In March, the Centers for Medicare & Medicaid Services (CMS) waived the minimum 75-hour training requirements for certified nurse aides to address “potential staffing shortages” in nursing homes related to the COVID-19 pandemic. This waiver has been followed by the provision of online “temporary nurse aide” certification programs by several providers.
The American Health Care Association (AHCA), representing the majority of the 15,000-plus nursing homes in the United States, recently reported that about 38,000 people have earned certification as temporary aides through its 8-hour online training. That training is to be combined with on-site training provided by the employing facility. Visit this link for information: https://educate.ahcancal.org/products/temporary-nurse-aide. The following are areas AHCA describes on the above website where a temporary nurse aide might provide care:
- Activities of Daily Living
- Bathing
- Oral Care
- Grooming – Shaving and Nail Care
- Dressing and Undressing
- Infection Control and Prevention
- Positioning, Moving, and Restorative Care
- Nutrition and Elimination
- Comfort Care and End of Life Care
According to the AHCA website, not all states allow temporary nurse aide certification. For example, eight states under special waivers, exceptions, or flexibilities are permitting such certification: Delaware, Indiana, Iowa, Maryland, Nebraska, New Jersey, New York, and West Virginia. Additionally, Alabama, Connecticut, District of Columbia, Georgia, Kansas, Mississippi, North Carolina, New Hampshire, Pennsylvania, South Carolina, Tennessee, and Virginia may allow temporary nurse aide designation if additional training is given, or other prerequisites are met. AHCA recommends checking frequently with your state, as additional states are in the process of adopting the use of temporary nurse aides.
Facilities should contact their state health care association or appropriate state agency about their specific state’s requirements regarding temporary nurse aide certification. Also, nursing homes should keep in mind that they are responsible for hiring aides with demonstrated competency and with clean backgrounds. Temporary nurse aides must be carefully supervised to ensure their performance on the job meets standards of care.
Compliance Perspective
Before hiring nurse aides with temporary certifications, determine if there are any state-specific provisions or additional training requirements, whether the state allows their employment in healthcare facilities, and ensure that required pre-employment screening is performed if hiring is permitted. Adequate supervision must be provided to ensure their competency and provision of quality of care that meets state and federal regulations.
Discussion Points:
- Review policies and procedures regarding employing nurse aides who have temporary certifications and the additional onsite training and supervision required to ensure that those aides are competent to perform the tasks they are assigned.
- Train supervisory staff regarding state requirements for employing and overseeing temporary nurse aides. Provide temporary aides with onsite training and the necessary supervision and observation to determine that they are competently performing the tasks assigned to them.
- Periodically audit to determine if individuals hired to become temporary nurse aides complete the course work and training required for temporary certification and that background screening is performed according to protocols.
