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Loophole Allows Uncertified Nurses Assistants at Nursing Homes

Male nurse with hand on head

In a health emergency, we are often willing to make exceptions on the qualifications of the person who jumps in to offer life-saving actions. We are all familiar with situations where an untrained hero jumps in to save a life with a Heimlich maneuver or CPR. That being the case, when we go to a healthcare facility, like a hospital or a nursing home, we expect our trained medical professionals to have … professional medical training, in full.

That might not be the case at the nursing home you or your loved one is counting on.

The vast majority of the healthcare providers that comprise the staff at nursing homes are professionals called Certified Nursing Assistants (CNAs). Unfortunately, many of these Certified Nursing Assistants are not exactly certified. The reason involves a long-standing problem, exacerbated by the plague of COVID.

Desperate Times Call for Desperate Measures

During the COVID pandemic, the government agency that regulates U.S. nursing homes, the Centers for Medicare and Medicaid (CMS), issued several emergency waivers that relaxed nursing qualification standards at nursing homes. Prior to 2020, newly trained CNAs could not work in nursing homes for longer than four months without meeting certain training and certification criteria. During COVID, the CMS felt forced to give nursing homes additional flexibility with regard to training and testing to meet the staffing demands of a Public Health Emergency.

No segment of society was hit harder by COVID than the nation’s nursing homes. It is estimated perhaps a quarter of the COVID deaths in the United States occurred in nursing homes. However, the fatalities due to the virus were not merely among the residents. Thousands of nursing home staff members were among the casualties of COVID outbreaks at nursing homes. In addition to the unprecedented death of staff members at nursing homes, many more CNAs simply quit the industry altogether during the pandemic, due to the risk of contracting COVID or because of the increasingly deteriorating conditions within the nursing homes.

Despite ending the waiver officially in June of 2022, the CMS provided guidance in August of the same year, allowing nursing homes to employ CNAs who have exceeded the four-month time limit for proper training and certification. The CMS explained the exception, citing that in some areas the demand for testing exceeded the capacity of the system.

This loophole has its critics.

According to the National Consumer Voice, an advocacy organization for improving nursing home care, “it appears that many facilities and states waited until the waiver ended in June and now are scrambling to meet the regulatory requirements. Additionally, the CMS waiver applies to all the certification requirements, regardless of whether it is caused by an inability to get aides trained or tested.” 

The Hiring Challenge of the Nursing Home Nurse

When you hear the word “nurse,” you probably imagine the professionals called Registered Nurses (RNs). However, there are different types of nurses and relatively few RNs at a nursing home compared to CNAs. Of course, the residents of nursing homes have regular access to RNs and doctors for medical issues and checkups. However, the resident of a nursing home or other long-term-care facility often needs more than just medical care. They might need assistance with daily activities, such as help with dressing, bathing, getting around, eating, and other functions we might take for granted. This combination of daily living assistance with attention to minor medical care is performed by lower-trained (and lower-paid) CNAs.

For the majority of the CNAs and other caregivers at nursing homes, it is a demanding job, with low pay and long hours. Because of the low compensation, many CNAs need to work multiple jobs, sometimes taking shifts at multiple nursing homes, to make ends meet. For most of them, company-offered benefits, such as sick time or vacation, are nonexistent. Taking care of the elderly, sick, and senile is an incredibly important job. It’s also incredibly difficult, frustrating, and thankless work. To make matters worse, it can also be life-threatening.

Because of the low pay and demanding nature of the job, it’s no surprise that nursing homes would have trouble attracting and retaining quality personnel. Most nursing homes operate far below the staffing level recommended by experts. The nursing home industry would have you believe that the problem is that there just aren’t enough people willing or qualified to do the job, due to factors out of their control, like COVID. The reality is that nursing homes for decades have deliberately kept their staffing levels low to reduce overhead and increase profits. This puts the lives of residents in jeopardy, and it also creates burnout for the CNAs and staff workers who are forced to pick up the slack in understaffed facilities.

Addressing the Problem

Law firms that specialize in nursing home negligence, like Brown & Barron, are exposing nursing homes that are responsible for serious injuries and death through their own negligence, including substandard staffing or training practices. If your loved one has experienced neglect or abuse, or you have suspicions of negligence, our team can apply decades of combined experience to your case. With more than 100 trials as lead trial counsel and multiple million-dollar verdicts, we’ve shown that we can get the results our clients deserve in nursing home abuse claims.

For more information, contact our legal team at (410) 698-1717 today.

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