Nursing Assistant Training Waiver: Update and Advocacy

Posted on September 16, 2020 by Jonathan Lips

In response to the COVID-19 pandemic, both the State of Minnesota and CMS have taken actions to help providers respond, including granting temporary flexibility

on workforce regulatory issues. Care center members have reached out recently with questions about the waiver modifying nursing assistant training requirements, and we wanted to provide an update on that issue. While the waiver is still in effect, it is not permanent, and we need to be vigilant in preparing for the waiver to expire.

The CMS waiver of federal nursing assistant training regulations is still in place. See MDH’s Nursing Assistant Training & Competency under COVID 1135 Waiver and State Law Clarification for details. CMS has the authority to extend the waiver as long as we are in a Public Health Emergency (PHE), and the PHE is currently extended through October 22^nd.  The U.S. Department of Health & Human Services can renew the PHE for additional 90 day periods beyond October, but we don’t know yet whether they will do that. CMS also has the ability to withdraw the waiver before the end of the PHE, but we do not expect that to happen.

We are working with LeadingAge National to urge CMS to extend the PHE and the nursing assistant waiver as long as possible, and to allow staffing flexibilities to continue after the PHE ends, to ensure a smooth transition back to the standard regulatory requirements. We have submitted a letter to MDH, DHS and the MN Department of Employment and Economic Development through the Long-Term Care Imperative, encouraging the State to support our advocacy in this area. And we will follow-up specifically with MDH to advocate for innovative and flexible nursing assistant training and testing approaches, such as:

• The possibility of moving the NAR exam online with PearsonVue, allowing training sites to complete the skills portion independently;
• Whether MDH would consider allowing testing to be completed onsite at the nursing home; and
• Expediting the process for new organizations to become approved training sites to ensure that NAR students have adequate access to the formal course.

Because the waiver is still in place, facilities can still use Basic Care Aides as nursing assistants at this time; but we need to recognize that the nursing assistant training/registry waiver will expire in late October if HHS does not extend the PHE and begin planning for that possibility. For example, if a facility has Basic Care Aides who are prepared to challenge the NAR exam, it would be advisable to check available testing dates over the next month. We spoke this week with HealthForce Minnesota (an initiative of the Minnesota State Colleges and Universities system), who informed us that testing is now available at the majority of MNSCU sites across the state and that more than 700 tests have been conducted since July 1. Some sites are also offering “refresher courses” to support individuals prior to testing.

Please stay tuned for updates on this issue and our advocacy efforts on behalf of members. Meanwhile, please email or call (651-603-3510) with your comments, questions and concerns.