CNA Reimbursement in Indiana

If you pay for your own CNA class, there is a federal law that requires nursing homes to pay you back what you paid for your CNA class. We will give you the paperwork you need in order to get reimbursed. It may take a few months to get your reimbursement. With your receipt and your certificate you get when you finish your CNA class, there will be more detailed information as to how you get your money paid back.

The NATCEP is uniquely a program for nurse aides in nursing homes. Individuals who provide care to residents in a nursing home must either be performing tasks for which they are licensed or be performing tasks allowed for certified nurse aide to perform. Hospitals and other healthcare settings are not required to have certified nurse aides so while they may hire someone who has completed the training and competency test to work in their facilities, there is no provisions regarding payment of the costs of the training. Individuals who are already hired by a nursing home at the time they begin their nurse aide training may not be required to pay any portion of their training and competency program.

Individuals who complete the training and competency program and then becomes employed by a nursing home within 12 months of completion, must be reimbursed for the costs incurred in completing the program. The nursing homes then submit those costs on their costs reports and are reimbursed by Medicaid. In other words, the individual has to go to work in a nursing home, submit documentation of the cost of the training, and then the nursing home reimburses those costs. Facilities are not required to reimburse the full amount right away because the individual could work one week, get their training paid and then quit. So facilities usually divide the cost into twelfths, or quarters, or something like that and pay it as the individual works that month or quarter. Any other coverage of these expenses would be at the discretion of the employer.

Reimbursement FAQ

Does the facility have to pay the nurse aides for the training costs?
Federal regulation at 42 CFR 483.152(c)(1) states that “No nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide training and competency evaluation program may be charged for any portion of the program (including any fees for textbooks or other required course materials).” Also, the federal regulation states at 42 CFR 483.152(c)(2), that “If an individual who is not employed, or does not have an offer to be employed, as a nurse aide becomes employed by, or receives an offer of employment from, a facility not later than 12 months after completing a nurse aide training and competency evaluation program, the State must provide for the reimbursement of costs incurred in completing the program on a prorated basis during the period in which the individual is employed as a nurse aide.” Only Medicare/Medicaid facilities have to reimburse training costs.

What is covered by the reimbursement?
NATCEP costs cover: All of the training coursework; fees for textbooks or other required course materials; registering individuals on the nurse aide registry; and any costs of giving or grading the examinations.

When does the nurse aide have to be reimbursed for the training program?
When a nurse aide pays for non-facility-based training costs and is hired within one year of successfully completing the NATCEP, the provider is expected to pay 100% of the costs. This can be paid at the time of hiring or can be prorated over a reasonable period of time. A reasonable period of time cannot be more than 12 months.

Does a nursing facility have to pay for the class for a nurse aide working in their facility or at a community college?
Yes. The nursing facility is responsible for paying for the class regardless of whether it’s at the facility or at a community college, within the time frames as stated above.

Since the facility paid for the training, does the aide have to work for the facility for a certain amount of time?
No. A facility cannot make a nurse aide work for a certain length of time. As long as the person passed the evaluations, he/she must be reimbursed for the training.

How does the facility report the reimbursement costs?
All costs that have to do with nurse aide training and competency evaluation programs (NATCEP) should be reported on Line 321 (NATCEP Costs) of the Medicaid Nursing Facility Financial Report. These costs include:

  1. Reimbursement made to nurse aides who personally paid for the cost of training classes.
  2. Wages for trainers.
  3. Costs from train-the-trainer classes.
  4. Training materials and supplies.
  5. Costs for nurse aide testing.

Wages for nurse aides while in training should not be reported on Line 321, but should be reported on Line 314 (Nurses Aides).

How do I know if the nurse aide was reimbursed at a different facility?
The nurse aide should only be reimbursed by one (1) facility per one (1) training program completed. It is the responsibility of the facility to do an employee background check to see if the nurse aide has completed the training, and if a different facility has already reimbursed him/her for the cost of training. This might mean the facility has to contact previous employers to find out if the new employee has already been reimbursed for his/her training program costs.

Any additional questions regarding NATCEP reimbursement, please contact Gina at ISDH (317) 233-7497.

Med Ed CNA Training Classes will issue one original receipt only.