North Carolina · nursing homes
North Carolina nursing home staff requirements: what you have to hold on every person
A North Carolina nursing home has to hold twenty-nine dated things on file for the people it employs. Twenty-eight of them are federal and are the same in every state. One is North Carolina's own with a section number behind it, and two more are real but could not be pinned to one, so they are named further down instead.
What North Carolina adds
One thing, on top of everything every nursing home in the country already holds. It names the section of North Carolina law it comes from, so you can read it yourself rather than take our word for it.
| What we track | How often | Where the rule comes from |
|---|---|---|
| A criminal history check through the SBI, and a national one as well if they have lived here less than five yearsThe five-year residency question decides which check you run, and it is asked once, in an interview. The wrong check held for five years looks exactly like the right one in a file. | Before they start. North Carolina sets no repeat. | N.C. Gen. Stat. 131E-265 |
The question that gets asked once
Almost everything on this page is a date. The North Carolina background check is not: it is a question, asked once, whose answer decides which of two different checks you run.
Have you lived in North Carolina for the last five years? Yes, and the state check is enough. No, and you need the national one too.
The failure here does not look like a failure. The file has a background check in it, dated, signed, filed. It is simply the wrong one for that person, and nothing on any list will ever flag it, because a list can only tell you whether a check is there. Only the interview note tells you whether it is the right check.
The practical answer is to record the residency answer next to the check itself, so the two are read together by whoever looks next.
What North Carolina does not add
No state training hours. No repeat background check. No state TB schedule we could confirm beyond the baseline. The eleven federal teaching topics further down this page are the training list for a North Carolina building.
What every nursing home in the country holds
These twenty-eight are the same in North Carolina as they are everywhere else, and they are most of the job. Each one names a CMS tag, a piece of the federal code, or both. The guides go through the ones that get cited most.
Licences and certificates
| What we track | How often | Where the rule comes from |
|---|---|---|
| A current RN license | When it runs out. Most last 2 years. | F839 · 42 CFR 483.70(e) |
| A current LPN license | When it runs out. Most last 2 years. | F839 · 42 CFR 483.70(e) |
| Nurse aide certification, still active on the state list | When it runs out. Most last a year. | F728 · 42 CFR 483.35(d) |
| A current license for therapy, social work and pharmacy staff | When it runs out. Most last 2 years. | F839 · 42 CFR 483.70(e) |
| A current administrator license | When it runs out. Most last a year. | F836 · 42 CFR 483.70(a) |
| Proof the food service director is qualified, where no dietitian works full time | When it runs out. Most last 3 years. | F801 · 42 CFR 483.60(a)(2) |
| Proof the activities lead is qualified | When it runs out. Most last 2 years. | F680 · 42 CFR 483.24(c)(2) |
Checks you run on a person
| What we track | How often | Where the rule comes from |
|---|---|---|
| A look at the state nurse aide list before the first shift | Before their first shift, then every 2 years | F729 · 42 CFR 483.35(d)(4) |
| A check for any finding of abuse or neglect against them | Every year | F606 · 42 CFR 483.12(a)(3) |
Health and safety
| What we track | How often | Where the rule comes from |
|---|---|---|
| A first TB check: history, symptoms and a test | Once, in their first two weeks | CDC 2019 via 42 CFR 483.80(a)(2) |
| The hepatitis B shot offered free, and their answer written down | Once, within ten working days of starting | 29 CFR 1910.1030(f) |
| A mask fit test for anyone who wears an N95 | When it runs out. Most last a year. | 29 CFR 1910.134(f) |
| A current CPR card at the healthcare level | When it runs out. Most last 2 years. | F678 · 42 CFR 483.24(a)(3) |
Teaching and in-service
| What we track | How often | Where the rule comes from |
|---|---|---|
| Orientation, before they work on their own | Once, in their first week | F940 · 42 CFR 483.95 |
| Teaching on abuse, neglect and dementia care | Every year | F943 · 42 CFR 483.95(c) |
| Teaching on residents' rights | Every year | F942 · 42 CFR 483.95(b) |
| Teaching on stopping infection spreading | Every year | F945 · 42 CFR 483.95(e) |
| Teaching on the quality program | Every year | F944 · 42 CFR 483.95(d) |
