1.2 Nebraska DHHS Nurse Aide Training Requirements and Registry Rules

Nebraska DHHS Regulatory Role & 75-Hour Training Mandate

In Nebraska, the regulation, certification, and registry management of nurse aides are governed by the Nebraska Department of Health and Human Services (DHHS) Division of Public Health, operating primarily under Nebraska Administrative Code Title 172, Chapter 108 (nurse aide training and competency evaluation). The State of Nebraska enforces statutory standards derived from the federal Omnibus Budget Reconciliation Act of 1987 (OBRA '87).

Mandatory 75-Hour Curriculum Breakdown

Nebraska law specifies that all individuals seeking placement on the Nebraska Nurse Aide Registry must successfully complete a state-approved training course consisting of at least 75 clock hours. Training programs are offered by community colleges, healthcare facilities, and vocational institutes approved by DHHS.

Per 172 NAC 108-004.01, nursing-home nurse aide courses must include at least 75 clock hours of instruction, including at least 16 hours of supervised practical training, plus at least 1 hour on reporting suspected abuse or neglect. Programs may exceed these minima. Classroom/lab/clinical splits vary by approved sponsor; do not treat unofficial hour splits as DHHS mandates.

Prerequisite Requirements Prior to Direct Resident Contact

Federal and Nebraska state regulations require that before nurse aide students have any direct hands-on contact with nursing home residents during clinical hours, they must complete at least 16 hours of instruction in five specific core areas:

1. Communications and interpersonal skills.
2. Infection control principles.
3. Safety and emergency procedures (including the Heimlich maneuver and fire response).
4. Promoting resident independence.
5. Respecting resident rights.

Core Eligibility Facts (DHHS)

• Minimum age: 16 years
• Complete a minimum of 75 hours of state-approved training (or the separate 21-hour ICF/IID basic resident care course when applicable)
• Complete one hour of Nebraska-specific abuse/neglect/misappropriation training
• Pass the state-approved written/oral exam and clinical skills exam
• No conviction of a crime of moral turpitude rationally related to nurse aide practice

Background Check Requirements & Registry Enrollment

To protect vulnerable populations in long-term care and hospital settings, Nebraska DHHS maintains strict screening rules for initial and ongoing enrollment on the Nebraska Nurse Aide Registry.

• Nebraska Child and Adult Abuse and Neglect Central Registry Check: Screening against state records of substantiated child or vulnerable adult abuse, neglect, or exploitation.
• Sex Offender Registry Check: Verification against national and state sex offender registries.

Disqualifying Offenses:
Substantiated Findings of Abuse/Neglect OR Felony Convictions of Violence/Theft
  ---> Permanent Denial / Removal from Nebraska Registry

Registry Placement Process

Upon successful completion of the 75-hour training program and passing both the knowledge and clinical skills exams, the testing provider electronically transmits exam results to Nebraska DHHS. DHHS then issues an official registry identification number and places the nurse aide on the Nebraska Nurse Aide Registry in Active status.

Certification Maintenance, Active Status & Reactivation

Nebraska DHHS does not issue expiration dates on Active nurse aide listings unless the status is Lapsed or Ineligible. Status is employment-based:

Active Status Criteria

To stay Active, a nurse aide must have worked as a nurse aide in a paid position within 24 months of their last nurse aide job, in an approved employer setting published by DHHS.

Facility employers submit hire and end-of-employment forms so the registry reflects current work history. Nurse aides can print a wallet card from the online registry search (Nebraska does not mail license cards).

Reactivation from Lapsed Status

A lapsed nurse aide may reactivate by retaking the written/oral and clinical exams through a DHHS-approved post-secondary re-competency testing provider. Bring registry verification or eligibility documentation as the provider instructs. After three failed attempts on an exam, the individual must retake the 75-hour nurse aide course.

Interstate Reciprocity & Endorsement into Nebraska

A certified nursing assistant holding active certification in good standing in another state or U.S. territory may apply for Interstate Reciprocity (Endorsement) to be added to the Nebraska Nurse Aide Registry without repeating training.

Requirements for Reciprocity Applicants

1. Active Registry Status: Must hold current, unexpired nurse aide certification in the originating state.
2. No Misconduct Findings: Must have a clear registry record with no substantiated findings of abuse, neglect, or misappropriation of resident property in any state.
3. Equivalent Training: Must have completed a nurse aide training program meeting federal 75-hour OBRA requirements.
4. Background Screening: Must pass Nebraska DHHS background checks, including Nebraska Child/Adult Abuse Registry screening.
5. Employment Verification: Proof of recent paid nursing-related employment within the past 24 months may be required depending on originating state rules.

All nurse aides transferring into Nebraska must complete a minimum one hour of Nebraska Abuse/Neglect/Misappropriation Training, even if similar training was completed in another state.