June 13, 2019
Staffing, including the number of staff and the adequacy of the education of nursing home (NH) personnel, is a vital factor in the delivery of quality care to residents.
Since 1987, a provision in the federal regulations removed a long-term care (LTC) facility’s ability to provide nurse aide training on site if the facility was assessed civil monetary penalties (CMPs) of $10,000 or more during an annual survey. The rationale was to ensure that providers were in substantial regulatory compliance using carrots as well as sticks (ie, rewards and not just penalties). The inability to provide a CNA training program would be a stick, or negative incentive, that would further pressure facility compliance.
It is now recognized that the inability to have sufficient levels of staff, particularly CNAs, does more to harm the quality of care for residents. The need for well-trained staff and the ability of a facility to provide CNA education is the foundation of the quality-of-care issue.
Representatives Sean Duffy (R-WI) and Collin Peterson (D-MN) have introduced legislation to rescind the prohibition on nurse aide training programs, known as “lockout.” Approximately 50% of Wisconsin LTC facilities and up to 75% of NHs in other states currently face lockout of facility-based CNA programs.
The rationale for and necessity of reversing this regulation—that has been in effect for more than 30 years—is significant. Having access to a workforce that is sufficiently educated and knowledgeable about the care and treatment of LTC residents is imperative for the operation of a NH.
The long-standing penalty does nothing to enhance the delivery of services and, rather, undermines a prospective employee’s ability to access the requisite education in the NH setting. The education of staff in the facility using a state-approved curriculum that can be offered continuously will serve to enhance the provision of care.
This is one regulation that NH residents no longer need.