Texas 5506 Nar Form in PDF Modify Texas 5506 Nar Here

Texas 5506 Nar Form in PDF

The Texas 5506-NAR form is a crucial document designed for the Texas Nurse Aide Registry, specifically used for employment verification and certain certification verifications for nurse aides. It serves as a way to verify an individual's employment as a nurse aide and ensure they meet the necessary in-service education requirements for recertification. By completing and submitting this form, nurse aides take a vital step towards maintaining their certification and continuing their professional journey.

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The Texas Nurse Aide Registry Form 5506-NAR plays a crucial role in the certification and recertification process for Nurse Aides in Texas, ensuring that individuals meet the necessary criteria to provide care. Designed for both nurse aides and their employers, this form is divided into two key sections. The first section requires detailed information from the nurse aide, including personal data, employment history, and compliance with continuing education and legal requirements. Notably, it mandates the disclosure of any criminal convictions and participation in mandatory in-service education and training in infection control and the use of personal protective equipment (PPE). The applicant's signature attests to the accuracy of the information provided. The second section, aimed at employers, seeks verification of the nurse aide's employment and performance, including an attestation to the absence of any disqualifying misconduct, which must be notarized. The form underscores the importance of accuracy and completeness in its submission, as any attempt to falsify information could lead to serious legal consequences. Additionally, the document provides links for verifying certification status and downloading necessary forms, highlighting the Texas Health and Human Services Commission’s efforts to facilitate access to resources and maintain transparency regarding the collection and correction of personal information.

Texas 5506 Nar Sample

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.

File Characteristics

Name of Fact Description
Form Purpose This form is used for employment verification for nurse aides in Texas, ensuring they meet recertification requirements.
Completion Sections The form is divided into two sections: Section 1 to be completed by the Nurse Aide and Section 2 to be completed by the Employer.
Submission Information Completed forms must be emailed to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov.
Governing Law The form is governed by Texas Health and Safety Code, §250.006, regarding criminal convictions and disqualifications.

Detailed Guide for Writing Texas 5506 Nar

The process of submitting the Texas 5506-NAR form is a critical step for nurse aides seeking to verify or recertify their status. Ensuring that the form is filled out accurately and completely is essential for a smooth process. This form serves as a verification of employment and in-service education, necessary for maintaining certification with the Texas Nurse Aide Registry. Following the steps carefully will help prevent potential delays or issues arising from incomplete information or documentation.

  1. Section 1 - Nurse Aide Completion:
    • Start by entering your full name, including your maiden name if applicable, in the designated spaces.
    • Provide your mailing address, ensuring you include both the street or P.O. Box, city, state, and ZIP Code.
    • Indicate your social security number, email address, and the best daytime phone number to reach you, including the area code.
    • Fill in your sex, date of birth, and CNA Certificate Number in the respective fields.
    • Respond to the verification questions about your status on the Employee Misconduct Registry, any convictions, and completion of in-service education and infection control courses.
    • Verify all the information provided is correct and sign at the bottom of Section 1 to confirm its accuracy.
  2. Section 2 - Employer Verification:
    • This section must be completed by your employer. Hand the form over to your facility program director, official keeper of records, or actual employer for completion.
    • Ensure the employer provides the necessary information, including the name of the company, contact information, and mailing address.
    • Your employer must certify the dates of your employment as a nurse aide, confirm the absence of disqualifying misconduct, and provide any relevant comments.
    • The employer's signature must be notarized. Confirm this step is completed before collecting the form for submission.
  3. Submission:
    • Before sending, double-check both sections for completeness and accuracy.
    • Email the completed form and any required documents to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov.

After the submission, the journey doesn't end there. The Texas Nurse Aide Registry will review your form, and if any information or document is missing, they will return your request without action. Hence, ensuring accuracy and completeness in the form submission is paramount. Furthermore, the certificate status can be verified online, and additional forms or information regarding in-service education programs are also available through the Texas Health and Human Services website. Remember, with the right attention to detail, the form submission process can be completed smoothly and efficiently, paving the way for your certification verification or recertification.

Common Questions

What is the Texas 5506-NAR form?

The Texas 5506-NAR form, also known as the Employment Verification form, is a document required by the Texas Nurse Aide Registry. It is used to verify the employment and in-service education of nurse aides seeking recertification in the state of Texas. The form consists of two sections; the first is to be completed by the nurse aide, and the second by the employer.

How do I complete Section 1 of the form?

In Section 1, the nurse aide must provide personal and certification details. It's important to fill out all the requested information accurately, including your name, maiden name (if applicable), social security number, and contact details. You must also answer questions about your listing on the Employee Misconduct Registry, criminal convictions, completion of in-service education, and infection control training. Don't forget to sign and date the section to verify that the information provided is correct.

