COVID-19: Nurse Aide

Update for Emergency Nurse Aide Training Programs Due to End of Public Health Emergency

As of May 11, 2020, the public health emergency ended and Emergency Order #21 is no longer in effect. Therefore, the Department of Health Services (DHS) has established a waiver request process to allow entities and facilities to continue to hire and train caregivers through the Emergency Nurse Aide Training Programs.

DHS is actively working to promulgate an emergency rule. Until the emergency rule is promulgated, both approved and temporary Emergency Nurse Aide Training Programs may request a waiver to allow for the continuation of training and hiring nurse aides to work in facilities. We continue to accept applications for new Emergency Nurse Aide Training Programs; new programs also have to apply for a waiver.

To request a waiver:
  • Email the Nurse Aide Training and Testing Program
  • Include the name of the facility and a request for a waiver of “all applicable regulations to allow for the continuation of the Emergency Nurse Aide Training Program.” It is not necessary to include specific regulatory references in your request.

We are able to accept students via the online survey who were hired and started training while the emergency order was in effect. Therefore, currently approved Emergency Nurse Aide Training Programs may continue to train students who began their training on or before May 18, 2020, without a waiver; current programs will have to apply for a waiver to train students new to the program after May, 18, 2020. Temporary nurse aides who have completed an Emergency Nurse Aide Training Program may also continue to work at this time

 

New 75-hour minimum nurse aide training

The 75-hour minimum nurse aide training program application materials are under development and information will be posted on the Nurse Aide Training and Registry Information webpage when available.

To ensure that hospitals, nursing homes, home health agencies, hospices, and intermediate care facilities for individuals with intellectual disabilities (ICFs/IID) have the capacity to absorb and effectively manage surges of COVID-19 patient, CMS has issued blanket 1135 waivers and Governor Evers has released Emergency Order 21.

In accordance with state and federal regulations, the Division of Quality Assurance has developed several training options to respond to the unprecedented need for additional certified nurse aides (CNAs) to join the workforce.

All options attempt to provide immediate assistance/relief during this time of crisis. As CMS has suspended all enforcement actions during the current unprecedented crisis, all nurse aide training and competency evaluation program (NATCEP) prohibition orders are suspended so all nursing homes may participate.

Emergency training options offer a path to train and employ staff during the COVID-19 pandemic emergency circumstances. Some paths will result in nurse aide inclusion on the Nurse Aide Registry, and others that may include employment sooner but not result in registry inclusion. Some options address current state-approved training programs and current nurse aide students whose ability to complete training may be suspended. Also included, is information for those individuals who may be new to caregiving and an overview of how the role of nurse aide assistants may be of benefit during this emergent crisis.

Whether a nursing home, hospital, home health agency, hospice, ICF/IID, current training program, or individual, please check out the following to expedite nurse aide training and employment. Nursing homes, hospitals, home health agencies, hospices, and ICFs/IID are also referred to as providers in the following sets of instructions.

1.  Emergency nurse aide training for nursing homes, hospitals, home health agencies, hospices, ICFs/IID, and existing training programs that lead to nurse aide certification and inclusion on the Nurse Aide Registry.

Introduction

This information pertains to those current nursing homes, hospitals, home health agencies, hospices and ICFs/IID who may be interested in creating an emergency nurse aide training program that leads to nurse aide certification and inclusion on the Registry. This outlines a path for nurse aide candidate employees to be on the Nurse Aide Registry while fulfilling a critical staffing need during this pandemic crisis.

*The opportunity to participate as an Emergency Nurse Aide Training Program is also extended to existing training programs that may still be operational at this time. Students would not be employees, as is the case with health care providers referenced below, but students may seek employment during training.

Steps to Complete if Interested

Indicate your interest to DHS (complete once)

  • Review minimal competency Nurse Aide Skills Checklist, F-02643 (PDF) to outline core curriculum
  • Confirm approach to 75-hour curriculum (minimum 16 hours of clinical)
  • Complete this online survey to indicate your interest
  • Gain DHS authorization to participate – DHS will respond with an approval email
  • Please note: Providers with current training programs with current state-approved 120-hour programs must perform these steps in order to offer a separate 75-hour emergency nurse aide training program option.

Perform steps 1-5 with each new individual or group of individuals who participate.

