DOH Releases Guidance on Temporary Nurse Aide Waiver Extension
The Department of Health (DOH) released guidance on Oct. 19th describing the waiver extension it received from the Centers for Medicare and Medicaid Services (CMS) enabling temporary nurse aides (TNAs) to continue working beyond four months. As previously reported here, due to shortages in certified nurse aide (CNA) training and testing capacity, CMS extended the waiver of nurse aide certification requirements under 42 CFR §483.35(d) until April 5, 2023 or the end of the federal Public Health Emergency (PHE) (whichever date comes first).
Although the DOH guidance offers a clarification regarding new nurse aides, the scope of the waiver remains unclear. The DOH guidance states: "On October 7, 2022 CMS further clarified new nurse aides can get trained, tested and certified while the waiver is in effect. However, the waiver only applies to staff who would otherwise be ineligible to work because they had been employed four months and were not able to complete training and certification due to an insufficient number of training and testing sites." Thus, it appears that new nurse aides hired after June 7th (the initial expiration of the blanket waiver) may continue working beyond four months if "they were unable to complete certification due to an insufficient number of training and testing sites."
It is nevertheless unclear whether nursing homes may continue to hire non-certified aides under the waiver without simultaneously enrolling them in a nurse aide training program (NATP). Under existing regulations, in the absence of a waiver, a non-certified aide may be hired only if they are a full-time employee in an approved NATP (see 42 CFR §483.35(d)(3)). It is unclear whether this provision is also waived under the waiver extension. LeadingAge NY has requested further clarification from DOH and LeadingAge National.
The DOH guidance emphasizes that the waiver requires ongoing reporting by the Department to demonstrate progress. We anticipate that this may require nursing homes to report their progress, and members are advised to maintain records of their efforts to complete trainings and schedule tests. The guidance strongly encourages providers to prepare for the end of the PHE by getting TNAs trained, tested, and listed on the Nurse Aide Registry as soon as possible.
Members are reminded that, in order to obtain their CNA certification, TNAs who meet certain criteria may complete a DOH-approved, abbreviated 40-hour training class, instead of the usual 100-hour NATP. To qualify for the abbreviated “TNA to CNA” training program, a TNA must have a minimum of 30 days or 150 hours of employment as a TNA. TNAs who do not meet this requirement must complete a standard NATP to obtain certification. Facilities interested in conducting an abbreviated TNA to CNA training program must receive DOH approval. More information about the transition program is available here.
Members with questions about training programs and test sites may contact DOH at NATP.DOH@health.ny.gov.
Contact: Karen Lipson, klipson@leadingageny.org