Curriculum Guidelines

Medicaid Nurse Aide Curriculum Guidelines

INTRODUCTION: The 1987 Omnibus Reconciliation Act (OBRA) mandates education and competency evaluation for all nurse aides employed by nursing facilities in all states. This Kentucky Medicaid Nurse Aide Curriculum Guide meets the course requirements of the applicable Medicaid regulation (42 CFR 483.152). This seventy-five (75) hour nurse aide training program includes a minimum of sixteen (16) hours of supervised clinical instruction.

Sixteen (16) hours of training in the following areas are required prior to any direct contact with the resident

  1. Communication and interpersonal skills
  2. Infection control
  3. Safety/emergency procedures, including clearing the obstructed airway - conscious adult
  4. Promoting resident’s independence
  5. Respecting resident's rights
    1. providing privacy and maintenance of confidentiality
    2. promoting the resident’s right to make personal choices to accommodate their needs
    3. giving assistance in resolving grievances and disputes
    4. providing needed assistance in getting to and participating in resident and family groups and other activities
    5. maintaining care and security of resident’s personal possessions
    6. promoting the resident’s right to be free from abuse, mistreatment, and neglect, and the need to report any instances of such treatment to appropriate facility staff
    7. avoiding the need for restraints in accordance with current professional standards

The remaining theory/lab hours include the following:

  1. Personal care skills
    1. transfers, positioning, and turning
    2. caring for the resident’s environment
    3. bathing
    4. grooming, including mouth care
    5. dressing
    6. skin care
    7. bedmaking
    8. assisting with eating and hydration
    9. proper feeding techniques
    10. toileting, including specimen collection
  2. Basic nursing skills
    1. taking and recording vital signs
    2. measuring and recording height and weight
    3. recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor
  3. Mental health and social service needs
    1. modifying aide’s behavior in response to resident’s behavior
    2. awareness of developmental tasks associated with the aging process
    3. how to respond to resident behavior
    4. allowing the resident to make personal choices, providing, and reinforcing other behavior consistent with the resident’s dignity
    5. using the resident’s family as a source of emotional support
  4. Care of congnitively impaired residents
    1. techniques for addressing the unique needs and behaviors of individuals with dementia
    2. communicating with cognitively impaired residents
    3. understanding the behavior of cognitively impaired residents
    4. appropriate responses to the behavior of cognitively impaired residents
    5. methods of reducing the effects of cognitive impairments
  5. Basic restorative services
    1. training the resident in self-care according to the resident’s abilities
    2. use of assistive devices in transferring, ambulation, eating, and dressing
    3. maintenance of range of motion
    4. proper turning and positioning in bed and chair
    5. bowel and bladder training
    6. care and use of prosthetic and orthotic devices
  6. Caring for residents when death is imminent

Kentucky Curriculum Guidelines Mapped to:

