(A) “Orientation program” means a program which provides the nursing assistant with explanations of:

(i) Facility structure;

(ii) Policies;

(iii) Procedures;

(iv) Philosophy of care;

(v) Description of the resident population; and

(vi) Employee rules.

(B) This orientation phase is not included as part of the Long-Term Care Facility Nursing Assistant Training Program;

(20) “Petitioner” is a person who appeals a finding that such person has, while acting as a nursing assistant in a facility or while being used by a facility in providing services to a resident, abused or neglected a resident, or has misappropriated a resident’s property;

(21)(A) “Primary instructor” means an individual who:

(i) Is a registered nurse licensed in this state to practice, if the registered nurse moves from a state that has joined the Interstate Nurse Licensure Compact, Arkansas Code § 17-87-601 et seq., to Arkansas and meets all requirements for licensure in Arkansas, does not have any disciplinary action regarding their license by the licensing entity or authority;

(ii) Possesses a minimum of two (2) years’ general nursing experience as a registered nurse including at least one (1) year of long-term care nursing services in a long-term care facility setting within the last ten (10) years;, and

(iii) Annually attends an eight (8) hour class, authorized by the Department of Human Services, regarding updates to applicable laws and rules, best practices, and common issues encountered in long-term care facilities.

(B) See Arkansas Code § 20-10-702;

(22) “Resident” means an individual who resides in long-term care facilities who receives a range of services, including medical and personal care;

(23) “Skills training” means training composed of both skills demonstration in the classroom lab and skills performance in the clinical area with residents in a long-term care facility;

(24) “Supervised practical training” means, pursuant to 42 C.F.R. § 483.152, training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse;

(25) “Task performance record” means a list of the major duties and skills to be learned in the program and the trainee’s performance of each;

(26) “Trainee” means an individual who is enrolled in a nursing assistant

training program and who is not permitted to perform nursing services for residents during the training period for which they have not been trained and found to be competent; and

(27) “Virtual instruction” or “virtual training” means a method of teaching that is taught either entirely online or when elements of face-to-face courses are taught online through learning management systems and other educational tools and platforms.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

Subpart 2

20 CAR § 403-201 General rule {#sec-20-car-403-201 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-201}

20 CAR § 403-201. General rule.

A facility must not use any individual working in the facility as a nursing assistant for more than four (4) months (meaning one hundred twenty (120) calendar days) unless that individual has successfully completed a training program and competency examination approved by the Department of Human Services as required by the Centers for Medicare and Medicaid Services.

20 CAR § 403-202 Training {#sec-20-car-403-202 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-202}

20 CAR § 403-202. Training.

(a) Nursing assistant training programs must include materials that provide a basic level of both knowledge and demonstrable skills for each individual completing the program.

(b)(1) Each course must be prepared and administered in accordance with the training course guidelines prescribed in the Arkansas Long-Term Care Facility Nursing Assistant Training Curriculum.

(2) This curriculum is to be used as a guide for conducting in-person or virtual training in both facility and nonfacility programs.

(c)(1) These guidelines essentially provide the outline for in-person and virtual training programs and can be enhanced by the inclusion of current information to keep training relevant to changing needs.

(2) The content provides fundamental information and leaves open the opportunity for an instructor to function as necessary in response to perceived student requirements.

(3) It is important to recognize that the curriculum guidelines identify the limitations, for example, limitations to the scope of practice, of the long-term care facility nursing assistants’ direct care responsibilities.

(d)(1) Each in-person or virtual training program must use the behavioral stated objectives in the Arkansas Long-Term Care Facility Nursing Assistant Training Curriculum for each unit of instruction.

(2) These objectives state the measurable performance criteria that serve as the basis for the state competency examination.

(3) The instructor shall conduct a review of each unit objective with trainees at the beginning of each unit so that each trainee knows what is expected of them in each part of the training program.

(e)(1) Upon successful completion of the required in-person or virtual training, the trainee must pass the state competency examination administered by the Department of Human Services (see 20 CAR § 403-501 et seq.).

(2) An individual must complete the state competency examination within twelve (12) months of graduation from a training program or retraining will be required.

20 CAR § 403-203 Implementation requirements {#sec-20-car-403-203 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-203}

20 CAR § 403-203. Implementation requirements.

(a)(1) Pursuant to 42 C.F.R. § 483.152, a nurse aide training and competency examination program must include, at a minimum, a combination of classroom (in-person or virtual) and clinical instruction.

(2) The requirement for state certification shall include a minimum of ninety-one (91) hours of training which consist of no less than seventy-five (75) clock hours of training, including sixteen (16) hours of supervised practical training, for a total of ninety-one (91) hours.

(b) The clinical site must be a long-term care facility, skilled nursing unit, or rehabilitation unit located in an acute care facility or inpatient hospice unit which has not been disqualified by restrictions as described in 20 CAR § 403-302.

(c)(1) A minimum of sixteen (16) hours initial classroom, in-person or virtual, instruction is required in Part I.

(2) This will include both theory instruction and skills demonstration in the classroom lab.

(3) During Part I, the trainee is not allowed on the floor as part of a facility’s staffing pattern.

(4) After completion of Part I, a trainee may be used in a facility’s staffing pattern but only assigned to duties for which they have demonstrated competency.

(5) Documentation of acceptable performance of all skills and duties shall be on file with the primary instructor (see 20 CAR § 403-204, nursing assistant trainee activities).

(d)(1) Parts II and III require the completion of the remaining seventy-five (75) clock hours of training consisting of theory, classroom lab, and clinical skills training.

(2) Clinical skills training must include at least sixteen (16) hours of supervised practical training in a facility, performing tasks on an individual under the direct supervision of the instructor.

(3) Clinical skills training assignment or supervision by another nursing assistant is prohibited.

(e) The ratio of trainees to instructors in the in-person or virtual classroom must not exceed twenty-four (24) trainees to one (1) instructor (primary or additional instructor) and the ratio for skills training must not exceed twelve (12) trainees to one (1) instructor.

(f)(1) Staff in training can be employed after completing lessons one through eleven (1 – 11) for a total of sixteen (16) hours of course work and may continue to work on the floor while they are actively progressing through the Long-Term Care Facility Nursing Assistant Training Program (NATP).

(2) However, they cannot be included in the staffing ratio if they are actively participating in class instruction.

(g)(1) Each program shall issue a written statement to each trainee upon successful completion of the program in the form of a certificate of completion which shall include the:

(A) Program’s name;

(B) NATP license number;

(C) Student’s name and a numerical identifier such as a driver’s license number or identification number from a valid government-issued document that contains a current photo, such as:

(i) State or national identification card;

(ii) Alien registration card;

(iii) Military identification; or

(iv) Passport;

(D) Begin date and end date; and

(E) Signature of the primary instructor.

(2) Such certificate, or copies thereof, shall serve as evidence of successful completion of a training program to be eligible to take the state competency examination.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-204 Nursing assistant trainee activities {#sec-20-car-403-204 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-204}

20 CAR § 403-204. Nursing assistant trainee activities.

(a)(1) Each trainee shall wear identification during all skills training portions that identifies them as a trainee.

(2) Identification must be visible to:

(A) Residents;

(B) Family members;

(D) Staff.

(b)(1) A nursing assistant who has begun a training program and has not completed the program may be hired by a facility to provide care for which they have received training and demonstrated competence.

(2) Nursing assistants are not permitted to perform services for residents during the training period for which they have not been trained and found by the training program to be competent.

(c)(1) Documentation of each trainee’s acceptable performance of each skill or procedure must be maintained by the primary instructor on the Task Performance Record (DMS-741 form) provided by the Department of Human Services.

(2) This record consists of the following:

(A) Tasks performed, which include duties and skills completed;

(B) Satisfactory performance date; and

(d)(1) A program must terminate a trainee when provided with substantial evidence or a determination that the trainee is guilty of resident neglect or abuse or misappropriation of resident property.

(2) The program establishes procedures for a review of the allegations when requested by the trainee.

(3) The program shall inform the department of any trainees terminated under these circumstances.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-205 In-person facilities and resources {#sec-20-car-403-205 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-205}

20 CAR § 403-205. In-person facilities and resources.

(a) The nursing assistant training program shall require the provision of physical facilities as follows:

(1) Temperatures conducive to the weather;

(2) Clean and safe conditions;

(3) Adequate lighting;

(4) Space to accommodate all students; and

(5) All equipment for simulating resident care in a classroom or lecture (see instructional equipment under 20 CAR § 403-902(3)).

(b) The physical facilities including classrooms, laboratories, conference space, library, and educational materials shall be adequate to meet the needs of the:

(1) Program;

(2) Number of trainees; and

(3) Instructional staff.

(1) Blackboard;

(2) Flipchart;

(3) Projector or screen;

(4) DVD;

(5) Anatomical chart;

(6) Mannequin;

(7) Bed; and

(8) Lavatory or sink.

(d) The Department of Human Services will not require or endorse any single textbook or other material; examples include but are not limited to videotape or film.

(e) There are several resources on the market and each facility or school will have the choice in selecting their textbooks or other training materials.

(f) The curriculum guide is to be used so each program will know the objectives and procedures expected to be communicated to the nursing assistant trainee for them to pass the state competency examination.

