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New Issue Brief on Training of Temporary Nurse Aides

July 20, 2021

In order to address anticipated staffing shortages within nursing homes and the suspension of training programs caused by the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) in March 2020 waived a long-standing federal requirement that nurse aides be fully trained and certified within four months of being hired. Certified Nurse Aides (CNAs) provide the most direct care to nursing home residents, helping with personal care services such as transfers, ambulation, and assistance with eating and toileting. There is no official term for nurse aides hired during the pandemic under the CMS waiver, although they are often referred to as temporary nurse aides (TNAs).

It is anticipated and hoped that many TNAs will stay in the field and become CNAs. However, these workers must have the appropriate training to deliver high quality care to residents. To equip CNAs with the skills they need, federal regulations require CNAs to complete 75 hours of training. There are currently efforts by both CMS and the states to weaken the federal nurse aide training standards. CMS has released guidance encouraging states to consider crediting TNAs for time worked as a substitute for federally required training hours. At the same time, multiple states have already enacted or have pending legislation that also counts hours worked as hours trained; similar legislation has been introduced at the federal level (H.R. 331).

Reduced training puts residents and staff at risk.  Less training leaves workers less equipped with the skills and knowledge needed to provide quality care.  Workers with less training are more likely to be injured and to cause injury to residents. Furthermore, work experience as a TNA during the pandemic does not equate to training.

Reducing the number of training hours to less than 75 hours is a step in the wrong direction and would result in TNAs being ill-prepared for their important work. To ensure quality care for nursing home residents, TNAs must complete the federally required 75-hour training.

Read the Issue Brief.

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