Nurse Aide Registry Verification for Nursing Homes
Short answer: before a nursing home lets someone work as a nurse aide, it must receive registry verification that the person met the competency requirements, and it must seek information from every state registry it believes will have information on that person (42 CFR 483.35(d)(4)-(5)). Here is what that means in practice, and what to keep in the file.
Updated October 21, 2026 · Checked against the official sources listed at the end
The rule: verify before the first shift
Under 42 CFR 483.35(d)(4), a facility must receive registry verification that the individual has met competency evaluation requirements before allowing them to serve as a nurse aide. Two narrow exceptions apply: a full-time employee in a state-approved training and competency evaluation program, and someone who can prove they recently completed a state-approved program and has not yet been placed on the registry.
Under 483.35(d)(5), the facility must also seek information from every state registry that it believes will include information on the individual. An aide who worked in another state, or lives near a state line, needs those registries checked too.
Two time limits that catch facilities
- 4 months: a facility may not use anyone as a nurse aide for more than 4 months, full time, unless they are competent and have completed a state-approved training and competency evaluation program or competency evaluation program (483.35(d)(1)).
- 24 months: if an aide went 24 consecutive months without providing nursing or nursing-related services for pay since their last program, they must complete a new training and competency evaluation program or competency evaluation (483.35(d)(6)).
- Temporary, per diem and agency aides are held to the same standards as permanent staff (483.35(d)(2)).
The yearly items that go with it
The facility must complete a performance review of every nurse aide at least once every 12 months (483.35(d)(7)), and in-service training must be at least 12 hours a year, including dementia management and resident abuse prevention (483.95(g)). In CMS's nursing home deficiency data (September 2026 file, surveys from March 2017 to August 2026), the aide performance review (F730) was cited 1,492 times and the aide in-service rule (F947) 1,119 times.
What to keep in each aide's file
- The dated registry verification from your state, and from each other state you checked, with the registry's name.
- The date the aide first worked as a nurse aide in your facility.
- The training and competency evaluation program completion, with its date.
- Each year's performance review and in-service hours, with certificates.
How Pact handles it
Pact tracks each aide's registry checks, in-service hours, annual review, license or certification, TB and BLS on one page per person, reminds staff 30, 14 and 7 days before anything runs out, and checks everyone against OIG's exclusion list every month. Pact's staff look each aide up on the state's registry by hand and save the dated result in the aide's file. Pact Compliance Review also checks every document aides upload, usually within minutes, 24/7. $10 per active staff member a month, $250 minimum.
Common questions
Do I have to check other states' nurse aide registries?
Yes, every state registry the facility believes will include information on the individual (42 CFR 483.35(d)(5)). A practical test: any state where the aide has lived, worked or trained.
Can an aide start before the registry check comes back?
No. The facility must receive registry verification before allowing the person to serve as a nurse aide, except for a full-time employee in a state-approved training program or someone who just completed one and isn't on the registry yet (483.35(d)(4)).
Do agency aides need a registry check too?
Yes. A facility can't use temporary, per diem or leased aides who don't meet the same requirements (483.35(d)(2)), so check them before their first shift.
How many in-service hours do nurse aides need?
At least 12 hours a year, including dementia management and resident abuse prevention training (483.95(g)).
Sources
- 42 CFR 483.35: Nursing services (nurse aide hiring, registry verification)
- 42 CFR 483.95: Training requirements (in-service for nurse aides)
- CMS Provider Data Catalog: nursing home health deficiencies