Wis. Admin. Code DHS 129

Nurse Aide Training Programs

This Wisconsin administrative code chapter establishes certification and approval requirements for training programs that prepare nurse aides, medication aides, and feeding assistants who work in nursing homes, hospitals, facilities for the developmentally disabled, home health agencies, and hospices. It sets standards for program curricula, instructor qualifications, competency evaluation, and a state registry of nurse aides. Operators of such training programs must obtain department approval, undergo onsite reviews, submit annual reports, and comply with federal and state requirements governing program content and instructor credentials.

Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
1 DEPARTMENT OF HEALTH SERVICES DHS 129.03
Chapter DHS 129
CERTIFICATION OF PROGRAMS FOR TRAINING AND TESTING NURSE AIDES, MEDICATION 
AIDES AND FEEDING ASSISTANTS 
Subchapter I — General Provisions
DHS 129.01 Authority and purpose.
DHS 129.02 Applicability.
DHS 129.03 Definitions.
DHS 129.04 Waivers and variances.
Subchapter II — Nurse Aide Training and Testing
DHS 129.05 Nurse aide training program approval process.
DHS 129.06 Standards for instructors of nurse aide training programs.
DHS 129.07 Standards for nurse aide training programs.
DHS 129.08 Standards for nurse aide competency evaluation programs.
DHS 129.09 Registry.
DHS 129.10 Nurse aide program appeals.
Subchapter III — Feeding Assistants
DHS 129.11 Feeding assistant training program requirements.
DHS 129.12 Feeding assistant training program curriculum.
DHS 129.13 Feeding assistant training program completion.
DHS 129.14 Standards for instructors of feeding assistant training programs.
DHS 129.15 Feeding assistant training program approval process.
DHS 129.16 Feeding assistant employment requirements.
DHS 129.17 Feeding assistant training program requirements.
DHS 129.18 Feeding assistant training program record retention requirements.
DHS 129.19 Feeding assistant training program prohibitions.
DHS 129.20 Feeding assistant training program appeals.
Subchapter IV — Medication Aides
DHS 129.21 Medication aide training program application and approval process.
DHS 129.22 Standards for instructors of medication aide training programs.
DHS 129.23 Nursing home medication aide student qualifications.
DHS 129.24 Standards for nursing home medication aide training programs.
DHS 129.25 Nursing home medication aide training program operation.
DHS 129.26 Medication aide training program prohibitions.
DHS 129.27 Hospice medication aide training program approval process.
DHS 129.28 Standards for instructors of hospice medication aide training 
programs.
DHS 129.29 Hospice medication aide student qualifications.
DHS 129.30 Standards for hospice medication aide training programs.
DHS 129.31 Hospice medication aide training program operation.
Note: Chapter HSS 129 was renumbered to chapter HFS 129 under s. 13.93 (2m) 
(b) 1., Stats., and corrections made under s. 13.93 (2m) (b) 7., Stats., Register, June, 
1999, No. 522. Chapter HFS 129 as it existed on November 30, 2008, was repealed 
and a new chapter DHS 129, as renumbered from chapter HFS 129 under s. 13.92 
(4) (b) 1., Stats., was created, Register November 2008 No. 635, effective December 
1, 2008.
Subchapter I — General Provisions
DHS 129.01 Authority and purpose. This chapter is 
promulgated under the authority of ss. 146.40 (2m), (3), (3g), and 
(5), and 227.11 (2) (a), Stats., to provide conditions of approval 
for training programs and competency evaluation programs for 
persons who work as nurse aides, medication aides or feeding as-
sistants in hospitals, nursing homes or facilities for the develop-
mentally disabled, home health agencies or hospices certified un-
der 42 USC 1395 to 1395ccc, and conditions for including per-
sons in the department’s registry of nurse aides.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correc-
tion made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 16-
088: am. Register September 2017 No. 741, eff. 10-1-17.
DHS 129.02 Applicability. This chapter applies to any 
facility, agency or other organization that proposes to maintain a 
registry of nurse aides, train or administer competency evaluation 
testing of nurse aides, feeding assistants, or medication aides un-
der a program approved by or under contract with the department 
under this chapter, and to all persons automatically included or 
eligible for inclusion and requesting inclusion in the department’s 
registry of nurse aides.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.03 Definitions. In this chapter:
(1) “Abuse” has the meaning specified in s. DHS 13.03 (1).
(2) “Basic nursing course” means a course or combination of 
courses that contain the basic nursing skills, competencies and 
knowledge that the department is satisfied are generally equiva-
lent in content to the skills contained in s. DHS 129.07 (1).
(3) “Body mechanics” means the use of the muscle and skele-
tal systems during activity and when positioning the body for 
work tasks, given that the task is within the limits of worker capa-
bility when assisting in the movement, positioning and transfer of 
clients.
(4) “Caregiver misconduct registry” has the meaning speci-
fied in s. DHS 13.03 (4).
(5) “Client” means a person receiving care, treatment or diag-
nostic services from a health care provider.
(6) “Client care ergonomics” means a multifaceted, standard-
ized approach for client mobility tasks, which incorporates the 
evaluation of client characteristics to assure proper selection and 
use of equipment by caregivers according to algorithms for client 
transfer and mobility activities.
(7) “Client related services” means care, treatment or diag-
nostic services provided to a client.
(8) “Clinical setting” means one of the following:
(a) A practice setting where care and treatment of clients 
occur.
(b) A health care-related setting, where care and treatment of 
clients occurs.
(9) “Competency evaluation program” means a testing pro-
gram for nurse aides that is approved under this chapter and con-
sists of all of the following components:
(a) A written or oral examination.
(b) A skills demonstration examination.
(10) “Complicated feeding problems” means difficulty in 
swallowing, recurrent lung aspiration, or tube or parenteral or IV 
feedings.
(11) “Department” means the Wisconsin department of 
health services.
(12) “Developmental tasks” means those functions normally 
associated with the aging process, including acceptance of and 
adjustment to psychosocial and physiological processes, transi-
tion throughout adulthood, retirement development, and life 
review.
(13) “Direct supervision” means that an RN or LPN is imme-
diately available on the same unit, floor or wing as the nurse aide 
while the nurse aide is performing client-related services.
(14) “Employment” means working for another for compen-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.03 WISCONSIN ADMINISTRATIVE CODE 2
sation on a full-time, part-time, temporary, per diem, contractual 
or other basis.
(15) “Facility for the developmentally disabled” means a 
place or a distinct part of a place where five or more unrelated 
persons reside and who, because of their developmental disabili-
ties, require access to 24-hour nursing care or treatment for devel-
opmental disabilities as defined under rules promulgated by the 
department for facilities for the developmentally disabled. “Fa-
cility for the developmentally disabled” does not include any of 
the following:
(a) A convent or facility owned or operated exclusively by and 
for members of a religious order that provides reception and care 
or treatment of an individual.
(b) A hospice that directly provides inpatient care.
(c) An assisted living facility, as defined in s. 50.034, Stats.
(d) A nursing home.
(16) “Feeding assistant” means a person at least 16 years old 
who has completed a state-approved feeding assistant training 
program and who is paid by a nursing home, or a person who is 
used under an arrangement with another agency or organization 
to assist clients who have no feeding complications with the activ-
ities of eating and drinking. “Feeding assistant” does not mean 
an individual who is a licensed health professional or registered 
dietician; volunteers without money compensation; or a nurse 
aide.
(17) “General supervision” means at least intermittent face-
to-face contact between supervisor and nurse aide, but does not 
require the continuous presence of the supervisor in the same 
area during client-related services.
(18) “Disability” means a physical or mental impairment that 
makes ability to care for oneself unusually difficult or limits one’s 
capacity to work.
(19) “Health care provider” means any of the following:
(a) A nursing home.
(b) A facility for the developmentally disabled.
(c) An intermediate care facility for individuals with intellec-
tual disabilities.
(d) A hospital.
(e) A home health agency.
(f) A hospice.
(g) A rural medical center that provides one or more of the 
services listed in pars. (a) to (f).
(20) “Home health agency” has the meaning specified in s. 
50.49 (1), Stats.
(21) “Hospice” means an organization, program or place as 
defined in s. 50.90 (1), Stats., and ch. DHS 131, and is certified as 
a provider of services under 42 USC 1395 to 1395ccc.
(22) “Hospice medication aide” means a nurse aide who is 
able to administer medications in a hospice after passing a de-
partment-approved medication course.
(23) “Hospital” has the meaning specified in s. 50.33 (2) , 
Stats.
(24) “Licensed health care professional” means a physician, 
physician’s assistant, nurse practitioner, physical, speech or occu-
pational therapist, an occupational therapy assistant, a registered 
nurse, a licensed practical nurse or any other health or health ser-
vice professional subject to the jurisdiction of the Wisconsin de-
partment of safety and professional services.
(25) “Licensed practical nurse (LPN)” means an individual 
who is licensed under s. 441.10 (1) and (4) to (8), Stats., or who 
has a temporary permit under s. 441.10 (9), Stats.
(26) “Mechanical support” means any article, device or gar-
ment that is used only to achieve the proper position or balance of 
the client.
(27) “Misappropriation” has the meaning specified in s. DHS 
13.03 (12).
(28) “Misconduct” means abuse or neglect of a client or mis-
appropriation of a client’s property as specified in s. DHS 13.03 
(1), (12) and (14).
(29) “Neglect” has the meaning specified in s. DHS 13.03 
(14).
(30) (a) “Nurse aide” means a person, regardless of the per-
son’s title, who provides routine client-related services under the 
supervision of a registered nurse or licensed practical nurse. 
“Nurse aide” includes any of the following:
1. Any person on the registry.
2. Any person providing nursing or nursing-related services 
to clients, regardless of the title under which the person is 
employed.
3. Any person who has successfully completed a training 
program under s. DHS 129.07 and a competency evaluation pro-
gram under s. DHS 129.08.
4. Any person employed to provide nursing or nursing-re-
lated services, or employed within the last 24 months as a nurse 
aide by a health care provider.
5. Any person eligible to be included on the registry under s. 
146.40, Stats.
6. Any student nurse on assignment for greater than 120 
days.
(b) “Nurse aide” does not mean a person who is licensed, re-
ceives a permit, is certified or is registered under ch. 441, 448, 
449, 450, 451, 455 or 459, Stats.
(c) “Nurse aide” does not mean a person whose duties primar-
ily involve skills that are different from those taught in training 
and competency evaluation programs approved under ss. DHS 
129.07 and 129.08. A volunteer is not a “nurse aide”.
(30m) “Nurse aide training program” means an instructional 
program for a nurse aide that is approved by the department as 
mandated by s. 146.40 (3) or (3g), Stats.
(32) “Nursing home” has the meaning specified in s. 50.01 
(3), Stats.
(33) “Nursing home medication aide” means a nurse aide 
who is able to administer medications in a nursing home or a fa-
cility for the developmentally disabled after passing a depart-
ment-approved medication course.
(34) “Onsite review” means an evaluation of a training pro-
gram conducted at the physical location of the training program 
to verify the program is in compliance with the terms of the ap-
proval issued.
(35) “Plan of correction” means the training program’s plan 
to correct all areas identified as deficient during an onsite review.
(36) “Preliminary approval” means the initial 3 month ap-
proval issued by the department following the completed review 
and verification of all aspects of the application.