  1. Hire/sponsor a candidate for the Nurse Aide Emergency Training program (repeat steps 1-5 as needed)
  2. Ensure completion of 16 -hour initial essential training, as required in Wis. Admin. Code § DHS 129.07(2)(b)(1&2). Completion is required prior to providing direct resident care and can be obtained in a variety of ways:
  1. Online: Bellin College initial 16-hour essential nurse aide at no charge (available to all interested providers whether you have your own curriculum or not).
  2. Classroom: initial 16-hour classroom training from a current training program (for students currently enrolled in or completed a traditional nurse aide training program).
  3. Provider: initial 16-hour essential training that encompasses communication and interpersonal skills, infection control, safety/emergency procedures (including the Heimlich maneuver), promoting resident independence, and respecting resident rights.
  1. Submit list of students enrolled in the training program to DHS via online survey that will initiate a TestMaster Universe (TMU) record to indicate a student participating in training.
  2. Train enrolled students, at least 59 additional hours, 16 of which must be clinical at a minimum, until students achieve competency in all areas of the skills checklist. Complete and sign a checklist for each student that will serve as certificate of completion.
  3. Submit list of students who have completed training. These students should have acquired adequate knowledge and skills in all core competency areas on the skills checklist. Email the list along with signed copies of each student’s checklist to Wisconsin Nurse Aide Registry staff. This will allow DHS to complete their TMU training record and the candidate will be eligible to sit for the nurse aide competency exams. Those candidates who successfully complete exams will be listed on the Nurse Aide Registry.

DHS Nurse Aide Skills Checklist, F-02643 is available in both pdf and MS Word versions.

Supporting Rationale

The following is background information providing an overview of how the Nurse Aide Emergency Training program will work. This outlines a path for nurse aide candidate employees to be on the Nurse Aide Registry while fulfilling a critical staffing need during this pandemic crisis.

  1. Required training hours during pandemic reduced
    1. Temporarily allow nursing homes, hospitals, home health agencies, and ICFs/IID to apply for a variance to train at 75 hours with 16 hours of clinical instead of 120 hours with 32 hours of clinical.
    2. Nurse aide students employed by a provider are allowed to begin working after completing 16 hours of initial essential training. A 16-hour online course of initial training curriculum from Bellin College is available, however, classroom training via a current training program (for students currently enrolled) or 16-hour nursing home specific training are also acceptable.
    3. Essential topics to be covered in the 16-hour initial training before students provide direct resident care are:
      1. Communication and interpersonal skills
      2. Infection control
      3. Safety/emergency procedures, including the Heimlich maneuver
      4. Promoting resident independence
      5. Respecting resident rights
  1. Students must have a completion certificate or attestation of the 16-hour initial essential training curriculum (articulated above) prior to providing direct resident care.
  2. The 16-hour initial training counts towards the 75-hour total, leaving 59 hours remaining (minimum 16 hours clinical).
  3. Students must attain proficiency as outlined in core competency checklist upon completing 75 hours.
  1. Training program applications, curriculum review, and reporting streamlined
  1. Participating providers would complete a short survey with minimal information needed for tracking purposes. Apply online to collect pertinent information.
  1. Base information includes demographics, contact information, nursing contacts, etc.
  2. Requires provider commitment to provide 75 hours of training to students.
  • Ensure 16 hours initial training plus 59 hours, 16 of which must be clinical (see above).
  1. Agreement to provide completed candidate information to DHS to allow candidate to test and be listed on the Nurse Aide Registry.
  1. DQA will grant individual variances that will allow the provider to begin training without centralized formal review and approval of the curriculum and classroom requirements.
  2. DQA continues efforts to assess online programs which providers may use for the initial 16 hours of essential training that are required before students provide direct contact with residents.
  3. Upon completion of 75 hours of training, a candidate must meet the minimal qualifications and be provided a checklist with attestation of competency. This completion checklist will serve as the training program completion certificate and allow a nurse aide candidate the ability to test and be on the Registry.
  4. Participating providers could include all eligible nursing homes and hospitals, home health agencies, hospices, and ICFs/IID including those under prohibition (all enforcement actions have been suspended per CMS during this emergency crisis). This option is also being extended to current approved nurse aide training programs.
  1. Instructor applications, review, and reporting streamlined
    1. DQA will grant individual variances to allow a variety of instructors and instructor qualifications, in essence waiving some of the Primary Instructor requirements. The primary instructor for a training program must be a registered nurse licensed to practice in Wisconsin or registered nurse from an enhanced Nurse Licensure Compact state, who has experience working as a registered nurse. Completion of a “train the trainer” course could also be waived.
    2. There is potential to leverage nursing instructors from approved programs that are temporarily closed, as well as nursing instructors at existing provider programs that are offering the training.
  1. Nurse Aide Registry software TestMaster Universe (TMU) reporting
  1. Participating providers will be established in the nurse aide registry software as temporary training programs with limited approval of a 75-hour curriculum.
  2. After training completion, nurse aide candidates will be associated in the system as attending/completing training with one of these programs.
  3. Nurse aide candidates will be eligible to take the nurse aide competency exams upon completion of this temporary training program (for up to one year after completing their training).
  4. Candidates will be allowed to work beyond the typical 120 days without being on the registry for the duration of the emergency event. Many test events have been canceled due to the pandemic, but once these start occurring again, test event processing will resume.
  5. DHS will be able to report on the participating providers and associated nurse aide candidates, and subsequent nurse aides.
  6. Nurse aide candidates will not appear on the Wisconsin Nurse Aide Registry until after successful completion of both knowledge and skills demonstration competency exams.
  1. Current nurse aide students in training programs – referrals
  1. Nurse aide students currently enrolled in a training program (that is temporarily suspended) can complete their training and gain hands on experience through a participating emergency nurse aide training program provider.
  2. Existing nurse aide training programs can assist their students by providing an attestation for each student who has completed the essential initial 16-hour curriculum (outlined above) that would be the equivalent to a certificate of completion of a standalone 16-hour course.
  3. Existing nurse aide training programs can further assist both students and providers by completing the core competency checklist for each student to indicate the progress and stage of completion of their current training program. The provider completing the student training will still be responsible to ensure the candidate is competent in all skills, but providing approximate competency now will be helpful to both the provider and the student.
  4. Both the current approved training program and the emergency training provider would be credited with providing the fundamental nurse aide training to these candidates.

