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Outline

The journey to becoming a certified Nurse Aide I in South Carolina involves a detailed process, outlined by the North Carolina Department of Health and Human Services Division of Health Service Regulation Health Care Personnel Education and Credentialing Section. Individuals aiming to get listed on the North Carolina Nurse Aide I Registry through reciprocity must meticulously follow a set of guidelines as stipulated in the Nurse Aide I Registry Reciprocity Application. The application critically reviews eligibility, requiring applicants to demonstrate they are active and in good standing on another state's nurse aide registry, free from pending or substantiated findings of misconduct, and possess relevant employment experience or have passed a state-approved competency examination within the past two years. Furthermore, personal identification and completion of a state-approved nurse aide training and competency evaluation program are mandatory prerequisites. The application form guides the applicant through providing personal information, elucidating their nurse aide training, registry statuses in other states, employment types relevant to the nurse aide designation, and a detailed employment history. This comprehensive process ensures that every applicant adheres to high standards, maintaining the integrity and quality of care associated with the Nurse Aide I designation in North Carolina.

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North Carolina Department of Health and Human Services

Division of Health Service Regulation

Health Care Personnel Education and Credentialing Section

Phone: 919-855-3969

NURSE AIDE I REGISTRY RECIPROCITY APPLICATION

DHSR Has 10 Business Days from Date of Receipt to Review the Application.

INSTRUCTIONS:

▪Review Part 1 below and determine if you meet the eligibility requirements to be listed on the North Carolina Nurse Aide I Registry.

▪If you meet the eligibility requirements, then complete and submit all pages of the application (pages 1 through 6) and any required supportive documentation. Incomplete applications will not be processed.

▪

▪

Please use black or blue ink only. Other ink colors are not be readable via fax. Return completed application by mail or fax.

oMailing Address: 2709 Mail Service Center, Raleigh, NC 27699-2709

o Fax Number: 919-733-9764

Do Not Submit More Than One (1) Application Unless Instructed by DHSR.

PART 1: DETERMINE ELIGIBILITY

Consistent with Rule 10A NCAC 13O .0301, to be eligible to be listed on the North Carolina Nurse Aide I Registry, you must meet the five (5) criteria listed below.

1.You are listed as active and in good standing on another State registry of nurse aides.

o A temporary listing on a State registry of nurse aides will not be accepted.

2.You have no pending or substantiated findings of abuse, neglect, exploitation, or misappropriation of resident or patient property recorded on any State registry of nurse aides.

3.You have been employed as a nurse aide for monetary compensation consisting of at least a total of eight hours of time worked performing nursing or nursing-related tasks delegated and supervised by a Registered Nurse in the past two years (previous 24 consecutive months).

oIf you have not been employed as a nurse aide, then you are only eligible for reciprocity if you successfully passed a state-approved nurse aide I competency examination and was listed on the Nurse Aide I Registry in the State(s) of reciprocity in the past two years (previous 24 consecutive months).

oPrivate duty nurse aide employment type does not meet the eligibility requirements for reciprocity.

4.You have a social security card and an unexpired government-issued identification containing a photograph and signature.

oThe name listed on your social security card and unexpired government-issued identification containing a photograph and signature must match.

oThe name listed on both identifications must match the name listed on the nurse aide registry in the State(s)

of reciprocity.

oIf the names do not match, then you must submit documentation verifying any name changes (e.g., birth certificate, marriage license, divorce decree, notice of resumption of former name, etc.).

5.You completed a state-approved nurse aide training and competency evaluation program that meets the requirements of 42 CFR 483.152 or a state-approved competency evaluation program that meets the requirements of 42 CFR 483.154.

DHSR/HCPEC-4515 (Revised February 2021)

Page 1 of 6

PART 2: PERSONAL INFORMATION

▪

▪

▪

Answer all questions. Print legibly.

Include hyphens and suffixes in your legal name if applicable (No Nicknames).

