Regulatory Update

Nurse Aide Training Waiver Extended

Polaris Group Profile
Polaris Group
March 14, 2023
Polaris Group Profile
Polaris Group
March 14, 2023

As of August 29, 2022, CMS has revised guidance for a temporary nurse aide training program whose Oct 7th end date has threatened many individuals’ ability to comply with staffing requirements. The agency will issue waivers that may be statewide, county-wide or at the individual facility level when localized barriers to training or testing exist. The previous mandate that all aides would have to meet normal compliance standards by the first week of October is on hold. CMS indicates flexibility will be granted and that providers and individuals should keep careful records of attempts to complete certification to avert compliance problems.

Here is the latest guidance as directed in QSO-22-15-NH & NLTC & LSC:

CMS waived the requirements which required that a SNF and NF may not employ anyone for longer than four months unless they met the training and certification requirements under §483.35(d). CMS previously provided information related to nurse aides working under this blanket waiver in CMS memorandum QSO-21-17- NH. This memo provides additional information as well on the modification of this waiver below.


We remind states that all nurse aides, including those hired under the above blanket waiver at 42 CFR §483.35(d), must complete a state approved Nurse Aide Competency Evaluation Program (NATCEP) to become a certified nurse aide. State approved NATCEPs must have a curriculum that includes training in the areas defined at 42 CFR §483.152(b), such as respecting residents’ rights, basic nursing skills, personal care skills, and caring of cognitively impaired residents. Additionally, the requirements at 42 CFR §483.154(b)(i) and (ii)requires these nurse aides pass a written or oral exam, and demonstrate skills learned. Lastly, we note that CMS did not waive the requirement that the individual employed as a nurse aide be competent to provide nursing and nursing related services at 42 CFR §483.35(d)(1)(i), and that requirement must continue to be met.


We are aware that there may be instances where the volume of aides that must complete a state approved NATCEP exceed the available capacity for enrollees in a training program or taking the exam. This may cause delays in nurse aides becoming certified. 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 (42 CFR §483.35(d)) is still available and the aide may continue to work in the facility while continuing to attempt to become certified as soon as possible. However, for all other situations, this waiver is terminated. When capacity issues exist, facilities should inform their state officials of the issue. State agencies should also verify the capacity issues that are reported. Lastly, state agencies should provide their CMS Location with information about the status of their NATCEPs.

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