CMS Revised Guidance Offers Nursing Homes Flexibility in Nurse Aide Training

By Carol Davis

Nursing homes struggling to get uncertified temporary nurse aides (TNA) trained to federal training requirements by the Oct. 7 deadline now have more flexibility.

The Centers for Medicare & Medicaid Services has issued a revised guidance that will provide waivers to allow nursing homes to continue certifying TNAs beyond the deadline to keep staffing at safer levels.

In the early days of the COVID-10 pandemic, CMS enacted several temporary public health emergency (PHE) blanket waivers intended to provide healthcare providers needed flexibility to respond to the pandemic.

The waivers for TNA certification ended June 6, but TNAs who began the certification process had the traditional four months’ time to become certified, meaning they must become certified before October 7, 2022, to continue working as a nurse aide.

Under the revised guidelines, CMS will issue waivers at two levels:

  • To an individual facility “when there are localized barriers to training/testing in a state or county not otherwise covered by a waiver.”
  • Countywide- or statewide “when there are widespread barriers to training/testing that are statewide or in a particular county within a state.”

Waivers are time-limited, and state agencies are expected to work toward resolution of barriers to certification, according to CMS. They also may be required to provide progress reports on the submitted action plan in order to maintain the waiver.

A state or individual facility, however, can’t retain a waiver longer than the declaration of a PHE; if the PHE ends during or before the waiver, the waiver also ends. The PHE is set to expire in mid-October, but the Biden administration is expected to extend it into January 2023.

The newest waiver addresses concerns expressed earlier this month by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) in a letter to Xavier Becerra, secretary of the U.S. Department of Health and Human Services.

That letter requested reinstatement of the waiver on training and certification of TNAs “who have been a valuable member of the care team during this pandemic.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.