First Name:

Middle Name:

Last Name:

Prior Name(s) (if applicable):

First Name:

 

 

Middle Name:

 

 

Last Name:

 

 

 

 

 

 

 

First Name:

 

 

Middle Name:

 

 

Last Name:

 

 

 

 

 

 

 

 

 

 

 

 

Gender:

 

 

Social Security Number:

 

Email Address:

 

 

 

(include all 9 numbers)

 

 

□ MALE

□ FEMALE

 

 

 

 

 

 

 

 

 

 

 

Telephone Number:

 

Date of Birth:

 

 

Mother’s Maiden Last Name:

(include area code)

 

 

 

 

 

 

 

 

_________/________/__________

 

 

 

 

mm

dd

yyyy

 

 

 

 

 

 

 

Did You Serve in the Military?

 

 

 

 

□ YES

□ NO

 

 

 

 

Did You Work in a Military Occupational Specialty (MOS) Where You Performed Nursing or Nursing-Related Tasks?

□ YES □ NO □ I DID NOT SERVE IN THE MILITARY

Are You Currently Married to an Active Member of the Military or a Military Veteran?

□ YES □ NO

Mailing Address:

Street/PO Box:

City:

Zip Code:

Apt. #:

State:

County:

DHSR/HCPEC-4515 (Revised February 2021)

Page 2 of 6

PART 3: STATE-APPROVED NURSE AIDE I TRAINING & COMPETENCY EVALUATION PROGRAM

Answer both questions below.

□ YES

□ NO

Did You Complete a State-Approved Nurse Aide I Training Program that Consisted of At Least

75 Hours of Training?

 

 

 

 

 

□ YES

□ NO

Did You Successfully Pass a State-Approved Nurse Aide I Competency Examination?

 

 

 

 

PART 4: NURSE AIDE I REGISTRIES

▪

▪

Complete the table and questions below.

List all states that you have an active or expired nurse aide I registry listing. We will verify that you have no findings in the states where your listing is active or expired.

▪For all active listings, you must include, with this application, documentation verifying that each registry listing is active and in good standing in the State of reciprocity. The documentation should be dated within 30 calendar days before the date your application is received by the Department.

▪If your listing is active and you are currently working as a nurse aide in Alabama, then you must submit a signed letter from your current employer, on official company letterhead, indicating your nurse aide status is active in the state of Alabama.

State Name or

 

Is Your Registry

Original Issue Date:

Expiration Date:

Registry Certification or

Abbreviation:

 

 

Listing

 

 

 

 

 

 

Registration Number:

 

 

Current/Active?

 

 

 

 

 

 

 

 

 

□ YES

□ NO

______/______/______

______/______/______

 

 

 

mm

dd

yyyy

mm

dd

yyyy

 

 

 

 

 

 

 

 

State Name or

 

Is Your Registry

Original Issue Date:

Expiration Date:

Registry Certification or

Abbreviation:

 

 

Listing

 

 

 

 

 

 

Registration Number:

 

 

Current/Active?

 

 

 

 

 

 

 

 

 

□ YES

□ NO

______/______/______

______/______/______

 

 

 

mm

dd

yyyy

mm

dd

yyyy

 

 

 

 

 

 

 

 

State Name or

 

Is Your Registry

Original Issue Date:

Expiration Date:

Registry Certification or

Abbreviation:

 

 

Listing

 

 

 

 

 

 

Registration Number:

 

 

Current/Active?

 

 

 

 

 

 

 

 

 

□ YES

□ NO

______/______/______

______/______/______

 

 

 

mm

dd

yyyy

mm

dd

yyyy

 

 

 

 

 

 

 

 

 

 

 

□ YES □ NO

 

Are You Listed on More Than Three State Nurse Aide Registries in an Active or Expired

 

 

 

Status?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you answered YES, then you must attach a separate sheet of paper providing the registry information for the States not listed in the table above.

DHSR/HCPEC-4515 (Revised February 2021)

Page 3 of 6

□ YES □ NO

Do You Have Any Pending or Substantiated Findings of Abuse, Neglect, Exploitation, or Misappropriation of Resident or Patient Property Recorded on Any State Registry of Nurse Aides?