Kostelnick: Mosby’s Textbook for Long-Term Care Nursing Assistants, 9e
Section Topic Chapter Suggested Hours
II. A. Communication and interpersonal skills 1, 2, 3, 4, 5, 6, 7 6
B. Infection Control 14 3
C. Safety/emergency procedures, including clearing the obstructed airway – conscious adult 11, 12, 13, 18, 19, 44 3
D. Promoting resident’s independence 4, 6, 9 2
E. Respecting resident’s rights 2, 7 2
III. A. 1. Transfers, positioning, and turning 15 3
2. Caring for the resident’s environment 16 1
3. Bathing, including mouth care 18 10
4. Grooming 19  
5. Dressing 19  
6. Skin care 8, 9, 31, 32, 34  
7. Bed making 17 4
8. Assisting with eating and hydration 20 2
9. Proper feeding techniques 20  
10. Toileting 22, 23, 29 4
III. B. 1. Taking and recording vital signs 27 8
2. Measuring and recording height and weight 28 1
3. Recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor 4, 25, 26, 30 - 38 2
III. C. 1. Modifying aides behavior in response to resident’s behavior 1, 6, 9, 10, 39, 40 4
2. Awareness of developmental tasks associated with the aging process 1, 6, 9, 10, 39, 40  
3. How to respond to resident behavior 1, 6, 9, 10, 39, 40  
4. Allowing the resident to make personal choices, providing, and reinforcing. other behavior consistent with the resident’s dignity 1, 6, 9, 10, 39, 40  
5. Using the resident’s family as a source of emotional support 1, 6, 9, 10, 39, 40  
III. D. 1. Techniques for addressing the unique needs and behaviors of individuals with dementia 33, 40  
2. Communicating with cognitively impaired residents 33, 40  
3. Understanding the behavior of cognitively impaired residents 33, 40  
4. Appropriate responses to the behavior of cognitively impaired residents 33, 40  
5. Methods of reducing the effects of cognitive impairments 33, 40  
III. E. 1. Training the resident in self-care according to the resident’s abilities 22 2
2. Use of assistive devices in transferring, ambulation, eating, and dressing 24  
3. Maintenance of range of motion 24, 35 45  
5. Bowel and bladder training 22, 23  
6. Care and use of prosthetic and orthotic devices 33, 24  
III. F. Caring for residents when death is imminent 45 2
Hartman’s Nursing Assistant Care The Basics, 6e
Section Topic Chapter Suggested Hours
II. A. Communication and interpersonal skills 2 6
B. Infection Control 2 3
C. Safety/emergency procedures, including clearing the obstructed airway – conscious adult 2 3
D. Promoting resident’s independence 3 2
E. Respecting resident’s rights 3 2
III. A. 1. Transfers, positioning, and turning 6 3
2. Caring for the resident’s environment 7 1
3. Bathing, including mouth care 6 10
4. Grooming 6  
5. Dressing 6  
6. Skin care 6  
7. Bed making 7 4
8. Assisting with eating and hydration 8 2
9. Proper feeding techniques 8  
10. Toileting 6 4
III. B. 1. Taking and recording vital signs 7 8
2. Measuring and recording height and weight 7 1
3. Recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor 2 2
III. C. 1. Modifying aides behavior in response to resident’s behavior 2 4
2. Awareness of developmental tasks associated with the aging process 3  
3. How to respond to resident behavior 2  
4. Allowing the resident to make personal choices, providing, and reinforcing. other behavior consistent with the resident’s dignity 3  
5. Using the resident’s family as a source of emotional support 3  
III. D. 1. Techniques for addressing the unique needs and behaviors of individuals with dementia 5  
2. Communicating with cognitively impaired residents 5  
3. Understanding the behavior of cognitively impaired residents 5  
4. Appropriate responses to the behavior of cognitively impaired residents 5  
5. Methods of reducing the effects of cognitive impairments 5  
III. E. 1. Training the resident in self-care according to the resident’s abilities 3, 6, 7 2
2. Use of assistive devices in transferring, ambulation, eating, and dressing 9  
3. Maintenance of range of motion 9  
5. Bowel and bladder training 9  
6. Care and use of prosthetic and orthotic devices 9  
III. F. Caring for residents when death is imminent 3 2
ACHA How to Be a Nurse Assistant, 8e
Section Topic Chapter Suggested Hours
II. A. Communication and interpersonal skills 2 6
B. Infection Control 4 3
C. Safety/emergency procedures, including clearing the obstructed airway – conscious adult 5 3
D. Promoting resident’s independence 1, 3 2
E. Respecting resident’s rights 3, 12 2
III. A. 1. Transfers, positioning, and turning 7 3
2. Caring for the resident’s environment 6 1
3. Bathing, including mouth care 4 10
4. Grooming 4  
5. Dressing 4  
6. Skin care 9  
7. Bed making 6 4
8. Assisting with eating and hydration 8 2
9. Proper feeding techniques 8  
10. Toileting 4 4
III. B. 1. Taking and recording vital signs 6 8
2. Measuring and recording height and weight 6 1
3. Recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor 9 2
III. C. 1. Modifying aides behavior in response to resident’s behavior 2 4
2. Awareness of developmental tasks associated with the aging process 2, 9  
3. How to respond to resident behavior 2, 10  
4. Allowing the resident to make personal choices, providing, and reinforcing. other behavior consistent with the resident’s dignity 1, 2, 3, 12  
5. Using the resident’s family as a source of emotional support 3  
III. D. 1. Techniques for addressing the unique needs and behaviors of individuals with dementia 10  
2. Communicating with cognitively impaired residents 10  
3. Understanding the behavior of cognitively impaired residents 10  
4. Appropriate responses to the behavior of cognitively impaired residents 10  
5. Methods of reducing the effects of cognitive impairments 10  
III. E. 1. Training the resident in self-care according to the resident’s abilities 7 2
2. Use of assistive devices in transferring, ambulation, eating, and dressing 7, 8  
3. Maintenance of range of motion 7  
5. Bowel and bladder training 7  
6. Care and use of prosthetic and orthotic devices 6, 7  
III. F. Caring for residents when death is imminent 11 2

Applicable to all training programs, regardless of textbook choice:

A minimum of three (3) multiple choice tests are required. All tests must be averaged, and a 70% minimum average is required.

Required texts for students and instructors:

  • Kostelnick, C. (2024). Mosby’s textbook for long-term care nursing assistants (9the ed.). Elsevier, Inc.
  • Kostelnick, Kelly C. (2024). Mosby’s workbook and competency evaluation review for long-term care assistants (9tph ed.). Elsevier, Inc.
  • Hartman Publishing, Inc, Fuzy, C. (2022). Hartman’s Nursing Assistant Care the Basics (6to ed.). Hartman Publishing, Inc Hartman
  • Publishing, Inc, C. (2022). Workbook, Hartman’s Nursing Assistance Care the Basics (6th ed.). Hartman Publishing, Inc
  • Boschert, C. (2024). How to be a Nurse Assistant (8th ed.). American Health Care Association (AHCA)
  • American Health Care Association (AHCA), C. (2018). Workbook, How to Be a Nurse Assistant (8th ed.). American Health Care Association (AHCA)

Kentucky Community and Technical College System (2024). Kentucky Medicaid Nurse Aide Testing Procedures Manual and Study Guide.

Resource materials for teacher:

  1. Each publisher has online resources. Please contact your sales associate for access assistance.
  2. The Federal Law related to Nurse Aide Training and Competency Evaluation (42 USC 1396r) and the Federal Regulation (42 CFR 483.152) can be found at eCFR :: 42 CFR 483.152 -- Requirements for approval of a nurse aide training and competency evaluation program.
  3. The Kentucky Administrative Regulation (907 KAR 1:450) about nurse aide training and the registry can be found at Title 907 Chapter 1 Regulation 450 • Kentucky Administrative Regulations • Legislative Research Commission
  4. The Kentucky Department for Medicaid Services Program Manual can be found at Nurse Aide Training - Cabinet for Health and Family Services (ky.gov) and scrolling down to 907 KAR 1:450.

NOTE: Compliance with all applicable regulations is the responsibility of the instructor and program administrators