As pandemic era waivers are winding down and the public health emergency (PHE) will eventually come to an end, CMS officials are urging nursing home leaders to begin getting used to no longer relying on the Covid-related flexibilities.
“We are encouraging health care providers to prepare for the end of the flexibilities and begin to move forward if you don’t need that particular waiver and flexibility so that we can ensure that health and safety standards are in place,” said Jean Moody-Williams, deputy director of the Center for Clinical Standards and Quality.
She made her remarks virtually on Thursday during the agency’s latest nursing home stakeholder call.
Although the declaration is currently only in effect through Oct, 13, U.S. Department of Health & Human Services Secretary Xavier Becerra is expected to renew the PHE. Becerra has previously said he would give health care officials at least 60 days notice before ending the declaration.
One such nursing home waiver that expired this week involved the temporary nurse aide (TNA) program, which allowed non-certified nurse aides to work for longer than four months as they prepare for their exams.
The Centers for Medicare & Medicaid Services announced back in April that it had planned to phase out the waiver, among others tied to the public health emergency (PHE). Anyone hired prior to June 7 would have until Oct. 7 to meet testing requirements, CMS had said.
But in August CMS issued updated guidance that provided opportunities for individual facility and statewide or county waivers to get additional time to certify TNAs when testing and training barriers were apparent.
Massachusetts, Washington, Indiana and Louisiana have had their statewide waiver requests approved so far, but more than 10 states were still waiting for further information to be able to apply for the waiver as of Monday, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) had said.
AHCA reported on Thursday that CMS had granted the remaining waiver requests, but waited until the last minute to do so.The advocacy organization was pushing CMS to reinstate the blanket federal waiver given the ongoing training and testing backlogs.
“We are deeply saddened that around the country, many temporary nurse aides will no longer be able to provide care to residents starting tomorrow because the federal government has failed to provide the necessary support. The Administration’s inaction to retain these valuable and experienced caregivers will only further deplete the available workforce in nursing homes,” Holly Harmon, senior vice president of quality, regulatory & clinical services at AHCA/NCAL said in a statement.
CMS had previously cited survey findings that linked resident weight loss, depression and pressure ulcers to the “lack of certain minimum standards” as one reason why the waiver was coming to an end.
There does appear to be some attention at the congressional level on the issue, at least in the form of proposed legislation.
The Building America’s Health Care Workforce Act would give TNAs an additional 24 months following the end of the COVID-19 public health emergency to complete testing.
TNAs would also be able to apply their on-the-job experience and training toward the 75-hour federal training requirement to become a CNA, which is currently allowed in some states, if the bill passed.
Despite its enthusiastic reception from industry leaders, the bill has yet to gain any traction.
Companies featured in this article:
AHCA, American Health Care Association, Centers for Medicare & Medicaid Services, CMS
