Texas Certified Nurse Aide Registration Defense

Let the Lento Law Firm Defend Your Texas CNA Registration

Texas, with its 590 hospitals with around 78,000 beds, offers certified nurse aides some of the best and biggest hospital systems and metropolitan regions in which to work. Dallas, Fort Worth, Houston, San Antonio, and Austin are all great metropolitan areas in which to work as a certified nurse aide. Houston's Methodist Hospital and Memorial Hermann - Texas Medical Center, San Antonio's University Hospital and Methodist Hospital, and Dallas's Parkland Memorial Hospital and Baylor University Medical Center make a formidable list of very large and sophisticated metropolitan hospitals.

Texas certified nurse aides, though, must maintain their Texas CNA registration to enjoy nurse aide practice and income at those and other Texas hospitals, clinics, and healthcare facilities. Disputes over patient care, professionalism, personal misconduct, nursing credentials, and other matters can lead to license disciplinary charges. Don't despair if you face CNA registration charges. The Lento Law Firm's premier Professional License Defense Team is available across Texas for your best defense of CNA misconduct allegations. Call 888.535.3686 or chat with us now to retain the best Professional License Defense Team available in Texas.

Texas Nurse Aide Registration

Texas's Nursing Practice Act regulates the practice of nursing across the state. Section 301.4515 of the Nursing Practice Act expressly prohibits anyone from using the terms nurse aide, nurse assistant, or any similar title like certified nursing assistant, certified nurse aide, or CNA unless that person is practicing under the delegated authority of a Texas-licensed nurse or other federal or state law.

You must maintain your registration as a nurse aide if you intend to continue CNA practice in Texas. Texas Health & Safety Code Sections 250.001 et seq. create Texas's Nurse Aide Registry or NAR. Section 250.003(a)(2) prohibits any Texas healthcare facility or other employers from employing an individual as a nurse aide or assistant unless that person has a current NAR registration. Section 250.035(a) lists the initial requirements for a Texas nurse aide registration:

To be listed on the nurse aide registry, an applicant must: (1) complete a training program approved by the commission that includes: (A) not less than 100 hours of coursework as specified by rule; and (B) a competency evaluation on completion of the training program; and (2) hold a certificate of registration issued by the commission on completion of the training program required under Subdivision (1).

Texas Nurse Aide Regulation

But just getting your Texas CNA registration isn't enough to continue your nurse aide practice in Texas. You must also maintain your registration through successive renewals. Texas Health & Safety Code Section 250.0035(d) authorizes state administrators to provide for "the regulation of nurse aides as necessary to protect the public health and safety." Texas Administrative Code Rule 556.3 defines the standards by which nursing training programs must educate and train certified nurse aides. Texas Administrative Code Rule 556.6 requires nurse aides to meet all those standards to pass their competency evaluation for Nurse Aide Registry. Rule 556.9 requires nurse aides to renew their certificate of competency every twenty-four months, which requires further training and continued experience. You won't get to continue your work as a nurse aide in Texas unless you maintain your NAR registration.

Texas Nurse Aide Discipline

In between renewing your Texas nurse aide registration, you may face misconduct, unprofessionalism, and other charges that place your name on a misconduct registry, require your job termination, and prevent your NAR renewal. Misconduct allegations against you can lead to the entry of your name in the Texas Department of Health and Human Services's employee misconduct registry. Texas Health and Safety Code Section 253.007 creates the misconduct registry. Texas Health and Safety Code Section 250.003(c)(1) requires an employer to immediately discharge a nurse aide whose name state disciplinary officials have entered in Section 253.007's misconduct registry. And the above NAR renewal rules prohibit renewals of nurse aides whose names appear in the misconduct registry. You must defend and defeat misconduct allegations to maintain your NAR registration and Texas nurse aide employment.

