Strengthen your healthcare team’s future by implementing in-house CNA training programs, ensuring compliance with new CMS staffing mandates. Discover how this strategic move can enhance your hiring pipeline and elevate patient care standards.

Staffing mandates are here, now what? The complexities and challenges of maintaining nursing staff levels from nurse aides to registered nurses (RNs) have long been evident in the post-acute care space. Turnover, burnout, and higher acuities contribute to many long-term care facilities’ hardships regarding staffing. 

These challenges existed long before the recent Centers for Medicare and Medicaid Services (CMS) mandate established minimum staffing requirements for nurse aides and RNs in nursing homes.  So now, looking toward the future, nursing facilities must think outside the box when prioritizing staffing and training initiatives, especially for caregivers. In fact, it’s estimated that the mandate requires more than 100,000 new nurses and nurse aides nationwide to fill the demand. 

Understanding CMS 3442-F

The Nursing Home Minimum Staffing Rule, a pivotal component of the nursing home reform package introduced by CMS, sets forth specific guidelines for staffing ratios. Under this mandate, CMS requires that nursing homes receiving Medicare and Medicaid funds provide 3.48 hours of total staffing per resident per day. The rule further breaks down the hours to require that RNs provide 0.55 hours and nurse aides deliver 2.45 hours to each resident daily. According to KFF, only 19% of nursing facilities currently meet all of the staffing minimums. These stipulations serve as a benchmark to ensure that facilities adequately staff nursing professionals to meet the complex needs of their residents.

Compliance with these staffing requirements poses significant challenges for many skilled nursing facilities and could cost the long-term care industry $6.5 billion yearly to comply. Across the country, facilities are grappling with staffing shortages with today’s ratios, exacerbating an already complex and demanding environment. The shortage of qualified nurse aides and registered nurses strains existing staff and compromises the quality of care provided to residents. 

However, the fight could be long from over. The American Health Care Association, the Texas Health Care Association, and three skilled nursing facilities filed a lawsuit against the Health and Human Services Secretary and the CMS Administrator on May 23, 2024. They are asking the US District Court for the Northern District of Texas’s Aramillo Division to strike the law because the rule is “arbitrary and capricious.”

Investing in innovative training to build and retain your future CNA workforce

The current practice of depending on conventional channels, such as training schools and community colleges to recruit and train future nurse aides, has proven inadequate. The demand continually outpaced the supply of competent CNAs, even before the new mandate. And many new grads feel unprepared for the realities of the role, leading them to leave the profession.

According to a September 2023 study by PHI, there will be more than 769,000 total job openings for nursing assistants between 2021 and 2031. This massive number is related to workers moving into other roles and many leaving the workforce altogether. Nursing home administrators and key decision-makers must take proactive steps now to meet the requirements of the mandate and ensure quality care for those entrusted to their facility.

In-house CNA training programs emerge as a proactive solution, enabling facilities to assert control over their staffing pipeline. This approach not only addresses immediate staffing needs but also fosters a culture of continuous improvement and investment in the professional development of healthcare personnel. However, it can be challenging to choose a curriculum that provides students with the content needed to meet state and federal regulations and teaches them the realities of the role. 

Cinematic Health stands out as a leader in innovation with ReadyCNA, a flexible and online story-based training content that can help meet the demands of the new staffing requirements. Columbia Health in Wisconsin, a Cinematic Health partner, implemented the curriculum at a time when staffing shortages plagued their daily operations. Lexi Aranda, the Director of Nursing, shared, “I felt the videos showed the day-to-day life of a CNA well and showed the emotions one goes through when working with residents better than just having an in-person lecture class and textbook.”

Unlike traditional methods, ReadyCNA utilizes the power of storytelling to immerse students in engaging narratives that enhance comprehension and retention. By integrating real-life scenarios and compelling characters into the curriculum, learners gain context that facilitates a deeper understanding of crucial concepts. Research shows that story-based learning can boost retention rates by up to 20 times, underscoring the effectiveness of this approach. Through captivating stories, learners learn the clinical and soft skills required to excel in their careers.

Benefits of online training

Online learning has transformed the world of healthcare training and development in recent years. It offers a viable solution to the many challenges nursing facilities face when looking to the future of training and staffing CNAs in the post-mandate world. Let’s review some of the benefits care facilities can expect to see when embracing online training.

Optimize Your RN Workforce

RNs are a limited resource in long-term care, even before the new mandate. Finding one with the time and desire to conduct CNA training classes can be a significant barrier when running an internal program. ReadyCNA effectively alleviates a substantial part of the training responsibility by providing the theory portion online. This shift in training delivery allows RNs to concentrate on delivering exceptional care and plan for the in-person training requirements.

