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In the healthcare sector, particularly within the state of Texas, maintaining and verifying the credentials of nurse aides is a process safeguarded rigorously to ensure the highest standard of patient care. The Texas 5506-NAR form, integral to this verification process, serves as a critical tool for both nurse aides and their employers. It combines employment verification with a compliance check against critical regulatory requirements. This form must be meticulously completed, first by the nurse aide and subsequently by their employer, to validate the aide's employment status and to confirm adherence to state-mandated training and conduct standards. The verification process, which hinges on the accurate and comprehensive completion of this form, addresses several vital checks: from the verification of the nurse aide's certification status and employment details to ensuring they are not listed on the Employee Misconduct Registry (EMR) and have met specific in-service education requirements. Additionally, it verifies that they have not been convicted of offenses disqualifying them from practice, per the Texas Health and Safety Code. Submission is streamlined through email, facilitating a convenient yet secure exchange of sensitive information. Moreover, the form plays a pivotal role in the recertification process, underlining its significance in maintaining the integrity and quality of patient care through the verification of the continued competency and ethical standing of nurse aides in Texas.

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Texas Nurse Aide Registry

Form 5506-NAR

September 2021-E

Employment Verification

 

Section 1 (To be completed by Nurse Aide. Please read the following instructions before completing this form.)

Complete all information in Section 1 and sign to verify that the information provided is correct.

Obtain employer verification (Section 2). Form must be emailed to Texas Nurse Aide Registry at: nurseaideregistry@hhs.texas.gov. To verify your

Certified Nurse Aide (CNA) certification, use the following link: https://emr.dads.state.tx.us/DadsEMRWeb/.

Note: A list of approved in-service education programs can be found at: https://hhs.texas.gov/nar-cbts or https://hhs.texas.gov/nar-approved-inservice. The Texas Nurse Aide Registry will return (without action) incomplete requests and requests without the required documents.

Name of Applicant (Last, First, Middle):

Maiden Name (if applicable):

 

 

Mailing Address (Street or P.O. Box):

City:

Social Security No.:

Email Address:

State:

 

ZIP Code:

Daytime Phone No. with Area Code:

Sex:

 

Date of Birth:

CNA Certificate No.:

Male

Female

 

 

 

 

 

 

Verification of requirements for Nurse Aide Recertification

Are you listed on the Employee Misconduct Registry (EMR) as unemployable?

Yes

No

 

 

Have you been found to have a conviction of a criminal offense listed in Texas Health and Safety Code, §250.006?

Yes

No

If yes, give date of conviction.

 

 

 

 

 

 

 

 

 

 

Have you completed 24 hours of in-service education in the past two years?

Yes

No

 

 

Note: In-service education requirements are subject to audit. Be prepared to submit in-service certificates if contacted by Texas Health and Human Services Commission (HHSC).

Have you completed an HHSC course in infection control and proper use of personal protective equipment (PPE) once each year

Yes

No

in the past 24 months?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature – Nurse Aide

Date

 

 

Section 2 (To be completed by the Employer – Instructions)

This section must be completed by the facility program director, official keeper of records or actual employer.

Notarize employer signature at the bottom of this section and return to nurse aide.

Employer Name or Company Name:

Daytime Area Code and Phone No.:

Mailing Address (Street or P.O. Box):

City:

State:

ZIP Code:

I certify that the individual named above is/was employed by me as a nurse aide and performed nursing/nursing-related services from

to

 

 

and that I am not aware of any disqualifying misconduct.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature – Employer

 

 

 

 

Date

 

 

 

 

 

 

Sworn and subscribed to me on this

 

day of

, 20

, in

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County, in the state of

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature – Notary Public

 

 

 

 

 

Date Commission Expires

 

 

Place Notary Seal or Stamp Here

 

Tampering with, or attempting to falsify, a government record such as a nurse aide certificate is a third-degree felony punishable by up to 10 years in prison and a $10,000 fine.

Form 5506-NAR

Page 2 / 9-2021-E

Address:

Did you sign and complete all information in Section 1?

Did your employer notarize his/her signature in Section 2?

Did you know?

You can verify certificate status by using the following link: https://emr.dads.state.tx.us/DadsEMRWeb/.

You can download forms from our website: https://hhs.texas.gov/doing-business-hhs/licensing-credentialing-regulation/nurse- aide-registry/nar-forms.

