Omnibus Budget Reconciliation Act OBRA 1987 (OBRA) created the Nurse Aide Registry and Training Program.

The OBRA requirements to employ nurse aides in nursing facilities:

• Only nurse aides who are enrolled in a training program or on the State Registry may be employed as a nurse aide in a nursing facility.
  
• All nurse aides must be trained and tested within 120 days of date on which they were hired.
  
• All nurse aides must only perform those tasks for which they have been trained and proved competent.
  
• OBRA prohibits any individual from paying for his or her training or testing if he or she is currently employed (or has offer of employment) as a nurse aide by a Medicaid/Medicare participating nursing facility.