Federal nurse aide training standards in nursing facilities have been largely waived during the COVID-19 emergency. When the emergency declarations end, however, all “temporary nurse aides” are required by federal law to receive training and pass tests in order to be certified as permanent nurse aides.
It is in the interests of both nurse aides and nursing facility residents that aides receive all required training. But the nursing facility lobby has argued for “grandfathering” of temporary nurse aides into permanent certification, and the federal government unfortunately has moved in that direction.
Justice in Aging and the Center for Medicare Advocacy have jointly authored an issue brief, States are Weakening Training Standards for Nursing Facility Aides, With No Response by CMS, which discusses the states that have weakened nurse aid training requirements.
The Centers for Medicare & Medicaid Services (CMS) has given states and nursing facilities leeway to retroactively count nurse aide work hours as training hours, and some states have exploited that leeway to weaken nurse aide training requirements for permanent certification. This is a public policy mistake, as illustrated by the flimsy mechanisms used by some states to claim that past work in understaffed facilities during the pandemic was actually meaningful and comprehensive training. In some states, these mechanisms allow for certification with no actual training aside from the aide’s initial online class.
CMS should require the comprehensive training required by the relevant regulations, and states should withdraw their procedures that have allowed work to be retroactively and perfunctorily classified as “training.” In practice, this will require CMS to assert its oversight authority on this issue, rather than looking away.
States that have allowed work hours to be counted retroactively as training include Louisiana, New Jersey, New York, Tennessee, and Virginia. Advocates should tell CMS to assert its authority to stop states from allowing uncertified nurse aids to continue to work once the public health emergency has expired.