Texas Nurse Aide Disciplinary Proceedings

The Texas Department of Health and Human Services pursues disciplinary proceedings against nurse aides under Texas Administrative Code hearing procedures. Texas Administrative Code hearing procedures are lengthy and detailed. They include:

  • the filing of disciplinary charges with the State Office of Administrative Hearings;
  • the State Office's service of notice on the nurse aide accused of misconduct;
  • the State Office's appointment of an administrative law judge to conduct the hearing on the charges;
  • attorney representation of the accused nurse aide if the nurse aide retains such representation;
  • exchange of documentary evidence between the parties before the hearing;
  • attempts to resolve the matter by mediation between the parties;
  • prehearing conferences narrowing the issues, and further attempting voluntary resolution;
  • a formal hearing involving the presentation of witnesses and documentary evidence and including the right of cross-examination;
  • a written decision stating the results and rationale; and
  • limited court appeal of adverse decisions.

The Department's website summarizes its own internal procedures as follows: "HHS also reviews and investigates allegations of abuse, neglect or misappropriation of resident property by nurse aides. If there's a finding of an alleged act of abuse, neglect, or misappropriation, the nurse aide may request both an informal reconsideration and a formal hearing before the finding is placed on the registry." You and your Lento Law Firm Team may thus have other opportunities to negotiate favorable resolution of charges outside of the above formal hearing procedures.

Grounds for Texas Nurse Aide Discipline

Both of the above Texas Health and Safety Code Sections 250.003(c)(1) and 253.007 list the grounds for entry of a nurse aide's name in the state's employee misconduct registry. Those grounds include when the nurse aide has "committed an act of abuse, neglect, or mistreatment of an individual using the consumer-directed service option or a consumer, or misappropriation of the property of an individual using the consumer-directed service option or of a consumer." Consider the following examples of those grounds, along with ways in which our skilled and experienced attorneys might defend your charges.

Nurse Aide Abuse of an Individual

Abuse allegations typically involve intentional, deliberate, and even malicious actions that a nurse aide directs toward an individual under the nurse aide's care. The abuse may be sexual, physical, or even mental and emotional. The individual may complain of the abuse, or a family member, other care providers, or other people may complain. Abuse complaints from an individual with a mental disability, especially paranoid schizophrenia, may be fabricated or inaccurate but require effective defense nonetheless. Testimony from reliable witnesses as to inaccurate or frivolous complaints, and records of the individual's unreliable memory and communication, may help defend the abuse charge.

Nurse Aide Neglect of an Individual

Neglect allegations typically involve careless or reckless acts leaving an individual in a deprived and endangered condition or state. Neglect may include a nurse aide's failure to appear for duty or omission to provide due care while on duty. Neglect of a bedridden patient may, for instance, result in soiled clothing and bedding, bed sores, dehydration, malnourishment, and similar conditions. But neglect could also include a single failure, such as raising bed rails or assisting with the transfer, resulting in a sudden fall and serious injury. Testimony or records showing that others were responsible for the neglect and that the individual was not your responsibility may help defend the neglect charge. So, too, could evidence that any harm or deprivation was from the course of a disease or from an accident rather than your neglect.

Nurse Aide Mistreatment of an Individual

Mistreatment allegations typically involve substandard care for an individual resulting in the individual's harm. In mistreatment cases, the nurse aide has performed aide services rather than neglected to provide services but has done so outside of the accepted practice of nurse aides. Using the wrong chemical cleaning agents or using the wrong method of bed transfer, resulting in the patient's serious injury would be mistreatment examples. Testimony that your actions were within the nurse aide standard of care, that your actions did not result in any injury, or that others mistreated the individual rather than you could all help defend a mistreatment charge.

Nurse Aide Property Misappropriation

Property misappropriation allegations typically involve a claim that the nurse aide had unusual access to the individual's cash, jewelry, or other valuable effects and that the nurse aide used that access to steal or convert the property. Misappropriation might also include allegations that the nurse aide used coercion or duress to convince the individual to convey the property, although those allegations are more properly categorized as undue influence rather than misappropriation. Testimony and records showing that the individual lost no property, that you did not take any property, or that others were more likely than you to have taken the property may help defend against a misappropriation charge. So, too, may evidence that the complaining individual is an unreliable reporter whose testimony lacks credibility.