(37) “Primary instructor” means a registered nurse licensed 
to practice in Wisconsin who has a minimum of 2 years of nurs-
ing experience working as a registered nurse, at least one year of 
which must be in the provision of long-term care facility services, 
and who has completed a course in adult education or supervising 
nurse aides.
(38) “PRN medications” means medications administered as 
necessary based on the resident’s or patient’s condition.
(39) “Program” means the facility, agency or other entity or 
individual who operates an approved training program.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
3 DEPARTMENT OF HEALTH SERVICES DHS 129.04
(40) “Program trainer” means an individual from a health re-
lated field who provides specialized training about that field to 
nurse aides under the general supervision of the primary 
instructor.
(41) “Qualified clinical setting” means a clinical setting un-
encumbered by restrictions imposed under 42 CFR 483.151.
(42) “Qualified medication consultant” means one of the 
following:
(a) A pharmacist licensed in Wisconsin.
(b) An advanced practice nurse prescriber as defined in s. N 
8.02 (2).
(c) A masters-prepared registered nurse, teaching medication 
administration to RN or LPN students.
(43) “Registered nurse (RN)” means an individual who is li-
censed as a registered nurse under s. 441.06, Stats., or who has a 
temporary permit under s. 441.08, Stats., to practice as a regis-
tered nurse.
(44) “Registry” means the department’s record of all persons 
who are eligible to be employed by a health care provider, and 
who have either:
(a) Successfully completed a training and competency evalua-
tion program.
(b) Met the eligibility requirements under s. DHS 129.09 (5) 
to be included in the registry.
(45) “Restorative services” means the therapeutic practice, 
education and training to restore, promote, and maintain the 
client’s fullest possible level of functioning.
(46) “Restraint” means any garment, device, or medication 
used primarily to modify client behavior by interfering with the 
free movement of the client or normal functioning of a portion of 
the body, and which the client is unable to remove easily, or con-
finement in a locked room, but does not include mechanical 
support.
(47) “Revocation” means withdrawal of a nurse aide training 
program’s or competency evaluation program’s approval for fail-
ing to comply with applicable state requirements specified in s. 
146.40, Stats.
(48) “Rural medical center” has the meaning specified in s. 
50.50 (11), Stats.
(49) “Statement of deficiencies” means the official document 
on which the Department records citations.
(50) “Student nurse” means an individual who is enrolled in a 
school for professional nurses or a school for licensed practical 
nurses that meets standards established by the Board of Nursing 
under s. 441.01 (4), Stats., and ch. N 1, or who has successfully 
completed the course work of a basic nursing course in any 
school that is approved by the Board of Nursing under s. 441.06 
(1) (a), Stats., but has not successfully completed the examination 
under s. 441.06 (1) (e) or 441.10 (1) (e), Stats.
(51) “Substantial change” means a change to the facility, 
agency, organization or person that administers the training; pro-
gram designee; program site; the curriculum; the classroom; the 
clinical site; primary instructor; and program trainer.
(52) “Suspension” means a temporary withdrawal of the de-
partment’s approval for a facility, agency or other organization to 
provide a training or competency evaluation program if the entity 
providing the program is not in compliance with an approval pre-
viously issued by the department.
(53) “Training program” means a program approved under 
this chapter to train nurse aides, feeding assistants or medication 
aides.
(54) “Variance” means the department’s approval of an alter-
nate requirement requested by a health care provider in place of a 
requirement of this chapter.
(55) “Waiver” means the department’s approval of an exemp-
tion requested by a health care provider from a requirement of 
this chapter.
(56) “Waiver of prohibition” means an authorization for a 
program to be taught in but not by the entity’s staff that has had 
its approval denied or withdrawn pursuant to Public Law 105-15, 
Section 1819 (f) (2) and Section 1919 (f) (2) of the Social Secu-
rity Act, and 42 USC 1395i3 (f) (2) and 42 USC 1396r (f) (2).
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correc-
tions in (1), (4), (21), (23), (27), (28) and (29) made under s. 13.92 (4) (b) 7., Stats., 
Register November 2008 No. 635; correction in (24) made under s. 13.92 (4) (b) 6., 
Stats., Register February 2012 No. 674; correction in (50) made under s. 13.92 (4) 
(b) 7., Stats., Register July 2015 No. 715; correction in (25) and (50) made under s. 
13.92 (4) (b) 7., Stats., Register November 2015 No. 719; CR 16-088: cr. (30m) Reg-
ister September 2017 No. 741, eff. 10-1-17; 2019 Wis. Act 1: am. (19) (c) Register 
May 2019 No. 761, eff. 6-1-19; CR 20-068: am. (18) Register December 2021 No. 
792, eff. 1-1-22; CR 21-087: r. and recr. (30m), r. (31) Register June 2022 No. 798, 
eff. 7-1-22; CR 25-055: am. (30) (a) 2. Register February 2026 No. 842, eff. 3-1-
26.
DHS 129.04 Waivers and variances. (1) REQUIRE-
MENTS FOR WAIVERS OR VARIANCES. The department may grant 
a request for a waiver of or a variance from a requirement of this 
chapter if the department finds that the waiver or variance will 
not adversely affect the health, safety or welfare of any client; and 
that either:
(a) The requirement that the health care provider or program 
seeks relief from would result in unreasonable hardship or is in-
feasible as applied to the training program or competency evalua-
tion program.
(b) If the request is for a variance, the proposed alternative to 
a rule, including new concepts, methods, procedures, practice, 
techniques, equipment, personnel qualifications, pilot project or 
other alternative is in the interest of client care and management 
or more effective training or testing programs or management.
(2) PROCEDURES. (a) Requests. A request for a waiver or 
variance may be made at any time, shall be made in writing to the 
department and shall state all of the following:
1. The rule from which the waiver or variance is requested.
2. The time period for which the waiver or variance is 
requested.
3. The reason or reasons for which the waiver or variance is 
requested.
4. If the request is for a variance, the proposed alternative to 
the rule, including new concepts, methods, procedures, practice, 
techniques, equipment, personnel qualifications, pilot project or 
other alternative or alternatives the program proposes and a de-
scription of how the proposed alternative or alternatives serves 
the interests of training and competency evaluation in a manner 
that is as protective as the requirement from which the variance is 
sought; and
5. Assurances that sub. (1) will be satisfied.
6. The department may require additional information from 
the health care provider or program prior to acting on the request.
Note: A request for a waiver or variance should be addressed to the Division of 
Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969 or faxed to 608-264-
6340.
(b) Grants and denials. 1. The department shall grant or 
deny in writing each request for a waiver or variance. The notice 
of denial shall contain reasons for the denial.
2. The terms of a waiver or variance shall be modified upon 
agreement between the department and the health care provider 
or program.
3. The department may impose additional conditions on a 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.04 WISCONSIN ADMINISTRATIVE CODE 4
waiver or variance it considers necessary to protect the health, 
safety or welfare of clients.
4. The department may limit the duration of any waiver or 
variance.
(c) Revocation. The department may revoke a waiver or vari-
ance, with written notice to the program, subject to the hearing 
requirements in par. (d), for any of the following reasons:
1. The department determines the waiver or variance is ad-
versely affecting the effectiveness of the health care provider or 
program.
2. The health care provider or program failed to comply with 
the waiver or variance as granted or with a condition of the 
waiver or variance.
3. The health care provider or program notifies the depart-
ment in writing that the program wishes to relinquish the waiver 
or variance and be subject to the rule previously waived or varied.
4. Revocation is required by a change in law.
(d) Hearings. A health care provider or program may contest 
the denial of a requested waiver or variance by requesting a hear-
ing under ch. 227, Stats., and s. DHS 129.10.
(3) NURSE AIDE TRAINING OR COMPETENCY EVALUATION 
PROGRAM WAIVER OF PROHIBITION. Pursuant to amendments 
made to Public Law 105-15, Section 1819 (f) (2) and Section 
1919 (f) (2) of the Social Security Act, and 42 USC 1395i-3 (f) 
(2) and 42 USC 1396r (f) (2), the department may authorize a 
waiver of the 2-year prohibition for approval of training programs 
or the competency evaluation program offered in but not by a fa-
cility under the following circumstances:
(a) No other department-approved program is offered within a 
reasonable distance of the facility.
(b) The facility shall have an adequate environment for oper-
ating the program. An adequate environment means the citations 
leading to the prohibition were non-resident and non-nursing care 
related.
(c) If the citations leading to the prohibition were resident or 
nursing care related:
1. The citations were corrected at revisit and there were no 
cites at or since the previous standard survey that were resident or 
nursing care related; or
2. The program termination resulted from a new citation at a 
standard survey revisit and the facility had no other citations at or 
since the previous standard survey that were resident or nursing 
care related; or
3. The facility had an immediate jeopardy situation in a resi-
dent or nursing care related area that was corrected at the time of 
survey and had no other citations at or since the previous standard 
survey that were resident or nursing care related; or
4. The facility had a history of resident or nursing care re-
lated citations, but has demonstrated efforts beyond normal 
means to attain and maintain substantial compliance. History 
means since the most recent training program approval.
(d) The facility’s physical environment is adequate in that the 
physical or structural requirements are in substantial compliance 
or there is a waiver request pending.
(e) The program provided in the facility shall be by another 
entity unrelated to the facility that has agreed to provide the train-
ing. Competency testing shall also be done by an entity unrelated 
to the facility or the training program.
(f) The facility requesting the waiver shall notify the State 
long term care ombudsman of the request for waiver. The om-
budsman may comment to the department identifying any con-
cerns about whether the facility may serve as a training site.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; CR 25-
055: am. (3) (intro.), renum. (3) (a) (intro.) to (3) and am., r. (3) (a) 1. to 3. Reg-
ister February 2026 No. 842, eff. 3-1-26.
Subchapter II — Nurse Aide Training and Testing
DHS 129.05 Nurse aide training program approval 
process. (1) APPLICATION. (a) An applicant for nurse aide 
training program approval shall apply for approval of their pro-
gram on a form provided by the department.
Note: To obtain a copy of the application, email the Division of Quality Assur-
ance at: DHSWIDQA_NATCEP@dhs.wisconsin.gov.
(b) The program shall provide any additional information re-
quested by the department during the department’s review of the 
application.
(c) The program shall designate an individual who is respon-
sible for the operation and compliance of the program with all ap-
plicable provisions of this chapter. The program shall note the 
designee on the application for approval.
(d) All aspects of the program shall be in compliance with all 
applicable federal, state and local laws.
(2) ACTION BY THE DEPARTMENT. (a) Initial review of a 
training program. 1. Upon receiving an application for approval 
of a training program, the department shall review the program to 
determine the program’s compliance with ss. DHS 129.06 and 
129.07. The department shall review the program for all of the 
following:
a. Program content, length and ratio of classroom instruction 
to skills training.
b. Qualifications of instructors.
c. Clinical setting and type of clinical supervision.
d. Provision for written evaluation of the program.
e. Reasonable accommodations for prospective students with 
disabilities.
f. Criteria for successful completion.
g. Appropriate furnishing of physical facilities to meet class-
room instruction and skills training needs.
2. Within 90 days after receiving a training program applica-
tion, the department shall either issue a preliminary approval or 
deny the application. Preliminary approval may be granted for a 
period of 3 months. If the application is denied, the department 
shall give the program reasons, in writing, for the denial and de-
scribe the process to appeal the denial.
3. If an application for approval of a training program is de-
nied, the program may not resubmit an application for approval to 
train nurse aides for 6 months from the date of the denial of the 
application.
