The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:
"Board" means the Virginia Board of Nursing.
"Client" means a person receiving the services of a certified nurse aide, to include a patient in a health care facility or at home or a resident of a long-term care facility.
"Nurse aide education program" means a program designed to prepare nurse aides for certification that is approved by the board.
18VAC90-25-15. Identification; accuracy of records.
A. Any person regulated by this chapter who provides direct
patient care shall, while on duty, wear identification that is clearly visible
and indicates the
person's first and last name and the appropriate title
issued to such person by the board under which he is practicing in that
setting. Any person practicing in hospital emergency departments,
psychiatric and mental health units and programs, or in health care facilities
units offering treatment for patients in custody of state or local
law-enforcement agencies may use identification badges of first name and first
letter only of last name and appropriate title. Name identification on a
badge shall follow the policy of the facility in which the nurse aide is
B. A certificate holder who has changed his name shall submit as legal proof to the board a copy of the marriage certificate, a certificate of naturalization, or court order evidencing the change. A duplicate certificate shall be issued by the board upon receipt of such evidence.
C. Each certificate holder shall maintain an address of record
with the board. Any change in the address of record or in the public address,
if different from the address of record, shall be submitted in writing or
electronically to the board within 30 days of such change. All notices required
by law and by this chapter to be
mailed sent by the board to any
certificate holder shall be validly given when mailed sent to the
latest address of record on file with the board.
A. The following fees shall apply:
1. Annual renewal for certified nurse aide
2. Returned check
3. Application for certification as an advanced certified nurse aide
4. Renewal of advanced certified nurse aide certification
5. Reinstatement of advanced certified nurse aide certification
B. Fees shall not be refunded once submitted.
Certification of Nurse Aides
18VAC90-25-70. Initial certification for the nurse aide registry.
executive director of the board shall issue a
certificate as a certified nurse aide to each applicant who qualifies for such a
certificate under §§ 54.1-3024, 54.1-3025, 54.1-3026, and 54.1-3028 of
the Code of Virginia and provisions of this chapter.
B. Nurse aide competency evaluation.
1. The board may contract with a test service for the development and administration of a competency evaluation, which shall be a state examination.
2. All individuals completing a nurse aide education program in
Virginia shall successfully complete the
competency evaluation state
examination required by the board prior to being certified and to using the
title Certified Nurse Aide.
3. The board shall determine the minimum passing standard on
competency evaluation state examination.
C. Initial certification shall be for two years.
18VAC90-25-71. Certification by examination.
A. To be placed on the registry and certified by examination, the nurse aide must:
1. Have satisfactorily completed:
a. A nurse aide education program approved by the board;
b. At least one clinical nursing course that includes at least 40 hours of clinical experience involving direct client care within the past 12 months while enrolled in a nursing education program preparing for registered nurse or practical nurse licensure; or
c. A nursing education program preparing for registered nurse licensure or practical nurse licensure;
2. Pass the
competency evaluation state examination
required by the board; and
3. Submit the required application and testing fee as prescribed by the board.
B. An applicant who fails to take the board-approved skills and written portions of the state examination within two years of completion of the training or who has failed the examination in three attempts shall reenroll and successfully complete another approved nurse aide training program before reapplying.
18VAC90-25-80. Renewal or reinstatement of certification.
A. Renewal of certification.
1. No less than 30 days prior to the expiration date of the
current certification, a notice for renewal shall be
mailed sent by
the board to the address of record of each currently registered
certified nurse aide.
2. The certified nurse aide shall annually submit a completed
renewal application with the required fee
of $30 and verification
attestation of performance of nursing-related activities for
compensation within the two years immediately preceding the expiration date.
3. Failure to receive the application for renewal shall not relieve the certificate holder of the responsibility for renewing the certification by the expiration date.
4. A certified nurse aide who has not performed nursing-related
activities for compensation during the two years preceding the expiration date
of the certification shall repeat and pass the nurse aide
evaluation state examination prior to applying for recertification
renewal of certification. 5. The board shall also charge a fee of $35 for a returned
B. Reinstatement of certification.
1. An individual whose certification has lapsed for more than 90 days shall submit the required application and renewal fee and provide:
a. Verification of performance of nursing-related activities for compensation in the two years prior to the expiration date of the certificate and within the preceding two years; or
b. Evidence of having repeated and passed the nurse aide
evaluation state examination.
2. An individual who has previously had a finding of abuse, neglect, or misappropriation of property is not eligible for reinstatement of his certification, except as provided in 18VAC90-25-81, which provides a process for removal of the finding of neglect based on a single occurance.
