120 Day Rule Explanation

AGING AND LONG-TERM SUPPORT ADMINISTRATION

120 Day Rule Explanation

Each nursing facility that hires an individual who is not a nursing assistant – certified to perform resident care has 120 days total in which to help the person complete state-approved training and testing.

This is a Federal regulation [42 CFR Chapter IV 483.75(2, 3, 4)].
There is nothing in these regulations that allows a nursing facility to employ a resident caregiver who has not trained and successfully tested to work longer than 120 days.
A facility cannot fire and rehire the nursing assistant to restart the 120-day clock.
A facility cannot start the 120 days over again if they put the individual through a second training and testing sequence.
The duration of time between when an individual is hired and fired, or between training and testing attempts has no effect on application of the 120-day rule. This is a lifetime time limit for any nursing facility.
Federal survey standards F Tags 494 and 495 restate this 120-day requirement.
Nursing assistants, who have worked 120 days without completing the required training and testing, can be employed to work in jobs that do not involve direct resident care.

The Federal Regulations [Chapter 483.75 (2)] state:

(2) General rule - A facility must not use any individual working in the facility as a nurse aide for more than 4 months (120 days), on a full-time basis, unless:

That individual is competent to provide nursing and nursing related services; and

(A) That individual has completed a training and competency evaluation program, or a competency evaluation program approved by the State as meeting the requirements of Chapter 483.151-483.154 of this part;
(B) that individual has been deemed or determined competent as provided in Chapter 483.150 (a) and (b)