If you answered YES to the question above, then list the States below.

States Where You Have a Pending or Substantiated Finding:

PART 5: EMPLOYMENT TYPE

▪Select the employment type where you performed nursing or nursing-related tasks delegated and supervised by a Registered Nurse in the past 2 years only (previous 24 consecutive months). Private duty nurse aide employment does not meet the eligibility requirements for reciprocity.

▪Select all that apply.

□ Adult/Family Care Home

□ Home Health/Home Care

□ Hospice

 

 

 

 

 

□ Hospital

□ Mental Health

□ Nursing Home

 

 

 

 

 

□ Other (please specify):

 

 

 

 

□ I Did Not Work as a Nurse Aide; I Successfully Passed a State-Approved Nurse Aide I Competency Evaluation

Program and Was Listed on the Nurse Aide I Registry in the State(s) of Reciprocity in the Past 2

Years (Previous

24 Consecutive Months).

 

 

 

 

 

 

 

PART 6: EMPLOYMENT HISTORY

▪Provide employment information where you performed nursing or nursing-related tasks delegated and supervised by a Registered Nurse in the past 2 years only (previous 24 consecutive months). Do not include private duty nurse aide employment.

▪If you did not work as a nurse aide, then leave blank.

FACILITY/AGENCY/EMPLOYER #1

Name:

 

 

 

 

 

 

 

 

Street/PO Box:

 

 

 

 

 

 

 

 

City:

 

State:

 

Zip Code:

 

 

 

Date of Hire as a Nurse Aide (month/year):

Last Reported Date of Employment as a Nurse Aide (month/year):

_____/_______

_____/_______

 

mm

yyyy

mm

yyyy

 

 

 

 

DHSR/HCPEC-4515 (Revised February 2021)

 

 

Page 4 of 6

□ YES □ NO

Is the Employer a Staffing Agency?

If you answered YES to the question above, then list the States below.

States Where You Worked for the Staffing Agency in the Past 2 Years (Previous 24 Consecutive Months):

□ YES

□ NO

Did You Work as a Nurse Aide for Monetary Compensation (i.e., For Payment or For Wages)

 

 

in the Past 2 Years (Previous 24 Consecutive Months)?

 

 

 

□ YES

□ NO

Did You Work At Least 8 Hours Performing Nursing or Nursing-Related Tasks Delegated

 

 

(i.e., Assigned) and Supervised by a Registered Nurse in the Past 2 Years (Previous 24

 

 

Consecutive Months)?

 

 

 

If you answered YES to either question above, then provide the First and Last Name of the Registered Nurse. It is not required that the RN sign below.

Registered Nurse First Name and Last Name:

FACILITY/AGENCY/EMPLOYER #2

Name:

Street/PO Box:

City:

 

 

State:

 

Zip Code:

 

 

 

 

Date of Hire as a Nurse Aide (month/year):

Last Reported Date of Employment as a Nurse Aide (month/year):

_____/_______

 

_____/_______

 

mm

yyyy

 

mm

yyyy

 

 

 

 

 

 

□ YES □ NO

Is the Employer a Staffing Agency?

 

 

 

 

 

 

 

 

 

 

 

 

If you answered YES to the question above, then list the States below.

States Where You Worked for the Staffing Agency in the Past 2 Years (Previous 24 Consecutive Months):

□ YES

□ NO

Did You Work as a Nurse Aide for Monetary Compensation (i.e., For Payment or For Wages)

 

 

in the Past 2 Years (Previous 24 Consecutive Months)?

 

 

 

 

□ YES

□ NO

Did You Work At Least 8 Hours Performing Nursing or Nursing-Related Tasks Delegated

 

 

(i.e., Assigned) and Supervised by a Registered Nurse in the Past 2 Years (Previous 24

 

 

Consecutive Months)?

