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Guthrie, Dean, McKinley Introduce Bill To Address Nursing Home Workforce Shortages

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Congresswoman Madeleine Dean (PA-04), and Congressman David B. McKinley, P.E. (WV-01) introduced Building America’s Health Care Workforce Act to help bolster America’s health care workforce in nursing homes.

“Since the start of the COVID-19 pandemic, our country has lost more than 240,000 nursing home jobs. To address this dire workforce shortage, I introduced a bill to temporarily extend flexibilities created during the COVID-19 Public Health Emergency that allow temporary nurse aides to put their on-the-job training in nursing homes toward ultimately becoming a Certified Nursing Assistant. My goal is to bring more qualified workers into senior care settings to ensure that our most vulnerable populations are receiving safe and quality care, while also providing workers an opportunity to further their professional development and earn higher wages. I’m proud to put forward this commonsense solution to strengthen our health care workforce and will continue to work on ways to improve health care as Republican Leader of the Energy and Commerce Committee’s Health Subcommittee,” said Guthrie.

“The Building America’s Health Care Workforce Act will not only help our nation continue to address the workforce shortage in health care, but it will strengthen that workforce and ensure that our senior populations receive the quality care they deserve,” Rep. Dean said. “Temporary nurse aides have played a critical role in caring for our seniors during the pandemic, and we can allow them to gain more firsthand experience – and extending the waiver for TNAs to work in long term care facilities will give them the time to learn and grow in their careers and on their way to becoming Certified Nursing Assistants.”

“Seniors in West Virginia and across the country deserve high quality care that skilled nursing facilities provide. But like many industries, skilled nursing facilities have experienced workforce shortages for a long time, which were exacerbated by the Covid-19 Pandemic,” said Rep. McKinley. “This legislation eliminates barriers and streamlines the process for training and retaining nurse aides and will encourage people to return to the workforce to support our deserving seniors.”


Prior to the COVID-19 Public Health Emergency, individuals working in Medicare-Medicaid certified long term care facilities were only permitted to work as nurse aides in these facilities for four months unless they became certified. To become a Certified Nursing Assistant (CNA), individuals would be required to complete at least 75 hours of state-approved training and competency evaluation program within those four months.

The Trump Administration waived these requirements at the beginning of the COVID-19 Public Health Emergency in order to address a significant workforce shortage in these facilities as a result of COVID-19. The Public Health Emergency permitted individuals known as temporary nurse aides to work in these facilities for longer than four months as long as they completed approved training and showed competency in providing nursing and nursing-related services. Also, per state approval, this gave temporary nurse aides the ability to put the hours worked as a temporary nurse aide toward the 75-hour requirement to become a CNA.

The Building America’s Health Care Workforce Act builds off these important flexibilities by extending this policy for 24 months following the COVID-19 Public Health Emergency. Specifically, this bill would allow temporary nurse aides to continue employment in this role and allow them to put on-the-job experience and training toward the 75-hour training requirement to become a CNA. This would maintain patient safety protections by requiring competency evaluations that assess temporary 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.  It 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.

On April 7, 2022, Centers for Medicare & Medicaid Services (CMS) announced that certain regulatory flexibilities on nursing homes would be rolled back, including only allowing the flexibilities for nurse aides’ certification under certain circumstances, making this legislation even more critical to pass.