TX HHS Form 5506-NAR. Texas Nurse Aide Registry Employment Verification

Form 5506-NAR is an official employment verification form used by Certified Nurse Aides (CNAs) in Texas to renew their listing on the Texas Nurse Aide Registry. The form documents recent employment, required training, and compliance with eligibility rules so that the Health and Human Services Commission (HHSC) can confirm that the nurse aide remains qualified to work in long-term care and related settings.

Purpose of Form 5506-NAR

The primary purpose of Form 5506-NAR is to verify that a nurse aide has met the employment and training requirements necessary for recertification. Texas requires nurse aides to periodically confirm active work experience and completion of mandatory in-service education to remain eligible for employment.

This form connects three key elements: the nurse aide’s self-certification, the employer’s verification of work performed, and a notarized confirmation that the information is accurate.

When This Form Must Be Submitted

Form 5506-NAR must be submitted when a Certified Nurse Aide is applying for recertification through the Texas Nurse Aide Registry. Common situations include:

• A CNA renewing certification before it expires
• A CNA who worked during the past renewal period and must document employment
• A CNA returning to work after a break and updating registry status

The form is not required if the nurse aide does not meet renewal eligibility and is instead required to retrain or retest.

Who Is Allowed to Complete the Form

The form is completed by two parties:

• The nurse aide, who completes and signs Section 1
• The employer, who completes Section 2 and signs in front of a notary

The employer must be the actual organization that employed the nurse aide and can attest to nursing or nursing-related services performed.

Explanation of Each Key Section

Section 1 – Applicant’s Information

This section is completed by the nurse aide and includes personal identifying information such as name, date of birth, Social Security number, and CNA certificate number. The nurse aide also answers eligibility questions related to misconduct, criminal history, and required training.

By signing this section, the nurse aide certifies that all information provided is accurate.

Verification of Recertification Requirements

This portion confirms whether the nurse aide:

• Is listed as unemployable on the Employee Misconduct Registry
• Has disqualifying criminal convictions under Texas Health and Safety Code
• Completed 24 hours of in-service education within the last two years
• Completed annual HHSC training in infection control and proper use of PPE

Incorrect answers can result in denial of recertification.

Section 2 – Employer and Company Information

This section must be completed by the employer. It verifies that the nurse aide performed nursing or nursing-related services during a specific period and that the employer is not aware of disqualifying misconduct.

The employer’s signature must be notarized, making this a sworn statement.

Notary Certification

The notary confirms the employer’s identity and signature. Missing or improper notarization will cause the request to be returned without action.

Practical Tips for Completing Form 5506-NAR

• Complete Section 1 fully before giving the form to your employer.
• Verify that your employer uses their legal business name.
• Ensure the employer signs in front of a notary.
• Double-check training completion dates before answering.
• Upload the completed form through your TULIP account, not by mail.

Common Mistakes to Avoid

• Submitting the form without notarization
• Leaving required fields blank
• Using an employer who did not directly employ you
• Incorrectly reporting training or work history
• Uploading the form outside the TULIP system

Legal and Regulatory Context

Form 5506-NAR is required under Texas regulations governing nurse aide certification and registry maintenance. HHSC uses this form to enforce workforce standards, protect residents in long-term care facilities, and ensure compliance with misconduct and criminal background rules.

The form includes a warning that falsifying information is a third-degree felony, carrying serious criminal penalties.

Real-Life Examples of Use

• A CNA renewing certification after two years of continuous employment.
• A long-term care facility employee confirming work history for registry renewal.
• A nurse aide documenting compliance after completing required in-service education.

Documents Commonly Submitted with This Form

• In-service education certificates
• PPE and infection control training records
• Employer employment records
• TULIP application confirmation

Frequently Asked Questions

Where is Form 5506-NAR submitted?

It is uploaded through the nurse aide’s TULIP account.

Does the employer have to notarize the form?

Yes, notarization is required.

Can a former employer complete Section 2?

Yes, if they directly employed the nurse aide during the period listed.

What happens if the form is incomplete?

The registry returns it without action.

Is employment verification required for every renewal?

Yes, when employment is used to meet renewal requirements.

What are the penalties for false information?

Falsification may result in criminal charges.

Related Forms

• CNA Renewal Application (TULIP)
• Approved In-Service Education Program Records
• Employee Misconduct Registry Verification

Form Details

• Form Name: Texas Nurse Aide Registry Employment Verification
• Form Number: 5506-NAR
• Issued By: Texas Health and Human Services Commission
• State: Texas
• Revision Date: December 2024