 

 

 

 

DHSR/HCPEC-4515 (Revised February 2021)

Page 5 of 6

If you answered YES to either question above, then provide the First and Last Name of the Registered Nurse. It is not required that the RN sign below.

Registered Nurse First Name and Last Name:

NOTE:

You must attach a separate sheet of paper if you had more than two employers where you performed nursing or nursing- related tasks delegated and supervised by a Registered Nurse in the past 2 years only (previous 24 consecutive months). Do not include private duty nurse aide employment.

PART 7: IDENTIFICATION

▪

▪

Include a copy of your social security card with the submission of your application.

Include a copy of an unexpired government-issued identification containing a photograph and signature with the submission of your application.

▪The name listed on your social security card and unexpired government-issued identification containing a photograph and signature must match.

▪The name listed on both identifications must match the name listed on the nurse aide registry in the State(s) of reciprocity.

▪If the names do not match, then you must submit documentation verifying any name changes (e.g., birth certificate, marriage license, divorce decree, notice of resumption of former name, etc.).

▪Copies of identifications received by fax may not be readable. Please ensure copies of your identifications are readable before submitting your application. If your identifications are not readable, then you will be asked to re-submit the application and your identifications again.

The Following are Acceptable Government-Issued Identifications Containing a Photograph and Signature:

•Current, non-expired driver’s license (or expired driver’s license and temporary permit)

•U.S. government-issued Military I.D.

•State-issued identification card

•Passport (US or foreign, current, non-expired)

•Current, non-expired federal-issued employment authorization document (EAD) photo identification card

•Alien registration card

PART 8: APPLICANT SIGNATURE

I certify that all the information provided in this application is true and complete. I understand that if the information I have provided in this application is found to be fraudulent, then my listing will be removed from the North Carolina Nurse Aide I Registry and I will be required to pass a North Carolina state-approved nurse aide I training program and the North Carolina state-approved nurse aide I competency examination. I give my permission to any state registry to disclose all information requested in this application to the North Carolina Division of Health Service Regulation, Health Care Personnel Education and Credentialing Section.

First Name (print): _________________________________________________________________________________

Middle Name (print): _______________________________________________________________________________

Last Name (print): _________________________________________________________________________________

Signature: _________________________________________________ Date: ________________________________

REMINDER:

You Must Submit All Pages of the Application (Pages 1 through 6), Your Social Security Card, and a Current Government-Issued Identification with Photograph and Signature for Review and Approval.

DHSR/HCPEC-4515 (Revised February 2021)

Page 6 of 6
⇓ South Carolina Nurse Aide

Form Characteristics

Fact Detail
Application Review Time The Division of Health Service Regulation (DHSR) has 10 business days from the date of receipt to review the Nurse Aide I Registry Reciprocal Application.
Ink Color for Application Applicants must use only black or blue ink for the application as other colors are not readable via fax.
Eligibility Criteria Summary To be eligible for listing on the North Carolina Nurse Aide I Registry through reciprocity, applicants must meet criteria such as being active and in good standing on another state's nurse aide registry, having no substantiated findings of abuse or neglect, having worked as a nurse aide for at least eight hours in the past two years, possessing a social security card and unexpired government-issued ID with matching names, and having completed a state-approved training and competency evaluation program.
Governing Law Eligibility for the North Carolina Nurse Aide I Registry is consistent with Rule 10A NCAC 13O.0301, and training programs are required to meet the standards set forth in 42 CFR 483.152 or 42 CFR 483.154.

Guidelines on Filling in South Carolina Nurse Aide

Filling out the Nurse Aide I Registry Reciprocity Application for South Carolina meticulously is critical for those who aspire to transfer their credentials from another state. Successfully navigating through this application ensures that you're acknowledged as a qualified nurse aide within South Carolina, provided you meet the specific requirements laid out by the Division of Health Service Regulation. This not only formalizes your status but also opens up opportunities for employment within the state's healthcare system. Here's a breakdown of the steps needed to complete the form accurately.

