of in-service education of the facility. In carrying out the previous sentence, a nursing facility must, to the extent practicable and appropriate, employ a registered professional nurse who has received training in adult education and gerontology. . (2) Technical amendment Paragraph (1) of section 1919(d) of the Social Security Act ( 42 U.S.C. 1396r(d) ) is amended by redesignating subparagraph (V) as subparagraph (E). (c) Effective date The amendments made by this section take effect on the date of enactment of this Act and apply with respect to the administration of skilled nursing facilities and nursing facilities on or after the date that is one year after such date of enactment. 5. Nurse training requirements with respect to skilled nursing facilities under Medicare program and nursing facilities under Medicaid program (a) Medicare (1) Orientation for registered professional nurses, licensed practical nurses, and nurse aides Section 1819(d) of the Social Security Act ( 42 U.S.C. 1395i–3(d) ) is amended by adding at the end the following new paragraph: (5) Orientations A skilled nursing facility must provide to registered professional nurses, licensed practical nurses, and nurse aides, before such registered professional nurses, licensed practical nurses, and nurse aides are assigned to provide direct care services to residents in the facility, orientations providing education on the policies and emergency procedures of the facility and on residents’ rights under this section. . (2) Requirements for nurse aide training and competency evaluation programs and for nurse aide competency evaluation programs Subparagraph (A) of section 1819(f)(2) of the Social Security Act ( 42 U.S.C. 1395i–3(f)(2) ) is amended— (A) in the matter preceding clause (i), by inserting after 1988 the following: , and update, as determined necessary by the Secretary