20 CAR § 403-206 Virtual training {#sec-20-car-403-206 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-206}

20 CAR § 403-206. Virtual training.

See 20 CAR § 403-801.

20 CAR § 403-207 Orientation program {#sec-20-car-403-207 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-207}

20 CAR § 403-207. Orientation program.

(a) All nursing assistants must receive an orientation program that includes, but is not limited to, an explanation of:

(1) The organizational structure of the facility;

(2) Policies and procedures, including but not limited to disaster plans, for example, fire, earthquake, flood, or tornado;

(3) The philosophy of care of the facility;

(4) The description of the resident population; and

(5) Employee rules.

(b) This facility orientation training program is not included in the required ninety-one (91) hours of nursing assistant training.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-208 Ongoing in-service training {#sec-20-car-403-208 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-208}

20 CAR § 403-208. Ongoing in-service training.

(a)(1) All facilities will continue to provide ongoing in-service training on a routine basis both in groups and as necessary in specific situations on a one-to-one basis.

(2) Each nursing assistant must receive one (1) hour of in-service training per month.

(b)(1) The facility must complete a performance review of each nursing assistant at least once per year and provide regular in-service training based on the outcome of these reviews.

(2) The in-service training should address areas of weakness and be sufficient to ensure the continuing competence of the nursing assistants.

(c)(1) In addition to training needs identified by performance reviews, in-service training should also address the special needs of residents as determined by each facility.

(2) Training can be received on the unit, as long as it is:

(A) Directed toward skills improvement;

(B) Provided by appropriately trained staff; and

(d)(1) Effective July 1, 2006, facilities are strongly encouraged to offer in-service training for nursing-home-employed certified nursing assistants who were certified in Arkansas prior to July 1, 2006, that covers the Barbara Broyles Alzheimer and Dementia Training that is included in the Arkansas Long-Term Care Facility Nursing Assistant Training Curriculum.

(2)(A) Facilities should maintain records that verify each employee who was certified in Arkansas prior to July 1, 2006, has received this training.

(B) After July 1, 2006, and ongoing, the new Alzheimer’s training is strongly encouraged for certified nursing assistants registered in Arkansas through reciprocity from other states and test candidates who are allowed to challenge the state competency test based on exemptions found in 20 CAR § 403-504.

20 CAR § 403-209 Nonpermanent employees {#sec-20-car-403-209 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-209}

20 CAR § 403-209. Nonpermanent employees.

Nursing assistants who are employed or leased through a temporary hiring service must have completed an approved training program and passed the state competency evaluation test prior to employment and utilization by a facility.

Subpart 3

20 CAR § 403-301 Location {#sec-20-car-403-301 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-301}

20 CAR § 403-301. Location.

(a)(1) Nursing assistant training programs may be offered by or in nursing facilities, as well as outside facilities.

(2) The clinical portion of the training must be conducted in all cases and must utilize a nursing facility and its residents.

(3)(A) Nursing facilities may offer a complete training program or may contract with another organization, or both, to provide the training unless they are sanctioned.

(B) Sanctioned nursing facilities cannot offer the training.

(b) Other groups or institutions (examples include but are not limited to employee organizations, vocational or technical schools, community colleges, and private institutions) may conduct programs upon the Department of Human Services’ approval.

(c)(1) Programs offered to the public and charging a tuition fee must submit an application and be approved by the department before they can be licensed through the State Board of Private Career Education.

(2) This provision would not apply to the state schools (such as a vocational, technical, or community college) or programs offered by long-term care facilities who train their own employees or potential on-call employees.

20 CAR § 403-302 Restrictions {#sec-20-car-403-302 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-302}

20 CAR § 403-302. Restrictions.

(a)(1) The Department of Human Services shall not approve a program offered by or in a nursing facility which, in the previous two (2) years, has done the following:

(A) Operated under a waiver of the nurse staffing requirements in excess of forty-eight (48) hours during the week;

(B) Been subjected to an extended survey or partially extended survey; or

(i) A civil money penalty of no less than five thousand dollars ($5,000);

(ii) Denial of payment for new admissions;

(iii) Appointment of temporary management;

(iv) Closure; or

(v) Transfer of residents to another facility.

(2) “Extended survey”, as defined for this section, means a survey which includes a review of facility policy and procedures pertinent to Level A deficiencies in:

(A) Resident rights;

(B) Resident behavior and facility practices;

(D) Quality of care.

(3) “Partial extended survey” means a survey conducted as a result of a deficiency in Level A requirements other than those listed above in the extended survey definition.

(b) Facility-based training programs are prohibited from charging tuitions or training fees to their nursing assistant employees or those who have received an offer of employment for any portion of the program, including any fees for textbooks or other required course materials (see 20 CAR § 403-901 et seq.).

20 CAR § 403-303 Application {#sec-20-car-403-303 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-303}

20 CAR § 403-303. Application.

(a)(1) Each facility or entity that desires to offer a program shall file an Application for Program Approval form prescribed by the Department of Human Services (Form DMS-724).

(2) Application forms are available on the Department of Human Services - Division for Provider Services and Quality Assurance website or you can request an application by emailing: natpcertification@dhs.arkansas.gov.

(b)(1) An outline showing the lesson plans and teaching modules utilized to cover the curriculum contents must be attached to the application.

(2) This should specify the:

(A) Elements covered in each module;

(B) Hours of classroom theory;

(D) Hours in the clinical area in a nursing home.

(3) Each facility’s application must also include the following:

(A) Primary instructor resumes or work history to establish long-term care experience;

(B) Assistant instructor resume or work history to establish long-term care experience;

(D) Professional license verification; and

(E) Additional information, as requested by the department.

(c)(1) When applicable for renewals, verification of school licensure by the State Board of Private Career Education within the Division of Higher Education will be required.

(2) A notarized copy of the school licensure must be included with applications for new programs and for renewal of programs.

(3) Notification to the division verifying additional instructors and any changes in instructors will be required with each application.

(d) Application must be submitted to the department and approved by the department prior to the start of the first course.

(e) An application must be completed and signed by the primary instructor.

(f)(1) Applications that are received incomplete may cause postponement of the program starting date.

(2) A notice of deficiency in the application will be mailed to an applicant within fifteen (15) business days of the date of filing.

(3) The applicant will be given an opportunity to correct any deficiencies.

(g)(1) Notice of approval or disapproval of the application will be given to the entity within fifteen (15) business days of the receipt of a complete application.

(2) If the application is to be disapproved, the reasons for disapproval shall be given in the notice.

(h)(1) An applicant may request a review on a disapproval in writing within ten (10) business days of receipt of the notice of the proposed disapproval to the Director of the Division of Higher Education.

(2) If no request is made, the entity is deemed to have waived the opportunity for a hearing.

20 CAR § 403-304 Changes in programs {#sec-20-car-403-304 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-304}

20 CAR § 403-304. Changes in programs.

(a) Prior to major changes in the course, an application must be resubmitted for approval.

(b) Major changes include, but are not limited to:

(1) Change in training provider;

(2) Change in delivery site, such as from classroom to virtual;

(3) Change in clinical site;

(4) Change in instructor; and

(5) Complete revision of course structure, including change in hours allotted to one (1) or more modules.

(1) Change in materials, such as handouts, textbooks, or videos;

(2) Change in order in which modules are taught; or

(3) Addition of modules or tasks not required by rules or guidelines.

20 CAR § 403-305 Withdrawal of approval {#sec-20-car-403-305 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-305}

20 CAR § 403-305. Withdrawal of approval.

(a)(1) Provisions for monitoring and review of compliance with program requirements are specified in this section.

(2) The Department of Human Services shall withdraw approval of a training program when:

(A) The program has one (1) or more restrictions;

(B)(i) The entity offering the program refuses to permit visits by the department, whether announced or unannounced.

(ii) Any facility that refuses to permit unannounced visits is subject to having its provider agreement terminated;

(D) The program has an excessive failure rate for trainees on the state competency evaluation test over a three-year period and after opportunities to address the failure rate through enhanced monitoring;

(E)(i) Renewal is not completed prior to renewal date.

(ii) Long-Term Care Facility Nursing Assistant Training Program approval will be suspended until renewal is completed and approved;

(F) The program makes or causes to be made any false statement or representation of a material fact used in determining rights or any application for payment by any entity for reimbursement of training costs as allowed in 20 CAR § 403-901 et seq.;

(G) The program makes or causes to be made any false statement or representation that training was provided when training was not provided;

(H) The program makes or causes to be made, or induces or seeks to induce the making of, any false statement or representation of a material fact with respect to the conditions or operation of the program in order for the program to qualify either upon initial approval or reapproval;

(I) The program makes or causes to be made any false statement or representation that the amount of training costs is greater than the actual cost of the training to obtain Medicaid reimbursement, as allowed in 20 CAR § 403-901 et seq., that exceeds the actual cost of training;

(J) The program makes or causes to be made any false statement or representation of a material fact in violation of this part; or

(K) The state determines that any of the applicable requirements of 42 C.F.R. § 483.152 or 42 C.F.R. § 483.154 are not met by the program.

(b) When the state withdraws approval of a nurse aide training and competency evaluation program or competency evaluation program:

(1) The state must notify the program in writing, indicating the reason or reasons for withdrawal of approval from the program; and

(2) Students who have started a training and competency evaluation program from which approval has been withdrawn must be allowed to complete the course.