Criminal Grounds for Texas Nurse Aide Discipline

Criminal conviction of a nurse aide can also result in discipline, entry of the nurse aide's name in the employee misconduct registry, immediate employment termination, and the inability to renew NAR registration. Texas Health and Safety Code Section 253.006 lists the many disqualifying criminal offenses. Beware if you face criminal charges for any of these listed grounds for revoking your nurse aide registration:

  • criminal homicide or deadly conduct;
  • kidnapping, unlawful restraint, and smuggling of persons;
  • sexual abuse of a young child or disabled individual;
  • indecency with a child or indecent exposure;
  • sexual assault, aggravated sexual assault, or aggravated assault;
  • injury to or exploitation of a child, elderly individual, or disabled individual;
  • abandoning or endangering a child;
  • aiding suicide;
  • agreement to abduct from custody;
  • sale or purchase of child;
  • arson, robbery, or aggravated robbery;
  • invasive visual recording;
  • terroristic threat;
  • online solicitation of a minor;
  • money laundering or healthcare fraud;
  • obstruction or retaliation; and
  • cruelty to livestock animals.

Defending Your Texas CNA Disciplinary Charges

To raise an effective defense to your Texas nurse aide registration disciplinary charges, you must believe that your defense is possible. You won't prevail, for instance, if you ignore the disciplinary notice and, as a consequence, suffer default on the charges. Hearing officials will construe your failure to respond as your admission that the charges were true and that your discipline is appropriate. You need to respond timely to the disciplinary charges. Our skilled and experienced attorneys can help you defend nursing license charges. Your response should raise your available defenses while clearly and accurately communicating the factual grounds for your defense. Above all, don't ignore the charges. Contact our premier Professional License Defense Team now to strategically defend your Texas nurse aide disciplinary charges.

Value Your Texas Nurse Aide Registration

You also won't likely mount an effective defense to your Texas nurse aide registration disciplinary charges if you fail to appreciate the value of your nurse aide registration. Don't undervalue your present nurse aide practice. It likely generates important income for you. It also gives you a valuable ministry to others that both cares for others while encouraging you about your personal and professional values. Your nurse aide practice also gives you a schedule, community, and standing, all important to your mental, emotional, and social well-being. And it's not simply a matter of valuing your nurse aide practice but instead valuing your full nursing career. Many nurse aides go on to complete education, training, and licensure for LPN and RN practice. Those practices can substantially increase your nursing compensation, standing, and satisfaction, whether you reside and work in Dallas, Houston, San Antonio, Fort Worth, or another Texas region. Value your nursing career by defending and defeating your nurse aide disciplinary charges.

The Meaning of Texas Nurse Aide Disciplinary Charges

Don't make the mistake of thinking that the Texas nurse aide disciplinary charges you face mean that disciplinary officials already believe that you have committed a serious wrong. To the contrary, investigators may already suspect that you have not committed any wrong and that you will have a good explanation for what others have alleged constitutes wrongdoing. Investigators know that complainants only tell one side of the story. They also know that the other side of the story, meaning your side of the story, is necessary to get an accurate picture of what happened. That's another good reason for you to take the disciplinary charges seriously enough to respond with the help of our skilled and experienced attorneys. Let us help you put your side of the story before the investigators and, if necessary, the administrative law judge in a way that they can understand and appreciate your own skill and commitment to sound nurse aide practice.

Increased Stakes of Texas Nurse Aide Disciplinary Charges

Your stakes may be higher than you expect when facing Texas nurse aide disciplinary charges. Texas, like many other states, recognizes nurse aide reciprocity. What that means is that if you already have nurse aide registration or CNA status in another state, then Texas will recognize that registration or certification without requiring you to complete the same educational requirements again in Texas. And because Texas grants reciprocity to other states, those other states grant Texas nurse aides the same reciprocity to register in those states.

