As you may have recently heard, effective September 27, the Texas Health and Human Services Commission (HHSC) adopted an amendment to Title 26 of the Texas Administrative Code, Chapter 556, regarding Nurse Aides and Nurse Aide Training and Competency Evaluation Programs.


What this means is that now Assisted Living communities are eligible to be designated clinical sites, allowing them to conduct on-site training for Nursing programs. Offering Nursing instruction onsite is a great recruiting and employee benefit. This gives Assisted Living communities a competitive advantage in the job market which is especially important given the ongoing Nurse shortage in the state.


According to research by the HHSC, the Nursing shortage is expected to worsen by 2032. Demand for vocational nurses is projected to outpace supply every year through 2032. Shortages for Nurse Practitioners are expected to grow from about 4,500 FTEs (Full Time Employees)  to almost 20,000 FTEs. Meanwhile, the projected shortage of Registered Nurses is expected to grow from currently 29,000 FTEs to over 57,000 FTEs by 2032.


Texas is a state with high demand for Senior Living that is only projected to continue. According to the Houston Business Journal, Between 2020 and 2026 alone, the population of people 65 and over is estimated to increase by over 2 million. By 2060, the population of people 65 and over in Texas is expected to more than double from 2020 amounts.


The new Amendment aims to address the shortage of certified Nursing Aides (CNAs) by expanding the definition of clinical site to allow Assisted Living communities to serve as a Nurse Aides Training and Competency Evaluation Program s (NATCEP) site. The Amendment also added a waiver for a NATCEP to use a laboratory setting for a clinical skills training site and provides the requirements by which a nursing facility may request a waiver of a NATCEP prohibition related to a civil money penalty from the Centers for Medicare and Medicaid Services.


For more information and questions email: [email protected] reference Rule Amendments regarding NATCEP Clinical Site.


Sources: Nursing Shortages Presentation (; Why Texas is experiencing sustained senior living growth - Houston Business Journal (