(b) Pre-approval and monitoring. 1. The department shall 
conduct a preliminary approval onsite review before issuing a 
preliminary approval, to verify that the classroom and equipment 
are adequate for the training program.
2. Following the 3 month preliminary approval period, the 
department shall conduct an onsite review to verify compliance 
with the requirements of this chapter. The department shall ei-
ther issue a formal approval or revoke the preliminary approval.
3. If preliminary approval for a training program is denied or 
revoked, the program may not resubmit a request for approval to 
train nurse aides for 6 months from the date the preliminary ap-
proval for the training program was denied or revoked.
(c) Post-approval review and monitoring. 1. The department 
shall conduct a post-approval review of a program every 2 years 
after the date on which the department formally approves the pro-
gram. The department may conduct an announced or an unan-
nounced on-site review of the program at any time to verify that 
the program remains in compliance with this chapter.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
5 DEPARTMENT OF HEALTH SERVICES DHS 129.06
2. The program designee shall submit an annual report to the 
department on a form provided by the department and shall pro-
vide any additional information requested by the department dur-
ing the department’s review of the program. The program de-
signee shall provide reasonable means for the department to ex-
amine records and gather requested information.
3. The program designee shall submit for approval any sub-
stantial change in the program to the department in writing. A 
program may not implement the proposed change in the program 
without the department’s written approval. In this subdivision, 
“substantial change” means a change in the program designee un-
der s. DHS 129.05 (1) (c) , primary instructor under s. DHS 
129.06 (1), training course for primary instructors under s. DHS 
129.06 (3), curriculum under s. DHS 129.07 (1), or program site 
under s. DHS 129.07 (2) (a) or (c).
4. An approved training program may be granted inactive 
status if no training was conducted in the previous 24 consecutive 
months. The training program will be required to submit a new 
application in its entirety if the period of inactivity is 36 consecu-
tive months or longer.
5. If at any time the department determines that a program 
has failed to comply with a requirement of this chapter, the de-
partment may, after providing written notice, impose a plan of 
correction on the program, or suspend or revoke approval of the 
program.
(d) Enforcement. 1. The department may deny or withdraw 
approval of a new or existing program for any of the following 
reasons:
a. The program cannot provide satisfactory evidence that the 
program meets the standards for program approval.
b. The program did not conduct any training classes within 
the previous 24 consecutive months.
c. The program fails to allow the department to conduct an 
on-site visit of the training program.
2. The department may withdraw program approval immedi-
ately or prescribe the time within which the deficiencies identi-
fied during an onsite review shall be corrected. All notices of de-
ficiency shall be given in writing to the program contact, identi-
fied in s. DHS 129.05 (1) (c). The program contact may submit a 
plan of correction to the department. If the program fails to cor-
rect the deficiency within the specified time, the approval may be 
withdrawn.
3. When program approval is withdrawn, the program shall 
do all of the following:
a. Submit a plan to the department within 10 business days 
after the withdrawal of the program’s approval for the completion 
of the program of the enrolled students with another program in 
good standing with the department.
b. Allow students who have started that program to complete 
the course with another program that is in good standing with the 
department.
c. Provide for custody of the training records for a 3 year time 
period as required in s. DHS 129.07 (2) (f).
4. Denial or withdrawal of facility-based training is subject 
to the requirements of applicable federal law.
5. If the approval is withdrawn, the program may request a 
hearing under in s. DHS 129.10.
6. If approval of the program is denied or withdrawn under 
subd. 1., the program may not reapply for program approval for 6 
months from the date of the denial or withdrawal of the program 
approval.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correc-
tion in (2) (d) 6. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 
635; CR 20-068: am. (2) (a) 1. e. Register December 2021 No. 792, eff. 1-1-22.
DHS 129.06 Standards for instructors of nurse 
aide training programs. (1) PRIMARY INSTRUCTOR. (a) 
The primary instructor for a training program shall be a regis-
tered nurse licensed to practice in Wisconsin, who has at least 2 
years of experience working as a registered nurse, of which at 
least one year of experience shall be actual work experience in 
providing care in a nursing home that meets the requirements of 
sections 1919(a), (b), (c) and (d) of the Social Security Act.
(b) Notwithstanding par. (a), the primary instructor for a 
training program conducted by a hospital shall have at least one 
of the 2 years experience working as a registered nurse in a 
hospital.
(c) Notwithstanding par. (a), for a primary instructor in a 
training program in a home health agency-based program, shall 
have at least one of the 2 years experience working as a registered 
nurse in the provision of home health care.
(d) A primary instructor shall provide to the program a re-
sume documenting the instructor’s education and clinical experi-
ence in meeting clients’ psychosocial, behavioral, cognitive and 
physical needs, and the program shall maintain the instructor’s 
resume on file and shall include a copy of the instructor’s resume 
with the program’s application for program approval.
(e) The primary instructor shall attend a training course for 
instructors approved by the department under sub. (3). The de-
partment may waive this requirement for an instructor who has 
taken a substantially equivalent course or who has substantially 
equivalent training or clinical experience.
(f) A primary instructor is considered active as long as the in-
structor remains affiliated with an approved course. If the pri-
mary instructor leaves the program and does not become affili-
ated with another program the instructor’s approval as a primary 
instructor is inactivated as of the date the instructor leaves the ap-
proved program.
(g) The department may revoke approval of a primary instruc-
tor if the department determines the primary instructor failed to 
comply with any requirement of this chapter.
(2) PROGRAM TRAINER. (a) Only persons licensed in health 
care and public health fields may serve as program trainers to 
meet specialized training needs. This may include licensed regis-
tered nurses, licensed practical nurses, pharmacists, dietitians, 
social workers, registered sanitarians, fire safety experts, health 
care administrators, gerontologists, psychologists, physical and 
occupational therapists, activity therapists, speech and language 
pathologists, audiologists, and high school instructors who are 
approved by the administration in their respective districts to 
teach health occupation courses.
(b) A program trainer shall have at least one year of work ex-
perience in the area the program trainer will provide training.
(c) A program trainer shall work under the general supervi-
sion of the primary instructor.
(3) TRAINING COURSE FOR PRIMARY INSTRUCTORS. Applica-
tion for approval of a training course for primary instructors shall 
be made on a form provided by the department. The department 
shall review an application for approval of a training course for 
primary instructors and shall approve or deny the application 
within 90 days after receiving the application. The application 
shall include documentation of all of the following:
(a) The instructor shall be a registered nurse licensed to prac-
tice in Wisconsin and have at least 2 years of experience as an in-
structor of nursing practice or nurse aides.
(b) The course shall be a minimum of 16 hours in length.
(c) The training course shall include the following areas:
1. The principles of adult learning and training techniques.
2. Formulating training objectives, including behavior objec-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.06 WISCONSIN ADMINISTRATIVE CODE 6
tives which state measurable performance criteria to provide a 
basis for competency evaluation.
3. Designing the curriculum to provide a logical organization 
of the material to be covered.
4. Developing lesson plans.
5. Choosing appropriate teaching strategies and 
methodologies.
6. Developing learning materials.
7. Applying methods for evaluating trainee learning.
8. Effectively supervising trainees’ clinical practice.
9. Defining criteria for successful achievement of training 
program objectives, including development of oral and written 
examinations and development of methods for demonstrating 
skills based on behaviorally stated course objectives; and
10. Developing a recordkeeping system.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.07 Standards for nurse aide training pro-
grams. (1) CURRICULUM FOR A NURSE AIDE TRAINING PRO-
GRAM. The training program shall include theory and practice in 
all of the following care areas:
(a) Interpersonal communication and social interaction. The 
program shall include the theory of and practice in communicat-
ing and interacting on a one-to-one basis with a client; serving as 
part of a team implementing client care objectives; demonstrating 
sensitivity to a client’s emotional; social and psychological needs 
through directed interactions; and skills that enable expressions 
of age-appropriate behavior by allowing a client to make personal 
choices and by reinforcing behavior that supports a client’s sense 
of dignity. After completion of this portion of the training pro-
gram, a nurse aide shall do all of the following:
1. Identify the components of a caregiver-client relationship 
and be able to recognize and demonstrate understanding of all of 
the following:
a. The uniqueness of each client, in terms of that person’s 
age, disability, family status, financial status, gender, marital sta-
tus, race, and sexual orientation, and cultural, generational, so-
cial, ethnic, religious or other background, values or 
characteristics.
b. The needs of a client with Alzheimer’s disease, dementia, 
mental illness, intellectual disability, or other cognitive disabili-
ties or impairments.
c. Ways both nurse aides and clients can cope with stress.
d. What constitutes caregiver misconduct.
e. The messages conveyed by body language, speech and fa-
cial expressions.
2. Demonstrate an ability to establish effective relationships 
with clients and be able to do all of the following:
a. Communicate with clients in a respectful manner that af-
fords clients dignity.
b. Explain procedures and activities to clients before carry-
ing out those procedures or beginning those activities.
c. Demonstrate concern for clients who have long-term or 
disabling illnesses or who are dying.
d. Identify developmental tasks associated with the aging 
process.
3. Demonstrate an ability to use appropriate verbal and non-
verbal communication skills with clients and be able to do all of 
the following:
a. Recognize effective listening techniques.
b. Distinguish assertive from aggressive responses.
c. Identify the difference between non-acceptable and ac-
ceptable touching during job performance.
d. Identify therapeutic interventions and specialized tech-
niques for responding to client’s wandering and confusion.
4. Recognize common barriers to communication, including 
language, vision changes, hearing loss, speech problems, mem-
ory loss, disorientation and pain.
5. Demonstrate an ability to promote the independence of 
clients within the limitations of their physical, mental and intel-
lectual impairments by fostering self-help skills through appro-
priate responses to clients’ attempts to provide self care, includ-
ing recognizing clients’ level of ability in self care activities.
6. Identify the role of the family and other persons of impor-
tance to the client in the client’s care and as resources for client 
emotional support.
(b) Basic nursing skills. The program shall include the theory 
of and practice in basic nursing skills, including bed making, tak-
ing vital signs, measuring height and weight, caring for the 
client’s environment, measuring fluid and nutrient intake and 
output, assisting in the provision of proper nutritional care, walk-
ing or transferring the client using body mechanics and appropri-
ately selected equipment with regard to principles of client care 
ergonomics, and maintaining infection control and safety stan-
dards. A nurse aide shall do all of the following:
1. Use acceptable personal hygiene.
2. Recognize the components of working relationships.
3. Identify how and when to seek guidance, using the super-
visory channels of communication within the facility or agency.
4. Use proper body mechanics.
5. Demonstrate an understanding of the meaning of common 
medical terms and abbreviations.
6. Observe and report changes in client behavior and physical 
status, including signs and symptoms of common diseases and 
conditions.
7. Recognize when a client may be choking and respond 
appropriately.
8. Recognize the normal physical and psychological changes 
associated with aging.
9. Identify the basic principles of nutrition and hydration.
10. Recognize and report deviations from a client’s normal 
food and fluid intake and output.
11. Recognize the basic requirements of commonly pre-
scribed therapeutic diets.
12. Use common measures to promote a client’s skin in-
tegrity, considering the client’s ethnicity, race and age.
13. Demonstrate appropriate techniques in walking, transfer-
ring, positioning and transporting clients.
14. Recognize and respond appropriately to unsafe environ-
mental conditions, including damp floors, frayed electrical cords 
and loose hand rails.
