To help bolster America’s health care workforce in nursing homes, Representatives Brett Guthrie (R-KY), Madeleine Dean (D-PA), and David B. McKinley (R-WV), have introduced a bill, Building America’s Health Care Workforce Act (H.R. 7744), to allow temporary nurse aides (TNAs) awaiting certification to continue operating under the flexibilities put in place during the COVID-19 pandemic Public Health Emergency.

During the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) issued a federal Section 1135 waiver which allowed TNAs to work in long-term care facilities for longer than four months without having to be certified. On April 7, 2022, CMS announced that certain regulatory flexibilities on skilled nursing facilities (SNFs) and nursing homes would be discontinued, including allowing the flexibilities for nurse aides’ certification under certain circumstances. As a result, SNFs and nursing facilities would have to have their TNAs certified and tested by October 7, 2022.

The Building America’s Health Care Workforce Act would keep some of the flexibilities afforded to TNAs in place for 24 months following the COVID-19 public health emergency. This would allow TNAs an opportunity to continue their employment and put their on-the-job experience and training toward the 75-hour federal training requirement, as some states currently allow. A competency evaluation of a nurse aide may be conducted at the SNF where the aide is (or will be) employed if the State in which the facility is located does not offer an evaluation (in person or online) at least once a week.

Representative Guthrie’s press release announcing the introduction of the bill emphasizes that the proposed legislation “would help maintain patient safety protections by requiring competency evaluations that assess temporary certified nurse aides on a variety of factors, including interpersonal skills, performing basic nursing skills, personal care skills, and mental health and social service needs to name a few.” This bill would also allow continuity of care for residents served in nursing homes so they can retain their direct caregivers who have been by their side throughout the pandemic, Rep. Guthrie said in his release. Additionally, the bill would require a new Congressional study, one year after enactment, on the appropriateness of maintaining the waiver.