  1. Begin by reviewing Part 1 of the application to determine your eligibility. Ensure you meet all five criteria listed before proceeding.
  2. Use black or blue ink to complete the application as requested. This ensures your application is legible and processed without delays.
  3. Fill out your personal information in Part 2. This includes your name, social security number, email address, telephone number, and mailing address. Make sure to include any hyphens and suffixes in your legal name and avoid using nicknames.
  4. Answer the questions regarding your training in Part 3. Confirm whether you have completed a state-approved nurse aide I training program and passed the competency examination.
  5. In Part 4, list all states where you have an active or expired nurse aide I registry listing. Attach documentation that verifies your active and good standing status for all listed states.
  6. Select the type of employment where you performed nursing or nursing-related tasks in the last two years in Part 5. Remember, private duty nurse aide employment does not qualify.
  7. Provide your employment history in Part 6, detailing information for locations where you worked under the supervision of a Registered Nurse. Do not include private duty nurse aide employment.
  8. If any section asks for a YES or NO answer, make sure to mark the appropriate box clearly.
  9. Double-check all information for accuracy before submitting the application. Incomplete or incorrect applications cannot be processed.
  10. Mail or fax the completed application along with any required supportive documentation to the provided address or fax number. Ensure not to submit more than one application unless instructed by DHS—.

After submitting your application, the Department of Health Service Regulation has ten business days to review your information. During this period, it's crucial to keep a copy of your application and all supporting documents for your records. This proactive step can help address any inquiries swiftly and ensure your application process moves forward without unnecessary delays.

Common Questions

What are the eligibility requirements to be listed on the North Carolina Nurse Aide I Registry through reciprocity?

To be eligible for the North Carolina Nurse Aide I Registry through reciprocity, applicants must meet five key criteria: being listed as active and in good standing on another state’s nurse aide registry (temporary listings are not accepted); having no pending or substantiated findings of abuse, neglect, exploitation, or misappropriation of property recorded on any state nurse aide registry; having at least eight hours of employment performing nursing or nursing-related tasks under an RN's supervision in the past two years, or having passed a state-approved nurse aide I competency exam in the state of reciprocity within the last two years if not employed; having a valid social security card and an unexpired government-issued identification, both with matching names to the state’s nurse aide registry; and having completed a state-approved nurse aide training and competency evaluation program, or a state-approved competency evaluation program alone.

Can I apply if I've worked as a private duty nurse aide?

No, employment as a private duty nurse aide does not meet the eligibility requirements for reciprocity. To qualify, your employment must have involved nursing or nursing-related tasks that were delegated and supervised by a Registered Nurse, within settings approved by the state.

What identification documents are required for the application?

Applicants must provide a social security card and an unexpired government-issued photo ID (for example, a driver's license or passport). The names on both documents must match each other and also the name listed on the nurse aide registry in the state(s) of reciprocity. In cases where names do not match due to legal name changes, applicants must supply supporting documentation such as a marriage license or divorce decree.

What if my nurse aide registration is from another state but currently expired?

To apply for reciprocity, your nurse aide registration in another state needs to be active and in good standing. Having an expired registration does not meet the eligibility requirements for reciprocity to the North Carolina Nurse Aide I Registry.

How do I submit my application and what is the reviewing timeframe?

Applications should be completed using black or blue ink, and all six pages along with any required supportive documentation, must be submitted either by mail or fax to the provided addresses. The North Carolina Division of Health Service Regulation Health Care Personnel Education and Credentialing Section will review the application within 10 business days from the date of receipt.

Is there a specific training program length required to qualify for reciprocity?

Yes, applicants need to have completed a state-approved nurse aide training program that consisted of at least 75 hours of training, or they should have successfully passed a state-approved nurse aide I competency examination if they have not been employed as a nurse aide.

If I have findings of abuse or neglect in another state, can I still apply for reciprocity?

