Members of Congress Urge CMS to Support States, Temporary Nurse Aides Amidst Historic Long Term Care Workforce Challenges

Advocacy; Workforce
Members of Congress on both sides of the aisle are asking the Centers for Medicare and Medicaid Services (CMS) to work with lawmakers to address historical workforce challenges in long term care. 

Last week, a bipartisan group of 14 federal lawmakers, led by Congressman Brett Guthrie (R-KY-2), sent a letter to CMS, requesting the agency’s support of H.R. 7744, the Building America’s Healthcare Workforce Act. The legislation would extend the 1135 waiver flexibilities for a period of 24 months upon the end of the COVID-19 public health emergency (PHE) declaration. The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) supported the bill when it was introduced earlier this year. 

The flexibilities have been critical in allowing long term care facilities to hire temporary nurse aides (TNAs) during the COVID-19 pandemic, especially as nursing homes continue to face the worst job loss compared to all other health care sectors. TNAs provide companionship and assistance to residents for non-clinical, everyday tasks. More than 300,000 heroes stepped up to serve seniors during the pandemic by completing online training to become a TNA. A survey of TNAs found that more than 80 percent are interested in becoming certified nursing assistants (CNAs). However, nationwide, many aides face delays in earning their certification due to state training and testing backlogs. 

Earlier this year, CMS announced it was ending the 1135 waiver ending the employment of TNAs as members of the caregiving team in just a few weeks, on October 7. However, the agency recently announced a partial option, offering states and nursing facilities the ability to apply for a short-term waiver. While this was a step in the right direction, industry experts​ argue that training and testing delays that currently exist in the majority of states may extend well beyond the PHE. In their letter to CMS, the bipartisan group of lawmakers concur:

“However, the announcement further states that these waivers will only be in effect for as short as possible and expire immediately once the COVID-19 Public Health Emergency Declaration expires, meaning patients’ access to this critical bedside care could be threatened if these localized certification and testing issues are not resolved before the PHE expires.

Federal policymakers must advance comprehensive, supportive solutions that help address the long term care labor crisis and support our frontline heroes who wish to further their caregiving career. Congress should pass the Building America’s Healthcare Workforce Act, and CMS should immediately reinstate the 1135 blanket waiver for TNAs and keep this waiver in place at least until the end of the PHE. 

View the full letter here