What are the employer's responsibilities in filling out Section 2?

The employer must accurately fill out Section 2 of the form. This includes certifying the period during which the nurse aide was employed, providing details of the nursing or nursing-related services performed, and noting any disqualifying misconduct. The employer's signature must be notarized at the bottom of this section before it is returned to the nurse aide.

How do I submit the Texas 5506-NAR form?

To submit the form, ensure both sections are completed and the employer's signature in Section 2 is notarized. Then, email the completed form along with any required documents to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov.

How can I verify my Certified Nurse Aide (CNA) certification status?

You can verify your CNA certification status online by visiting the following link: https://emr.dads.state.tx.us/DadsEMRWeb/ . Verification is essential for ensuring your records are up to date and for facilitating the recertification process.

Where can I find a list of approved in-service education programs?

A list of approved in-service education programs is available on the Texas Health and Human Services Commission (HHSC) website. You can access these lists by visiting either https://hhs.texas.gov/nar-cbts or https://hhs.texas.gov/nar-approved-inservice . These programs are designed to meet the education requirements necessary for nurse aide recertification.

What happens if I submit an incomplete form?

The Texas Nurse Aide Registry will return any incomplete requests or requests without the required documents without action. It is crucial to ensure that all parts of the form are filled out correctly and that all necessary supporting documents are included with your submission.

What are the penalties for falsifying a government record?

Falsifying a government record, such as a nurse aide certificate, is considered a third-degree felony in Texas. This can be punishable by up to 10 years in prison and a $10,000 fine. It is important to provide accurate and truthful information on the Texas 5506-NAR form to avoid such penalties.

Can I correct information on the form after it’s been submitted?

Yes, you have the right to request corrections to information that is determined to be incorrect. If you need to make any corrections after submitting the form, you should contact the Texas Nurse Aide Registry at 512-438-2050 to find out about your information and your right to request corrections.

Where can I download the Texas 5506-NAR form?

You can download the Texas 5506-NAR form from the Texas Health and Human Services Commission (HHSC) website at https://hhs.texas.gov/doing-business-hhs/licensing-credentialing-regulation/nurse-aide-registry/nar-forms . It's important to use the most current version of the form for your recertification application.

Common mistakes

  1. Not completing all required fields in Section 1. One common mistake is the omission of vital information in Section 1. Every field asks for essential details, including your name, Social Security number, email address, and certification number. Missing any piece of this information can lead to your form being returned without action.

  2. Failing to sign Section 1. Your signature serves as verification that the information provided in Section 1 is accurate. Overlooking the signature part might cause a delay in processing your form or result in its rejection.

  3. Not obtaining a notarized signature from the employer in Section 2. It's essential for the employer to not only complete Section 2 but also to have their signature notarized. Uncertified forms can be a significant obstacle in confirming your employment status as a nurse aide.

  4. Inaccurate reporting of in-service education hours or failure to document properly. Candidates must have completed 24 hours of in-service education in the past two years. However, underreporting your hours or neglecting to be prepared with certificates of completion if audited could jeopardize your recertification.

  5. Overlooking the instructions about emailing the completed form. Once all parts of the 5506-NAR form are filled out and signed appropriately, the whole document must be sent to the specified email address. Failure to email the form to the Nurse Aide Registry at nurseaideregistry@hhs.texas.gov or sending it to the wrong email can delay or invalidate your submission.

Common oversights and mistakes can hinder the recertification process for nurse aides. Paying careful attention to the details when completing the Texas 5506-NAR form is crucial. Including all required information, ensuring all signatures are in place, and following through with the specified submission process are vital steps in achieving successful recertification.

Documents used along the form

When managing your certification through the Texas Nurse Aide Registry, especially with the Form 5506-NAR, it's crucial to be aware of and understand other forms and documents that may be necessary during the certification or recertification process. Such documents ensure that all requirements and standards set by the Texas Health and Human Services Commission are met, thereby maintaining the high level of care expected from certified nurse aides.

  • Form 5505-NAR: This is the Request for Waiver of Nurse Aide Training and Competency Evaluation Form. It is used by individuals who are seeking exemption from the standard training and competency evaluation based on their previous health care training and work experience.
  • Form 5508-NAR: The Employment Verification Form is similar to Form 5506-NAR but is specifically designed for those nurse aides who are currently seeking to renew their expired certification. It includes an employer verification section to confirm employment in a nursing or nursing-related services role.
  • Form 5560-NAR: This Update Form is essential for any nurse aide who needs to update their personal information with the Texas Nurse Aide Registry, such as a change of name or address. Keeping personal information current is crucial for receiving timely notifications and maintaining certification status.
  • Criminal History Check: Although not a form provided by the Texas Nurse Aide Registry, a criminal history check is a crucial document required for initial certification and, in some cases, recertification. This check ensures that the nurse aide meets the state's legal standards for working with vulnerable populations.