(c)(1) The program may file for a reconsideration of the withdrawal of approval of a nurse aide training and competency evaluation program within ten (10) business days of the notification.

(2) The reconsideration shall be forwarded to the Division of Higher Education.

Subpart 4

20 CAR § 403-401 Primary instructor {#sec-20-car-403-401 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-401}

20 CAR § 403-401. Primary instructor.

(a) The primary instructor shall:

(1) Be a registered nurse currently licensed in Arkansas or licensed under a compact license, or holding a multistate privilege to practice if the registered nurse moves from a state that has joined the Interstate Nurse Licensure Compact, Arkansas Code § 17-87-601 et seq., to Arkansas and meets all requirements for licensure in Arkansas;

(2)(A) Not be under any current disciplinary action by the Arkansas State Board of Nursing.

(B) Disciplinary action includes, but is not limited to, probation, suspension, revocation, or voluntary surrender of license due to disciplinary action; and

(3)(A) Possess a minimum of two (2) years of general nursing experience as a registered nurse including at least one (1) year of long-term care nursing services in a nursing facility setting within the last ten (10) years (Arkansas Code § 20-10-702).

(B) "General nursing experience" means nursing experience which may include, but is not limited to:

(i) Employment;

(ii) Internship;

(iii) Externship; or

(iv) Other means including working in:

(a) A nursing assistant education program;

(b) A long-term care facility;

(d) A geriatrics department, excluding geriatric psychiatry;

(e) A long-term acute care hospital (recuperative care);

(f) Home healthcare;

(g) Hospice care; or

(h) Other long-term care setting.

(b) In a facility-based program, the training of nursing assistants may be performed under the general supervision of the director of nursing (DON), who is prohibited from performing the actual training (unless replacement DON coverage is provided).

(c)(1) An individual who will be the primary instructor and meets the above criteria must submit the Application for Program Approval (Form DMS-724) to identify their teaching qualifications.

(2) This must include nursing experience, supervisory experience, and either teaching experience or certificate of attendance in an instructor workshop.

(d) The individual must annually submit proof of attendance in an eight-hour class authorized by the Department of Human Services regarding updates to applicable laws and rules, best practices, and common issues encountered in long-term care facilities.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-402 Primary instructor responsibilities {#sec-20-car-403-402 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-402}

20 CAR § 403-402. Primary instructor responsibilities.

(a)(1) There must be only one (1) primary instructor (PI).

(2) A PI may oversee a maximum of four (4) sites.

(3) All questions and correspondence pertaining to the site will be directed to the PI.

(4) The PI shall participate in the planning of each lesson or teaching module, including clinical instruction, whether or not the PI teaches the lesson.

(b) The PI of a nursing assistant training program shall be responsible for supervision of the program and ensuring that the following requirements are met:

(1) Course objectives are accomplished;

(2) Each trainee exhibits the appropriate skills and knowledge to conduct any part of the training;

(3)(A) That each instructor is monitored and evaluated in the classroom, learning laboratory, and clinical training whenever they are teaching an assignment or introducing material for the first time and at periodic intervals.

(B) Performance reviews of instructors must be documented and maintained;

(4)(A) The provision of direct individual care to assigned residents by a trainee is limited to appropriately supervised clinical experience.

(B) Instructors shall serve as supervisor of trainees while in clinical areas and providing resident care;

(5)(A) Each trainee shall demonstrate competence in clinical skills and fundamental principles of resident care.

(B) The task performance record must be approved and signed or initialed by the primary instructor;

(6)(A) Records are kept in order to verify the participation and performance of each trainee in each phase of the training program.

(B) Satisfactory completion of the training program shall be attested on each trainee's record; and

(7) Each trainee is issued a certificate of completion within ten (10) calendar days of course completion and as described in 20 CAR § 403-203(g).

20 CAR § 403-403 Additional instructor or guest speaker {#sec-20-car-403-403 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-403}

20 CAR § 403-403. Additional instructor or guest speaker.

(a)(1) Instructors may use other qualified resource personnel from the health field as guest instructors or speakers in the program to meet the objectives for a specific unit.

(2) Examples include but are not limited to:

(A) Pharmacists;

(B) Dietitians;

(D) Sanitarians;

(E) Advocates;

(F) Gerontologists;

(G) Nursing home administrators; and

(H) Nurse aid program staff.

(3) Guest instructors must have a minimum of one (1) year of experience in their respective fields and must not have current disciplinary action by their respective regulatory board.

(b)(1) Additional instructors such as registered nurses or licensed practical nurses may be used to provide instruction, skills training, or supervision.

(2) They must be under the general supervision of the primary instructor, currently licensed in Arkansas, and shall not be subject to any current disciplinary action by the Arkansas State Board of Nursing.

(3) Disciplinary action includes, but is not limited to, probation, suspension, revocation, or voluntary surrender of license due to disciplinary action, and have a minimum of one (1) year of long-term care experience.

(4) All final skills check-off reviews must be approved by the primary instructor.

(c) The Application of Program Approval (Form DMS-724) shall be used to identify each additional instructor or guest speaker and their qualifications to teach.

Subpart 5

20 CAR § 403-501 Transition {#sec-20-car-403-501 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-501}

20 CAR § 403-501. Transition.

The initial implementation of these training and examination requirements has covered three (3) basic phases:

(1)(A) Deemed equivalence waivers.

(B) A nursing assistant shall be deemed to have satisfied the requirement of completing a training and competency examination program approved by the state if the nursing assistant:

(i) Completed a program that offered a minimum of sixty (60) hours of nursing assistant training before July 1, 1989, and if such received before July 1, 1989, up to fifteen (15) hours of supervised and practical nursing assistant training or regular in-service nursing assistant education (initial training must be at least seventy-five (75) hours of classroom instruction, as well as sixteen (16) hours of supervised practical training, a total of ninety-one (91) hours);

(ii) Completed a course of at least one hundred (100) hours of nursing assistant training and was found competent, whether by the state or not, before January 1, 1989; or

(iii) Has served as a nursing assistant at one (1) or more facilities of the same employer in the state for at least twenty-four (24) consecutive months before December 19, 1989.

(C)(i) Individuals will not qualify for these waivers if they have not provided nursing or nursing-related services for a period of twenty-four (24) months or longer since completing training.

(ii) They will be required to complete a new training program and state examination to obtain current certification.

(D) Facilities who wish to obtain certification for the above-described individuals should submit to the Department of Human Services an Interstate Transfer Form (DMS-798) with attached copies of documents or certificates verifying course completion and the number of hours in a course;

(2)(A) Employment status as of July 1, 1989.

(B) All individuals working as nursing assistants in Arkansas nursing facilities as of July 1, 1989, were allowed to become certified by passing the state examination.

(D) These ninety-one (91) hours consisted of seventy-five (75) hours of formal classroom training course as well as sixteen (16) hours of supervised practical training.

(E) After October 1, 1990, nursing assistants must now complete the ninety-one-hour training requirements to qualify to take the state examination, regardless of past employment status on July 1, 1989; and

(3)(A) July 1, 1989 – ongoing.

(B) Effective July 1, 1989, a facility must not use any individual working in the facility as a nursing assistant for more than four (4) months (one hundred twenty (120) calendar days) unless they have successfully completed a training program and competency examination approved by the department, as described in this part.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-502 Examination {#sec-20-car-403-502 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-502}

20 CAR § 403-502. Examination.

(a)(1) The Department of Human Services or its appointed agency shall be responsible for administering the competency examination.

(2) The examination shall be based upon the training curriculum requirements specified in the Arkansas Long-Term Care Facility Nursing Assistant Training Curriculum.

(b)(1) The examination will be in English.

(2) Translation of this examination will be offered, if needed.

(3) Additional accommodations can be made by the department or contractor based on a documented need, however, an additional fee may be required.

(c)(1) The competency examination shall consist of two (2) components, a written or oral examination and a skills demonstration.

(2) Each examination candidate will be allowed to choose between a written or oral examination.

(3) The oral examination will be read from a prepared text in a neutral manner.

(d)(1) Foreign language translation dictionaries must be shown to the registered nurse test observer at check-in and to the knowledge test proctor when entering the knowledge test room.

(2) No electronic dictionaries are allowed.

(3)(A) No definitions or instances of writing are allowed in the translation dictionary.

(B) If there are any definitions or instances of writing, the translation dictionary will not be permitted to be used during testing.

(e)(1) The written or oral component shall be developed from a pool of examination questions.

(2) Only a portion will be used in the exam.

(3) The skills demonstration shall consist of five (5) randomly selected questions drawn from a pool of tasks ranked based on the level of difficulty.

(f) The skills demonstration component will be performed in a facility, not disqualified by criteria specified in 20 CAR § 403-402, or laboratory setting.

(g) The skills demonstration will be administered and evaluated by a registered nurse (RN) with at least one (1) year experience in providing care for the elderly or chronically ill.

(h)(1) The skills demonstration component may be proctored by facility or training site personnel, RNs as described above, if secure, standardized, and scored by the contractor approved by the department.

(2) Proctoring will not be approved in facilities prohibited as specified in 20 CAR § 403-402.

(i)(1) To complete the competency examination successfully, an individual must pass both the written or oral examination and the skills demonstration.