Email the completed form and required documents to the Texas Nurse

Aide Registry at nurseaideregistry@hhs.texas.gov

With a few exceptions, you have the right to request and be informed about the information that the Texas Health and Human Services Commission (HHSC) obtains about you. You are entitled to receive and review the information upon request. You also have the right to ask HHSC to correct information that is determined to be incorrect (Government Code, Sections 552.021, 552.023, 559.004). To find out about your information and your right to request correction, please contact the Nurse Aide Registry at 512-438-2050.

Document Attributes

Fact Name Detail
Form Identifier Texas Nurse Aide Registry Form 5506-NAR, September 2021-E
Main Purpose Employment Verification for Nurse Aides
Section 1 Requirements Completion and signature by the Nurse Aide to verify personal and certification information
Section 2 Notarization Must be completed and signed by the employer and notarized
Submission Email nurseaideregistry@hhs.texas.gov
Certification Verification Link Texas CNA Certificate Verification
Governing Law for Misconduct and Criminal Conviction Disclosure Texas Health and Safety Code, §250.006
Penalty for Falsification Third-degree felony, up to 10 years in prison and a $10,000 fine

How to Fill Out Texas 5506 Nar

Filling out the Texas 5506-NAR form is a crucial step towards maintaining or verifying your status as a certified nurse aide (CNA) in Texas. This form is essential for those seeking recertification and verification of employment in a healthcare setting. Before diving into the steps required to complete this form, it’s important to gather all necessary information, including your CNA certificate number, employment details, and records of any required in-service education. Attention to detail and accuracy is key in ensuring a smooth processing of your application.

  1. Start with Section 1, which must be filled out by you, the nurse aide. Begin by entering your Name of Applicant including your last name, first name, and middle initial. Include your Maiden Name if applicable.
  2. Provide your Mailing Address, including the street or P.O. Box, City, State, and ZIP Code.
  3. Enter your Social Security Number and Email Address for communication purposes.
  4. Fill in your contact information accurately by providing your Daytime Phone Number with Area Code.
  5. Specify your Sex, Date of Birth, and your CNA Certificate Number.
  6. Answer the questions regarding your status on the Employee Misconduct Registry (EMR), any convictions of criminal offenses as stated in Texas Health and Safety Code §250.006, completed hours of in-service education, and annual infection control and PPE training in the last 24 months.
  7. Ensure you sign and date Section 1 to verify the correctness of the information provided.
  8. Proceed to Section 2, which needs to be completed by your employer. This section must be handed over to your employer for completion.
  9. Your employer must provide their Name or Company Name, contact information including the Daytime Phone Number with Area Code, and the Mailing Address.
  10. The employer must detail your employment period, stating the duration of your employment as a nurse aide and confirm the absence of any disqualifying misconduct.
  11. After completing Section 2, your employer is required to sign and date the form. It’s crucial that the employer’s signature is notarized.
  12. After both sections are complete, double-check all information for accuracy and completion.
  13. Finally, email the completed form along with any required documents to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov.

Following these meticulous steps ensures the Texas Nurse Aide Registry receives a complete and accurate representation of your certification and employment status. A trivial mistake can delay the process, so it's critical to review each section carefully before submission. Remember, the integrity of the information provided safeguards not only your professional standing but also the well-being of those in your care.

More About Texas 5506 Nar

  1. What is the purpose of the Texas 5506-NAR form?

    The Texas 5506-NAR form is designed for Nurse Aides seeking recertification in the state of Texas. Its primary purpose is to verify the employment of the Nurse Aide and ensure they meet specific requirements, including not being listed on the Employee Misconduct Registry, not having convictions of certain criminal offenses, completing in-service education hours, and completing courses in infection control and the proper use of personal protective equipment. This form is a crucial step in maintaining one's certification and ensuring the quality of care provided by nurse aides.

  2. How does one complete Section 1 of the form?

    Section 1 must be filled out by the Nurse Aide themselves. It requires providing accurate personal information, answering questions regarding recertification requirements, and signing to verify that all provided information is correct. It is essential that the nurse aide completes every part of this section thoroughly to avoid delays or the refusal of the recertification process.

