(a) Only HHSC, or an entity HHSC approves, may provide a competency evaluation, which must be administered by a skills examiner at an approved evaluation site.     
      (b) A trainee is eligible to take a competency evaluation if the trainee has successfully completed the training portion of a NATCEP, as determined by the program director, or is eligible under §556.11 of this chapter (relating to Waiver, Reciprocity, and Exemption Requirements).     
      (c) If a trainee cannot take a competency evaluation at the NATCEP location where the trainee received training, the trainee may take a competency evaluation at another location approved to offer the evaluation.     
      (d) An eligible trainee must obtain from the program director a signed competency evaluation application and a certificate or letter of completion of training. The trainee must arrange to take the competency evaluation at an approved location and must follow the instructions on the competency evaluation application.     
      (e) A NATCEP must:      
        (1) promptly, after one of its trainees successfully completes the NATCEP training, approve the trainee to take a competency evaluation;       
        (2) provide the trainee with information regarding scheduling a competency evaluation; and       
        (3) ensure that the trainee accurately completes the competency evaluation applications.       
      (f) A trainee must:      
        (1) take a competency evaluation within 24 months after completing the training portion of a NATCEP;       
        (2) verify the arrangements for a competency evaluation;       
        (3) complete a competency evaluation application and submit the application in accordance with application instructions;       
        (4) request another competency evaluation if the trainee fails a competency evaluation; and       
        (5) meet any other procedural requirements specified by HHSC or its designated skills examiner.       
      (g) A competency evaluation must consist of:      
        (1) a skills demonstration that requires the trainee to demonstrate five randomly selected skills drawn from a pool of skills that are generally performed by nurse aides, including all personal care skills listed in the curriculum; and       
        (2) a written or oral examination, which includes 60 scored multiple-choice questions selected from a pool of test items that address each course requirement in the curriculum. Written examination questions may be printed in a test booklet with a separate answer sheet or provided in an online testing format as approved by HHSC. An oral examination must be a recorded presentation read from a prepared text in a neutral manner that includes questions to test reading comprehension.       
      (h) A trainee with a disability, including a trainee with dyslexia as defined in Texas Education Code §51.970 (relating to Instructional Material for Blind and Visually Impaired Students and Students with Dyslexia), may request a reasonable accommodation for the competency evaluation under the Americans with Disabilities Act.     
      (i) To successfully complete the competency evaluation, a trainee must achieve a score HHSC designates as a passing score on:      
        (1) the skills demonstration; and       
        (2) the written or oral examination.       
      (j) A trainee who fails the skills demonstration or the written or oral examination may retake the competency evaluation twice.      
        (1) A trainee must be advised of the areas of the competency evaluation that the trainee did not pass.       
        (2) If a trainee fails a competency evaluation three times, the trainee must complete the training portion of a NATCEP before taking a competency evaluation again.       
      (k) HHSC informs a trainee before the trainee takes a competency evaluation that HHSC issues a certificate of registration and records successful completion of the competency evaluation on the NAR.     
      (l) HHSC, or its designee, issues the certificate of registration and records successful completion of the competency evaluation on the NAR within 30 days after the date the trainee passes the competency evaluation.     
      (m) A nursing facility must not offer or serve as a competency evaluation site if the nursing facility is prohibited from offering a NATCEP under the provisions of §556.3(f) of this chapter (relating to Nurse Aide Training and Competency Evaluation Program (NATCEP) Requirements).     
      (n) A trainee may not be charged for any portion of a competency evaluation if the trainee is employed by or has received an offer of employment from a nursing facility on the date the trainee takes the competency evaluation.     
      (o) HHSC reimburses a nurse aide for a portion of the costs incurred by the individual to take a competency evaluation if the individual is employed as a nurse aide by, or has received an offer of employment from, a nursing facility within 12 months after taking the competency evaluation.     
     Source Note:        The provisions of this §556.6 adopted to be effective September 24, 2018, 43 TexReg 6326; amended to be effective August 8, 2021, 46 TexReg 4693; amended to be effective September 27, 2022, 47 TexReg 6201