(2) If an individual does not complete the examination satisfactorily, they will be advised of areas which they did not pass and their right to take the examination two (2) more times.

(j)(1) All candidates will be allowed up to three (3) attempts within a twelve-month period to successfully complete all portions of the competency examination.

(2) Failure after three (3) attempts will require retraining in order to qualify to sit for the competency examination.

(3) An individual has twelve (12) months to successfully pass the test after retraining.

(k)(1) Any trainee who is employed by any long-term care facility and fails any portion of the competency examination after three (3) attempts is prohibited from providing nursing services to residents in a long-term care facility.

(2) Based on the program rules, these individuals may maintain their employment status if they re-enroll in a new training program.

(3) They would be required to follow the program implementation requirements of completing the first sixteen (16) hours (Part I) of training, prior to direct resident contact, and can only be assigned job duties thereafter in which they have been deemed competent to perform as they complete the remainder of the full ninety-one (91) hours of training.

(4) Upon successful completion of their training, they should be scheduled for the next available competency examination.

(l)(1) All individuals who successfully complete the examination shall be placed on the Certified Nursing Assistant/Employment Clearance Registry and issued a state certificate.

(2) Information on the registry shall be made available for public inquiry (see 20 CAR § 403-701 et seq.).

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-503 Examination fees, dates, and locations {#sec-20-car-403-503 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-503}

20 CAR § 403-503. Examination fees, dates, and locations.

(a)(1) The Department of Human Services does not require an initial fee for this occupational license, however, there is a fee to take the state examination.

(2) The amount of the examination fee will be announced in a timely manner by the department or designated contractor.

(b) If there were to be an initial fee, per Arkansas Code § 17-5-104, the following individuals would not be required to pay an initial fee for this license:

(1) An individual receiving assistance through the:

(A) Arkansas Medicaid Program;

(B) Supplemental Nutrition Assistance Program;

(D) Temporary Assistance for Needy Families Program; or

(E) Lifeline Assistance Program;

(2) An individual who was approved for unemployment within the last twelve(12) months; or

(3) An individual who has an income that does not exceed two hundred percent (200%) of the federal poverty income guidelines.

(1) A criminal background check;

(2) An examination or a test; or

(3) A medical or drug test.

(d)(1) The examination will be given at multiple sites geographically dispersed throughout the state.

(2) Schedules of times, locations, and registration requirements will be announced in a timely manner by the department or designated contractor.

(e) The competency examination, including written, oral, and skills components, may be administered in the facility of the candidate’s employment unless the facility is disqualified by the department under criteria specified in 20 CAR § 403-402.

(f) Each candidate must have appropriate verification of the training requirements (see 20 CAR § 403-301 et seq., and 20 CAR § 403-504).

(g)(1) The department will be responsible for paying the examination fee one (1) time for individuals who are employed by a Medicaid-certified long-term nursing facility or those individuals that have a commitment (letter of intent as defined in 20 CAR § 403-901(b)) to be employed in a Medicaid-certified nursing facility.

(2) Letters of intent to hire from Medicaid-certified nursing facilities must be dated within twelve (12) months immediately preceding the date of the application to take the examination.

(3) Independent examination candidates who are taking the competency examination without an employment connection to a long-term care facility will be responsible to pay their own examination fee.

(4) In accordance with 42 C.F.R. § 483.154, no nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide competency examination program may be charged for any portion of the program.

(5) If an individual who is not employed, or does not have an offer to be employed, as a nurse aide becomes employed by, or receives an offer of employment from, a facility not later than twelve (12) months after completing a nurse aide training and competency examination program, the state must provide for the reimbursement of costs incurred in completing the program on a pro rata basis during the period in which the individual is employed as a nurse aide.

20 CAR § 403-504 Candidate qualifications {#sec-20-car-403-504 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-504}

20 CAR § 403-504. Candidate qualifications.

(a)(1) The following is a list of qualifications for the state competency exam:

(A) Nursing assistants who were trained in approved nonfacility programs, for example, career colleges, vocational or technical schools, or proprietary schools, after January 1, 1989;

(B) Nursing assistants who were trained in approved facility (nursing homes) programs after July 1, 1989;

(C)(i) Registered nurses or students who have finished the basic nursing course, for example, Introduction to Nursing or Fundamentals of Nursing.

(ii) The individual must provide a copy of their school transcript or documentation showing successful completion of the basic nursing course to qualify for the state competency examination;

(D) Registered nurses or licensed practical nurses that have had disciplinary action resulting in suspension, revocation, or voluntary surrender of license due to disciplinary action shall not be allowed an exemption to training or be allowed to challenge the state examination;

(E)(i) Home health aides who have met appropriate federal training or examination requirements for home health aide certification.

(ii) Verification must show completion of a minimum of seventy-five (75) hours classroom training and sixteen (16) hours of supervised practical training or federal testing requirements as a home health aide.

(iii) This provision does not apply to personal care aides as their training requirements of forty (40) hours do not meet the ninety-one-hour requirement for the Long-Term Care Facility Nursing Assistant Training Program;

(F)(i) Individuals from other states who can verify completion of a state-approved geriatric nursing assistant training program but were not tested and registered.

(ii) If registered in the other state, see 20 CAR § 403-505 for reciprocity transfers without further examination.

(iii) Verification of course completion rests with the individual and must be submitted to the Department of Human Services-designated contractor for approval to take the Arkansas competency examination; and

(G)(i) Nursing assistants whose certification has become inactive based on the recertification requirements (see 20 CAR § 403-603).

(ii) These individuals shall be required to be retested for recertification.

(iii) Permission for retesting shall require an admission slip obtained from the examination agency prior to the specified examination date.

(iv) Note. Individuals listed on the long-term care facility Certified Nursing Assistant/Employment Clearance Registry with a disqualification status due to a substantiated administrative finding of abuse, neglect, misappropriation of resident property, or a disqualifying criminal record in accordance with Arkansas Code § 20-38-101 et seq., shall not be eligible to take the competency examination.

(b)(1) All other individuals trained in programs that have not received approval from the department as a training provider shall not qualify and shall not be allowed to take the examination.

(2) Such programs may include hospitals, emergency medical technicians, medical assistant programs, personal care aides, correspondence courses, independent study, on-the-job training, or in-service training, as they are not acceptable in lieu of the approved training program.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-505 Certified nursing assistant licensure of uniformed service members, veterans, and spouses {#sec-20-car-403-505 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-505}

20 CAR § 403-505. Certified nursing assistant licensure of uniformed service members, veterans, and spouses.

(a) Pursuant to Arkansas Code § 17-4-101 et seq., the following rules apply to licensure for uniformed service members, uniformed service veterans, and their spouses for licensure as defined below:

(1) A uniformed service member stationed in the State of Arkansas;

(2) A uniformed service veteran who resides in or establishes residency in the State of Arkansas; and

(3) The spouse of:

(A) A uniformed service member stationed in the State of Arkansas;

(B) A uniformed service veteran who resides in or establishes residency in the State of Arkansas;

(C) A uniformed service member who is assigned a tour of duty that excludes the uniformed service member's spouse from accompanying the uniformed service member and the spouse relocates to this state; and

(D) A uniformed service member who is killed or succumbs to their injuries or illness in the line of duty if the spouse establishes residency in the state.

(b) Automatic certified nursing assistant licensure.

(1) Automatic certified nursing assistant licensure will be provided to current license holders to expedite their entry into the workforce of this state by means of reciprocity.

(2) Reciprocity may be granted without further training or testing.

(3) The process of reciprocity includes the following:

(A) Completion of an application with all required forms;

(B) Submission of DD 214/DD-214/separation documents;

(D) Submission of an image or copy of individual's Social Security card;

(E) Submission of an image or copy of valid United States Government-issued photo identification; and

(F) Proof of service education, training, experience, and service-issued credentials by means of a joint service transcript.

(1) Completion of a training and competency evaluation program to become registered as a nursing assistant in another state, territory, or district of the United States that meets federal guidelines; and

(2) A holder in good standing with certified nursing assistant licensure within a similar scope of practice by another state, territory, or district of the United States.

(d) Temporary or provisional certified nursing assistant licensure.

(1) A temporary or provisional certified nursing assistant licensure will be granted to a uniformed service member, or their spouse, or a uniformed service veteran, or their spouse, while expediting full licensure when considering an application for initial licensure.

(2)(A) The Department of Human Services will consider education, training, national certification, experience, and service-issued credentials of uniformed service members and uniformed service veterans that are applying for initial certified nursing assistant licensure.

(B) The following criteria will be classified as meeting service education, training, national certification, experience, and credentials:

(i) Ninety-one (91) hours of approved education, training, or experience in healthcare; or

(ii) Passing the Arkansas nurse aide testing with three (3) given attempts within one hundred eighty (180) days post application.

(e) Extension of license expiration and continuing education requirements for uniformed service members, uniformed service veterans, and their spouses. The department will extend the expiration date and any continuing education requirements for certified nursing assistant licensure renewal for a deployed uniformed service member or their spouse as follows:

(1) An extension of the expiration date of a certified nursing assistant licensure for one hundred eighty (180) days following the date of the uniformed service member’s return from deployment; and

(2)(A) An extension from continuing education requirements for one hundred eighty (180) days following the date of the uniformed service member or from the uniformed service member’s return from deployment.

