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CMS Waives Training and Certification Requirements for 15 States

October 11, 2022

On August 29, 2022, CMS issued formal guidance to nursing homes, counties, and states on how they may continue to operate without properly certified staff. This guidance came only two months after CMS rescinded the March 2020 waiver that allowed nursing homes to employ aides who are not fully trained and certified in accordance with federal requirements. This waiver was issued at the beginning of the pandemic and resulted in tens of thousands of insufficiently trained workers to provide direct care to nursing home residents. The August 29, 2022 guidance effectively continued the waiver for states, counties, or facilities that could meet certain criteria. Consumer Voice strongly opposed the August 29, 2022 guidance, noting that CMS itself had acknowledged this policy had resulted in poor health outcomes for nursing residents.  

Now, less than two months later, CMS has waived the full training and certification requirements for fifteen states.  These states were granted an extension to their waiver because they demonstrated testing backlogs or other delays that providers said prevented them from converting a large number of temporary nurse aides into permanent fully certified nurse assistants.  These states are Rhode Island, Massachusetts, Washington, Indiana, Louisiana, Maryland, Minnesota, Oklahoma, Pennsylvania, Texas, Vermont, New York, Georgia, New Jersey and Tennessee. Those waivers expire on various dates.
As a result of this policy, tens of thousands of nursing home residents will receive care from some staff who are not fully trained or certified as required by federal rules. Nursing facilities and states had over two years to create plans to have aides trained and certified. Instead, it appears that many facilities and states waited until the waiver ended and now are scrambling to meet the regulatory requirements.  

Residents, families, and other consumers concerned as to whether a nursing home is employing uncertified aides can:

  • Ask the nursing home administrator if the facility is currently operating with a nurse aide certification waiver. If so, how many nurse aides are uncertified? What is the facility's plan and timeline to get all aides fully trained and certified?
  • Contact your local state survey agency to determine whether a facility, county, or state has received a waiver of the nurse aide certification requirements.  
  • If a state or county has been granted a waiver, ask the state survey agency what their plan is to get all nurse aides fully trained and certified.

Report all instances or concerns regarding poor care to the local long-term care ombudsman and the state survey agency. 

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