15. Recognize and respond appropriately to emergency situ-
ations including following emergency evacuation procedures.
16. Demonstrate appropriate hand washing techniques.
17. Understand and use commonly used alternatives to re-
straints in accordance with current professional standards.
18. Maintain the safety and cleanliness of client care areas.
19. Make use of proper isolation technique.
20. Perform commonly accepted infection control practices, 
including proper gloving technique and proper disposal of blood 
and body fluids and secretions.
21. Make occupied and unoccupied beds.
22. Measure temperature, pulse and respiration.
23. Measure a client’s weight and height.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
7 DEPARTMENT OF HEALTH SERVICES DHS 129.07
24. Record objective information.
25. Apply nonprescription ointments to unbroken skin areas.
26. Recognize the general effects of prescribed routine 
medications.
27. Recognize therapeutic interventions and specialized 
non-pharmacological pain control interventions.
28. Assist with care of clients when death is imminent.
29. Assist with post-mortem care.
30. Maintain the safety and cleanliness of areas where food 
is stored.
(c) Personal care skills. The program shall include the theory 
of and practice in basic personal care skills, including bathing, 
mouth care, grooming, dressing, toileting, and assistance with 
eating, hydration and skin care. A nurse aide shall demonstrate 
the ability to do all of the following:
1. Give a complete or partial bed bath to a client and assist a 
client in taking a bath or a shower.
2. Provide care of the client’s perineal area.
3. Apply appropriate oral hygiene practices when assisting a 
client with oral hygiene, including caring for the client’s dentures.
4. Care for a client’s nails, hair and skin.
5. Shave and shampoo a client, including applying nonpre-
scription medicated shampoos.
6. Dress and undress a client.
7. Prepare a client for meals.
8. Assist in feeding a client, including helping a client use 
adaptive devices and feeding utensils and encouraging a client to 
eat nutritionally balanced meals.
9. Assist a client with bowel and bladder elimination.
(d) Basic restorative services. The program shall include the 
theory of and practice in providing restorative services. Basic 
restorative services include the application of assistive devices for 
ambulation; eating and dressing; maintenance of range of motion 
through appropriate exercises; proper turning and positioning 
both in bed and chair; proper transferring techniques; bowel and 
bladder training; and care and use of prosthetic devices such as 
hearing aids, artificial eyes and artificial limbs. A nurse aide 
shall demonstrate the ability to do all of the following:
1. Recognize the importance of bowel and bladder programs.
2. Recognize the method for maintaining and improving 
musculoskeletal functioning by promoting joint mobility, body 
alignment and movement, including being able to do all of the 
following:
a. Position clients by use of pillows, towel rolls, padding and 
footboards.
b. Perform simple range of motion exercises.
c. Assist clients in the use of crutches, walkers, wheelchairs, 
canes, prostheses and appliances.
3. Transfer clients safely and according to principles of pa-
tient care ergonomics and with proficiency in use of available 
equipment that is used to transfer clients.
Note: Equipment used to transfer clients includes, but is not limited to, mechan-
ical lifts, friction reducing devices; wheelchairs and gait belts.
4. Reinforce breathing exercises, including coughing and 
deep breathing.
5. Help clients use hearing aids and visual aids.
(e) Rights of clients. 1. The program shall provide instruction 
on the principles of and requirements relating to clients’ rights. 
The nurse aide shall demonstrate an understanding of all of the 
following obligations:
a. Providing privacy for clients in treatment, living arrange-
ments and personal care needs.
b. Maintaining the confidentiality of client health and per-
sonal records.
c. Allowing clients to make personal choices to accommo-
date the clients’ needs.
d. Providing help clients need in getting to and participating 
in activities, including client and family group meetings.
e. Maintaining the personal possessions of clients in good 
and secure condition.
f. Interacting with clients without abusing or neglecting the 
clients.
g. Interacting with clients without misappropriating the 
clients’ property.
h. Immediately reporting to appropriate facility or agency 
staff every instance of abuse or neglect of a client or misappropri-
ation of a client’s property as defined in s. DHS 13.03 (1), (12), 
and (14).
2. The nurse aide shall demonstrate behavior that recognizes 
that clients have rights and that the aide respects those rights. 
The nurse aide shall do all of the following:
a. Demonstrate respect and concern for each client’s rights, 
preferences and awareness of age, color, disability, family status, 
financial status, gender, marital status, race, sexual orientation, 
and ethnic, cultural, social, generational and religious 
differences.
b. Show respect for cultural, ethnic and religious food 
preferences.
c. Recognize what constitutes abuse of clients and demon-
strate an understanding of how to interact with clients without 
abusing them or without appearing to abuse them.
d. Demonstrate prevention and intervention skills with com-
bative clients that balance appropriate client care with a need to 
minimize the potential for injury to the aide and others.
e. Recognize the role of state and federal regulatory agencies 
in licensing or otherwise approving providers and in investigating 
complaints of abuse of client property.
f. Demonstrate an understanding of the process by which a 
client or staff member may file a complaint on behalf of a client 
and seek redress for a perceived violation of client rights.
g. Recognize the role of client advocacy groups as client 
resources.
h. Demonstrate awareness of how to file a complaint with the 
department regarding operations within the provider setting.
(f) Dementias. The program shall include instruction about 
dementia and specific techniques for meeting the basic needs of 
clients with dementia. The nurse aide shall demonstrate an un-
derstanding of all of the following:
1. The nature of dementia, including the cause, course and 
symptoms of the impairment. The effects that brain changes have 
on the person’s moods, abilities and functioning.
2. The effects on the client of staff verbal and nonverbal 
communication with the client and means of modifying these 
communications and approaches to facilitate effective interaction 
between clients and staff.
3. The feeding and fluid intake problems associated with de-
mentia and the specialized techniques for addressing those 
problems.
4. The effect of the environment on clients with dementia 
and the appropriate environmental stimuli to use with those 
clients to reduce stress and maximize normal functioning and 
how to incorporate strategies that preserve function and prevent 
excess disability.
5. Possible causes of dementia related symptomatic behavior 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.07 WISCONSIN ADMINISTRATIVE CODE 8
changes, specifically focusing on understanding behavior as an 
attempt to communicate unmet needs and then how to address the 
unmet need including an understanding of how pain impacts 
behavior.
6. Ways to help the person with dementia continue meaning-
ful involvement in his or her day, the importance of structure and 
routine and the incorporation of the person’s life story and past 
interests, routines, tastes, values and background.
7. The stress involved for the client, family and nurse aide in 
caring for a client with dementia and techniques for coping with 
this stress and ways to address the person with dementia’s core 
needs of having self-esteem boosted, being useful, giving and re-
ceiving love, and caring for self and others.
(2) PROGRAM OPERATION. (a) Class setting. 1. Programs 
shall ensure that classrooms and lab facilities are adequate to 
meet the needs of the program, based on the number of students 
enrolled and how the classroom space is used. Programs shall en-
sure that classroom and skills labs have adequate temperature 
controls, clean and safe conditions, adequate space to accommo-
date students, adequate lighting, and all training equipment 
needed, including audiovisual equipment and any equipment 
needed for simulating resident care. Lab equipment shall be in 
the skill lab at all times necessary for demonstration, practice, 
and student demonstration. Any area designated as a classroom 
or lab in a facility-based program shall be an area that is not des-
ignated for resident care.
2. The program shall have qualified faculty members for 
both the classroom and the skills portion of the program.
3. The program shall have reasonable accommodations for 
students and prospective students with disabilities.
(b) Program standards for training programs. 1. A training 
program shall include at least 75 training hours as required under 
42 CFR 483.152 (a). At least 16 of those 75 training hours must 
be in a clinical experience in a clinical setting as required under 
42 CFR 483.152 (a) and approved by the department. The first 
16 hours of training shall be provided in a classroom setting be-
fore a student has direct contact with clients. Tours of a facility, 
including observations of clients and day-to-day facility activi-
ties, may be incorporated into the classroom hours. Competency 
evaluation under s. DHS 129.08 and provider orientation may not 
be counted toward meeting the 75-hour minimum requirement.
2. The program shall cover all of the following during the 
first 16 hours of classroom training:
a. Communication and interpersonal skills.
b. Infection control.
c. Safety and emergency procedures.
d. Promoting residents’ independence.
e. Residents’ rights.
3. A health care provider may employ a student as a nurse 
aide after the student has completed 16 hours of classroom train-
ing in the topics in subd. 2., and if the student is a full-time per-
manent employee, and is enrolled in an approved training pro-
gram. The training program shall provide the health care 
provider with verification that the program has provided the in-
struction specified in subd. 2.
4. The program shall provide notification to students spon-
sored by Medicaid-certified nursing facilities that the students 
are not responsible for any costs associated with training, includ-
ing deposits for textbooks or supplies used.
(c) Clinical setting. Before a student performs any client-re-
lated services, the RN primary instructor shall determine that the 
student has been trained and found proficient in providing those 
services. The training program shall ensure all of the following:
1. Access to a clinical setting approved by the department 
that is adequate to meet the needs of the program.
a. Clinical settings shall be in compliance with state and fed-
eral law. The program designee or primary instructor and the 
health care provider with whom the program has contracted are 
responsible for verifying that the clinical facility is in compliance 
with state and federal law. This verification shall be documented 
in the program’s files and shall be available during the evaluation 
process.
b. The agreement between the program and the clinical set-
ting shall be reviewed and renewed annually by the department 
and upon any change of facility or school administration. A copy 
of the agreement shall be submitted to the department.
c. During classroom and lab instructions, students shall be 
oriented to the various forms used to document resident informa-
tion. Instructors shall supervise documentation on the appropri-
ate flow sheets and forms during the clinical rotation.
d. Before a student begins a clinical rotation, the primary in-
structor shall evaluate and document that the student successfully 
demonstrated the ability to perform a skill.
e. Students may not give hands-on care to a resident who is 
not assigned to the student unless the student is under the direct 
supervision of the primary instructor.
f. Students who are under the general supervision of the pri-
mary instructor may be paired, during the student’s clinical rota-
tion, with nurse aides who are employed by the health care 
provider.
g. Students shall maintain safe practices, infection control 
and respect resident rights at all times.
h. Students shall demonstrate knowledge regarding their as-
signed residents’ diagnoses and identified needs.
i. Students and instructors shall wear clothing that is in com-
pliance with program policy and that is appropriate for perform-
ing resident care. The clothing shall include a nametag that des-
ignates the name of the nurse aide training program and the per-
son’s status as a student or instructor.
j. The scheduled clinical hours shall provide experiences that 
meet expected outcomes outlined in the program curriculum.
k. The length of the clinical day may not exceed 8 hours.
L. A health care facility may serve as the site of clinical in-
struction for up to 2 nurse aide training programs at the same 
time, except that the department may decide to allow more than 2 
programs at a single health care facility on a case-by-case basis in 
conjunction with the facility’s administrative staff.
m. The program shall not be used as a substitute for staff ori-
entation or staff education programs.
