Nurse Aide Training and Competency Evaluation Programs (NATP or NATCEP)

The LDH-HSS (Health Standards Section) reviews and approves or disapproves nurse aide training and competency evaluation programs for the state of Louisiana.

Any person or entity who wishes to offer a NATP/NATCEP must receive approval from the LDH-HSS. 


The Nurse Aide Training Application, along with the information detailed below, are required for approval of an NATP/NATCEP.  You must read the instructions below prior to submission of the application.


What you need to know about the application process:

  • Incomplete applications will be returned, and will delay approval of your program
  • If the application contains errors or discrepancies, you will be notified and given an opportunity to make corrections. This will delay approval of your program
  • The federal regulations require the state respond to a request within 90 days of receipt of the application.  Although it will usually be processed well within that time frame, please allow at least 30 days from the date you mail your application before inquiring about the status
  • Proprietary schools must obtain approval from the Board of Regents prior to conducting nurse aide training. Please review the license application and fee process prior to submission of NAT application to LDH
  • Nursing facilities that have been subject to one or more of the following actions in the previous 2 years are not eligible to provide nurse aide training, and may not serve as a clinical training site for other programs:
  1. Waiver for nursing services;
  2. Extended or partially extended survey;
  3. Assessed civil money penalty greater than $10,483;
  4. Denial of payment for new Medicare/Medicaid admissions;
  5. Termination from Medicare/Medicaid;
  6. Operated under trustee appointment for resident safety; and/or
  7. Closure of facility or transfer of residents due to state action.


As a reminder to NATP's: Clinical training cannot be performed in a facility that is ineligible to conduct NAT due to any of the reasons as noted in CFR  483.151 (above).  The facility is not required to notify the NATP; therefore, it is the responsibility of the NATP  to ensure the facility is eligible to serve as a clinical training site.Nursing Home Directory




A Nurse Aide Training Program must include a minimum of:

  1. 40 hours of classroom training
    • must have at least 16 hours of lab (skills) training, which is considered part of the classroom instruction;
    • must denote the lab/skills time in curriculum, including the subject area to which it correlates
  2. 4 hours of orientation to the clinical training site (not included in program hours); and
  3. 40 hours of clinical training (hands-on resident care in a nursing home or skilled nursing facility)



Programs approved after June 2012 must use one of 2 approved textbooks:

  1. How to Be a Nurse Assistant, 4th (or subsequent) edition, by American Health Care Association
  2. Successful Nursing Assistant Care, 2nd (or subsequent) edition, by Hartman Publishing**

**Subsequent editions are titled Nursing Assisting: A Foundation in Caregiving


A proposed curriculum must be submitted with the application.  It must include the time allotted for each unit/subject, the time allotted to lab instruction, and should be consistent with the program hours submitted on the application.


The textbook must be used as the curriculum.


**Please click here for a curriculum example and additional information.



Clinical Contract:

For non-facility based programs, a valid clinical contract (copy) must be submitted for each clinical site to be used.  All clinical instruction must be performed at a LA licensed long term care facility (nursing home or hospital-based skilled nursing facility). Click here for a list of nursing homes.  The school must verify the nursing home is eligible to serve as a clinical training site (see above).  The clinical contract shall:

  • Indicate the agreement is for the purpose of nurse aide training
  • Include verbiage that NH will allow current class to complete training if contract is cancelled
  • Include verbiage that NH will notify school if the NH becomes ineligible due to enforcements as noted per CFR 483.151 (b)(2)
  • Specify a beginning and expiration date of the contract
  • Include printed name and title of individuals entering into agreement
  • Include date and signature of individuals entering into agreement
  • If the signature page is separate, the name of the entities must be included

The contract shall NOT indicate the nursing home will be responsible for instruction, evaluation, assignments, oversight, or any other aspects of the program (the only exception would be a Preceptor program).  



Policy and Procedure:

The program’s policies/procedures shall be submitted with the application.  Below are the minimum areas that must be addressed for approval.  Please see the requirements for each, as noted in the federal and/or state regulations. The policy must provide your program's procedure for assurance the requirements will be met.