If there are any pending or substantiated findings of abuse, neglect, exploitation, or misappropriation of resident or patient property recorded against an applicant in any state, they would not be eligible for listing on the North Carolina Nurse Aide I Registry. These criteria help ensure that all individuals listed on the registry meet the highest standards of professionalism and ethical behavior.

Common mistakes

When completing the South Carolina Nurse Aide form, people often make several common mistakes. These errors can delay the process or impact the application's approval. It's important to fill out the form carefully and accurately to ensure a smooth submission process.

  1. Not reviewing the eligibility requirements in Part 1 carefully, which can lead to submitting an application without meeting all necessary criteria.
  2. Using ink colors other than black or blue, which are not readable via fax, potentially causing important information to be missed or misread.
  3. Submitting more than one application due to confusion or misunderstanding the instructions, which can complicate the review process.
  4. Failing to include all required supportive documentation, such as evidence of standing on another state registry of nurse aides or proof of employment.
  5. Not using the applicant’s legal name or failing to include hyphens and suffixes if applicable, leading to discrepancies in identification.
  6. Mismatch between the name on the social security card and government-issued identification, without submitting necessary documentation to explain the difference.
  7. Omitting information on employment history where nursing or nursing-related tasks were performed, which is crucial for establishing eligibility based on work experience.
  8. Incorrectly indicating the employment type or failing to specify other types of employment where nursing-related tasks were performed outside of conventional settings.
  9. Forgetting to list or incorrectly listing states where the applicant has an active or expired nurse aide I registry listing, which is important for verifying no findings of abuse or neglect.
  10. Lack of clarity or omission of details regarding the nurse aide training and competency evaluation program completed, which is necessary to verify the educational and professional background.

Addressing these common mistakes before submission will help in successfully completing the application process for the South Carolina Nurse Aide Registry.

Documents used along the form

When applying for a position as a Nurse Aide in South Carolina, or engaging in reciprocity applications like the one from the North Carolina Department of Health and Human Services, applicants will generally need to complement their application with a range of supporting documents. These documents not only help in establishing the applicant's professional standing but also assist in verifying their identity and qualifications. Below is a list of documents that are often required alongside the Nurse Aide Application form.

  • Proof of Education: Diplomas or transcripts from educational institutions, confirming the completion of required training programs.
  • Criminal Background Check: A report from a reputable agency showing the applicant's criminal history to ensure the safety of patients and colleagues.
  • Employment Verification Letter: A letter from previous employers detailing the applicant's work history, roles, and responsibilities. This document is crucial for proving recent work experience in the field.
  • Current Resume: A detailed resume that outlines the applicant’s education, certifications, and professional experiences related to nursing and healthcare.
  • Certification of a State-Approved Training Program: A certificate that verifies the applicant has completed a state-approved nurse aide training and competency evaluation program.
  • Passport Sized Photos: Recent color photographs that are often required for identification purposes within the application file.
  • Identification Documents: Government-issued photo ID (such as a driver’s license or passport) and social security card to confirm the applicant’s identity and legal ability to work.

Each document plays a unique role in supporting the Nurse Aide’s application by providing evidence of qualifications, legal compliance, and readiness for employment. Applicants should carefully review the requirements stipulated by the respective department or employer to ensure a complete and timely application process.

Similar forms

The Employment Eligibility Verification Form I-9 is similar to the South Carolina Nurse Aide form in that both require individuals to validate their eligibility for specific activities within the United States – employment in general for the I-9, and inclusion in the North Carolina Nurse Aide Registry specifically. Each form mandates verification of identity and eligibility, with specific documents (e.g., social security card and government-issued photo ID) needing to be presented to satisfy the requirements. The primary purpose is to ensure compliance with federal and state regulations, albeit in different contexts.

The Credential Verification Service for New York State application parallels the Nurse Aide form, as both involve the verification of qualifications and credentials for professionals moving between states. Each one requests detailed personal information and a history of professional certification or registration. They ensure the individual meets the state-specific requirements to practice their profession, though one focuses on a broad range of healthcare professions while the other is specific to nurse aides.