  3. What is required for Section 2 of the form?

    Section 2 must be completed by the employer, such as a facility program director, the official keeper of records, or the actual employer. It involves certifying the employment period of the nurse aide and acknowledging the absence of any disqualifying misconduct. Importantly, the employer's signature must be notarized before the form is returned to the nurse aide, which is a critical step in the verification process.

  4. How does one submit the completed 5506-NAR form?

    The completed form, along with any required documents, must be emailed to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov. This is the official submission method, and it is important to make sure the email contains all necessary documentation to ensure a smooth recertification process.

  5. Is there a way to verify the status of a Nurse Aide's certificate online?

    Yes, the status of a Nurse Aide's certificate can be verified online at https://emr.dads.state.tx.us/DadsEMRWeb/. This helpful tool allows nurse aides and employers to quickly check the certification status, which is crucial for employment and compliance with Texas Health and Human Services Commission (HHSC) regulations.

  6. What happens if the 5506-NAR form is incomplete?

    The Texas Nurse Aide Registry will return any incomplete requests or requests without the required documents without action. It is vital to review the form carefully and ensure that all sections are filled out completely and accurately before submission to avoid any delays in the recertification process.

  7. What are the consequences of falsifying information on the 5506-NAR form?

    Falsifying information on the 5506-NAR form, or any government record, is considered a third-degree felony. Such actions can result in up to 10 years in prison and a fine of up to $10,000. This severe penalty underscores the importance of providing accurate and truthful information on the form.

  8. How can one find more information or get help with the form?

    For more guidance or to address specific concerns regarding the 5506-NAR form, individuals can contact the Nurse Aide Registry at 512-438-2050. This contact option is available to those seeking further information or needing assistance with the form, ensuring support is readily accessible.

Common mistakes

When completing the Texas Nurse Aide Registry Form 5506-NAR, careful attention to detail is crucial to avoid delays or rejection of your application. Here are five common mistakes people make:

  1. Not providing complete information in Section 1: Every field in this section must be filled out accurately, including the name of the applicant, mailing address, email address, and all other personal information requested. Missing information can lead to the form being returned without action.

  2. Forgetting to sign Section 1: The applicant’s signature is necessary to verify that the information provided is correct. An unsigned form is considered incomplete and will not be processed.

  3. Omitting employer verification in Section 2: This section is vital for the verification of employment as a Nurse Aide. It must be completed by the employer, and the failure to obtain this verification will result in the form being incomplete.

  4. Lack of notarization on the employer’s signature in Section 2: The employer’s signature must be notarized to confirm their identity and their testimony regarding the applicant's employment. Not having this section properly notarized is a common oversight that leads to rejection of the form.

  5. Not checking for disqualifying misconduct or convictions: Applicants must answer honestly about any listings on the Employee Misconduct Registry or convictions of a criminal offense as specified. Failure to disclose this information or misunderstanding the requirement can lead to serious consequences, up to and including felony charges for falsifying government records.

In addition to these mistakes, here are useful tips to ensure your form is correctly filled out:

  • Verify your Certified Nurse Aide (CNA) certification status online before submission.

  • Review the in-service education programs approved by Texas Health and Human Services Commission (HHSC) and ensure your compliance.

  • Email the completed form along with required documents to the specified email address, making sure no piece of information is left unanswered.

  • Be prepared to submit in-service certificates if contacted for an audit by the HHSC.

  • Remember, accurate and thorough completion of the form speeds up the process, ensuring that you can serve as a CNA without unnecessary delays.

Documents used along the form

Completing the Texas Nurse Aide Registry Form 5506-NAR is a significant step for Certified Nurse Aides (CNAs) in Texas needing to verify their employment to maintain their certification. However, this is just one piece of the puzzle. Several other forms and documents often accompany Form 5506-NAR to streamline professional credentials, compliance, and verification processes. Understanding these documents helps ensure that CNAs and their employers adhere to Texas Health and Human Services Commission requirements efficiently.

