New Fed Funds, Career Ladder Offer Remedy for CNAs in Nursing Homes Facing Severe Burnout

The Geriatric Workforce Enhancement Program (GWEP) is undergoing changes that could help operators bolster their workforces with better trained direct care workers and improve the career ladder for certified nurse aides (CNAs).

The Moving Forward Coalition, an organization engaged in enhancing the quality of care at nursing homes, held a presentation on the latest updates to GWEP on Thursday highlighting how CNAs often lack opportunities for career advancement.

Coalition leaders noted that a number of smaller career pathways programs have emerged across the country, but there is still a need for a more “comprehensive, standardized career pathway model for CNAs that would offer CNAs a widely recognized credential and commensurate wage increases.”


Skilled Nursing News too has reported on a number of nursing home providers across the U.S. individually pushing initiatives for career development of direct care workers. However, these efforts need to be more standardized, sector experts have long suggested.

The Coalition’s members are currently immersed in communities as they work on revising the nine action plans launched in summer 2022 to improve quality of long-term care, including the one focused on workers, Alice Bonner, chair of the Coalition said.

‘Retention, retention, retention’


Bonner explained that CNAs, who make up the core of the nursing home workforce, often face limited opportunities for advancement and feel underprepared and under appreciated. All this leads to job dissatisfaction, burn out and turnover.

“So it’s about recruitment, but it’s also about retention, retention, retention,” said Bonner, emphasizing one of the Coalition’s action plans to reduce turnover of CNAs.

And that’s where GWEP – a federally funded initiative in existence since 2019 – can make a difference. Originally designed to educate, train and support the long-term care workforce, in its latest iteration, the program emphasizes collaborative efforts with community partners, aiming to bridge care gaps and enhance health outcomes for residents, according to Dr. Joan Weiss, deputy director of the Division of Medicine and Dentistry at the Health Resources and Services Administration (HRSA).

Weiss highlighted key differences in the 2024 GWEP version compared to its 2019 predecessor during the presentation saying, “We want to develop reciprocal partnerships between academia, primary care sites, delivery systems and community-based organizations to transform clinical training environments into integrated geriatrics and primary care sites and delivery systems that are age-friendly and dementia friendly.”

Weiss said the current program’s emphasis on career advancement is a groundbreaking requirement.

“We really want our applicants to address career advancement for CNAs and for community health workers,” she said, noting that CNAs often find fulfillment in their roles but lack clear pathways for career progression. The updated GWEP program encourages the use of Department of Labor or state agency registered apprenticeship programs to support CNAs’ career development.

“The applicants must maximize patient and family engagement to address care gaps and improve health outcomes for older adults by integrating geriatrics with primary care and other specialties,” she said. 

The anticipated budget for the program is approximately $43 million, with around 43 awards expected, Weiss said. Of this, at least $230,000 of the funding must be allocated to Alzheimer’s disease and dementia-related training activities, she said.

The GWEP program’s period of performance spans from July 1, 2024, through June 30, 2029.

Emphasis on tribal, underserved, and rural primary care sites

Weiss also discussed the focus of the program on tribal, underserved, and rural primary care sites, with nursing homes and facilities being a priority. Eligible applicants include schools of health professions, accredited graduate programs, and health care facilities. Programs leading to certification as CNAs are also eligible, emphasizing partnerships between educational institutions and health care facilities.

“There should be a mechanism for CNA’s to advance within their own discipline,” she said. “And we hope that these career ladders will do this.”

Additionally, Weiss said, there is a requirement to use the U.S. Department of Labor or state agency registered apprenticeship programs to support career development for CNAs and community health workers.

Weiss highlighted the need for interprofessional training involving at least three disciplines, with medicine being a mandatory component. 

“You have five years to get these in place,” she said. “So it’s not like you have to have it done within the first year.”

To apply to receive funds through the GWEP program, facilities can get more information and access to the application at the HRSA website. Application period ends on Feb. 26, 2024.

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