Professional License Application forms across various states bear resemblance to the Nurse Aide form by requiring detailed personal information, proofs of eligibility, and prior professional experience. These forms serve to verify that the applicant meets the specific professional standards necessary to safeguard public health and welfare, similarly ensuring that only qualified individuals are granted permission to work within highly regulated professions.

The Background Check Authorization form also shares similarities with the Nurse Aide form, chiefly in gathering comprehensive personal information and obtaining consent to verify the applicant’s background for any criminal or professional misconduct. Both forms aim to protect vulnerable populations by ensuring that those who seek to work in sensitive positions are properly vetted and do not pose a risk.

The Medical Licensing Examination application forms, much like the Nurse Aide form, necessitate applicants to supply extensive personal information, previous experience, and verification of eligibility. Both processes are stringent, with the goal of only having skilled and competent individuals providing care, thereby maintaining high standards within the medical profession, even though the specifics of the roles and the breadth of the examination content may differ.

Employment Application forms found in healthcare settings exhibit similarities with the Nurse Aide application, requesting detailed personal history, employment background, and verifications of certifications. These steps ensure that candidates are qualified for the positions they seek, prioritizing the wellbeing of patients and adhering to industry regulations, though with a wider scope in terms of the variety of roles available.

The Interstate Medical Licensure Compact Application shares commonalities by facilitating the process for medical professionals to be licensed in multiple states, similar to how the Nurse Aide form enables aides to transfer their registry status across state lines. Both streamline the credential verification process for ease of mobility within the profession, ensuring that standards are met across states.

Foreign Credential Verification processes resemble the Nurse Aide application in their requirement for detailed personal information, professional history, and proof of qualifications. These verifications are critical for ensuring that individuals trained outside of the United States meet the rigorous standards required to practice within, focusing on equivalency of education and competency to protect public health.

Volunteer Application forms for healthcare providers mirror the essence of the Nurse Aide form by requiring personal information, background checks, and validations of competence and eligibility. Although volunteers might not receive monetary compensation, the emphasis on verifying the suitability of individuals to work in sensitive environments aligns closely, with the ultimate focus on safeguarding patient safety and care quality.

The Drug Enforcement Administration (DEA) Registration application is akin to the Nurse Aide form in its requirement for individuals to prove their eligibility and credibility to perform specific roles - prescribing controlled substances in the case of DEA registration. Both forms involve rigorous checks and validations to ensure that the professionals meet nationally set standards for their respective responsibilities, underlining the importance of integrity and eligibility in healthcare professions.

Dos and Don'ts

When completing the South Carolina Nurse Aide form, it is important to follow specific guidelines to ensure your application is accurately processed. Below are key do's and don'ts to consider:

  • Do review the eligibility requirements under Part 1 to confirm you qualify for listing on the North Carolina Nurse Aide I Registry.
  • Do complete all pages of the application form, from pages 1 through 6, thoroughly.
  • Do use only black or blue ink as these are the only colors readable via fax.
  • Do submit any required supportive documentation alongside your application to verify your eligibility and qualifications.
  • Do ensure your name matches across all documents, including your social security card, government-issued ID, and any other registry listings.
  • Do provide detailed employment history for the past two years to demonstrate your experience as required under Part 6 of the form.
  • Don't submit more than one application unless specifically instructed by DHSR.
  • Don't leave any questions unanswered; ensure all requested information is provided.
  • Don't overlook the requirement to attach documentation confirming active and good standing status on other State registries of nurse aides if applicable.
  • Don't forget to return the completed application by mail or fax to the address or fax number provided in the instructions.

Adhering to these guidelines will help streamline the application process and increase the likelihood of successful inclusion on the North Carolina Nurse Aide I Registry.

