101 STAT. 1330-164
PUBLIC LAW 100-203—DEC. 22, 1987
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July 1, 1989) for more than 4 months unless the individual— "(i) has completed a t r a i n i n g and competency evaluafc"?^l?' i r tion program, or a competency evaluation program, approved by the State under subsection (e)(1)(A), and J, "(ii) is competent to provide such services. i&*jffi N" ' i; j! I •
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"(B) OF F E R I N G COMPETENCY EVALUATION PROGRAMS FOR CURRENT EMPLOYEES.—A skilled n u r s i n g facility m u s t pro-
vide, for individuals used a s a n u r s e aide by the facility as of July 1, 1989, for a competency evaluation program approved by the State under subsection (e)(1) and such p r e p a r a t i o n a s may b e necessary for the individual to complete such a program by January 1, 1990. "(C) COMPETENCY.—The skilled nursing facility must not permit an individual, other than in a training and competency evaluation program approved by the State, to serve as a nurse aide or provide services of a type for which the individual has not demonstrated competency and must not use such an individual as a nurse aide unless the facility has inquired of the State registry established under subsection (e)(2)(A) as to information in the registry concerning the individual. "(D) RE-TRAINING REQUIRED.—For purposes of subpara-
graph (A), if, since an individual's most recent completion of a training and competency evaluation program, there tw has been a continuous period of 24 consecutive months ^ during none of which the individual performed nursing or 3. nursing-related services for monetary compensation, such •: individual shall complete a new training and competency evaluation program. »r "(E) REGULAR IN-SERVICE EDUCATION.—The skilled nurs» ing facility m u s t provide such regular performance review b. and regular in-service education as assures that individuals used as nurse aides a r e competent to perform services as b • nurse aides, including training for individuals providing 1 nursing and nursing-related services to residents with cognitive impairments. SSNJP s "(F) N U R S E AIDE DEFINED.—In this paragraph, the term 'nurse aide' means any individual providing nursing or nursing-related services to residents in a skilled nursing facility, b u t does not include a n individual— "(i) who is a licensed health professional (as defined in subparagraph (G)), or "(ii) who volunteers to provide such services without monetary compensation. Ti "(G) LICENSED HEALTH PROFESSIONAL DEFINED.—In this asii.: paragraph, the term 'licensed health professional' means a physician, physician assistant, nurse practitioner, physical, oi lo') speech, or occupational therapist, registered professional nurse, licensed practical nurse, or licensed or certified social worker. "(6) PHYSICIAN SUPERVISION AND CUNICAL RECORDS.—A skilled nursing facility must— "(A) require that the medical care of every resident be provided under the supervision of a physician; "(B) provide for having a physician available to furnish '-n necessary medical care in case of emergency; and
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