2. An adequate number of primary instructors in the clinical 
setting to provide safe and effective supervision and assistance of 
students.
a. Primary instructors shall not function in another role 
while supervising students in the clinical setting.
b. A ratio of 6 to 8 students per instructor is considered to be 
adequate in most circumstances.
c. The primary instructor shall evaluate and document that a 
student demonstrated successfully the ability to perform a skill 
before the student begins a clinical rotation.
d. The primary instructor shall make all student clinical as-
signments with the approval of the health care provider. The in-
structor shall complete a review of each resident’s chart to re-
trieve pertinent information needed by the students to provide the 
required cares. Care plan information shall be reviewed at the be-
ginning of each clinical experience and shall include new orders 
or changes in each resident’s status.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
9 DEPARTMENT OF HEALTH SERVICES DHS 129.08
e. A student’s assignment shall be shared with the clinical 
setting to which the student is assigned before the student arrives 
at the clinical setting.
f. Each student shall be given an individual assignment. 
More than 2 students shall not be assigned to the same resident at 
the same time.
g. Clinical assignments shall include all of the following:
i. Care of clients with varied levels of care needs.
ii. The opportunity to be evaluated on organizational skills 
and time management.
h. The RN primary instructor is responsible for supervising 
the clinical performance of each LPN program trainer.
(d) Nursing home-based program. Training of nurse aides 
may be performed under the general supervision of the director 
of nursing for a facility; however, the director of nursing may not 
act as the primary instructor or as a program trainer. Primary in-
structors shall not be involved in more than one role while super-
vising students in the clinical area.
(e) Expectations and records. 1. The training program shall 
maintain a list of the required skills and competencies that a stu-
dent will complete by the end of the training program.
2. On the list of skills, the primary instructor shall verify, by 
initialing and dating each individual skill, that the student has sat-
isfactorily performed that skill. When a student has satisfactorily 
completed all required skills and competencies and attained the 
necessary knowledge, as well as achieved the stated course com-
pletion criteria, the trainee qualifies to enter a competency evalu-
ation program.
3. The primary instructor shall provide a copy of the stu-
dent’s performance record to the student at the conclusion of the 
student’s training.
(f) Record retention. The training program shall retain all 
records required by this section for a period of at least 3 years af-
ter a student completes the training program.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correc-
tion in (1) (e) 1. h. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 
No. 635; renumbering in (2) (c) 2. g. made under s. 13.92 (4) (b) 1., Stats., Register 
November 2008 No. 635; CR 16-088: am. (1) (intro.), cr. (1m), am. (2) (b) (title), 1., 
cr. (2) (bm), am. (2) (d), (e) 1. Register September 2017 No. 741, eff. 10-1-17; cor-
rection in (1m), (2) (b) made under s. 35.17, Stats., Register September 2017 No. 
741; 2019 Wis. Act 1: am. (1) (a) 1. b. Register May 2019 No. 761, eff. 6-1-19; CR 
20-068: am. (2) (a) 3. Register December 2021 No. 792, eff. 1-1-22; CR 21-087: r. 
and recr. (1) (title), (intro.), r. (1m), r. and recr. (2) (b) (title), 1., r. (2) (bm) Register 
June 2022 No. 798, eff. 7-1-22.
DHS 129.08 Standards for nurse aide competency 
evaluation programs. (1) EXAMINER QUALIFICATIONS. The 
examiner conducting the clinical competency program of a stu-
dent shall be an RN with at least one year experience caring for 
the elderly or chronically ill of any age.
(2) WRITTEN OR ORAL EVALUATION COMPONENT. (a) The 
RN examiner will give each student instructions for the written or 
oral evaluation component. After the student’s written or oral 
evaluation has begun, the RN may designate another person to 
proctor the written or oral evaluation.
(b) The competency evaluation program shall develop a pool 
of test questions that addresses all 6 content areas and their com-
ponents under s. DHS 129.07 (1) . The test questions shall in-
clude enough questions to form 3 separate and complete 
examinations.
(c) The competency evaluation program shall develop written 
and oral examinations from the pool of test questions. The con-
tent of the written and oral examinations shall reflect the content 
and emphasis of the training program approved by the 
department.
(d) The competency evaluation program shall provide stu-
dents with written and oral examinations in English. If the stu-
dent will be working in a provider setting in which the predomi-
nant language is other than English, the program may not refuse 
to test in the language that is predominant in that work setting.
(e) The competency evaluation program may develop an oral 
examination for nurse aides with limited literacy skills. To do so, 
the program shall adapt the written examination for oral testing. 
The oral examination shall cover the same subject areas included 
in the original written examination adapted for oral testing, and 
shall include a component to determine the aide’s ability to read 
basic, objective, job-related information, such as reading a 
client’s name band or a client’s flow sheet.
(f) A minimum of 50 written or oral questions shall be asked 
in each examination. The questions shall cover at least the 6 care 
areas under s. DHS 129.07 (1) and shall be selected randomly 
from the following areas:
1. A minimum of 4 questions in the area of interpersonal 
communication and social interaction.
2. A minimum of 7 questions in the area of basic nursing 
skills. Of these 7 questions, at least one question shall address 
each of the following areas:
a. Observation, reporting and documentation of changes in 
client status and services furnished.
b. Recognizing and reporting change of client condition and 
status to supervisor.
c. Knowledge of emergency procedures.
d. Knowledge of infection control procedures.
e. Maintenance of a clean, safe and healthy environment.
3. A minimum of one question in the area of personal care 
skills.
4. A minimum of 3 questions in the area of basic restorative 
services.
5. A minimum of 5 questions in the area of client rights. Of 
these 5 questions, at least one question shall address each of the 
following areas:
a. Right to respect.
b. Right to privacy and confidentiality.
c. Right to maintain personal property.
6. A minimum of 5 questions in the area of dementias.
(g) To successfully complete the written or oral portion of the 
competency evaluation program, the student shall obtain satisfac-
tory scores as identified in par. (f).
(3) DEMONSTRATION COMPONENT. (a) The competency 
evaluation program shall develop a pool of skill demonstration 
scenarios. There shall be a sufficient number of skill demonstra-
tion scenarios to measure the individual’s ability to perform the 
required job tasks. Skills demonstration scenarios shall be ran-
domly selected from the pool of skills to be demonstrated. The 
care areas of interpersonal communication and social interaction 
shall be integrated throughout the skills demonstration scenarios.
(b) The skills demonstration shall consist of a demonstration 
of at least 5 randomly selected items drawn from a pool consist-
ing of the tasks generally performed by nurse aides. This pool of 
skills shall include all skills listed in s. DHS 129.07.
(c) The criteria for successful completion of a competency 
evaluation program shall include the passing scores in all re-
quired skills.
(4) EXAMINATIONS. To be included on the registry under 
s. DHS 129.09, a student shall successfully pass a Wisconsin-ap-
proved nurse aide competency evaluation examination. If a per-
son fails to pass any component of the competency evaluation ex-
amination, the individual need only retake the failed component. 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.08 WISCONSIN ADMINISTRATIVE CODE 10
The person may retake the component failed as many times as 
needed. The competency evaluation program shall ensure that 
each repeat examination shall differ in content from any examina-
tion previously taken by the individual.
(5) PROGRAM OPERATION. The competency evaluation pro-
gram shall maintain all of the following standards in operating 
the program:
(a) Reasonable accommodations for students with 
disabilities.
(b) An adequate number of examiners to provide safe and ef-
fective supervision and assistance.
(c) Assurance that examiners do not test students they have 
trained.
(d) Skills demonstration exercise portions of the examination 
are conducted at a ratio of one examiner to one student.
(e) Competency evaluation facilities that are adequate to meet 
the needs of the testing program.
(f) Retention of all records required under this section for a 
period of at least 3 years.
(g) A system to prevent unauthorized disclosure of the pool of 
test questions and the results of the individual competency 
evaluations.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correc-
tion in (2) (g) made under s. 13.92 (4) (b) 7., Stats., Register May 2011 No. 665; CR 
20-068: am. (5) (a) Register December 2021 No. 792, eff. 1-1-22; CR 25-055: am. 
(4) Register February 2026 No. 842, eff. 3-1-26.
DHS 129.09 Registry. (1) CONTENT OF THE REGISTRY. 
The department shall maintain information about a person on the 
registry, including:
(a) The person’s eligibility for employment in a department-
approved or licensed health care provider.
(b) The person’s social security number.
(c) The person’s first name, middle initial, and last name.
(d) The person’s current mailing address.
(e) The person’s date of birth.
(f) The date the aide completed a training program approved 
under s. DHS 129.07, if applicable.
(g) The date the aide completed a competency evaluation pro-
gram, if applicable.
(h) The competency evaluation program number, if 
applicable.
(i) The dates, if any, that indicate the aide’s employment 
status.
(j) The date the aide was included on the registry.
(k) The 2 character alphabetic postal code of any state other 
than Wisconsin in which a finding of abuse, neglect, or misappro-
priation has been placed on the registry against the aide.
(L) Any finding of abuse or neglect of a client or misappropri-
ation of a client’s property made by the department under s. 
146.40 (4r) (b), Stats., or, if appealed, by a hearing officer under 
s. 146.40 (4r) (d), Stats., and a brief rebuttal statement provided 
by the affected nurse aide under s. 146.40 (4r) (e) , Stats., if the 
nurse aide disputes the finding.
(2) NOTIFICATION OF COMPLETION. (a) The department or 
the department’s contractor shall place an individual’s name on 
the registry within 30 days after an individual has satisfactorily 
completed the competency evaluation program.
(b) An individual who is eligible for inclusion in sub. (5) in 
the registry, but for whom notification is not required under par. 
(a), or a hospital, nursing home, facility for the developmentally 
disabled, home health agency or hospice on behalf of that indi-
vidual, may apply to the department to include that individual in 
the registry.
(3) APPLICATION FOR INCLUSION ON THE REGISTRY. (a) 
Upon receiving an application under sub. (2) (b), the department 
or its agent shall review the application and make any inquiries 
necessary to determine if the individual is eligible to be included 
in the registry. False eligibility information submitted to the de-
partment or its contractor shall result in denial of the application 
or, if the application had already been processed, shall result in 
the individual’s removal from the registry.
(b) Within 30 days after receiving an application, the depart-
ment or its contractor shall approve the application and include 
the person in the registry, or deny the application. If the applica-
tion for inclusion is denied, the department or its contractor shall 
give the individual, or the facility or agency that submitted the 
application on behalf of the individual, reasons, in writing, for the 
denial.
(4) RELEASE OF REGISTRY INFORMATION. The registry shall 
serve as an official record of persons who are qualified by train-
ing and testing, or experience, to work as a nurse aide or a medi-
cation aide. The department may use registry information in its 
surveys of facilities and agencies. With the exception of sub. (1) 
(b), the information included in the registry about nurse aides is 
public information. A written request for registry information 
shall be accompanied by a self-addressed, stamped envelope.
Note: Written requests for registry information may be sent to the Office of 
Caregiver Quality, P.O. Box 2969, Madison, WI 53701-2969.
(5) ELIGIBILITY FOR INCLUSION ON THE REGISTRY. An indi-
vidual is eligible to be included in the registry only if at least one 
of the following is true:
(a) The individual has, within 120 days of beginning employ-
ment as a nurse aide, successfully completed a training program 
and a competency evaluation program for nurse aides that are ap-
proved by the department under s. 146.40, Stats.
(b) The individual has successfully completed an approved 
training program and a competency evaluation program in an-
other state that meet criteria for acceptance in this state.
(c) The individual has completed a basic nursing course from 
a board-approved school for nursing under s. 441.01 (4), Stats., or 
has completed a basic nursing course approved in another state by 
that state’s board of nursing and the student nurse has success-
fully completed a competency evaluation program.