| Teaching on the compliance and ethics program, if your company runs five or more buildings | Every year | F946 · 42 CFR 483.95(f) |
| Teaching on mental health and behavior needs | Every year | F949 · 42 CFR 483.95(i) |
| Teaching on talking with residents, for hands-on staff | Every year | F941 · 42 CFR 483.95(a) |
| Teaching on what to do in an emergency | Every year | 42 CFR 483.73(d)(1) |
| Teaching on blood and needle safety | Every year | 29 CFR 1910.1030(g) |
| Teaching on the chemicals they handle | When they start, and again when a new chemical arrives | 29 CFR 1910.1200(h) |
| Twelve hours of teaching for each nurse aide | 12 hours every year, counted from their own start date | F947 · 42 CFR 483.95(g) |
| A written look at how each nurse aide is doing | Every year | F730 · 42 CFR 483.35(d)(7) |
| Teaching on keeping resident information private | When they start, and again whenever your privacy policy changes | 45 CFR 164.530(b)(1) |
Employment paperwork
| What we track | How often | Where the rule comes from |
|---|---|---|
| Form I-9, filled in and kept | Once, in their first three days of work | 8 CFR 274a.2(b)(1)(ii) |
Three more that nearly every building does anyway
These three are not on the tables above, and the reason is narrow: they rest on federal guidance or on a reporting program rather than on a rule with a section number. Almost every nursing home does all three, several state Medicaid programs have made the first one a condition of payment, and a page that called them law would be a page a surveyor would stop trusting.
- A check against the federal list of people barred from Medicare and Medicaid work. Every month. A name that was clear in January can be on it in February, so this is one to run on employees and contractors alike.
- Teaching on the signs of TB. Every year. What the signs are, who is at risk, and what to do about it. Teaching, not a test.
- A flu shot, or their reason for saying no. Every year. Their answer either way, written down. The count of who said yes is what goes in the yearly report.
What you still have to check yourself
Real in North Carolina, and not on the tables above, because we could not put a section number next to them without guessing. Guessing at a citation is worse than admitting the gap, because the guess is the thing somebody quotes back.
- The two-step skin test or blood test for TB when somebody starts. Every North Carolina building does this. We could not pin it to a section number, so it is not in the table above.
- Whether North Carolina asks for a yearly TB check after that baseline. We could not confirm it either way, so take the national 2019 approach as your floor.
- A check of the Health Care Personnel Registry before somebody starts, which is where a finding of abuse, neglect or misappropriation against a person in this state is recorded.
Where the North Carolina rows came from
Read on .
Questions North Carolina buildings ask
When does North Carolina require a national criminal history check?
When the person has not lived in North Carolina for the last five years. Otherwise the state check through the SBI is the one. It is a question asked once at interview, and the answer decides which check you run, which is why it is worth writing down alongside the result.
Does North Carolina re-run the background check?
N.C. Gen. Stat. 131E-265 sets it before somebody starts and does not set a repeat. That makes North Carolina quieter than Texas, which comes back around every year, or Washington, which comes back every two.
Does North Carolina require an annual TB test?
The baseline at hire is clear and every building runs it. Whether a yearly check follows is the item we could not confirm, so we have not put a number on it. The national 2019 approach, which is questions rather than a repeat test, is the sensible floor while you check with your own source.
What is the Health Care Personnel Registry?
The North Carolina list of findings of abuse, neglect, misappropriation or diversion against people who work in health care settings in this state. You check it before somebody starts. It is a different list from the criminal history check and it catches different things, so running one is not running the other.
Does North Carolina add nurse aide training hours?
No. The aide hours stay at the federal twelve a year, counted from each person's own hire anniversary, with no state topics on top of the eleven federal ones.
Where to go next
- How Credolex works in a nursing home
- F726: nurse aide competency, the guide behind the tag North Carolina leans on
- What Florida asks for
- What Texas asks for
- What Pennsylvania asks for
- Every state we have read so far