C. A certified nurse aide whose certification has been suspended or revoked by the board and who is eligible for reinstatement may apply for reinstatement by filing a reinstatement application and fulfilling requirements of subsection B of this section.
18VAC90-25-81. Removal of a finding of neglect.
A. If a finding of neglect was made against a certificate holder based on a single occurrence, an individual may petition for removal of the finding of neglect provided:
1. A period of at least one year has passed since the finding was made; and
2. The individual
seeking reinstatement demonstrates
sufficient evidence that employment and personal history do not reflect a
pattern of abusive behavior or neglect.
B. A certificate holder can petition the board only once for removal of a finding of neglect.
18VAC90-25-100. Disciplinary provisions for nurse aides.
The board has the authority to deny, revoke, or suspend
a certificate issued, or to otherwise discipline a certificate holder upon
he the certificate holder has violated any of the
provisions of § 54.1-3007 of the Code of Virginia. For the purpose of
establishing allegations to be included in the notice of hearing, the board has
adopted the following definitions:
1. Fraud or deceit in order to procure or maintain a
certificate shall mean
, but shall not be limited to:
a. Filing false credentials;
b. Falsely representing facts on an application for initial certification, reinstatement or renewal of a certificate; or
c. Giving or receiving assistance in taking the
evaluation state examination.
2. Unprofessional conduct shall mean
, but shall not be
a. Performing acts beyond those authorized for practice as a
nurse aide or an advanced certified nurse aide as defined in Chapter 30 (§
54.1-3000 et seq.) of Title 54.1 of the Code of Virginia, and beyond those
authorized by the Drug Control Act (§ 54.1-3400 et seq. of the Code of
Virginia) or by provisions for delegation of nursing tasks in Part
(18VAC90-20-420 VI (18VAC90-19-240 et seq.) of 18VAC90-20 18VAC90-19.
b. Assuming duties and responsibilities within the practice of a nurse aide or an advanced certified nurse aide without adequate training or when competency has not been maintained;
c. Obtaining supplies, equipment or drugs for personal or other unauthorized use;
d. Falsifying or otherwise altering client or employer records, including falsely representing facts on a job application or other employment-related documents;
e. Abusing, neglecting, or abandoning clients;
f. Having been denied a license or certificate or having had a license or certificate issued by the board revoked or suspended;
g. Giving to or accepting from a client property or money for any reason other than fee for service or a nominal token of appreciation;
h. Obtaining money or property of a client by fraud, misrepresentation, or duress;
i. Entering into a relationship with a client or the
client's family that constitutes a professional boundary violation in which
the nurse aide uses his professional position to take advantage of the
vulnerability of a client or his family, to include
but not limited to
actions that result in personal gain at the expense of the client, an
inappropriate personal involvement or sexual conduct with a client;
j. Violating state laws relating to the privacy of client
but not limited to § 32.1-127.1:03 of the
Code of Virginia; or
k. Providing false information to staff or board members during the course of an investigation or proceeding.
3. For the purposes of interpreting provisions of subdivision
7 of § 54.1-3007
(7) of the Code of Virginia, a restriction on nurse
aide certification shall be interpreted as having a finding of abuse, neglect,
or misappropriation of patient property made in another state or being placed
on the abuse registry in another state.
18VAC90-25-110. Requirements for initial certification as an advanced certified nurse aide.
A. In order to be certified as and use the title of "Advanced Certified Nurse Aide," an applicant shall meet the following qualifications:
1. Hold current certification as a certified nurse aide in Virginia;
2. Have been certified for at least three years as a certified nurse aide;
3. Have never had a finding of abuse, neglect, or misappropriation of patient property entered on a nurse aide registry in any jurisdiction and have not had any disciplinary actions taken by the board within the five years preceding application for advanced certification;
4. Have a recommendation for advanced certification from a licensed nurse who has supervised the applicant in providing direct patient care for at least six months within the past year; and
5. Have successfully completed a minimum of 120 hours of advanced training in an approved program that includes a competency evaluation acceptable to the board.
B. An application for certification shall be accompanied by an
of $25 as specified in 18VAC90-25-16.
18VAC90-25-120. Renewal and reinstatement of certification as an advanced certified nurse aide.
A. Current certification as a nurse aide in Virginia must be maintained in order to hold certification as an advanced certified nurse aide.
