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 AHCA Backs Critical Legislation to Address Workforce Shortages

The Nursing Home Workforce Quality Act (HR 4468) introduced by Reps. Dwight Evans (D-Pa.) and Ron Estes (R-Kansas) would allow skilled nursing facilities (SNFs) that have been forced to suspend in-house certified nurse assistant (CNA) education programs after receiving a certain level of penalties to resume those programs once quality standards are met.

“This common-sense legislation would help nursing homes to fix problems that are identified, which would be a win for everyone affected, the patients, their families, and the nursing homes,” Evans said.  He added that it is “important to work across party lines on points of agreement so we can make progress for the people we represent.”

Estes said the legislation would help address critical shortages of CNAs, especially in rural areas, by allowing SNFs to resume CNA education programs faster.

The lawmakers said in-house CNA education at SNFs is often free to the CNA candidate, allowing students to avoid the burden of paying for an education program at a local community college or school, which may or may not exist in their geographic area.

This helps meet the need for CNAs while allowing SNFs to build their own pipelines of skilled nursing staff, the pair added.

In response to the proposal, Clifton Porter II, senior vice president of government relations at the American Health Care Association (AHCA), said “this is an incredibly important piece of legislation that will provide our members with the ability to combat the existing workforce challenges.”

He added that workforce recruitment and retention, particularly in rural areas, is one of the most pressing challenges confronting long term care providers today.

“The health care system has experienced a shortage of trained caregivers for critical roles for some time; nurses and nurse assistants are among the fastest growing occupations, but supply is not keeping pace,” Porter said.

Under current law, nursing centers that receive a threshold number of penalties for deficiencies in quality have a two-year mandatory suspension placed on in-house CNA certification programs. In 2017 alone, 277 skilled nursing facilities had a suspension of their training program due to this statutory mandate, and nearly 2,900 were unable to start such a program in 2017 due to this requirement, Evans said.

This penalty can be imposed for a single deficiency that may not have included harm to a resident or an episode that does not reflect systemic problems, he added.

The Nursing Home Workforce Quality Act would allow suspensions on in-house CNA education to be rescinded once deficiencies are assessed and found to be remedied, while allowing for additional oversight of facilities not exceeding the original two years.

“This piece of legislation will help ensure our nation can support the workforce needs of the long term care profession,” Porter said. “AHCA/NCAL [National Center for Assisted Living] continues to encourage Congress to support innovative programs and legislation that will help recruit, retain, and attract high-quality workers.”

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