ALERT: Workers Urgently Needed to Fight COVID-19 in Nebraska Long-Term Care Facilities

In response to the COVID-19 pandemic, several training and testing requirements have been temporarily modified and accelerated by the State of Nebraska and Centers for Medicare and Medicaid Services to support critical staffing needs in Nebraska’s assisted living and nursing facilities. Nebraskans are asked to join the fight against COVID-19 by serving as a temporary nurse aide, medication aide, or dining assistant in a local long-term care facility.


COVID-19 TEMPORARY STAFFING

Guidance from Nebraska Department of Health and Human Services

At a news conference on March 31, 2020, Governor Pete Ricketts announced Executive Order No. 20-12 Coronavirus—Relief For Hospitals and Health Care Facilities and Expanded Use of Telehealth Services. To assist Nebraskans, the Nebraska Department of Health and Human Services (DHHS) has provided answers to frequently asked questions about the Executive Order.

Temporary Nurse Aide
  • The Centers for Medicare and Medicaid Services (CMS) waived the federal requirement to allow a Temporary Nurse Aide to provide nurse aide care and services without completing the state-approved nurse aide training and being on the Nurse Aide Registry.
  • CMS did not waive the federal requirement that the facility ensure the Temporary Nurse Aide is competent to provide care and services to meet residents’ needs.
  • The Governor’s Executive Order suspends the state requirement to allow a Temporary Nurse Aide to provide nurse aide care and services without completing the nurse aide training.
  • The Governor’s Executive Order did not suspend the state requirement that the facility ensure the Temporary Nurse Aide is competent to provide care and services to meet residents’ needs.
  • If a facility uses a particular training curriculum, DHHS does not require the facility, the instructor, or the curriculum to be pre-approved.
  • Any nursing facility, including facilities with a two-year ban on providing nurse aide training, can utilize Temporary Nurse Aides as long as the aide is competent to provide the care and services.
  • The facility is responsible to ensure any Temporary Nurse Aide providing care or services is competent to provide the care or service.
  • The facility should maintain documentation for each Temporary Nurse Aide and the care and services he/she is competent to perform.
Temporary Dining Assistant
  • There is no waiver by CMS of the federal eight-hour training requirements for feeding assistants.
  • However, individuals can serve as a Temporary Nurse Aide who is competent to provide dining assistance to residents.
Temporary Medication Aide
  • The Governor’s Executive Order suspended Nebraska’s 40-hour training and exam requirements for Medication Aides in order to work in a nursing facility, assisted living facility, or intermediate care facility for persons with intellectual disabilities (ICF/ID).
  • If a facility uses a particular Temporary Medication Aide training curriculum, DHHS does not require the facility, the instructor, or the curriculum to be pre-approved.
  • The facility is responsible to ensure any Temporary Medication Aide providing care or services is competent provide the care or services.
  • The facility should maintain documentation for each Temporary Medication Aide and the care and services he/she is competent to perform.
  • The Temporary Medication Aide is still required to send the completed application, including signature of Temporary Medication Aide and the nurse who is ensuring competency, and appropriate fee to DHHS and be placed on the Medication Aide Registry.
  • If a Medication Aide has never been on the MA Registry before, then once the MA has completed their application and sent the application to DHHS, the MA can provide medications for up to 30 days without being on the Registry.
    • This 30-day grace period can be extended for Medication Aides who have been on the MA Registry before and are now completing a reapplication.
  • If county courthouses are closed and not able to provide certified copies of an applicant’s court records, DHHS will process the application based on the criminal background check, but all attempts should be made to send certified copies of criminal history to DHHS.
  • On average, DHHS is processing Medication Aide applications (initial, renewals, and reapplications) within 5-7 days of receiving the applications in the DHHS office unless the application is not complete.
    • Lack of completion is usually due to not including certified court copies of criminal convictions, not signing the application, or competencies have not been signed as completed on the application.

Recommendations from the Nebraska Health Care Association

Nebraska Health Care Association (NHCA) provided the following recommendations to members in an email on April 2, 2020.

Temporary Nurse Aide Suggestions

Training: Utilize the American Health Care Association’s Temporary Nurse Aide Course and Exam, which is available for free online at here.

Competency Demonstration: Facility nurse utilizes NHCA’s Nurse Aide Skills Packet to assess competency to provide specific care and services.

Documentation

  • Document the care and services the Temporary Nurse Aide will provide.
  • Retain copy of AHCA’s Temporary Nurse Aide Course and Exam Certificate of Completion.
  • Retain copy of NHCA’s Nurse Aide Skills Packet results.
Temporary Dining Assistant Suggestions

Temporary Nurse Aide who only assists with residents’ dining needs

Training: Utilize the American Health Care Association’s Temporary Feeding Assistant Course and Exam, which is available online for free online here.

Competency Demonstration: Facility nurse assesses competency to provide specific dining assistance.

Documentation:

  • Document the care and services the Temporary Feeding Assistant will provide.
  • Retain copy of AHCA’s Temporary Feeding Assistant Course and Exam Certificate of Completion.
  • Retain documentation of demonstrated competency.
Temporary Medication Aide Suggestions

Training: Utilize the  Nebraska Health Care Association’s Temporary Medication Aide 8-Hour Online Training or Medication Aide Instructor and Student Manuals.

Competency Demonstration: Facility nurse utilizes NHCA’s Medication Aide Skills Packet to assess competency to meet the requirements listed in Section 5 of DHHS’s medication aide initial application.

Documentation:

Additional Steps:

  • Send student-completed and signed initial application to DHHS with the signature of the facility nurse who assessed the competency in Section 5 of the application.
  • Note: Payment must be included with the completed application.
  • The Temporary Medication Aide can begin work after he or she is is notified of placement on the Medication Aide Registry.