(B) The department may require evidence of completion of continuing education before granting a subsequent certified nursing assistant licensure or authorizing the renewal of a certified nursing assistant licensure to allow full or partial exemption from continuing education requirements.

(f)(1) Uniformed service members, veterans, and spouses who successfully meet the criteria and standards within the provisions shall be placed on the Certified Nursing Assistant/Employment Clearance Registry and issued a state certificate.

(2) Information regarding military member licensure can be found on the Department of Human Services - Division of Provider Services and Quality Assurance website.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-506 Automatic occupational licensure of out-of-state individuals {#sec-20-car-403-506 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-506}

20 CAR § 403-506. Automatic occupational licensure of out-of-state individuals.

(a) Pursuant to the Automatic Occupational Licensure for Out-of-State Licensure Act, Arkansas Code § 17-7-101 et seq., a nursing assistant from another state may qualify as a nursing assistant in Arkansas if they meet the following criteria and provide documentation that reflects this:

(1) They do not have a disqualifying criminal offense under Arkansas Code § 17-3-102 or any additional state law relating to the occupational licensure;

(2) They do not have a complaint, allegation, or investigation pending for their occupational activity; or

(3) They are in good standing for one (1) year with an occupational licensure of similar scope of practice issued by another state, territory, or district of the United States or they have worked:

(A) In another state, territory, or district of the United States that does not use an occupational licensure to regulate an occupation or profession but is regulated by occupational licensure in this state; and

(B) At least three (3) years in the occupation.

(b) An individual who is granted automatic occupational licensure under this section shall meet all other occupational licensure requirements for a resident of this state and all renewal requirements of the occupational licensure, including without limitation a criminal background check and continuing education hours.

(d) The department shall require an applicant to furnish a bond, financial statement, or proof of insurance coverage, if required by state law.

Subpart 6

20 CAR § 403-601 Function and content {#sec-20-car-403-601 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-601}

20 CAR § 403-601. Function and content.

(a)(1) The Department of Human Services shall establish and maintain a registry of all individuals who have satisfactorily completed the training and competency examination program requirements.

(2) The Certified Nursing Assistant/Employment Clearance Registry shall be incorporated into the Adult and Long-term Care Facility Resident Maltreatment Central Registry which shall include substantiated administrative findings of abuse, neglect, or misappropriation of resident property for certified nursing assistants.

(b) The information in the Certified Nursing Assistant/Employment Clearance Registry shall be made available to the public and open for inquiries twenty-four (24) hours per day, seven (7) days per week, except for scheduled maintenance or at times of technical problems, by computer through an online website system (see 20 CAR § 403-602).

(c) The Certified Nursing Assistant/Employment Clearance Registry record, for each individual who has successfully obtained certification as a long-term care facility nursing assistant shall contain the following information:

(1) Individual’s full name;

(2) Date of birth;

(3) Name and date of the successfully completed state-approved training program;

(4) Certification number and date of issuance;

(5) Current active or inactive status; and

(6) Most recent recertification date.

(d)(1) The department shall review and investigate allegations of neglect, abuse, or misappropriation of resident property by a nursing assistant.

(2) A nursing assistant shall be given written notice by the department of a finding on an allegation and must request, in writing, a formal hearing within thirty (30) days of receipt of the notice, or the right to a hearing shall be waived.

(3) Following any appeal, the Certified Nursing Assistant/Employment Clearance Registry and the nursing assistant shall be notified of the findings.

(4) If the finding is substantiated either by the individual’s failure to appeal or by issuance of a final administrative order, the Certified Nursing Assistant/Employment Clearance Registry shall include the documented findings involving an individual listed in the Certified Nursing Assistant/Employment Clearance Registry, as well as any brief statement of the individual disputing the findings (see 20 CAR § 403-604 for the process to petition to remove findings of neglect).

(e)(1) The department, in the case of inquiries to the Certified Nursing Assistant/Employment Clearance Registry, shall verify if the individual is listed in the Certified Nursing Assistant/Employment Clearance Registry and shall disclose any information concerning a finding of resident neglect, resident abuse, or misappropriation of resident property involving an individual listed in the Certified Nursing Assistant/Employment Clearance Registry.

(2) It shall also disclose any statement by the individual related to the finding or a clear and accurate summary of such a statement.

20 CAR § 403-602 Inquiry process {#sec-20-car-403-602 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-602}

20 CAR § 403-602. Inquiry process.

(a)(1) A facility must inquire of the Certified Nursing Assistant/Employment Clearance Registry as to information in the registry concerning any individual to be used as a nursing assistant.

(2) A facility may not use an individual as a nursing assistant until registry inquiry and clearance is obtained.

(3) Registry inquiries shall be performed within five (5) calendar days of the offer of employment and prior to any resident contact.

(4) A facility must document all inquiries and must include such documentation in the personnel file of each nursing assistant used by the facility.

(b)(1) Registry clearance shall be obtained by computer access to the online website system.

(2) The URL address to the online website system shall be issued by the Department of Human Services, or its designated agent, and may be subject to change.

(3) If needed, facilities should contact the department for the latest website information.

(c)(1) The online website system will maintain an internal log of each inquiry made by Arkansas nursing facilities using a numeric code (registry identification number) assigned to each facility.

(2) The internal log shall be monitored by the department to verify each facility’s compliance with inquiry requirements.

(d)(1) The online website system is capable of providing a printable registry clearance verification report document for the nursing facility’s use in recordkeeping.

(2) The facility shall be required to print the registry clearance report and maintain this report in the employee’s personnel file.

(e)(1) Registry clearances accessed through the online system require the nursing assistant’s Social Security number and date of birth.

(2) Facilities must have the Social Security number or certification number in order to ensure an accurate inquiry.

(3) Name searches are possible on the online system but accuracy is not assured.

(4)(A) Name searches may also be obtained by calling the department.

(B)(i) Please note, however, that name searches by calling the department do not generate a verification log of the clearance.

(ii) Therefore, facilities shall avoid the use of name searches when the need for documentation and accuracy of the registry check is required.

History

Codification Notes: “URL” means Uniform Resource Locator. Authority: Arkansas Code § 20-10-705

20 CAR § 403-603 Certification renewal {#sec-20-car-403-603 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-603}

20 CAR § 403-603. Certification renewal.

(a)(1) The initial certification period is valid for twenty-four (24) months.

(2) Each certificate contains an expiration date.

(3) The Department of Human Services will develop a plan and procedure to renew each nursing assistant certification listed in the Certified Nursing Assistant/Employment Clearance Registry on a biennial basis (every two (2) years).

(4) The renewal process will require the nursing assistant to document having worked as a nursing assistant for monetary compensation during the prior two (2) years.

(5) This provision shall be defined by at least one (1) documented day (meaning eight (8) hours) of employment providing nursing or nursing-related services for monetary compensation in any setting.

(b) Certified nursing assistants who provide services for private pay clients must include a check stub and a notarized letter from the employer, which should include certified nursing assistant duties performed within the twenty-four-month period to verify current employment or employment within the last twenty-four-month period.

(c)(1) Employing facilities or individuals shall be required to submit updated information to the Certified Nursing Assistant/Employment Clearance Registry to establish ongoing eligibility for active status.

(2) The Certified Nursing Assistant/Employment Clearance Registry shall make inactive those individuals who cannot document having worked in an aide capacity within a twenty-four-month period.

(3) Nursing assistants who are currently employed as a nursing assistant at the time of their renewal will be renewed for twenty-four (24) months.

(4) Nursing assistants who are not currently employed will be renewed for twenty-four (24) months beginning with the last day employed as a nursing assistant.

(5) A certification that has been expired for a period longer than twenty-four (24) months cannot be renewed and the individual shall retest and complete sixteen (16) hours of clinical training to recertify to an active status.

(d) An individual will be required to successfully complete a new competency evaluation test to become recertified (see 20 CAR § 403-504(a)(1)(G)), if documentation of having worked in an aide capacity within the previous twenty-four-month period cannot be provided, or for any certification that has been expired for over twenty-four (24) months.

(e)(1) The process to renew a nursing assistant certification shall be overseen by the department or its agent.

(2) Each certified nursing assistant shall be responsible for renewing their certification online approximately sixty (60) calendar days before the expiration of their certification.

(f)(1) Individuals listed on the Adult and Long-term Care Facility Resident Maltreatment Central Registry with a disqualification status due to a substantiated administrative finding of abuse, neglect, misappropriation of resident property, or a disqualifying criminal record in accordance with Arkansas Code § 20-38-101 et seq., shall not be eligible to renew their certification.

(2) Individuals approved for removal of a neglect finding pursuant to 20 CAR § 403-604 shall be eligible to renew their certification.

(g) Nursing assistant certifications may not be renewed more than sixty (60) calendar days prior to the expiration date.

(h)(1) Renewals may be completed through the online website.

(2) The department or its designated agent shall provide instructions for the online renewal process.

(i)(1) The Certified Nursing Assistant/Employment Clearance Registry renewal must be fully completed by the certified nursing assistants and the information must be accurate to the best of their knowledge.

(2) Failure to fully complete the renewal or provide false or inaccurate information shall constitute the basis for denial of certification renewal.

