A facility must develop, implement, and maintain an effective training program for all new and existing staff; individuals providing services under a contractual arrangement; and volunteers, consistent with their expected roles. A facility must determine the amount and types of training necessary based on a facility assessment as specified at § 483.71. Training topics must include but are not limited to—

1. (a) Communication. A facility must include effective communications as mandatory training for direct care staff.
2. (b) Resident's rights and facility responsibilities. A facility must ensure that staff members are educated on the rights of the resident and the responsibilities of a facility to properly care for its residents as set forth at § 483.10, respectively.

3. (c) Abuse, neglect, and exploitation. In addition to the freedom from abuse, neglect, and exploitation requirements in § 483.12, facilities must also provide training to their staff that at a minimum educates staff on—

   1. (1) Activities that constitute abuse, neglect, exploitation, and misappropriation of resident property as set forth at § 483.12.
   2. (2) Procedures for reporting incidents of abuse, neglect, exploitation, or the misappropriation of resident property.
   3. (3) Dementia management and resident abuse prevention.
4. (d) Quality assurance and performance improvement. A facility must include as part of its QAPI program mandatory training that outlines and informs staff of the elements and goals of the facility's QAPI program as set forth at § 483.75.
5. (e) Infection control. A facility must include as part of its infection prevention and control program mandatory training that includes the written standards, policies, and procedures for the program as described at § 483.80(a)(2).

6. (f) Compliance and ethics. The operating organization for each facility must include as part of its compliance and ethics program, as set forth at § 483.85—

   1. (1) An effective way to communicate that program's standards, policies, and procedures through a training program or in another practical manner which explains the requirements under the program.
   2. (2) Annual training if the operating organization operates five or more facilities.

7. (g) Required in-service training for nurse aides. In-service training must—

   1. (1) Be sufficient to ensure the continuing competence of nurse aides, but must be no less than 12 hours per year.
   2. (2) Include dementia management training and resident abuse prevention training.
   3. (3) Address areas of weakness as determined in nurse aides' performance reviews and facility assessment at § 483.70(e) and may address the special needs of residents as determined by the facility staff.
   4. (4) For nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired.
8. (h) Required training of feeding assistants. A facility must not use any individual working in the facility as a paid feeding assistant unless that individual has successfully completed a State-approved training program for feeding assistants, as specified in § 483.160.
9. (i) Behavioral health. A facility must provide behavioral health training consistent with the requirements at § 483.40 and as determined by the facility assessment at § 483.70(e).

[81 FR 68870, Oct. 4, 2016, as amended at 89 FR 41000, May 10, 2024]