B. Renewal. If an individual is not eligible to renew as a certified nurse aide, certification as an advanced certified nurse aide may not be renewed. An advanced certification shall be renewed concurrently with the renewal of the basic certification as a nurse aide in Virginia by:
1. Submitting a completed renewal form and renewal fee
$20 as specified in 18VAC90-25-16; and
2. Attesting to completion of at least three contact hours per year of continuing education and training in any of the competency areas identified in the advanced certification training program. The board may grant an extension or waiver of the continuing education requirement based on good cause shown by the certified nurse aide.
C. Late renewal. An advanced certified nurse aide may renew certification for 90 days following the expiration date by meeting the requirements of subsection A of this section.
D. Reinstatement. If an advanced certification has not been renewed for 90 days following the expiration date, it shall only be reinstated if the applicant for reinstatement:
1. Holds current certification as a nurse aide in Virginia;
2. Submits a completed reinstatement application on a form provided by the board;
3. Pays the reinstatement fee
of $30 as specified in
4. Provides evidence that
he the applicant has
completed all required hours of continuing education and training.
Requirements for an approved advanced
certification education program. (Repealed.) A. The advanced certification education program shall be
approved by the Virginia Board of Nursing. An approved advanced certification education
program shall also be an approved nurse aide education program as set forth in
18VAC90-25-20. B. An advanced certification education program shall
consist of a minimum of 120 hours including a minimum of 40 hours of clinical
skills instruction in direct client care with on-site supervision by
instructional personnel. When nurse aides are engaged in direct client care in
the course of advanced certification training, the ratio shall not exceed 10
students to one instructor. C. The instructional personnel in an approved advanced
certification education program shall meet the requirements as set forth in
18VAC90-25-30. D. The curricula of an approved advanced certification
education program shall, at a minimum, meet the requirements of 18VAC90-25-140. E. Each advanced certification program shall develop an
individual record of major skills taught and the date of performance by the
student. At the completion of the program, the program shall provide each nurse
aide with a copy of this record and a certificate of completion. F. An advanced certification education program shall
develop and submit to the board a competency evaluation based on the curriculum
content required in 18VAC90-25-140. Such an evaluation shall include both a
written test on the curriculum and an assessment of manual skills. A record of
the reports of graduates' performance on the approved competency evaluation
program shall be maintained for a minimum of three years. G. Program review shall be in accordance with requirements
of 18VAC90-25-60 and shall be conducted concurrently with the on-site review of
the basic nurse aide education program. Loss of board approval for the basic
nurse aide education program shall automatically result in the loss of approval
for the advanced certification education program. H. When an advanced certification education program closes,
the provider shall notify the board of the date of closing and submit a list of
all graduates with their date of graduation.
Required curriculum content for an advanced
certification education program. (Repealed.) A. An advanced certification education program shall
include classroom and clinical instruction in the following curriculum: 1. Leadership and mentoring skills. a. Principles of adult learning; b. Learning styles; c. Evaluation methods to assess learner knowledge; d. Communication techniques and communication barriers;
emphasizing cultural diversity of coworkers and clients; e. Conflict management; f. Precepting and mentoring new certified nurse aides; g. Teamwork; h. Contributing to care plan development and
implementation; i. Organizational responsibilities; and j. Principles of documentation. 2. Care of the cognitively impaired client. a. Signs and symptoms of dementia; b. Concepts and techniques for addressing the unique needs
and behaviors of individuals with dementia, including but not limited to
agitation, combativeness, sundown syndrome, wandering, forgetfulness; c. Basic concepts of communication with cognitively
impaired clients, including techniques to reduce the effects of cognitive
impairment; d. Basic concepts of behavior management with cognitively
impaired clients; and e. Recognizing changes in the client's condition and
reporting and documenting such changes. 3. Restorative care. a. Anatomy and physiology with emphasis on the effects of
aging; b. Pathophysiology of common disorders of the elderly; c. Measures to assist clients with common medical problems;
d. Recognizing changes in the client's condition and
reporting and documenting such changes; e. Concepts to maintain or improve client mobility and
ability to perform activities of daily living; and f. Rehabilitation procedures. 4. Wound care. a. Prevention, identification and treatment of Stage I and
Stage II pressure ulcers; b. Positioning; c. Sterile and clean technique; d. Dressing changes; e. Concepts of hydration; f. Nutrition and weight loss; and g. Recognizing changes in the client's condition and
reporting and documenting such changes. B. Written objectives for each unit of instruction shall be
stated in behavioral terms that are measurable and shall be reviewed with the
students at the beginning of each unit.