2.  Temporary nurse aide training for nursing homes, hospitals, home health agencies, hospices, and ICFs/IID that does not lead to nurse aide certification and does not lead to inclusion on the Nurse Aide Registry.

Introduction

This information pertains to those interested in employment with a participating provider to assist as an emergency, temporary nurse aide. This path allows for temporary certification in an emergency nurse aide capacity but will not result in permanent nurse aide status and will not result in inclusion on the Nurse Aide Registry.

These temporary nurse aides are temporary, they may not be employed as nurse aides beyond pandemic, and will not be included on the Nurse Aide Registry without successfully completing formal nurse aide training curriculum and/or successful competency testing.

Steps to Complete if Interested
  1. Contact a nursing home, hospital, home health agency, hospice, or ICF/IID in your area to reach out for employment.
  2. Ensure you complete the initial 16-hour essential training curriculum. This is required to be completed prior to direct resident care. Providers utilizing temporary nurse aides may request access to the Bellin College 16-hour essential nurse aide training classroom. Please complete the online survey to obtain access to the classroom.
  3. As an employee, training may continue with the health care provider for which may be a combination of online and hands-on/in-person training.
  4. As this is a temporary nurse aide position, you will not be able to continue working as a Nurse Aide when the pandemic emergency is over.
  5. When the pandemic emergency is over, you may be able to be employed at state-regulated facilities such as an assisted living facility, community-based residential facilities, etc. that do not require nurse aide certification.
  6. You will not be included on the Wisconsin Nurse Aide Registry.
  7. You will not be eligible to be employed as a nurse aide after pandemic emergency.
 Supporting Rationale

These are temporary nurse aides, who will not be employed as nurse aides beyond pandemic, and will not be included on the Nurse Aide Registry without additional training and/or competency testing. This path provides immediate assistance/relief for employment purposes during pandemic emergency.

  1. Temporary nurse aides – limited training (16-hour initial training) alternative to nurse aide training
  1. Temporary nurse aide staff employed by a nursing home, hospital, home health agency, hospice, or ICF/IID are allowed to begin working after completing initial 16 hours of essential training. A 16-hour online course of essential curriculum is available, however, classroom training via a current training program (for students currently enrolled), or 16-hour essential training may also suffice.
  2. Topics to be covered before students provide direct resident care are:
  • Communication and interpersonal skills
  • Infection control
  • Safety/emergency procedures, including the Heimlich maneuver
  • Promoting resident independence
  • Respecting resident rights
  1. Provider must obtain proof of completion or provide training to temporary nurse aides as attestation of the 16-hour essential competencies above prior to providing direct resident care.
  2. Providers may also require additional training, whether online or hands-on/in-person, or a combination thereof.
  3. Temporary nurse aides are not eligible to take a competency exam, will not be tracked by DHS, will not be included on the Nurse Aide Registry, and will not be eligible to be employed as a CNA after pandemic emergency.

3.  Existing training programs can provide student training progress to participating providers who employ their students.

Introduction

This information pertains to those current Wisconsin approved nurse aide training programs, who may be temporarily suspended during this time of crisis. Existing training programs can play an important role in training completion to promote students currently working through the nurse aide certification process.