Misconceptions

There are several common misconceptions about the South Carolina Nurse Aide form that need to be clarified:

  • It’s a South Carolina form: Despite references to South Carolina, the form is actually for the North Carolina Department of Health and Human Services. This can easily confuse individuals who are looking for reciprocity in South Carolina but actually need to apply through North Carolina’s procedures.
  • Any state-approved nurse aide training is acceptable: The form specifies that the nurse aide training and competency evaluation program must meet the requirements of 42 CFR 483.152 or a state-approved competency evaluation program that meets the requirements of 42 CFR 483.154. Not all state-approved programs may meet these federal regulations.
  • Private duty nurse aide employment qualifies for experience: According to the form, employment as a private duty nurse aide does not meet the eligibility requirements for reciprocity. This is a common misconception because many nurse aides believe any type of employment, including private duty, counts towards their experience.
  • You can use any ink color for the application: The instructions clearly state that the application should be completed using black or blue ink only. This is to ensure readability, especially if the document is fax looks altered.
  • Temporary listings on State registries are accepted: The form explicitly states that a temporary listing on a State registry of nurse aides will not be accepted. Only individuals who are active and in good standing on another State registry are eligible.
  • Military service always counts towards employment experience: While the form does ask about service in a Military Occupational Specialty (MOS) where nursing or nursing-related tasks were performed, not all military service automatically qualifies. The key factor is performing nursing or nursing-related tasks under the supervision of a Registered Nurse.
  • <-innerse">More than one application is permissible: The instructions caution applicants against submitting more than one application unless explicitly instructed by the DHSR. Submitting multiple applications without being instructed to do so can lead to processing delays.
  • The process is immediate: The DHSR has up to 10 business days from the date of receipt to review the application. This indicates that the process takes time and is not immediate, contrary to what some applicants might expect.
  • Any government-issued identification is acceptable: The form requires an unexpired government-issued identification containing a photograph and signature. Additionally, the names on the ID and on the nurse aide registry in the state(s) of reciprocity must match. If they do not match, documentation verifying the name change must be submitted.

Understanding these points can help individuals correctly complete their application for reciprocity on the North Carolina Nurse Aide I Registry, thereby avoiding delays and increasing the likelihood of a successful application process.

Key takeaways

Filling out and using the South Carolina Nurse Aide form is a process that obliges precise attention to detail and an understanding of the requirements outlined by the North Carolina Department of Health and Human Services Division of Health Service Regulation. Here are key takeaways to ensure accuracy and compliance:

  • Eligibility Review: Before even reaching for a pen or typing a response, it’s crucial to diligently review the eligibility criteria under Part 1. Only applicants active and in good standing in another state's nurse aide registry, with no pending or substantiated findings of misconduct and a record of employment or successful nurse aide competency examination in the past two years, will be considered.
  • Documentation Is Key: Applicants must present a social security card and government-issued ID with matching names, along with evidence of name changes if applicable. This underscores the importance of preparedness and organization in gathering necessary documents well in advance.
  • Accurate and Legible Information: The entire application, including personal information and employment history, should be filled out legibly in black or blue ink. This speaks to the professional presentation and ensures the readability of submitted information.
  • Employment Verification: Proof of employment, demonstrating at least eight hours of nurse aide work under the supervision of a Registered Nurse in the last two years, is non-negotiable unless replaced by a state-approved competency evaluation for those not currently employed as a nurse aide.
  • Training and Competency: Detailing your training and passing of a state-approved nurse aide competency examination lends credibility to your application. Remember, these programs must align with federal requirements, underscoring the critical nature of selecting reputable educational paths.
  • Registry Status Confirmation: For applicants listed in multiple state registries, current status and good standing must be verified through documentation dated within 30 days prior to the application. This reinforces the necessity of timely, accurate application submission.
  • Single Submission: Submitting more than one application could complicate processing unless specifically instructed by the DHSR. This amplifies the importance of completing the application correctly the first time around.
  • Contact Information: Providing clear and current contact information facilitates smooth communication with the DHSR, ensuring any questions or concerns regarding your application can be promptly addressed.

Understanding these key points enhances the likelihood of a successful application process for the South Carolina Nurse Aide form, paving the way for career advancement and development in the healthcare sector.

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