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MDH Provides Further Clarification and Pathways for Staff Working Under Nurse Aide Waiver

On June 6, the Centers for Medicare and Medicaid Services (CMS) will terminate the COVID-19 waiver that has allowed basic care aides and caregivers to serve seniors without being on the Nursing Assistant Registry.

The Minnesota Department of Health (MDH) has confirmed three different pathways to transition caregivers who have been working under the 1135 blanket waiver to ensure they are on the Nursing Assistant Registry by Oct. 6.

Individuals currently working under the 1135 waiver have the following pathways:

  1. Enroll in a state-approved Nurse Aide Training and Competency Evaluation Program (NATCEP) by June 6, and complete the training program and pass the exam by Oct 6.
  2. Enroll in a NATCEP training program by June 6 but take advantage of the transition pathway developed by MDH, allowing facilities to credit training received while working in a long-term care facility under the waiver towards the required 75-hours of training. Individuals taking this route must still enroll in a NATCEP program by June 6 to ensure they meet training requirements and assist with completing any additional training needs. Testing then must be completed and passed by Oct 6.
  3. Choose not to enroll in a NATCEP program, but challenge and pass the test before June 7. If they do not pass the test by June 6, they must enroll in a NATCEP program.

Recent CMS guidance acknowledged that there might be instances where the volume of aides needing to complete a NATCEP or complete the state test may exceed the available capacity, causing delays in nurse aides becoming certified. According to the CMS memo, if a facility or nurse aide has documentation that demonstrates their attempts to complete their training and testing (e.g., timely contacts to state officials, multiple attempts to enroll in a program or test), a waiver of these requirements may still be available, and the aide may continue to work in the facility while attempting to become certified as soon as possible.

We are working with MDH to obtain further clarification about this extenuating-circumstances scenario: whether current training or testing capacity issues throughout the state are deemed significant enough to extend the waiver on an individual basis if needed and what specific documentation would be required. In the meantime, we recommend that facilities continue to retain documentation that demonstrates their attempts to complete training and testing.

New Employees Hired after June 6

For new employees hired after the waiver ends on June 6, the four-month regulatory timeframe will be reinstated, and standard practices before the waiver will return.

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