  • Form 5505-NAR: Request for Entry on the Texas Nurse Aide (NA) Registry through Reciprocity. This form is used by NAs moving to Texas who wish to be listed on the Texas Nurse Aide Registry without retaking the competency exam.
  • Form 5508-NAR: Employment Verification for Nurse Aides requesting renewal of their certification. Similar to Form 5506-NAR, it includes employment verification but is specifically designed for the recertification process.
  • Form 5528-NAR: Nurse Aide Registry Renewal Form. This is a critical form for CNAs seeking to renew their certification, affirming they've met all required hours of work and in-service education.
  • Form 5560-NAR: Request for Waiver of Nurse Aide Training and Competency Evaluation. Employed by individuals seeking exemption from the standard training due to other qualifications.
  • Form 5502-NAR: Application for Renewal/Reactivation. For CNAs whose certification has expired or been deactivated, this form initiates the renewal or reactivation process.
  • Form 5504-NAR: Request for Photo Identification Badge. CNAs in need of an official photo ID badge for employment purposes use this form.
  • Form 5507-NAR: In-Service Education Form. This form helps document continuing education hours, a requirement for maintaining CNA certification in Texas.
  • Form 5585-NAR: Application for Search of NAR for Unemployability Status. Employers use this form to verify if a potential hire is listed as unemployable on the Texas Nurse Aide Registry due to misconduct.
  • Form 5509-NAR: Request for Replacement/Correction of Nurse Aide Certificate. This form allows CNAs to request a new certificate if theirs is lost or contains errors.

Together, these forms ensure that the certification and verification process for Nurse Aides in Texas is comprehensive, up-to-date, and adheres to the state's strict standards for healthcare providers. By familiarizing with and properly managing these documents, CNAs and their employers can navigate the administrative landscape more smoothly, ensuring that the focus remains on providing high-quality care to those who need it the most.

Similar forms

  • Form 5505-NAR, Request for Entry on the Texas Nurse Aide (NA) Registry through Reciprocity: This form is similar to the Texas 5506-NAR form in that it is also used by nurse aides, but it caters to those seeking to enter the Texas Nurse Aide Registry via reciprocity from another state. Both forms require detailed personal information and involve verification processes that confirm the nurse aide's qualifications and legal eligibility to work.

  • Form 5528-NAR, Employment Verification for Nurse Aides Seeking Reactivation: This document shares similarities with the 5506-NAR form as it is also intended for verifying employment details of nurse aides. However, the 5528-NAR form specifically targets those wishing to reactivate their status on the Texas Nurse Aide Registry. Both forms necessitate employer verification and provide evidence of the nurse aide's work in nursing or nursing-related services.

  • Form 5560-NAR, Nurse Aide Registry Renewal Form: Similar in purpose to the 5506-NAR, this form is used by nurse aides to renew their registration. While the 5506-NAR form focuses on verifying current employment and in-service education to maintain certification, the 5560-NAR also involves steps to confirm continued eligibility and competency as a Certified Nurse Aide (CNA) in Texas.

  • Form 5502-NAR, Nurse Aide Registry Update Form: Like the 5506-NAR form, this document facilitates updating personal information on the Texas Nurse Aide Registry. Although it focuses more on changes to a nurse aide's name, contact information, or work status rather than employment verification, both forms are critical for maintaining accurate and current records within the registry.

  • Form 5008-NAR, Request for Waiver of Nurse Aide Training and Competency Evaluation: This form, while distinct in its purpose of requesting a waiver for the standard nurse aide training and evaluation, resembles the 5506-NAR form in its administrative role within the certification and regulatory processes of Texas nurse aides. Both forms are integral to the regulatory framework that ensures nurse aides meet necessary qualifications and maintain their credentials effectively.

Dos and Don'ts

When it comes to fulfilling professional obligations, accuracy and thoroughness are indispensable. This is especially true for nurse aides in Texas completing the 5506-NAR form, a document critical for recertification and verification of employment. Below are a series of recommendations aimed at ensuring your submission is both compliant and complete.

Do:
  • Double-check all entered information in Section 1 for accuracy. Ensuring your personal details are correct is crucial for your recertification process.
  • Have Section 2 filled out by your employer as required. This verification confirms your employment and is indispensable for the form’s approval.
  • Ensure your employer’s signature in Section 2 is notarized. This is a critical step for the validation of the form.
  • Verify your CNA certification status online to ensure all prerequisites for recertification are met before submitting your form.
  • Use the correct email address, nurseaideregistry@hhs.texas.gov, to submit the completed form. An accurate submission helps in timely processing.
Don't:
  • Submit the form without signing it. Your signature is necessary to authenticate the information provided in Section 1.
  • Forget to check whether you are listed on the Employee Misconduct Registry (EMR), as this affects your eligibility.
  • Omit any required documents or information. Incomplete forms will be returned without action.
  • Ignore the in-service education requirements. Make sure you have completed the necessary hours as this will be subject to audit.