With this hybrid approach, nursing staff only provide student support during the didactic portion of training. The nurse instructor can focus their efforts on hands-on education provided during lab and clinical hours. By reducing the training burden on RNs, ReadyCNA enables facilities to optimize the limited RN resources available to meet the increasing demand for CNAs.

Cultivate a Sustainable CNA Pipeline

Utilizing ReadyCNA for in-house training addresses immediate staffing needs and provides control over the pipeline of qualified and competent CNAs. It cultivates a culture of continuous learning and professional development within skilled nursing facilities, mitigates turnover rates, enhances employee satisfaction, and ultimately improves resident outcomes.

Alexa Aranda shared that before using Cinematic Health’s dynamic curriculum, she often filled CNA shifts at Columbia Health herself to allow staff time off. However, after two successful ReadyCNA training classes, scheduling improved significantly, reducing staff needing to cover extra shifts. This new training delivery method allowed them to allocate resources efficiently. “Employee morale has improved since staff aren’t being begged constantly to pick up extra hours or stay late, ” says Aranda. “Employees can take vacation whenever they want due to better staffing.” 

Another Cinematic Health Training partner, Spanish Cove Retirement Village in Yukon, Oklahoma, shares the sentiment. Don Blose, CEO, shared, “I cannot say enough good things about ReadyCNA. It has been a Godsend to us and enabled us to run close to capacity with certified nursing assistant staff.  Moreover, it takes a weight off our shoulders to not have to depend on external pipelines. It is nice to have our own built-in pipeline in place.” 

Control Training and Turnover Costs

It’s no secret that training CNAs is a costly endeavor. However, utilizing innovative training solutions such as ReadyCNA reduces nursing expenses during the theory portion of the program. RNs can remain in supervisory and care delivery roles while supporting students as they navigate through the story-based learning content. This win-win approach allows facilities to maximize their RN resources and reduce overhead costs associated with running an in-house training program. 

Turnover is another high-cost area associated with staffing CNAs. One reason many CNAs leave shortly after starting in their new position is a need for more understanding of the challenges and complexities of the role itself. ReadyCNA offers a real-world view through the storylines and characters students watch. They see how a new CNA navigates through the role in a way that classroom training can’t provide. This approach helps them fully embrace the realities of the CNA job so they are better prepared on day one.

Strengthen Training Opportunities in Rural Communities

Hybrid training allows facilities to cast a wide net and reach a more diverse pool of nurse aide applicants among a limited labor pool. Students can complete the theory portion of the training program at home around personal and professional responsibilities, minimizing the need to travel to a classroom until it’s time for lab and clinical training. 

Embracing online education for the theoretical aspect of CNA training removes geographical barriers and makes the profession more accessible to individuals who may not have had the opportunity otherwise. As Anne Newman, RN, Instructor at EmpRes, noted, “The Cinematic Health online training program has been a game-changer for student recruitment, particularly in rural areas where students usually have to travel long distances for nursing assistant programs. It also provides flexibility and convenience for those with young families.  This approach can increase the number of applicants and diversify the workforce, enriching teams with a broader range of perspectives and experiences. 

Navigating the future

Implementing in-house CNA training programs represents a proactive and strategic approach for nursing homes to navigate the complexities of mandated staffing compliance. Facilities must adapt and innovate to meet the evolving care needs of their residents. ReadyCNA’s flexible online training content allows nursing homes to comply with regulatory mandates while elevating the skill, empathy, and compassion their CNAs provide. In doing so, they reaffirm their commitment to excellence and ensure the well-being and safety of those entrusted to their care.

Author Bio

Melissa Mills, Head of Content, Cinematic Health

Melissa is an accomplished nurse whose expertise spans leadership, education, curriculum development, and operational management. Her clinical experience is deeply rooted in long-term care, home care, and hospice settings. She enjoys investing in the future of the healthcare workforce by creating compelling content rooted in best practices and empowerment for bedside caregivers. She is also deeply committed to addressing critical issues within the nursing profession, including the nursing shortage, burnout, and the need for robust workforce development initiatives to enhance care across the nursing continuum. She also serves as the fractional Executive Director for the Commission for Nurse Reimbursement, a non-profit organization dedicated to modernizing the nurse reimbursement model to create a sustainable and stable nursing workforce. Melissa holds a BSN from Chamberlain University and an MHA from the University of Cincinnati.