(j) When a nursing assistant renewal is processed and the nursing assistant is determined to be eligible for renewal, a new certificate showing the new expiration date will be available online for the certified nursing assistant to print and their Certified Nursing Assistant/Employment Clearance Registry record shall be updated to reflect the new certification period.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-604 Petition to remove neglect findings {#sec-20-car-403-604 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-604}

20 CAR § 403-604. Petition to remove neglect findings.

(a) Pursuant to federal law 42 U.S.C. § 1395i-3(g)(1)(D), in the case of a finding of neglect under 20 CAR § 403-601, the Department of Human Services shall establish a procedure that permits a certified nursing assistant to petition for the removal of a substantiated finding of neglect.

(b) Factors that must be met are:

(1)(A) The certified nursing assistant must have a substantiated finding of neglect.

(B) There shall not be a petition process available for substantiated findings of:

(i) Physical abuse;

(ii) Verbal abuse; or

(iii) Misappropriation of resident property;

(2)(A) The department makes a determination that the petitioner’s employment and personnel record does not reflect a pattern of abusive behavior or neglect.

(B) Factors to be considered shall include, but shall not be limited to:

(i) The neglect that resulted in a finding was a singular occurrence as identified in the incident investigation file;

(ii) The petitioner does not have a criminal conviction related to neglect, abusive behavior, or physical violence;

(iii) The petitioner’s name does not appear on the Adult and Long-term Care Facility Resident Maltreatment Central Registry or the department or the Division of Children and Family Services’ Child Maltreatment Central Registry;

(iv) Whether a pattern of abusive behavior or neglect is discovered through reference checks with prior employers or other parties; and

(v) Character references as provided by the petitioner; and

(3) At least one (1) year has passed since the petitioner’s substantiated finding of neglect was placed on the Adult and Long-term Care Facility Resident Maltreatment Central Registry or the Child Maltreatment Central Registry.

(1)(A) Petitioner shall submit a letter requesting the removal of the neglect finding.

(B) The letter shall be addressed to:

Division of Provider Services and Quality Assurance Nursing Assistant Training Program Mail Slot S-405 P.O. Box 8059 Little Rock, AR 72203-8059

; and

(2) The petitioner must provide the following information with their request letter:

(A) Full name and current mailing address;

(B) Daytime phone number;

(D) Date of birth;

(E) Name and daytime phone number of at least two (2) personal character references;

(F)(i) Letter of reference from any employment within the previous year from the date of the petition.

(ii) This letter must include a statement attesting to the petitioner’s work performance in relation to the lack of any incidents involving abusive or negligent behavior; and

(G)(i) A current criminal record report from the Division of Arkansas State Police.

(ii) If the petitioner is currently or has recently (within the previous twelve (12) months) lived in another state, a criminal record report must be provided from that state.

(iii) All criminal record reports must be an original document and copies will not be accepted.

(d)(1) The department shall review each petition for consideration for removal of the neglect finding.

(2)(A) The review shall be conducted by an administrative review panel consisting of at least three (3) members appointed by the Director of the Division of Provider Services and Quality Assurance.

(B) The panel shall meet within thirty (30) days of any petition.

(C) The review panel shall consider all information submitted by the petitioner and may conduct additional research as needed.

(e) The review panel shall render a decision within thirty (30) calendar days of the panel’s review, and the petitioner shall be notified in writing within ten (10) business days of the review committee’s final determination.

(f)(1) If the petition to remove the neglect finding is approved, the Certified Nursing Assistant/Employment Clearance Registry shall be updated within ten (10) business days to show the petitioner no longer has the neglect record and shall be eligible for employment in Arkansas long-term care facilities.

(2) Note that any certified nursing assistant whose certification has been expired for over twenty-four (24) months must successfully complete the state competency test to reestablish employment eligibility as a certified nursing assistant.

(g) Any applicant whose petition has been denied may not reapply for a subsequent petition request for a period of at least twelve (12) months from the date of the previous denial.

(h) If the petition to remove the neglect finding is denied by the review panel, any further appeals of the committee’s determination shall be based on the appeals procedures as listed below:

(1) Administrative hearings are available to persons, herein referred to as petitioners, who disagree with determinations to deny a petition to remove a neglect finding made by the department as described in this part;

(2)(A) If a petitioner wishes to appeal, they may do so by mailing a written notice of appeal to:

Office of Appeals and Hearings Arkansas Department of Human Services P.O. Box 1437-Slot S101 Little Rock, Arkansas 72203

(B) The notice shall be mailed by certified mail, with return receipt requested.

(i) Name of the petitioner;

(ii) Address of the petitioner;

(iii) Date of birth of the petitioner;

(iv) Phone number, if any, of the petitioner;

(v) The petitioner's place of employment; and

(vi) A short statement explaining why the petitioner believes the determination or decision is in error;

(3)(A) The notice of appeal must be postmarked by the Office of Appeals and Hearings within thirty (30) calendar days from the receipt of the notification of denial of the petition.

(B) No appeal shall be accepted after thirty (30) calendar days of receipt of the determination or decision; and

(4)(A) A hearing shall be conducted by the Office of Appeals and Hearings.

(B) The procedures to conduct the hearing are as follows:

(i)(a) The hearing record will contain all documents, exhibits, and testimony admitted into evidence by the hearing officer.

(b) Within twenty (20) calendar days of receipt of notice that a petitioner has requested a hearing, the petitioner and the department will prepare a file to be submitted to the Office of Appeals and Hearings and mail a copy of the file by certified mail, return receipt requested, to the other party.

(d) The department will also submit an administrative hearing statement summarizing the determination or decision. This statement is not evidence.

(e) Only such portions of each file as determined by the hearing officer to be relevant shall be included in the administrative hearing record;

(ii)(a) Both parties will be advised by the Office of Appeals and Hearings via certified mail, return receipt requested, that they have ten (10) calendar days from the date the certified mail receipt was signed in order to review the hearing file and submit a request to subpoena witnesses.

(b) The request shall include the name, address, and telephone number of all witnesses not employed by the department.

(c) Department employees will be expected to attend hearings and present testimony without the benefit of a subpoena and will be notified by the Office of Appeals and Hearings of their required presence at the hearing.

(d) Each party will be notified of any witnesses requested and will have five (5) business days from the receipt of this notice to request subpoenas for rebuttal witnesses.

(e) The Office of Chief Counsel will issue the subpoenas, pursuant to the terms and authority of Arkansas Code § 20-76-103;

(iii)(a) After the time frame has expired for subpoenaing witnesses, the hearing officer will schedule the hearing to afford the petitioner, the department, and their attorneys, if any, at least ten (10) calendar days’ notice of the date, place, and time of the hearing.

(b) The scheduling letter, sent via certified mail with return receipt requested, shall also contain the name of the hearing officer who will conduct the hearing.

(c) In the event that the petitioner, the department representative, or an attorney representing the petitioner suffers from illness or cannot attend the hearing due to scheduling conflicts, that party may request the hearing be continued.

(d) The hearing will be rescheduled by the hearing officer upon a showing of good cause.

(e) A request for continuance made by the petitioner or the petitioner's attorney will constitute a waiver of any objection as to timeliness of the hearing.

(f) In each case, the hearing and hearing record must be completed within one hundred twenty (120) calendar days of receipt of the request for a hearing;

(iv)(a) The hearing will take place at a place, time, and manner determined by the Office of Appeals and Hearings.

(b) Hearings may be conducted by telephone, by personal appearance of the parties, or by record review by the Office of Appeals and Hearings;

(v)(a) If the petitioner fails to appear for the hearing when conducted by telephone or by personal appearance of the parties and does not contact the Office of Appeals and Hearings prior to the date of the hearing of their inability to attend, the appeal will be deemed abandoned.

(b) The petitioner will be advised of this fact in the scheduling letter;

(vi)(a) It is the responsibility of the department to designate a representative prior to the time of the hearing.

(b) The representative should be familiar with the circumstances of the determination or decision and be able to summarize the pertinent aspects of the situation and present the documentation to support the basis for the determination or decision.

(c) The representative should also be able to answer questions posed by the petitioner or the hearing officer relative to the issues and should be prepared to cross-examine adverse witnesses.

(d) The representative may request the services of an Office of Chief Counsel attorney for representation at the hearing;

(vii)(a) If any party is to be represented by an attorney, notice shall be given to all parties and to the Office of Appeals and Hearings at least ten (10) calendar days prior to the hearing.

(b) Failure to furnish notice shall entitle other parties to a continuance to obtain counsel.

(viii) The hearing will be conducted by a hearing officer from the Office of Appeals and Hearings who had no part in the determination or decision upon which the hearing is being conducted;

(ix) The petitioner may be accompanied by friends or other persons and may be represented by a friend, legal counsel, or other designated representative;

(x) The hearing officer may not review the case record or other material either prior to or during the hearing unless such material is made available to the petitioner or their representative;

(xi)(a) The hearing will be conducted in an informal but orderly manner.

(b) The hearing officer will explain the hearing procedure to the petitioner.

(d) The department shall then present its case.

(e) After completion of the department’s case, the petitioner's case will be presented.

(f) The parties shall have the opportunity to present witnesses, advance arguments, offer additional evidence, and to confront and cross-examine adverse witnesses.

(g) If the petitioner is unable to present their evidence in a logical manner, the hearing officer will assist the petitioner.