Understanding and completing these documents, when applicable, are steps toward ensuring that certified nurse aides can provide safe and competent care to their patients. It’s important to check the most current forms and submission guidelines directly with the Texas Health and Human Services Commission or on their official website, as requirements can change. Always verify that you have the most up-to-date versions of each document and that you understand the specific submission processes for your situation.

Similar forms

The Texas 5506-NAR form shares similarities with forms like the Employment Eligibility Verification Form I-9, primarily due to the requirement for employee information verification by the employer. While the I-9 is used to verify the legal ability of individuals to work in the United States, the 5506-NAR focuses on validating the specific employment and credentials of nurse aides within Texas. Both forms require personal and employment details and an employer's acknowledgment of the employee's qualifications or eligibility.

Another document comparable to the Texas 5506-NAR form is the Professional License Verification form, commonly used in various professions to verify the licensure status of individuals. Like the 5506-NAR, this form ensures that the professional holds a valid, active license before employment in roles requiring specific certifications, such as healthcare, law, and education. Each form necessitates an official process to confirm the individual's eligibility and qualifications for professional responsibilities.

The Background Check Authorization form is also analogous to the Texas 5506-NAR form. Both documents are essential steps in pre-employment screening, with the Background Check Authorization gathering consent to verify an individual’s criminal, financial, and personal history, while the 5506-NAR verifies employment and certification status specific to nurse aides. Regulatory compliance and ensuring the suitability of an individual for a position are the primary objectives of both documents.

Continuing Education Verification forms share a common goal with the 5506-NAR, aiming to document and verify ongoing education— a vital requirement in professions requiring up-to-date skills and knowledge. While the Continuing Education Verification form may be used across various professions to confirm the completion of required educational activities, the 5506-NAR specifically checks for in-service education pertinent to nurse aides operating in Texas, ensuring their continuous professional development.

The Employee Misconduct Registry Check form, essential in the healthcare sector, is another document similar to the 5506-NAR. It is specifically designed to screen individuals for any history of misconduct that would disqualify them from working with vulnerable populations. While the focus of the Employee Misconduct Registry Check is to identify potential risks to client safety, the 5506-NAR also addresses this indirectly by verifying the absence of disqualifying misconduct for nurse aides, thereby upholding the integrity and safety of healthcare environments.

Also analogous is the Health Screening Report form, which, like the 5506-NAR, is a requisite in healthcare settings to ensure that personnel do not pose a health risk to vulnerable populations. The Health Screening Report typically verifies the absence of communicable diseases and fulfills immunization requirements, while the 5506-NAR includes checking compliance with infection control and proper use of personal protective equipment training, emphasizing the commitment to maintaining a safe healthcare environment.

The Credential Verification Service for the Nursing Profession (CVS-NP) application form, used by internationally educated nurses to validate their credentials in the United States, shares objectives with the 5506-NAR form. Both seek to confirm the professional qualifications and eligibility of nurses or nurse aides for employment. However, the 5506-NAR is specifically tailored to the Texas Nurse Aide Registry's requirements, highlighting the regional specificity of such verifications.

Lastly, the Personal Reference Check form bears similarity with the 5506-NAR form as both are tools for corroborating an individual's qualifications and character in the context of employment. While the Personal Reference Check form gathers assessments of an individual's work ethic, reliability, and temperament from references, the employer verification section of the 5506-NAR serves a similar purpose within a more structured and regulated framework, specifically targeting the verification of employment and conduct in the nurse aide profession.

Dos and Don'ts

When it comes to filling out the Texas 5506-NAR form, there are several essential dos and don'ts to keep in mind to ensure the process goes smoothly and efficiently. This form is a crucial step for Nurse Aides in Texas looking to verify employment, a step necessary for the recertification process. Here are some guidelines to help you navigate filling out the form correctly:

Do:
  • Ensure all information in Section 1 is complete and accurate before signing. It's crucial to verify that all personal information, including your name, mailing address, and contact details, are filled in correctly to avoid any delays or issues with your certification verification.
  • Obtain the necessary employer verification for Section 2. The form requires your employer's details and signature to confirm your employment as a Nurse Aide. This section must also be notarized, so make sure it's fully completed and properly signed by your employer.
  • Email the completed form along with any required documents to the Texas Nurse Aide Registry. Double-check that you have all the necessary documents and that they're sent to the correct email address to ensure your submission is processed without any problems.
  • Use the provided links to verify your CNA certification status and to access in-service education programs. Staying informed about your certification status and completing required in-service training is essential for remaining compliant with HHSC regulations.
Don't:
  • Submit the form without signing Section 1. Your signature is required to verify that the information you've provided is correct and complete. Without it, the form will be returned to you, causing delays in your recertification process.
  • Forget to have your employer's signature in Section 2 notarized. This is a critical step that verifies your employment status and experience. Failing to do so will result in the rejection of your application.
  • Ignore the requirement to submit supporting documents. If you're audited or asked to provide additional proof of your qualifications or in-service education, being unprepared can hamper your recertification efforts.
  • Overlook the importance of checking your information and your right to request corrections. It's within your rights to ask HHSC to correct any information that is found to be incorrect. Ensuring your records are accurate is fundamental for your career as a Nurse Aide.

Misconceptions

Understanding the Texas 5506-NAR form, required for nurse aides seeking employment verification, can sometimes be confusing due to prevalent misconceptions. It's crucial to clear up these misunderstandings to ensure nurse aides can smoothly navigate the process without unnecessary setbacks.

  • Misconception 1: "The Texas 5506-NAR form is optional for verifying employment." This form is mandatory for nurse aides in Texas needing to verify their employment for the purposes of maintaining or updating their certification with the Texas Nurse Aide Registry.

  • Misconception 2: "Any section of the form can be left incomplete if the information is not readily available." Each section of the form must be fully completed to avoid it being returned without action. The registry mandates that all fields are filled out to ensure accurate processing.

  • Misconception 3: "Employer verification is not necessary if you provide enough personal identification." Section 2 requires employer verification as a crucial part of the form; it cannot be substituted by providing additional personal identification or information.

  • Misconception 4: "Digital signatures are accepted on the form." The form explicitly requires a traditional signature from both the nurse aide and the employer, and the employer's signature must be notarized to validate the form.

  • Misconception 5: "You can submit the form without the notary section completed, as long as everything else is filled out." The notarization of the employer's signature is a required step; failure to complete this part will result in the form being returned.

  • Misconception 6: "The form serves as an immediate recertification of your CNA status." Completing and submitting the form is part of the recertification process, but does not itself grant recertification. The Texas Nurse Aide Registry must review and approve the submission first.

  • Misconception 7: "Email is the only way to submit the form." While email is a recommended submission method for convenience and speed, it's important to verify with the Texas Nurse Aide Registry if other submission methods are acceptable based on the most current guidelines.

  • Misconception 8: "The link provided for verifying CNA certification on the form is outdated and no longer works." The correct, up-to-date link is provided on the form, and it's crucial for nurse aides to use this specific link to verify their certification status.

  • Misconception 9: "In-service education certificates do not need to be kept after submitting this form." In-service education requirements are subject to audit; thus, maintaining these certificates is necessary in case the Texas Health and Human Services Commission (HHSC) contacts you for verification.

Addressing these misconceptions is vital for nurse aides to complete and submit the Texas 5506-NAR form accurately and efficiently. Proper understanding ensures the verification process proceeds without delays, supporting nurse aides in maintaining their certification and employment eligibility.

Key takeaways

When it comes to accurately completing and using the Texas 5506-NAR form, understanding the key elements of the process ensures that Certified Nurse Aides (CNAs) in Texas maintain their certification effectively. Here are some essential takeaways:

  • Section 1 is for Nurse Aides: It is crucial for the nurse aide to fill out all information in Section 1 accurately and sign it to confirm that the details provided are correct.
  • Employer Verification: Obtaining a verification from the employer is essential. This means Section 2 must be completed by the employer, which includes notarization of the employer's signature.
  • Email Submission: The completed form, along with any required documents, should be emailed to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov for processing.
  • Verification of Certification: CNAs can verify their certification status at any time using the provided link.
  • Keeping up with In-Service Education: Staying updated with in-service education is a requirement. CNAs must have completed 24 hours of in-service education in the past two years.
  • Annual Requirements: Completion of an HHSC course in infection control and proper use of personal protective equipment (PPE) once each year in the past 24 months is required.
  • Checking the Employee Misconduct Registry: Candidates must ensure they are not listed on the Employee Misconduct Registry (EMR) as unemployable.
  • Criminal Convictions: Disclosing any criminal offense listed in Texas Health and Safety Code, §250.006, is necessary.
  • The Texas Nurse Aide Registry rejects incomplete submissions or those lacking required documents, so thorough review before submission is important.
  • Legal Consequences for Falsification: It's important to understand that tampering with or attempting to falsify government records, including the nurse aide certificate, is a serious offense that can lead to felony charges.

By adhering to these guidelines, Certified Nurse Aides in Texas can ensure their certification remains valid and up to date. This not only aids in their professional development but also in providing quality care to their patients.

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