Admission requirements (performed PRIOR to admission to program):

  1. Criminal background check                                                                                                                                                                                                                                  *See memo regarding changes to CBC sent to all NATP's in July 2019.                                                                                                                                          *Must include what findings will prevent admission to the program. 
  2. National sex offender public registry check (                                                                                                                                                                              *Not included with the right to review.                                                                                                                                                                                                         *Must include what findings will prevent admission to the program. 
  3. CNA registry check                                                                                                                                                                                                                                                 *Must include what findings will prevent admission to the program. 
  4. DSW registry check                                                                                                                                                                                                                                                *Must include what findings will prevent admission to the program. 
  5. At least 16 years of age

Attendance policy (including make-up work/time, absences allowed, re-entry if student drops out or fails, etc.)

Instructor to Student ratio

  • RN Coordinator will be on site during all (classroom and clinical) training at least 50% of the instruction time

Program hours (class/lab/clinical)

Schedule of class and clinical (day/time/length of program)

Curriculum (textbook and edition to be used)

Skills Checklist:

  • Skills proficiency check-off/skills performance record must be completed prior to clinical
  • The skills performance record should coorelate with the curriculum: if curriculum notes that time will be spent on a skill, the skill must be on the skills performance record.  
  • No care or services will be performed until student has been deemed proficient
  • A copy of the skills check-off/performance record must be submitted with application
  • If procedure guide (in the corresponding workbook) will be used, specify in policy. A copy of the workbook procedure guide does not need to be submitted. 
  • The Prometric clinical skills are not the only skills that must be taught, and the skills procedure checkoff should not be submitted as the skills performance record.  

Clinical Training

  • All classroom and lab instruction must be complete prior to clinical
  • Clinical training will be performed only at eligible NH/SNF per 483.151(B)(2)
  • 4 hours of orientation to each clinical site that is used
  • Name of site(s)

Eligiblity to take competency exam  (what are the minimum requirements student must meet to be considered eligible to test?)

  • Regulatory minimum requirements are hours completed (refer to attendance policy) and skills proficiency

**Please note: the Nurse Aide Training program does not submit student information to the Nurse Aide Registry.  Once the student successfully completes (passes) both portions of the competency exam, the student's information is submitted by Prometric for placement on the Registry.  Please allow up to 15 business days for processing.

Competency exam by Prometric. The school must explicitly identify the following in their policy: 

  1. Completion of training program does not certify student to the Registry.  Successful completion of the training program will make student eligible to take the Nurse Aide Competency Evaluation. 
  2. Competency evaluation (written/oral and skills) will be performed by testing company Prometric.
  3. Whether application, testing fee, and retest fee is responsibility of student or the school (i.e., is the initial testing fee and/or retesting fee included with tuition or provided by program? Will school or student submit application to Prometric?)
  4. A student has 3 opportunities within 12 months to pass both portions of the exam. Specify whether tuition includes cost of retest (if required).
  5. If testing fee is included in tuition, school will submit application and test fees to Prometric within 10 calendar days of completion of training
  6. If test (or retest) fee is not included in tuition (student must pay for test), school must provide the Training Verification Form to student within 10 calendar days of completion of training. The specific cost of the competency exam must be included in policy if not included in tuition. 
  7. If retest is required, student is only required to retake the portion (written/oral or skills) that they failed.  The cost of retest must be included.
  8. If student does not pass the competency evaluation after 3 attempts, student must retrain (take complete course again)
  9. Address what (if any) additional instruction will be provided for students who do not successfully complete the competency exam.
  10. If test (or retest) fee is not provided by school, the policy must include the current fees charged by Prometric. 
  11. Statement that identifies whether school is approved as an in-facility testing (IFT) site with Prometric.  If not, students must be notified that test date scheduling will be based on regional test site date availability.  

In addition to above, the following applies to FACILITY BASED (NH) programs

  • Students cannot be charged for any portion of the program, including re-tests.  Students are allowed 3 opportunities within 1 year to pass both portions (written/oral and skills) of the competency evaluation.  A student is only required to retake the portion that they failed. If student is unsuccessful after 3 attempts, student must retrain.
  • Because of the new testing process, the state requirement that students of facility-based programs complete training and test within 60 days will not be enforced.  Instead, per the LTC federal regulation F728, 483.35 (d)(1), the nurse aide trainee must train and successfully complete the competency evaluation within 4 months of hire. (The state regulations will reflect this information with the next revision.)
  • The facility must submit the application and test fee to Prometric within 10 calendar days of completion of training.  Students should be given a copy of the Training Verification Form within 10 days of completion. 



