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Applications
These forms cannot be completed online. They cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. You must print the form and mail it to the address listed below:
DHHS, Division of Public Health
Licensure Unit
Medication Aides
PO Box 94986
Lincoln, NE 68509-4986
Address Change Form
Affidavit of Not Providing Services/Providing Services
Application for Registration (2 pages)
Application for Renewal (2 pages)
Course Completion
Name Change Form
Reissuance of Medication Aide Registration Card(s) Form
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Renewal
** If your Medication Aide registration has expired, do not use the "Application for Renewal" form. To reapply to the Medication Aide Registry, go to the section titled "Inactive" for the correct forms to reapply to the Medication Aide Registry.
Regulations requre you to provide your Social Security Number on applications/renewals. Please clearly and accurately write your Social Security Number on the appropriate line of the application/renewal.
All Medication Aide registrations shall expire two years after the date of registration issuance. Renewal notices will be mailed to individuals at the address we have on the Medication Aide Registry approximately 90 days prior to their expiration date. To renew, a Medication Aide must complete the Application for Renewal within 90 days preceding the period for which the requested registration will be effective and pay the $18 non-refundable renewal fee. If you are unsure of the expiration date, you may check the Medication Aide Registry. If you have not received your renewal notice, please check the Medication Aide Registry to verify the Department has your most current address. All registrants who fail to renew their registration by the expiration date will automatically have their registration status changed to EXPIRED and will not be eligible to provide medications until registration is complete and your status on the Medication Aide Registry is ACTIVE.
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Inactive or Expired or Care Staff Member
If you are an INACTIVE or EXPIRED Medication Aide you must do the following:
If you are an INACTIVE or EXPIRED Medication Aide 40 hour you must do the following:
If you are an OLD CARE STAFF MEMBER Medication Aide you must do the following:
You do not need to repeat the course or repeat the examiniation if both were completed before January 1, 1989.
Provision of Medications by a Medication Aide
The administration of medication is a regulated activity. Administration of medication includes three components:
- The physical act of taking/providing/applying a medication;
- Documentation of the physical act (in some circumstances); and
- Monitoring the therapeutic effects of the medication and taking appropriate action.
All of the components of administration may be performed by a recipient with the capability and capacity to make informed decision about medications, a caretaker (parents, foster parents, family, friends or legal guardians), or by a licensed health care professional. There are circumstances under which it is appropriate and desirable for recipients, caretakers, and licensed health care professionals to receive help with the administration of medication. Medication Aides provide this help by performing the first two components of administration.
Medication Aides may provide medications according to the five rights and document the provision only when a recipient with capability and capacity, a caretaker, or a licensed health care professional has authorized such provision and agrees to provide monitoring of the therapeutic effects of the medication and direction to the Medication Aide.
When direction and monitoring is provided, medication aides may provide routine medications by the oral, inhalation, topical and instillation routes. Routine medications are those for which the frequency of administration of medication, and the amount, strength, and method of administration is specifically fixed. Under certain conditions medication aides may be authorized to provide PRN medications, medications by additional routes, and to participate in monitoring.
Please note that individuals must have an active registration in order to provide medications.
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Medication Aide 40 Hour Course
Medication Aides working in Assisted Living Facilities, ICF-MR Facilities or Nursing Homes are required to complete a 40 hour course on the competencies required for the provision of medication. The courses are typically offered by facilities and the community colleges. The State of Nebraska does not have a listing of available courses. Interested persons should contact a prospective employer or community college for further information.
Nursing students can meet the course requirements by having an instructor in an approved program verify that the student has completed coursework related to the competencies. Applicants from other states can meet the course requirements by providing a record of course completion in the other state as long as their course consisted of at least 40 hours. Nursing students and out-of-state applicants who meet the course requirement are still required to demonstrate competency and take and successfully complete the medication aide 40 hour examiniation conducted by a State approved testing center.
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Medication Aide 40 Hour from another state
The following is needed to become a Medication Aide 40-hour from another State:
- Successful completion of the 40 hour Medication Aide examination conducted by a State approved testing center. Please refer back to the Examination Section for the link.
- Completed Application for Registration – 40 Hour (check the Medication Aide-40 hour box). The competency standards can be found in the Medication Aide Regulations, available in the Rules and Regulations section.
- Completed Documentation of Course Completion (this can be a certificate from your course with the number of hours included or this form completed by your instructor)
- Non-refundable fee of $18.00
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Medication Aide 40 Hour - Nursing Students
The following is needed for Nursing Students to meet the requirements for registration as a Medication Aide 40-hour:
- Successful completion of the 40 hour Medication Aide examination conducted by a State-approved testing center. Please refer back to the Examination Section for the link.
- Completed Application for Registration – 40 Hour (check the Medication Aide-40 hour box). The competency standards can be found in the Medication Aide Regulations, available in the Rules and Regulations section.
- Completed Documentation of Course Completion (completed by your instructor or a letter from your instructor indicating you have completed coursework related to the competencies identified in the Regulations)
- Non-refundable fee of $18.00
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Rules and Regulations/Statutes
Regulations Governing the Provision of Medications by Medication Aides and other Unlicensed Persons - 172 NAC 95
Regulations Governing the Medication Aide Registry - 172 NAC 96
Statutes relating to the Medication Aide Act
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Name and Address Change
To request an address change, you can fill out the Address Change Form, call Shane Bailey at (402) 471-4364, or e-Mail Shane at shane.bailey@nebraska.gov.
In order to change your name on your Medication Aide record, you must mail the name change form along with a copy of one item of documentation. Acceptable documentation includes: marriage certificate, divorce decree which states the name has been changed, or court order of legal change of name. (If you have both a Nurse Aide and a Medication Aide registration, you only need one name change form to change your name on both Registries.)
If you need a duplicate Medication Aide licensure card, you will need to fill out a Reissuance of Medication Aide Registration Card(s) Form and submit a $10 fee for each card you order.
You can also change your name when you are renewing your Medication Aide registration at no additional cost by crossing out the old name at the top of the renewal form and submitting a copy of the documentation with your renewal form. Your renewed registration card will be issued in your new name.
(If you also have a Nurse Aide record, please do NOT send any money for a new Nurse Aide licensure document as we do NOT issue any licensure documents for Nurse Aides in Nebraska.)
If you are not able to print off the name change form, you could submit a written request which includes your old name, new name, Social Security Number, mailing address, phone number, reason for name change, and notarized signature. Be sure to include one item of documentation.
Licensure Unit
Office of Nursing and Nursing Support
PO Box 94986
Lincoln, NE 68509-4986
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