(h) Questioning of all parties will be confined to the issue or issues involved;

(xii)(a) The hearing officer will prepare a comprehensive report of the proceedings.

(b) The report will consist of an introduction, findings of fact, conclusions of law, and decision.

(d) The determination shall be mailed to the petitioner and the department; and

(xiii) Any further review must be pursued in accordance with the Arkansas Administrative Procedure Act, Arkansas Code § 25-15-201 et seq.

Subpart 7

20 CAR § 403-701 Monitoring {#sec-20-car-403-701 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-701}

20 CAR § 403-701. Monitoring.

(a)(1) A program is subject to inspection at any reasonable time by personnel that are authorized by the Department of Human Services.

(2) After initial approval of a training program, the department has the right to do an onsite or virtual visit review to determine the program's implementation of and compliance with the requirements.

(3) To ensure ongoing compliance, the department has the right to complete unannounced, onsite, or virtual visits at a minimum of once every two (2) years.

(b)(1) Program reviews may be comprehensive or partial.

(2) Based on the findings of the most current review or overall test scores, a program may be reviewed more often and in depth.

(c)(1) The inspector will generate a report that will specify strengths and deficiencies of the program.

(2) The department will terminate programs that do not meet minimum requirements and that do not provide an acceptable plan for correcting deficiencies within the specified timeframe as established by the department.

(d) The program will be able to reapply for in-person or virtual instruction after the one-year suspension.

(e)(1) If a training program is deficient, a corrective action plan must be submitted to the department within ten (10) business days of receiving the notification.

(2) The corrective action plan may be returned to the program for further clarification if the plan does not accurately describe a plan that corrects the deficient practice.

(3) The department will send notification to the program upon approval of the corrective action plan.

(4) The corrective action plan must include, at a minimum, the following:

(A) Activities to correct deficiencies;

(B) Person responsible for correcting the deficiencies;

(D) Signature of the primary instructor.

(5) Failure to respond or inadequate corrective actions may cause suspension of the department’s approval of the program.

20 CAR § 403-702 Items subject to monitoring {#sec-20-car-403-702 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-702}

20 CAR § 403-702. Items subject to monitoring.

(a) Maintenance of secure records.

(1) Each training program shall provide for secure maintenance of records.

(2) Records to be maintained and protected shall include, at a minimum, the following:

(A) Names of enrollees;

(B) Names of those who successfully complete the program;

(D) Curriculum and any revisions of curriculum, with approval from the Department of Human Services;

(E) Tests, grades, course documents, skills checklist;

(F) Credentials of instructors;

(G) Documentation of all state approvals; and

(H) Record of complaints, for example:

(i) Nature of complaint;

(ii) Date of complaint;

(iii) Investigation summary; and

(iv) Outcome.

(b) Compliance with the following program-related curriculum content:

(1) Program length;

(2) Ratio of classroom-to-skills training;

(3) Qualifications of instructors;

(4) Quality of skills training supervision;

(5) Access for clinical training in a nursing facility that was not disqualified based on criteria specified in 20 CAR § 403-402;

(6) Physical (classroom and lab) facilities; and

(7) Virtual classroom capabilities.

(c) Quality of care. The quality of care provided by individual nursing assistants monitored during a licensing survey or certification survey.

(d) Success rate. The graduates' success rate of both virtual and in-person trainees on the state competency examination:

(1) Will be monitored by the department; and

(2) Shall be utilized as a criterion for revoking program approval.

(e) Any other requirements included in this part.

Subpart 8

20 CAR § 403-801 Virtual instruction only applies to lecture portion of training {#sec-20-car-403-801 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-801}

20 CAR § 403-801. Virtual instruction only applies to lecture portion of training.

(a) All content taught to students remains the same whether the program offers in-person or virtual instruction.

(b)(1) If the program chooses to offer virtual instruction, the expectation of delivery of information remains the same as in-person.

(2) Virtual instruction must be indicated on the application and a virtual plan must be submitted to the Department of Human Services for approval.

(3) If the program fails to meet the guidelines, it will result in temporary suspension, deficiency, or both.

(1)(A) A program is subject to inspection of virtual instruction at any time by department personnel.

(B) A program that provides virtual instruction must have practical capabilities and set forth expectations including, but not limited to, the following:

(i) Internet capabilities for the program and the participants;

(ii) Requirements of logging into the virtual site at least fifteen (15) minutes prior to the beginning of class and staying connected virtually until class ends;

(iii) A camera that is turned on during instruction; and

(iv) Individual logins that must be tracked and maintained for auditing purposes by the department;

(2)(A) Virtual programs are responsible for ensuring that the department has the virtual link to audit compliance with this part.

(B) The link must be functional and active at all times;

(3)(A) All participants must be able to have visible access to observe all curriculum activities.

(B) Examples include, but are not limited to, hands-on demonstration, notes on board, and all instruction provided by the program;

(4) All videos to be viewed must be included in the curriculum for in-person and virtual training;

(5) All skills labs must be in-person; and

(6) The programs must provide training materials prior to class, including but not limited to web access to materials.

Subpart 9

20 CAR § 403-901 General provisions {#sec-20-car-403-901 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-901}

20 CAR § 403-901. General provisions.

(a)(1) This section sets forth policy for direct reimbursement for allowable nursing assistant training costs incurred by Medicaid-certified nursing facilities.

(2) Allowable training costs will be separately tracked, documented, and submitted monthly as described herein.

(3) All reimbursements shall be made directly to the Medicaid-certified nursing facility.

(b)(1) Based on federal regulations, nursing assistants who are employed by, or who have a letter of intent to be employed by, a Medicaid-certified nursing facility may not be charged for any portion of the program, including any fees for textbooks or other required course material.

(2) The Department of Human Services shall be responsible to pay for the training costs one (1) time for individuals who are employed by or have a letter of intent to be employed by a Medicaid-certified nursing facility as set forth in this section.

(1) The facility must have on file a job application completed and signed by the individual receiving the letter of intent;

(2) The facility must complete a criminal record check on the individual in accordance with Arkansas Code § 20-38-101 et seq.; and

(3) The facility must retain copies of documents to verify compliance with these provisions as specified in 20 CAR § 403-905.

(d)(1) Allowable costs for nursing assistant training reimbursement may include the costs:

(A) For operation of an approved nursing assistant training program;

(B) Associated with a cooperative training effort with a neighboring approved training program, not claimed by that program; and

(2) Nursing assistant salaries and fringe benefits, including amounts paid while in training, and in-service or continuing education costs are not directly reimbursable but are included on the facility's annual cost report and reimbursed through the per diem rates.

(e)(1) Reimbursement of nursing facility costs for training of nursing assistants must be allocated between Medicaid, Medicare, and private pay patients.

(2) Medicaid may not be charged for that portion of these costs that are properly charged to Medicare or private pay activities.

(3) Therefore, the department will pay only the percentage of the total billed or maximum limit (see 20 CAR § 403-904) for nursing assistant training based on the percentage of Medicaid recipients indicated on the billing.

(4) Facilities should continue to bill for the total amount of expenses incurred.

(5) The recipient information should reflect the midnight census for the last day of the month.

20 CAR § 403-902 Allowable costs {#sec-20-car-403-902 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-902}

20 CAR § 403-902. Allowable costs.

The following costs are allowable for nursing assistant training:

(1) Nursing assistant transportation expenses. The dollar amount of transportation expenses paid directly to or reimbursed for the nursing assistant to attend training or to travel to a nursing assistant competency evaluation site;

(2) Books. The dollar amount spent for books purchased specifically for use in the nursing assistant training program;

(3)(A) Instructional equipment.

(B) The dollar amount spent for equipment.

(C) Examples include, but are not limited to, SMARTBoards, iPads, Apple TV, Chromebooks, multi-media projectors, and DVDs purchased specifically for use in the nursing assistant training program;

(4) Instructional videos. The dollar amount spent for things such as instructional videos purchased specifically for use in the nursing assistant training program;

(5) Other training materials. The dollar amount spent for other approved training materials purchased specifically for use in the nursing assistant training program;

(6)(A) Training space.

(B) The dollar amount spent for the rent of classroom space (outside the facility) and things such as lab equipment specifically for the nursing assistant training program.

(7)(A) Instructor wages.

(B) The dollar amount of wages paid to the nursing assistant instructor for training time, only while the nursing assistant instructor is not included in the nursing facility’s staffing pattern providing nursing services.

(D) Information reported to the Department of Human Services on Form DMS-755 is strictly for training, not testing activity;

(8)(A) Instructor fringe benefits.

(B) The dollar amount paid for fringe benefits to the nursing assistant instructor is for their training services only.

(C) The nursing assistant instructor is not to be included in the nursing facility's staffing pattern for providing nursing services;

(9) Nursing assistant consultant training fees. The dollar amount paid to a consultant trainer for nursing assistant training;

(10) Consultant reimbursable expenses. The dollar amount paid to a consultant trainer for reimbursable expenses such as travel and lodging;

(11)(A) Instructor workshop fees.

(B) The amount of tuition and registration fees paid for nursing assistant training program instructors to attend instructor workshops.

