PHI has updated its State Nurse Aide Training Requirements chart to reflect the minimum number of training hours and clinical hours required by each state and the District of Columbia in 2009.

As many as 30 states and DC now require nurse aides to have more training hours than the minimum number of hours mandated by federal regulations, the chart (pdf) shows.

Still, only 13 of these states and DC require a minimum of 120 or more training hours — the number of hours recommended by the Institute of Medicine (IOM) in its 2008 report Retooling for an Aging America. Maine tops the list for training hour requirements — 180 hours, beginning in 2010.

Twenty states lag far behind, with minimum training hour requirements that have not changed for 20 years.

Federal legislation — the Omnibus Budget Reconciliation Act of 1987 — requires that nurse aides have at least 75 hours of training, including at least 16 hours of supervised practical or clinical training, to work at Medicare- and Medicaid-certified nursing homes.

“PHI’s experience over the past 20 years, designing skills-based training for direct-care workers, has consistently demonstrated the need to increase the minimum training hours required for high quality care,” said Peggy Powell, who on January 1 will be named national director of PHI’s new Curriculum & Workforce Development Department.

“As demand increases for the care of elders and individuals with chronic illness and other disabling conditions in long-term care settings, having a more highly skilled direct-care workforce — with increased competence in clinical, core communication and problem-solving skills — is essential to provide high-quality service,” said Powell.

Meeting Federal Requirements

The majority of states (33) and DC require more than the minimum of supervised clinical training hours mandated by federal regulations. The number of clinical training hours required ranges widely with California and Missouri requiring the most: 100 clinical hours.

Federal regulations also:

• list the subject areas and skills to be taught,
• outline the qualifications for approved trainers,
• define the competency evaluation process,
• and require that each state establish and maintain a registry for nurse aides.

The IOM also recommends that federal requirements for certified nursing assistants and home health aides should include demonstration of competence in the care of older adults as a criterion for certification.