In short, your Texas nurse aide registration can mean that you can move to many other states for nurse aide employment without having to repeat your training and certification. Of course, the loss of your Texas nurse aide registration also means losing registration or certification in those other states. You will also likely have to report your Texas nurse aide discipline if you seek certification or registration in those other states. Defend your nurse aide disciplinary charges here and now, in Texas, or potentially lose your ability to practice nursing anywhere else in the United States.

Strategies for Defending Texas Nurse Aide Disciplinary Charges

When you retain the skilled and experienced attorneys on our Professional License Defense Team, you can expect strategic representation invoking Texas administrative hearing procedures for their best effect and your best disciplinary outcome. In the hands of our attorneys, the investigatory and adjudicatory process for licensed professionals facing disciplinary charges can be the professional's best friend. Consider these strategic approaches.

Responding to Nurse Aide Disciplinary Investigations

The tendency of a nurse aide facing daunting and confusing disciplinary charges can be to act defensively and aggressively, when the opposite strategic approach of acting proactively and diplomatically may produce far better outcomes. An administrative disciplinary proceeding isn't a criminal court proceeding. You can't simply rely on your constitutional rights against self-incrimination, to a presumption of innocence, and to the state's proof of charges beyond a reasonable doubt. You must instead present enough evidence on your behalf to at least equal the weight of the evidence against you. And the best time for doing so can be at the investigation stage. Our attorneys may be able to help you identify, gather, and present your defense evidence to the investigator in an organized, coherent, and compelling fashion. The investigator will likely have the authority to recommend dismissal of the charges, which is your best possible outcome before even having to answer formal charges.

Answering Nurse Aide Disciplinary Complaints

If, instead, the investigator recommends formal charges, our skilled and experienced attorneys can help you answer those charges timely, once again presenting your best legal and factual defenses supported by evidence. We can also help you discover, evaluate, and respond to the disciplinary officials' evidence. Knowing what the other side has against you can lead you to the evidence you need to rebut the charges. Our attorneys can also help arrange mediation and settlement conferences at which their creative win-win proposals for resolution may lead to the dismissal of the charges.

Conducting Formal Hearings

Our attorneys can also help you conduct a formal hearing before the administrative law judge if a formal hearing is necessary. Presenting evidence at a formal hearing generally takes refined advocacy skills. Cross-examination of opposing witnesses takes even more skills than our premier attorneys have the experience and insight to exercise. We can also help you research, draft, and submit hearing briefs and organize and present documentary evidence on your behalf, all often necessary for an effective defense.

Negotiating Consent Agreements

You may also have the opportunity to resolve your disciplinary charges by consent agreement. Consent agreements can be good or bad for the nurse aide facing disciplinary charges, depending on the terms the agreement contains. Don't enter into a consent agreement that requires you to relinquish your registration or sets your registration up for revocation. Instead, let our attorneys negotiate as favorable of a consent agreement as may be possible in your particular case.

Texas Nurse Aide Registry Defense

The Lento Law Firm's premier Professional License Defense Team is available across Texas for nurse aide registry defense. Our skilled and experienced attorneys are available to you whether you work at Houston's Methodist Hospital, San Antonio's University Hospital, Dallas's Parkland Memorial Hospital, or another one of Texas's fine hospitals or healthcare facilities in those metropolitan regions or in Fort Worth, Austin, or another Texas location. Give your nurse aide job and nursing career the credit they are due. Don't undervalue your nursing practice and ignore the disciplinary charges. The charges are only allegations, not findings that you have committed any misconduct. Trust the Lento Law Firm's Professional License Defense Team, as hundreds of other nurse aides, licensed practical nurses, registered nurses, and other professionals nationwide have done. Call 888.535.3686 or chat with us now for the best available nurse aide registration defense across Texas. Our attorneys are ready to undertake your defense.


Attorney Joseph D. Lento and the Lento Law Firm are committed to answering your questions about Physician License Defense, Nursing License Defense, Pharmacist License Defense, Psychologist and Psychiatrist License Defense, Dental License Defense, Chiropractic License Defense, Real Estate License Defense, Professional Counseling License Defense, and Other Professional Licenses law issues nationwide.
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