(C) Instructor workshops must meet requirements established by the Office of Long-Term Care to qualify for reimbursement and participants must be approved for attendance by the office;

(12) Instructor workshop travel expenses. Travel expenses and lodging paid directly or reimbursed for nursing assistant training program instructors to attend instructor workshops; and

(13)(A) Nursing assistant training tuition.

(B) The dollar amount spent on tuition for employees, and potential employees given a letter of intent dated within twelve (12) months immediately preceding the date of the completion of training, to attend nursing assistant training in an approved nonfacility training program.

(C) The actual amount of tuition paid for a student, up to a maximum of four hundred eighty dollars ($480) per student, will be reimbursed as allowable cost.

(D) This amount is based on the provision of the minimum ninety-one (91) hours training required by the department.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-903 Claims submission {#sec-20-car-403-903 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-903}

20 CAR § 403-903. Claims submission.

(a)(1) Claims for reimbursement of expenses incurred for nursing assistant training costs shall be submitted to the Department of Human Services monthly on Form DMS-755.

(2) Claims for the expense month can be submitted no earlier than the first day of the month or the last day of the month following the expense month.

(3)(A) The report forms will be designed to capture the above cost categories by use area in either formal approved or combined cooperative training.

(B) Therefore, documentation of these costs should be accounted for in a manner consistent with these categories.

(b)(1) Claims must be submitted to the department within thirty (30) calendar days following the end of the expense month.

(2) Claims not submitted timely or claims that are incomplete will not be accepted for payment and shall be returned to the facility.

(3) Corrected claims must be submitted within fifteen (15) calendar days of the date returned.

(c)(1) A claim for reimbursement may not be submitted for any month in which no students completed training.

(2) Unclaimed costs in this circumstance may be carried over to the month when students complete training and will still be subject to the four hundred eighty dollars ($480) maximum cost limit per student (see 20 CAR § 403-904, maximum cost limit).

(d) All submitted claims must include a copy of each trainee’s Certificate of Completion from the training program and a copy of the department-issued criminal records check.

(e) Determination letter. In accordance with 20 CAR § 404-203(a)(1), the facility must complete the criminal record check for each trainee prior to conducting the nursing assistant training or prior to sponsoring the trainee through the letter of intent to employ provisions as specified in 20 CAR §§ 403-901(b) and 403-902(13).

(f) Reimbursements are not allowed and shall be denied to facilities for the following:

(1) Individuals listed on the Adult and Long-term Care Facility Resident Maltreatment Central Registry with a disqualification status due to a substantiated administrative finding of abuse, neglect, misappropriation of resident property, or a disqualifying criminal record in accordance with Arkansas Code § 20-38-101 et seq.;

(2)(A) Individuals listed on the registry with an expired certification.

(B) These individuals are not required to be retrained and may retest in accordance with 20 CAR § 403-603(c); and

(3) Individuals who, prior to training, did not complete a criminal record check in accordance with Arkansas Code § 20-38-101 et seq.

(g)(1) All claim forms (DMS-755) must be submitted with original signatures of the nursing facility administrator.

(2) Copies will not be accepted.

20 CAR § 403-904 Maximum cost limit {#sec-20-car-403-904 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-904}

20 CAR § 403-904. Maximum cost limit.

(a) In an effort to establish proper and efficient administration of training costs reimbursements, a reasonable maximum cost limit shall be imposed.

(b)(1) Based on analysis of nursing assistant training costs, four hundred eighty dollars ($480) per student will be the maximum paid to facilities on their claims.

(2) This limit shall be imposed based on the number of students who finish the training program.

(c) Claims must show actual costs incurred and reimbursements will be made for actual costs but not to exceed the maximum limit of four hundred eighty dollars ($480) per student who completes the training.

Example: Claim form shows actual costs are one thousand two hundred fifty dollars ($1,250) with four (4) students completing the course. As one thousand two hundred fifty dollars ($1,250) is less than one thousand nine hundred twenty dollars ($1,920) (four (4) students multiplied by four hundred eighty dollars ($480) equals one thousand nine hundred twenty dollars ($1,920) maximum) the actual costs will be reimbursed. If this example had only two (2) students completing, the maximum would be nine hundred sixty dollars ($960) (two (2) students multiplied by four hundred eighty (480)) and the reimbursement would be capped at nine hundred sixty dollars ($960) rather than paying the full one thousand two hundred fifty dollars ($1,250) actual expenses.

History

History: Ark. R. 2026-83 (eff. July 1, 2026) Authority: Arkansas Code § 20-10-705

20 CAR § 403-905 Cost reporting and record retention {#sec-20-car-403-905 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-905}

20 CAR § 403-905. Cost reporting and record retention.

(a) Nursing assistant training costs directly reimbursed by the Department of Human Services shall be included in the nursing facility's annual Financial and Statistical Cost Report and shall be reported as revenue offsets to nursing assistant training costs.

(b) Facilities must retain receipts and documentation of nursing assistant training costs submitted to the department for reimbursement for a period of no less than five (5) years or until all audit findings are final.

(c) Any facility claiming reimbursement for costs that were not actually incurred, or not properly documented, will be required to provide restitution to the department and will be subject to fines, prosecution, or both, as authorized by state and federal statutes.

20 CAR § 403-906 Nursing assistant training cost reimbursement claim form {#sec-20-car-403-906 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-906}

20 CAR § 403-906. Nursing assistant training cost reimbursement claim form.

(a) The Nursing Assistant Training Cost Reimbursement Claim Form (DMS-755) is specific to each facility.

(b) To obtain a Form DMS-755, email natpcertification@dhs.arkansas.gov or visit: Department of Human Services – Division of Provider Services & Quality Assurance.

20 CAR Part 403 — Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program

Chapter X

Subchapter A

Subpart 1

20 CAR § 403-101 Purpose {#sec-20-car-403-101 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-101}

20 CAR § 403-102 Definitions {#sec-20-car-403-102 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-102}

Subpart 2

20 CAR § 403-201 General rule {#sec-20-car-403-201 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-201}

20 CAR § 403-202 Training {#sec-20-car-403-202 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-202}

20 CAR § 403-203 Implementation requirements {#sec-20-car-403-203 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-203}

20 CAR § 403-204 Nursing assistant trainee activities {#sec-20-car-403-204 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-204}

20 CAR § 403-205 In-person facilities and resources {#sec-20-car-403-205 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-205}

20 CAR § 403-206 Virtual training {#sec-20-car-403-206 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-206}

20 CAR § 403-207 Orientation program {#sec-20-car-403-207 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-207}

20 CAR § 403-208 Ongoing in-service training {#sec-20-car-403-208 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-208}

20 CAR § 403-209 Nonpermanent employees {#sec-20-car-403-209 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-209}

Subpart 3

20 CAR § 403-301 Location {#sec-20-car-403-301 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-301}

20 CAR § 403-302 Restrictions {#sec-20-car-403-302 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-302}

20 CAR § 403-303 Application {#sec-20-car-403-303 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-303}

20 CAR § 403-304 Changes in programs {#sec-20-car-403-304 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-304}

20 CAR § 403-305 Withdrawal of approval {#sec-20-car-403-305 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-305}

Subpart 4

20 CAR § 403-401 Primary instructor {#sec-20-car-403-401 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-401}

20 CAR § 403-402 Primary instructor responsibilities {#sec-20-car-403-402 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-402}

20 CAR § 403-403 Additional instructor or guest speaker {#sec-20-car-403-403 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-403}

Subpart 5

20 CAR § 403-501 Transition {#sec-20-car-403-501 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-501}

20 CAR § 403-502 Examination {#sec-20-car-403-502 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-502}

20 CAR § 403-503 Examination fees, dates, and locations {#sec-20-car-403-503 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-503}

20 CAR § 403-504 Candidate qualifications {#sec-20-car-403-504 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-504}

20 CAR § 403-505 Certified nursing assistant licensure of uniformed service members, veterans, and spouses {#sec-20-car-403-505 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-505}

20 CAR § 403-506 Automatic occupational licensure of out-of-state individuals {#sec-20-car-403-506 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-506}

Subpart 6

20 CAR § 403-601 Function and content {#sec-20-car-403-601 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-601}

20 CAR § 403-602 Inquiry process {#sec-20-car-403-602 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-602}

20 CAR § 403-603 Certification renewal {#sec-20-car-403-603 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-603}

20 CAR § 403-604 Petition to remove neglect findings {#sec-20-car-403-604 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-604}

Subpart 7

20 CAR § 403-701 Monitoring {#sec-20-car-403-701 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-701}

20 CAR § 403-702 Items subject to monitoring {#sec-20-car-403-702 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-702}

Subpart 8

20 CAR § 403-801 Virtual instruction only applies to lecture portion of training {#sec-20-car-403-801 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-801}

Subpart 9

20 CAR § 403-901 General provisions {#sec-20-car-403-901 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-901}

20 CAR § 403-902 Allowable costs {#sec-20-car-403-902 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-902}

20 CAR § 403-903 Claims submission {#sec-20-car-403-903 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-903}

20 CAR § 403-904 Maximum cost limit {#sec-20-car-403-904 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-904}

20 CAR § 403-905 Cost reporting and record retention {#sec-20-car-403-905 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-905}

20 CAR § 403-906 Nursing assistant training cost reimbursement claim form {#sec-20-car-403-906 omnilex-key=us-ar-regs-official--title-20-part-403--20 CAR § 403-906}

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