04/23/2026

Survey Tip of the Week: Effective Nurse Aide Training

Compliance with F947, Training for Nurse Aides under §483.95(g), goes beyond documenting the required 12 hours of training each year. Surveyors will evaluate whether the in-service training program is effective, individualized, and responsive to actual care needs. The State Operations Manual Appendix PP notes that the training must include dementia management training and resident abuse prevention training. Additionally, the training must address areas of weakness as determined in nurse aides' performance reviews and facility assessment at §483.71 and may address the special needs of residents as determined by the facility staff. For nurse aides providing services to individuals with cognitive impairments, the training must also address the care of the cognitively impaired.

Facilities should use surveyor probes as a self-assessment to evaluate whether their training program meets regulatory expectations. Key considerations include:

• How has in-service education addressed any areas of weakness identified in performance reviews, and any special resident needs, or needs of residents with cognitive impairments?
• How does the facility evaluate nurse aide performance to determine what topics must be included in in-service training to address areas of weakness?
• How does the facility determine when training content must be updated (e.g., in order to remain consistent with current professional standards and guidelines)?
• What process does the facility have to encourage nurse aides to express concerns and request training in challenging situations? How does the facility respond to nurse aide’s concerns and requests?
• Does the facility’s training address nurse aide training needs to ensure residents attain or maintain the highest practicable physical, mental, and psychosocial well-being as determined by resident assessments and individual plans of care?
• How does the facility assess nurse aides to determine if the training has been effective?
• Were nurse aides observed working with residents in a manner that indicates a training need?
• Did interviews with residents and/or resident representatives indicate any areas where training was needed?
• What type of training do the nurse aides report receiving about the concern identified by the surveyor?
• Verify the mandatory nurse aide in-service program is no less than 12 hours per year.
• Review facility training records which supports mandatory nurse aide attendance.