Program Coordinators and Instructors:

Each NATP must have an RN Coordinator, responsible for the general supervision of program.  Coordinators may serve as instructors (except DON). Instructors may be RN’s or LPN’s.

RN Coordinator(s):

  • The RN Coordinator is ultimately responsible for ensuring the program meets all federal and state regulatory requirements. 
  • In facility-based programs, the DON may serve as RN Coordinator, but is prohibited from performing actual training
  • May not serve as RN Coordinator for more than 2 programs simultaneously
  • Shall be ON SITE where program is conducted at least 50% of training performed (both classroom and clinical instruction)
  • Qualifications:
    1. Registered nurse with current, unencumbered license;
    2. Minimum of 2 years nursing experience, including at least 1 year in the provision of long term care facility (NH or SNF) services; and
    3. One of the following: VTIE, CTTIE, “train the trainer,” or master’s degree or above.

Instructor qualifications:

  1. Registered or Practical nurse with current, unencumbered license;
  2. Minimum of 2 years’ experience in the provision of long term care facility services; and
  3. one of the following: VTIE, CTTIE, “train the trainer,” or master’s degree or above in Nursing or Education.



Skills performance checklist:

  • Please note that Prometric's "Clinical Skills Checklist" shall NOT be used as the skills proficiency record/check-off.  Students must be proficient in ALL skills listed in the regulations, not just the skills that may be included in the competency evaluation.
  • The "Clinical Skills Checklist" available from Prometric is NOT to be used as a PROCEDURE GUIDE. It should be used as a TOOL, because it provides checkpoints that the Nurse Aide Evaluator (NAE) will use to compare with the candidate's performance.  The checkpoints are the steps that a MINIMALLY COMPETENT CNA would be expected to carry out when performing that skill. Therefore, the checklist may differ from the procedure guide presented in the textbook, because the competency is evaluating the MINIMUM competency required to function as a CNA
    • Example: If the textbook includes use of gloves during linen change of an occupied bed, but is not listed as a checkpoint on the skills checklist, the student will not be penalized for donning gloves.  HOWEVER, the student will be penalized on the "Standard Precautions" checkpoint if s/he contaminates themselves when removing the gloves. 



Equipment List: 

Provide a list of all equipment to be used for training, including audio-visual, resident care simulation supplies, etc.  

You may wish to refer to the Prometric website, because the test site information and the clinical skills checklist contain many, but not all, items that should be used in training. 

PLEASE NOTE:  The Prometric supplies required for approval as a testing site only lists those necessary to perform the skills that may be included on the Prometric skills competency evaluation.  As noted in the "Skills Performance Checklist" section above, students must be proficient in ALL skills noted in the regulations, not just those tested by Prometric. Therefore, submission of the testing site supply list only will not be sufficient for approval. 


Click here for links to the regulations, train the trainers, and other information.



Other information:

  • Approval to provide nurse aide training is granted specifically for the provider who submitted the application. There is no provision for subcontracting the training program.
  • Non-facility based programs will be surveyed within one (1) year of initial approval, then every two (years) after.
  • Facility-based programs will be surveyed during the annual survey.
  • If an approved program ceases to provide nurse aide training for a two (2) year period, the program shall be closed.
  • Train the trainer classes are provided by instructors approved by the LDH only. You must contact an approved instructor to schedule a class.  A list of train the trainers may be found here.
  • The competency evaluation is conducted by Prometric.  The application, Training Verification Form, and payment must be submitted to Prometric in order to schedule.  (The program's policy should indicate the procedure for this)
  • Due to the changes with Prometric, the state regulation that students must complete training and test within 60 days will not be enforced.  However, the federal regulation that requires an individual must not work greater than 4 months unless they have successfully completed an approved nurse aide training and competency program is still applicable.  
  • Facility based programs must submit the application (with payment) and the Training Verification Form to Prometric within 10 days of completion of training. 
  • Trainees of non-facility based programs shall be provided the Nurse Aide Training (NAT) Verification Form (if not included in tuiton) within 10 days of completion of training, so the student may schedule the competency evaluation . The student may test 3 times within 12 months before retraining is required. The NAT Verification Form cannot be withheld due to non-payment of tuition.
  • NATP’s shall notify trainees of their responsibility to notify the Registry of any changes in contact information (name, address, phone, email). Trainees shall also be provided the website of the LA Nurse Aide Registry, as the answers to most questions can be found there.  The address is