Black nurse caring for patient

Members of Congress from both major parties last week asked Centers for Medicare & Medicaid Services to support flexibilities to help with the nation’s long-term care facilities staffing crisis.

A group of 14 legislators asked CMS in a letter to encourage passage of The Building America’s Healthcare Workforce Act. The proposed legislation would extend the 1135 waiver flexibilities for a period of 24 months upon the end of the COVID-19 public health emergency declaration. The current statute gives nurse-aide applicants only four months to complete training once the PHE ends. 

The legislation also would allow temporary nurse aides to apply their on-the-job experience and training toward the 75-hour federal training requirement to become a certified nursing assistant. A survey of TNAs found that more than 80% are interested in becoming CNAs, according to the American Health Care Association..

CMS announced earlier in 2022 it was ending the 1135 waiver on Oct. 7, but updated that statement at the end of August. The most recent CMS guidance outlined how providers can show need and said that CMS will allow extensions at the state, county or individual facility level, when certain obstacles to training or testing exist, through the end of the COVID-19 public health emergency.

In their Sept. 9 letter to CMS, the lawmakers wrote that the most recent waiver relief may not be enough because of the backlogs in many states’ testing systems:

“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.”