(6) ELIGIBILITY TO WORK AS A NURSE AIDE. (a) State-li-
censed-only settings. Except as provided under sub. (7), a person 
included on the registry under any of the paragraphs in sub. (5), 
regardless of the title under which the person is employed, is eli-
gible to be employed as a nurse aide by a health care provider.
(b) Federally-certified settings. Except as provided under 
sub. (7), regardless of the title under which a person is employed, 
a person is eligible to be employed by a health care provider if the 
person is included on the registry under sub. (5) (a), (b) or (c), 
and if the person has performed nursing or nursing-related ser-
vices for monetary compensation at any time during the 24 con-
secutive months immediately before the individual’s employment 
in a health care provider’s setting would begin. If a person has 
not performed nursing or nursing-related services for monetary 
compensation at any time during the 24 consecutive months im-
mediately before the person’s employment would begin, in order 
to be eligible to be employed by a health care provider, the person 
shall successfully complete a department-approved training and 
competency evaluation program, or a department-approved com-
petency evaluation program for nurse aides.
(c) Student nurses. A person currently enrolled as a student 
nurse who has completed a basic nursing course at a school ap-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
11 DEPARTMENT OF HEALTH SERVICES DHS 129.11
proved by the Wisconsin Board of Nursing under s. 441.01 (4), 
Stats., is eligible to be employed as a nurse aide in a hospital, fa-
cility for the developmentally disabled, or federally-certified in-
termediate care facility for individuals with intellectual disabili-
ties even if that person is not included on the registry and even if 
that person has not successfully completed a competency evalua-
tion program under sub. (5) (c).
(7) EMPLOYMENT PROHIBITIONS. A federally-certified nurs-
ing home may not hire or continue to employ a nurse aide who 
has a finding of abuse, neglect or misappropriation entered on the 
registry as a result of an incident that occurred in a federally-cer-
tified nursing home. A federally-certified intermediate care fa-
cility for individuals with intellectual disabilities may not hire or 
continue to employ a nurse aide who has a finding of abuse, ne-
glect or misappropriation entered on the registry.
(8) REMOVING NURSE AIDES FROM THE REGISTRY. The name 
of a nurse aide who has not updated the nurse aide’s employment 
history on the registry in the previous five-year time period will 
be removed from the registry, except that the names of nurse 
aides with substantiated findings of caregiver misconduct as de-
fined in s. DHS 13.03 (13) will remain on the registry. For any 
person whose name is removed from the registry, In order to be 
placed on the registry again, the person shall successfully com-
plete another nurse aide training program and competency 
evaluation.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; renum-
bering in (6) (c) and correction in (8) made under s. 13.92 (4) (b) 1. and 7., Stats., 
Register November 2008 No. 635; 2019 Wis. Act 1: am. (6) (c), (7) Register May 
2019 No. 761, eff. 6-1-19.
DHS 129.10 Nurse aide program appeals. (1) SUB-
JECT OF APPEAL. Except for the denial of an approval of a nurse 
aide training or competency evaluation program under 42 CFR 
483.151 (b) (2) or (3) or the withdrawal of approval of a nurse 
aide training or competency evaluation program under 42 CFR 
483.15(e)(1) or (3), a health care provider may appeal to the de-
partment of administration’s division of hearings and appeals any 
of the following:
(a) A denial of a request for a waiver or variance under s. DHS 
129.04 (2) or the revocation of a waiver or variance under s. DHS 
129.04 (2) (c).
(b) A denial of an application for approval of training program 
under s. DHS 129.05 (1).
(c) A denial of an application for approval of a competency 
evaluation program under s. DHS 129.08.
(d) A denial of an application under s. DHS 129.06 (3) for ap-
proval of a training course for primary instructors.
(e) A denial under s. DHS 129.09 (5) of an application to in-
clude a person in the registry.
(f) A suspension or revocation of approval or the imposition 
of a plan of correction under s. DHS 129.05 (2) (d) 2.
(2) APPEALS OF WAIVER OR VARIANCE APPLICATION DE-
NIALS. A health care provider may contest the department’s de-
nial of a waiver or variance by requesting a hearing under s. 
227.42, Stats. The request for a hearing shall be filed with the de-
partment of administration’s division of hearings and appeals 
within 10 working days after receipt of the notice of denial. The 
request for hearing is considered filed when the request is re-
ceived by that division.
(3) ALL OTHER PROGRAM APPEALS. Except as provided un-
der sub. (2), all appeals filed pursuant to sub. (1) shall be in writ-
ing and shall take the form of a request for a hearing. The request 
for a hearing shall be filed with the department of administra-
tion’s division of hearing and appeals no later than 30 calendar 
days after the date of the denial, suspension or revocation, and is 
considered filed when received by that division.
(4) BURDEN OF PROOF. The program or person shall bear the 
burden of providing, by the preponderance of credible evidence, 
that the department’s denial of a requested waiver or variance was 
unreasonable.
Note: The address of the Department of Administration’s Division of Hearings 
and Appeals is P.O. Box 7875, Madison, Wisconsin 53707. Appeals may be deliv-
ered in person to that office at 5005 University Avenue, Room 201, Madison, Wis-
consin, or faxed to that office at 608-264-9885.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
Subchapter III — Feeding Assistants
DHS 129.11 Feeding assistant training program re-
quirements. (1) Wisconsin’s feeding assistant training pro-
grams shall require enrolled persons to successfully complete an 
approved feeding assistant training program, which includes all 
of the following federally-mandated topics, to be covered during a 
minimum of 8 hours of instruction:
(a) Feeding techniques.
(b) Assistance with feeding and hydration.
(c) Communication and interpersonal skills.
(d) Appropriate responses to resident behavior.
(e) Safety and emergency procedures, including the Heimlich 
maneuver.
(f) Infection control.
(g) Resident rights.
(h) Recognizing changes in residents that are inconsistent 
with the norm and the importance of reporting changes to the 
nurse.
Note: Safety and emergency procedures may also include Choking: First Aid 
taught by the American Red Cross and the American Heart Association.
(2) The feeding assistant training program shall also provide 
instruction on to all students on all of the following topics:
(a) Wisconsin’s Caregiver Program under ss. 50.065 and 
146.40, Stats., including background check requirements, the 
need to promptly report any misconduct allegations, the defini-
tions of abuse or neglect of a client or misappropriation of a 
client’s property and the rehabilitation review requirements.
(b) The client population who will be served by the feeding 
assistant in a program based in a nursing home. The facility-
based training program curriculum shall include training specific 
to the identified population types. This training shall include all 
of the following, but is not limited to:
1. Characteristics of the population, such as the client’s phys-
ical, social and mental health needs, and specific medications or 
treatments needed by the residents.
2. Program services needed by the clients.
3. Meeting the needs of clients with dual diagnoses, such as 
co-occurrence of mental health disorders and alcohol or drug de-
pendence or abuse, and maintaining or increasing the client’s so-
cial participation.
4. Self direction, self care and vocational abilities.
5. Instruction of feeding assistants who have been trained by 
another facility’s training program, for the current entity’s spe-
cific selected population.
(3) Programs may choose to add increased training 
requirements.
(4) The program determines the number of extra hours re-
quired for the training topics listed under sub. (2). However, the 
training shall be in addition to the minimum 8 hours required for 
the federally mandated topics under s. DHS 129.11 (1) (a) to (h).
(5) Training programs shall stress that the only direct, hands-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.11 WISCONSIN ADMINISTRATIVE CODE 12
on duty a feeding assistant is permitted to perform is assisting 
residents who have no complicated feeding problems to eat or 
drink.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.12 Feeding assistant training program 
curriculum. (1) Feeding assistant training programs shall use 
a training curriculum, which has been pre-approved by the de-
partment and determined to comply with the federally mandated 
topics under s. DHS 129.11 (1) (a) to (h).
(2) Feeding assistant training programs shall use the depart-
ment of health services, division of quality assurance video, The 
Wisconsin Caregiver Program: A Blueprint for Excellence, to 
provide feeding assistant students instruction regarding the re-
quirements of the caregiver program. A copy of the video is pro-
vided to the feeding assistant training program by the department.
(3) Training programs that are conducted in nursing homes 
shall submit to the department proposed training materials to 
provide feeding assistants instruction regarding the facility’s se-
lected resident population.
(4) Although the pre-approved standardized training curricu-
lums include additional skill information, such as, intake and out-
put and special care needs for residents with dysphasia, the in-
structor shall emphasize that the feeding assistant may not be per-
mitted to perform any other hands-on duty, beyond assisting resi-
dents who have no complicated feeding problems to eat and 
drink.
Note: Trained feeding assistants may identify the amounts of food and fluid con-
sumed according to facility policy and procedures.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.13 Feeding assistant training program 
completion. (1) A person may not provide hands-on assis-
tance with feeding or hydrating residents unless the person has 
successfully completed all of the following:
(a) A training program approved by the state for feeding assis-
tants, including additional instruction on the selected resident 
population and the Wisconsin Caregiver Program requirements.
(b) After completing the training course, a state-approved 
standardized written quiz with a score of 75 percent or greater. 
Individuals may request the quiz to be administered orally. In-
structors shall consider the needs of persons who have limited 
English proficiency or literacy difficulties.
(c) A state-approved standardized skill demonstration, deter-
mining hand washing and resident feeding competency with a 
score of 75 percent or greater.
(2) The instructor shall observe the trainee’s performance and 
initial and date each skill to verify the satisfactory or unsatisfac-
tory performance.
(3) Students who do not successfully pass the initial compe-
tency evaluation will be allowed the opportunity to review the 
training materials and retake the test. Programs can establish the 
number of times a candidate may retake the test. However, the 
program shall document the failure, opportunity for review and 
subsequent retake testing date.
(5) The instructor shall issue a state-approved certificate to 
each participant who successfully completes the feeding assistant 
program, documenting the name of the participant, the training 
program and the date of successful completion.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.14 Standards for instructors of feeding 
assistant training programs. (1) The feeding assistant 
training programs shall determine the appropriate qualifications 
for their instructors based on the needs of the selected clients and 
the nursing home.
(2) Training programs shall provide the name and qualifica-
tions of the proposed instructor to the department.
(3) The primary instructor may supplement the course by in-
cluding other individuals for lecture or demonstration whose 
qualifications or experience add benefit to the training program.
(4) A paid feeding assistant is not permitted to lead the train-
ing of another paid feeding assistant student.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.15 Feeding assistant training program 
approval process. (1) A nursing home wishing to operate a 
feeding assistant training program shall apply for approval from 
the department on a form provided by the department with the 
nursing home’s proposed selected resident population, curricu-
lum, and proposed feeding assistant instructor information.
(2) The department shall review the application and support-
ing materials to determine whether to approve or deny the feeding 
assistant training program. The department will issue a written 
notice regarding the decision of whether to approve or deny the 
application within 45 calendar days of receiving a complete 
application.
(3) Upon approval, the department shall issue, to the feeding 
assistant program, the standardized training curriculum the pro-
gram selects, a Wisconsin Caregiver Program video cassette, 
standardized competency evaluation materials, feeding assistant 
training program, certificate template, and a feeding assistant 
roster.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.16 Feeding assistant employment re-
quirements. (1) A nursing home may not employ or use any 
person as a feeding assistant unless the person is at least 16 years 
of age and has:
(a) Successfully passed a caregiver background check, that in-
cludes no employment or licensure-prohibitive offenses in s. 
