Four Month Rule Explanation

Each nursing facility that hires an individual who is not a nursing assistant – certified to perform resident care has four months from date of hire in which to help the person successfully 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 four months. 
  • A facility cannot fire and rehire the nursing assistant to restart the four month clock.
  • A facility cannot start the four months 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 four month rule. This is a lifetime time limit for any nursing facility.
  • Federal survey standards F Tags 494 and 495 restate this four month requirement.
  • Nursing assistants, who have worked four months 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, on a full-time basis, unless:

  1. That individual is competent to provide nursing and nursing related services; and
    1. 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;
    2. that individual has been deemed or determined competent as provided in Chapter 483.150 (a) and (b)