For nurse aides striving to uphold their certification, adherence to these guidelines when completing the 5506-NAR form is paramount. It not only reflects professionalism but also ensures continuity in the capability to provide quality care.

Misconceptions

There are several misconceptions about the Texas Nurse Aide Registry Form 5506-NAR that need to be clarified. Understanding these aspects is crucial for nurse aides and employers to ensure the process is handled correctly.

  • Misconception 1: Anyone can complete Section 1 of the form.

    This section is specifically designated for the nurse aide to complete. It requires personal information and a signature to verify that the information provided is accurate.

  • Misconception 2: Employers are responsible for submitting the form to the Texas Nurse Aide Registry.

    While employers must complete Section 2 and notarize their signature, it is the responsibility of the nurse aide to submit the completed form and any required documents to the Texas Nurse Aide Registry.

  • Misconception 3: The form can be submitted without a notarized employer signature.

    Section 2 of the form, completed by the employer, must be notarized. Submission without this notarization will result in the Texas Nurse Aide Registry taking no action on the request.

  • Misconception 4: In-service education is optional for recertification.

    A nurse aide must complete 24 hours of in-service education in the previous two years for recertification. This requirement is subject to audit, and aides may be asked to submit in-service certificates for verification.

  • Misconception 5: The form does not require a signature.

    Both the nurse aide and the employer must provide their signatures in their respective sections to verify the accuracy of the information provided.

  • Misconception 6: The form is only for nurse aides currently employed.

    The form serves as an employment verification for both current and past nurse aide positions, as long as the employment is relevant to the nurse aide’s certification and recertification process.

  • Misconception 7: You can't verify a certificate status online.

    Nurse aides and employers can verify certificate status online using the link provided by the Texas Health and Human Services Commission. This ensures that the information is up-to-date and accurate.

  • Misconception 8: Criminal convictions don't affect the recertification process.

    The form asks specifically if the nurse aide has been convicted of a criminal offense listed in the Texas Health and Safety Code, §250.006. A "Yes" answer may affect the recertification process and needs to be disclosed.

  • Misconception 9: All in-service education counts towards the 24-hour requirement.

    Only approved in-service education programs count towards the 24-hour requirement. Nurse aides should verify that the programs are approved by visiting the Texas Health and Human Services website.

  • Misconception 10: The form and instructions are difficult to access.

    Both the form and detailed instructions are readily available online at the Texas Health and Human Services website. This ensures that nurse aides and employers have access to the most current information and requirements.

Understanding these misconceptions is key to navigating the recertification process efficiently and ensures that nurse aides are in compliance with Texas regulations.

Key takeaways

When dealing with the Texas 5506-NAR Form, which is crucial for Nurse Aides in Texas, there are several key takeaways to ensure the process goes smoothly. Understanding these points can help navigate the form completion and submission process more effectively.

  • Complete Section 1 Carefully: Nurse Aides must fill out all the information in Section 1 accurately and sign it to confirm the details are correct. This is the first step in verifying your certification and ensuring that your submission is not returned for being incomplete.
  • Employer Verification is Crucial: Section 2 of the form requires completion and notarization by your employer. This serves as an employment verification process, which is essential for the Nurse Aide Registry to validate your working status and experience as a Nurse Aide.
  • Email Submission: Once both sections are completed and the employer's signature is notarized, the form must be emailed to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov. Email submission is the preferred method, making it convenient to send the form and any required documents promptly.
  • Verification of Certification: Nurse Aides can check the status of their certification anytime through the provided link (https://emr.dads.state.tx.us/DadsEMRWeb/). This is a helpful tool for both current and prospective employers to verify your qualifications and for your own records.
  • In-Service Education Proof May Be Required: Be prepared to submit certificates for the 24 hours of in-service education completed in the past two years if audited. This education is a requirement for recertification and ensures that Nurse Aides are up-to-date with the latest health care practices and regulations.

Understanding and following these guidelines when filling out and submitting the Texas 5506-NAR Form will streamline the recertification process for Nurse Aides. It's important for both the Nurse Aide and the employer to attentively complete their respective sections of the form to avoid delays or issues with recertification.

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