146.40 (4r), Stats., or s. 48.685, Stats.
(b) Successfully completed a feeding assistant training and 
competency evaluation program and been determined competent 
to provide feeding and hydration services to residents.
(2) Nursing homes shall ensure feeding assistants only serve 
residents who have no complicated feeding problems with eating 
and hydration.
(3) Residents with complicated feeding problems, as defined 
in s. DHS 129.03 (10) shall be fed and hydrated by either a li-
censed health care professional or a nurse aide.
(4) The facility shall base their resident selection for feeding 
assistants based on the charge nurse’s assessment and each resi-
dent’s latest assessment and plan of care.
(5) Feeding assistants who are 16 or 17 years of age shall 
work under the direct supervision of an RN or LPN.
(6) Feeding assistants 18 years and older shall work under the 
general supervision of an RN, or an LPN. The feeding assistant is 
not permitted to perform other nursing or nursing-related duties 
including, but not limited to, measuring or recording intake or 
output, transferring, or toileting, etc.
(7) A nursing home may not employ or use any individual 
who has successfully completed a feeding assistant training and 
competency evaluation program as a feeding assistant unless that 
nursing home has a department-approved feeding assistant train-
ing program.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
13 DEPARTMENT OF HEALTH SERVICES DHS 129.21
DHS 129.17 Feeding assistant training program re-
quirements. Approved feeding assistant training programs 
shall submit all of the following information to the department:
(1) The program designee shall submit for approval a sub-
stantial change in the program to the department in writing. A 
program may not implement the proposed change in the program 
without the department’s written approval. In this subdivision, 
“substantial change” means a change in the program designee, 
primary instructor under s. DHS 129.14 (2) and the curriculum 
under s. DHS 129.12.
(2) The program designee shall submit an annual report to the 
department on a form provided by the department, and shall indi-
cate the number of feeding assistants who were trained and tested 
during the year, including the number of individuals who dropped 
out or who failed the program.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.18 Feeding assistant training program 
record retention requirements. (1) Feeding assistant train-
ing programs shall maintain all of the following records for at 
least 3 years:
(a) All student skill checklists, written examinations, certifi-
cates and other relevant training records.
(b) Documentation of the training conducted and identifica-
tion of the instructor who conducted the training.
(c) Records of all individuals who have successfully com-
pleted the feeding assistant training and competency testing 
program.
(2) Training programs shall maintain the security of the test 
materials and certificate templates, to ensure disclosure or 
forgery does not occur.
(3) Nursing homes employing feeding assistants shall main-
tain all of the following personnel and other records for at least 3 
years after feeding assistant has competed training:
(a) A feeding assistant roster, recording all individuals em-
ployed by the facility as feeding assistants who successfully com-
pleted the feeding assistant training and competency evaluation, 
including a written or oral exam and a skill demonstration.
(b) A copy of each feeding assistant’s training certificate, kept 
in the person’s personnel file.
(c) The selected resident’s medical record, documenting that 
no complicated feeding condition exists.
(d) The feeding assistant’s annual in-service session(s), relat-
ing to feeding assistant duties.
(e) Annual evaluation documentation, determining a feeding 
assistant’s continued competence in feeding residents.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.19 Feeding assistant training program 
prohibitions. (1) The department will review substandard 
quality of care citations made under 42 CFR 483 that result in a 
prohibition of a nurse aide training or competency evaluation 
program for a nursing home, in order to determine the appropri-
ate action for a feeding assistant training program. Program deci-
sions will be made on a case-by-case basis.
(2) Any nursing home citation that directly relates to a feed-
ing assistant training program may result in termination by the 
department of the feeding assistant training program.
(3) Feeding assistant training programs may request a waiver 
of the feeding assistant training prohibition by submitting a re-
quest in writing to the department. The department shall issue a 
written decision, either approving or denying the request, within 
45 calendar days of receiving a complete waiver request.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.20 Feeding assistant training program 
appeals. (1) For any of the following department actions, a 
feeding assistant training program may request a hearing by filing 
an appeal with the department of administration’s division of 
hearings and appeals.
(a) A denial of an application to operate a feeding assistant 
training program.
(b) A denial of an approval of a feeding assistant instructor.
(c) A termination or suspension of an approved feeding assis-
tant training program.
(d) An imposed plan of correction.
(e) A denial of a request for a waiver or the revocation of a 
waiver.
(2) A request for a hearing shall be in writing and shall be 
filed with the department of administration’s division of hearings 
and appeals no later than 30 days after the date of the denial, sus-
pension or revocation. An appeal is considered filed when re-
ceived by the division of hearings and appeals.
Note: The address of the Department of Administration’s Division of Hearings 
and Appeals is P.O. Box 7875, Madison, Wisconsin 53707. Appeals may be deliv-
ered in person to that office at 5005 University Avenue, Room 201, Madison, 
Wisconsin.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
Subchapter IV — Medication Aides
DHS 129.21 Medication aide training program ap-
plication and approval process. (1) APPROVAL PROCESS. 
(a) All medication aide training programs based in nursing 
homes shall be approved by the department.
(b) Nursing homes and other entities wishing to operate a 
nursing home medication aide program shall submit a proposal 
for developing a medication aide course. The proposal shall in-
clude documentation of client needs, staff resources to provide 
the training and a description of the physical location of the train-
ing site. The proposal will be approved or denied by the depart-
ment, and the department shall issue a decision within 30 calen-
dar days of a completed proposal submittal.
(c) After a medication aide program proposal is approved, 
medication aide course curriculum, course outline, instructor 
qualifications and other materials shall be submitted to and ap-
proved by the department before the training program can be im-
plemented. The department will issue a decision on a completed 
course submittal within 90 calendar days.
(d) The department will limit the number of approved pro-
grams to a maximum of 10, subject to determined needs as sub-
mitted in program development proposals. If the department de-
termines there is a geographical or consumer-based need, the de-
partment may approve additional programs.
(2) POST APPROVAL REVIEW AND MONITORING. (a) The de-
partment shall conduct a post-approval review of a program every 
2 years after the date on which the department formally approved 
the program. The department may conduct an on-site review of 
the program at any time to verify the program remains in compli-
ance with the requirements of this chapter.
(b) The program designee shall submit a report at least every 
2 years to the department on a form provided by the department 
and shall provide any additional information requested by the de-
partment during its review of the program. The program de-
signee shall allow reasonable means for the department to exam-
ine records and gather requested information.
(c) The program designee shall report a substantial change in 
the program to the department in writing within 10 days of the 
change. A program may not operate without the department’s ap-
proval of any replacement or substantial change. Notwithstand-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.21 WISCONSIN ADMINISTRATIVE CODE 14
ing s. DHS 129.03 (51), in this subdivision, “substantial change” 
means any change in the instructor under s. DHS 129.22, or cur-
riculum under s. DHS 129.24 (1).
(d) All approved courses are subject to inspection. If at any 
time the department determines that a program has failed to com-
ply with a requirement of this chapter, the department may, after 
providing written notice, impose a plan of correction on the pro-
gram, suspend or revoke approval of the program.
(e) The department may revoke approval of an instructor if the 
department determines the instructor failed to comply with any 
requirement of this subchapter.
Note: Current course proposal and course curriculum content requirements can 
be obtained from the Division of Quality Assurance, P.O. Box 2969, Madison, WI 
53701-2969.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.22 Standards for instructors of medica-
tion aide training programs. A medication aide program in-
structor shall be one of the following:
(1) A registered nurse, licensed in Wisconsin, with teaching 
experience in the principles of adult learning and training tech-
niques and one or more years of experience in one of the follow-
ing positions within the last 5 years immediately before the per-
son will be a program instructor:
(a) An instructor in a school of nursing.
(b) A director of nursing in a nursing home or a hospital.
(c) An in-service director in a nursing home.
(d) A supervisory nurse in a nursing home.
(2) An approved primary instructor for nurse aide training 
under s. DHS 129.06.
(3) A pharmacist who is licensed in Wisconsin, with teaching 
experience in the principles of adult learning and training tech-
niques, and who has at least one year of experience as a consul-
tant to a nursing home.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.23 Nursing home medication aide stu-
dent qualifications. (1) STUDENT REQUIREMENTS. The stu-
dent shall be at least 18 years of age, have a high school diploma 
or a high school equivalency diploma, and shall be listed on the 
registry as eligible to work in federally-certified health care 
settings.
(2) WORK REQUIREMENTS. The student shall have at least 
2,000 hours of experience as a nurse aide in direct patient care 
within the last 3 years and have worked a minimum of 40 hours as 
a nurse aide within the last 90 days, with the residents to whom 
the student will be administering medications during the clinical 
experience portion of the course.
(3) WRITTEN RECOMMENDATION. The student shall have 4 
written recommendations, 2 from licensed charge nurses, one 
from the director of nursing of the nursing home where the stu-
dent will be working during the clinical experience, and one from 
the administrator of the nursing home where the student will be 
working during the clinical experience.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.24 Standards for nursing home medica-
tion aide training programs. (1) CURRICULUM. (a) Mini-
mum requirements. A training program shall include at least the 
following 6 areas, specified in pars. (b) to (h):
(b) Introduction. 1. To the course.
2. To the role of medication aides.
(c) Legal and ethical considerations. 1. Federal and state 
nursing home standards, regulations, statutes, and administrative 
rules.
2. Standards of Practice for Registered Nurses and Licensed 
Practical Nurses, ch. N 6 specific to registered nurse delegation.
3. Professional and staff roles and liabilities.
4. Resident rights regarding administration of medications.
5. Confidentiality of information related to residents.
6. Facility policies and procedures for administration of 
medications.
(d) Overview of body systems related to routes of medication 
administration and the classes of medications. 1. Anatomy of 
body structures that pertain to medication administration, includ-
ing structure of the eye, ear, nose, mouth, vagina, rectum, and 
skin, which are necessary to administer medication correctly via 
these routes.
2. Functions of these body structures that impact medication 
administration and effectiveness.
3. Diseases of these body structures that impact medication 
administration and medication effectiveness.
Note: Examples of anatomy, function and diseases are provided in the curricu-
lum development guide.
(e) Medication fundamentals, including:
1. Medication orders.
2. Medication mathematics, weights and measures.
3. Dosage forms, including pills, capsules, ointments, 
patches, and suppositories.
4. Drug effects and actions.
5. Classes or types of commonly used medications in nursing 
homes.
6. Use of the drug or drug indication.
7. Side effects of the medications.
8. Specific medication administration requirements.
Note: Chemotherapy is not part of the basic medication aide course.
9. Medication packaging systems.
10. Medication storage, destruction or return of medication.
(f) Medication administration. 1. Techniques and procedures 
of various routes of medication administration.
Note: Injections, and medications administered via a tube, a nebulizer, or an oxy-
gen route will not be evaluated as part of the basic nursing home medication aide 
curriculum.
2. Six “rights” of medication administration, including right 
patient, right drug, right dose, right route, right time, and right 
documentation.
(g) Observations, communication, and reporting. Require-
ments for timely reporting and documenting the administration of 
all medication, including the need for PRN medications and the 
resident’s response, refusal to take medication, omission of med-
ications, errors in the administration of medication and drug re-
actions and any change in the condition of a resident.
(h) Medication safety. 1. Prevention of medication errors.
2. Causes and reporting of medication errors.
(2) FACILITY AND CLASS SIZE. (a) The class facilities shall 
be of sufficient size and structure to allow adequate space and 
equipment to instruct the students.
(b) The total number of students in any one class shall not ex-
ceed 24.
(3) COURSE STRUCTURE. (a) Instruction. The program shall 
contain a minimum of 100 hours of instruction of which 60 hours 
shall be spent in classroom instruction and 40 hours of which 
shall be clinical experience in a nursing home. The department 
may not approve a program as a video-based program; however, 
videos, the internet, and other technology can be used to supple-
ment the classroom instruction.
(b) Medication consultant. The program shall have a desig-
nated, qualified medication consultant who will act as a resource 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
15 DEPARTMENT OF HEALTH SERVICES DHS 129.29
for medication issues, concerns, questions and assist in course 
updates.
(4) GRADING. (a) The curriculum shall contain a minimum 
of 6 quizzes. Copies of examples of the quizzes shall be submit-
ted to the department for approval as part of the curriculum. The 
curriculum shall require the student to achieve an average of 85 
percent or better on the quizzes before being allowed to take the 
final written exam.
(b) The curriculum shall contain a final written exam. A copy 
of the final written exam or exams shall be submitted to the de-
partment for approval as a part of the curriculum. The curricu-
lum shall require the student to achieve a grade of 85 percent or 
better on the final written exam before being allowed to take the 
practicum exam.
(c) The curriculum shall contain a practicum exam. Copies of 
the practicum exam shall be submitted to the department for ap-
proval as part of the curriculum. The curriculum shall require the 
student to achieve a grade of 85 percent or better on the practicum 
exam to be allowed to complete the clinical experience portion in 
a nursing home.
(d) The student shall complete the clinical experience portion 
in a nursing home under the direct supervision of a registered 
nurse preceptor. Each program shall submit to the department a 
clinical experience evaluation form for approval. The clinical ex-
perience evaluation form shall define the critical components of 
each type of medication administration skill as submitted at s. 
DHS 129.24 (1) (f). The nurse preceptor and program instructor 
shall use the approved clinical experience evaluation form to 
check each medication administration skill. To successfully com-
plete the clinical experience the student shall obtain satisfactory 
scores as identified in the approved evaluation form. The nurse 
preceptor and program instructor shall sign the form if each med-
ication administration skill has been successfully completed by 
the student.
(e) The curriculum shall contain a policy on quiz, final exam, 
and practicum exam retakes. The curriculum policy is subject to 
department approval.
(5) RECORD RETENTION. (a) The records of the program 
shall be retained on file by the instructional entity for at least 3 
years.
(b) The records file for each class shall contain all of the 
following:
1. Records of each student’s attendance.
2. Each student’s quiz scores.
3. A copy of each final exam and the exam’s answer key.
4. Each student’s final exam answer sheets.
5. Each student’s practicum exam scores.
6. Each student’s clinical competency skills check list.
7. Copies of each student’s certificates of completion.
8. Copies of each student’s registry forms;
9. Forms evaluating each student’s performance.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correc-
tion in (1) (a) made under s. 13.92 (4) (b) 7. , Stats., Register November 2008 No. 
635.
DHS 129.25 Nursing home medication aide train-
ing program operation. Approved medication aide training 
programs shall submit all of the following information to the 
department:
(1) Any substantial changes in the program shall be reported 
to the department in writing within 10 calendar days. The pro-
gram shall not implement the change until department approves 
the program’s proposed change in writing.
(2) The program shall submit to the department and to an en-
tity designated by the department the required records for registry 
designation as a medication aide.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.26 Medication aide training program pro-
hibitions. (1) The Department will review substandard quality 
of care citations made under 42 CFR 483 that result in a prohibi-
tion of a nurse aide training or competency evaluation program 
for a nursing home, in order to determine the appropriate action 
for a medication aide training program. Program decisions will 
be made on a case-by-case basis.
(2) Any nursing home citation that directly relates to a medi-
cation aide training program may result in termination by the de-
partment of the medication aide training program.
(3) A medication aide training program may request a waiver 
of the medication aide training program prohibition by submit-
ting a request in writing to the department. The department will 
issue a written decision, either approving or denying the request, 
within 45 calendar days of receiving a complete waiver request.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.27 Hospice medication aide training pro-
gram approval process. (1) All medication aide training 
programs for hospice agencies shall be approved by the 
department.
(2) Entities wishing to operate a hospice medication aide 
training program shall submit a course syllabus, course curricu-
lum, text book, list of students, proof of all student qualifications 
and course instructors’ names and qualifications to the depart-
ment for approval.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.28 Standards for instructors of hospice 
medication aide training programs. A hospice medication 
aide program instructor shall be one of the following:
(1) A registered nurse, licensed in Wisconsin, with one or 
more years experience as an instructor in a school of nursing or 
other educational institution.
(2) A registered nurse, licensed in Wisconsin, with 2 or more 
years experience as a director of nursing.
(3) A registered nurse, licensed in Wisconsin, with one or 
more years experience as an in-service director in a health care 
provider.
(4) A pharmacist licensed in Wisconsin, with one or more 
years experience as a hospice consultant.
(5) An other health care professional the department 
approves.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.29 Hospice medication aide student qual-
ifications. (1) STUDENT REQUIREMENTS. The student shall be 
at least 18 years of age at the completion of the course, have a 
high school diploma or high school equivalency diploma, be 
listed on the registry, and be eligible to work in a federally-certi-
fied facility. Nurse aides who have completed the 100-hour nurs-
ing home medication aide program are deemed to meet the hos-
pice medication aide program requirements.
(2) WORK EXPERIENCE. The student shall be employed as a 
nurse aide by a hospice agency and shall complete 2,000 hours in 
direct patient care within the 3 years immediately preceding the 
start of the course or by the end of the course.
(3) WRITTEN RECOMMENDATION. The student shall be rec-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 129.29 WISCONSIN ADMINISTRATIVE CODE 16
ommended in writing by the hospice administrator, and by a reg-
istered nurse who is working with the nurse aide.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
DHS 129.30 Standards for hospice medication aide 
training programs. (1) CURRICULUM. (a) Minimum re-
quirements. A training program shall include the following 6 ar-
eas specified in pars. (b) to (h).
(b) Introduction. 1. To the course.
2. To the role of the medication aide.
(c) Legal and ethical considerations. 1. Federal and state 
hospice standards, regulations, statutes, and administrative rules.
2. Standards of Practice for Registered Nurses and Licensed 
Practical Nurses, ch. N 6 specific to registered nurse delegation.
3. Professional and staff roles and liabilities.
4. Patient rights regarding administration of medications.
5. Confidentiality of information related to patients.
6. Facility policies and procedures for administration of 
medications.
(d) Overview of body systems related to the routes of medica-
tion administration and the classes of medications. 1. Anatomy 
of body structures that pertain to medication administration, in-
cluding structure of the eye, ear, nose, mouth, vagina, rectum, and 
skin, which are necessary to administer medication correctly via 
these routes.
2. Functions of these body structures that impact medication 
administration and effectiveness.
3. Diseases of these body structures that impact medication 
administration and medication effectiveness.
Note: Examples of anatomy, function and diseases are provided in the curricu-
lum development guide.
(e) Medication fundamentals. 1. Medication orders.
2. Medication mathematics, weights and measures.
3. Dosage forms, including pills, capsules, ointments, 
patches, and suppositories.
4. Drug effects and actions.
5. Classes or types of commonly used medications in hos-
pice settings.
a. Use of the drug or drug indication.
b. Side effects of the medications.
c. Specific medication administration requirements.
Note: Chemotherapy is not part of the basic medication aide course.
6. Medication packaging systems.
7. Medication storage, destruction or return of medication.
(f) Medication administration. 1. Techniques and procedures 
of various routes of medication administration.
Note: Injections, medications administered via a tube, nebulizers, and oxygen 
routes will not be evaluated as part of the basic hospice medication aide curriculum.
2. Six “rights” of medication administration including right 
patient, right drug, right dose, right route, right time, and right 
documentation.
(g) Observations and reporting. Requirements for timely re-
porting and documenting the administration of all medication, in-
cluding the need for PRN medications and the patient’s response, 
refusal to take medication, omission of medications, errors in the 
administration of medication and drug reactions and any change 
in the condition of a patient.
(h) Medication safety. 1. Prevention of medication errors.
2. Causes of medication errors.
3. Reporting of medication errors.
(2) FACILITY AND CLASS SIZE. (a) The class facilities shall 
be of sufficient size and structure so as to allow adequate space 
and equipment to instruct the students.
(b) The total number of students in any one class shall not ex-
ceed 24.
(3) COURSE STRUCTURE. The program shall have a minimum 
of 40 hours of instruction of which 32 hours is lecture and 8 
hours of which is quizzes, final examination and practicum. The 
32 hours of lecture shall contain hands-on and demonstrations of 
the appropriate techniques of medication administration. The 
program will not be approved as a prerecorded video-based pro-
gram; however, videos internet and other technology can be used 
to supplement the classroom instruction.
(4) GRADING. (a) The program shall have a minimum of 6 
quizzes. The student shall achieve an average of 85 percent on 
the quizzes in order to take the final written examination.
(b) The student shall achieve a grade of 85 percent or better 
on the final written examination to take the practicum. A student 
may be permitted one retake of the final written examination. 
Any retake shall occur at least 3 months after the student first 
took the final written examination.
Note: The final written examination is a state-generated examination and is ad-
ministered by the department or its designee.
(c) The practicum examination shall be administered after the 
final written examination and the student shall achieve a grade of 
85 percent or better on the practicum examination to pass the 
course. Retakes of the practicum examination shall not be 
permitted.
(d) If the student does not successfully pass either the final 
written examination or the practicum exam, the student shall re-
take the entire course.
(5) CERTIFICATION. The department or designee shall issue a 
certificate to each student who satisfactorily completes the 
course. The department or designee shall maintain a database of 
hospice nurse aides who complete this course.
Note: The nurse aide should retain his or her hospice medication aide certificate 
of completion.
(6) RECORD RETENTION. (a) The records of the program 
shall be retained by the instructional entity for at least 3 years.
(b) The records file for each student in each class shall contain 
all of the following:
1. The student’s qualifications.
2. The student’s record of attendance.
3. The student’s quiz scores.
4. A copy of the practicum requirements.
5. A copy of the student’s certificate of completion.
6. Program evaluation forms.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; renum-
bering in (1) (g) made under s. 13.92 (4) (b) 1., Stats., Register November 2008 No. 
635.
DHS 129.31 Hospice medication aide training pro-
gram operation. (1) Approved hospice medication aide train-
ing programs shall complete all of the following before conduct-
ing a course:
(a) Submit a sample of the practicum questions or scenarios to 
the department at least 2 weeks before the practicum 
examination.
(b) Establish a date for the state-generated final examination 
with the department.
(2) A training program representative approved by the depart-
ment shall administer the final examination. The representative 
shall send copies of sample quizzes, quiz scores, final exams, 
practicum scores and course evaluations to the department.
(3) The department shall score the examination and provide 
the students’ examination results to the course coordinator one 
week after the final examination. Within 30 days after receipt of 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
17 DEPARTMENT OF HEALTH SERVICES DHS 129.31
the information required in sub. (2), the department shall send a 
certificate of completion to the coordinator for distribution to 
each student who successfully passed the course.
(4) The department may revoke approval of an instructor if 
the department determines the instructor failed to comply with 
any requirement of this chapter.
History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842