*This section is intended for existing training programs (approved at the 120 hour minimum), to assist health care providers employ current students with some training completed and allow completion of core training in a streamlined manner.  Existing training programs who wish to start training a new session of new students at the emergency 75- hour minimum must apply to be an Emergency Nurse Aide Training program described in the first section of this webpage.

Steps to Complete
  1. Communicate with your students to raise awareness of this option to develop their career and meet a critical need. DHS will be compiling and publishing a list of participating providers to share with students.
  2. Assist students currently enrolled by providing an attestation for each student who has completed the initial 16-hour essential curriculum. An attestation would be the equivalent to a certificate of completion and allow students to continue and complete their training and gain hands on experience through participating providers.
  3. Complete student checklist to indicate the progress of training for each student. The hiring provider will be responsible for completing student training and ensure candidates competency of skills, but providing approximate competency at the onset will be helpful to both the provider and the student. Both the current approved training program and provider will be on record and credited with providing the fundamental nurse aide training to these candidates. DHS will assist in coordination of student records within TMU. DHS form Nurse Aide Skills Checklist, F-02643 is available in both pdf and MS Word versions.
Supporting Rationale

The following is background information providing an overview of how the Nurse Aide Emergency Training program will work. This outlines a path for nurse aide candidate employees to be on the Nurse Aide Registry while fulfilling a critical staffing need during this pandemic crisis. Existing training programs can play an important role to promote students currently working through the process.

  1. Current nurse aide students in training programs – referrals
  1. Nurse aide students currently enrolled in a training program (that is temporarily suspended or not in session) can complete their training and gain hands on experience through a participating emergency nurse aide provider.
  2. Nurse aide training programs can assist their students by providing an attestation for each student who has completed the essential initial 16-hour curriculum (outlined above) that would be the equivalent to a certificate of completion of a standalone 16-hour course.
  3. Nurse aide training programs can further assist both students and participating providers by completing the core competency checklist for each student to indicate the progress and stage of completion of their current training program. The provider completing the students training will still be responsible to ensure the candidate is competent in all skills, but providing approximate competency now will be helpful to both the nursing home and the student.
  4. Both the current approved training program and provider would be credited with providing the fundamental nurse aide training to these candidates.

4.  Hospitality aides deliver non-hands-on services in providing assistance to nurse aide staff and are not listed on the Nurse Aide Registry.

Introduction

This information pertains to persons interested in employment with a health care provider in a support role to provide assistance to certified nurse aides. This path allows for employment in a health care setting but will not result in inclusion on the Nurse Aide Registry.

Steps to Complete if Interested
  1. Contact a health care provider in your area to reach out to for employment
  2. Hospitality aides deliver non-hands-on services in providing assistance to nurse aide staff.
  3. Refer to Noncertified Individuals in Delivery of Non-Hands-On Services, P-01559 (PDF) to determine the types of duties you could perform without nurse aide certification.
Supporting Rationale

As certified nurse aide demand increases, providers may utilize assistants to nurse aides in certain non-hands-on service delivery. These ‘helpers’ or ‘hospitality aides’ can assist with traditional nurse aide duties that are non-direct care duties. This path provides immediate assistance and relief during this pandemic emergency and may continue beyond the immediate need.

Hospitality aides deliver non-hands-on services in providing assistance to nurse aide staff.

5.  Interested nurse aide candidates find a path to employment and the Nurse Aide Registry.

Introduction

This information pertains to interested candidates who want to follow the path to become a nurse aide and be included on the Wisconsin Nurse Aide Registry. This includes those new to the program, those who have completed a training program but not yet tested, and current students whose training program may be temporarily suspended.

Steps to Complete if Interested
  1. Review list of participating providers in your area to reach out to for employment.
  2. Contact a participating provider in inquire about employment.
  3. Ensure you complete the initial 16-hour essential training curriculum, required to be completed prior to direct resident care.
  1. For new candidates, coordinate with participating provider to complete your initial 16-hour essential training prior to providing care to residents. This may be a 16-hour online course or 16-hour initial provider-specific training. An  attestation of completion is required prior to direct care with residents.
  2. For those who are currently in training (or complete but not yet tested), contact your current training program for a certificate of completion of the initial 16-hours of essential training. If you have not started training yet or have not completed the initial 16 essential hours, coordinate with the provider to acquire this prior to providing care to residents.
  1. As an employee, training will continue with the provider for successful completion of a core competency skills checklist and can build upon the knowledge and training already provided by your current training program.
  2. Employer will provide certificate of completion checklist to DHS as you successfully acquire the core competencies required of a nurse aide.
  3. You will then be able to schedule competency exams that, upon successful completion, will enable you to be listed on Wisconsin’s Nurse Aide Registry.
Supporting Rationale


The following is background information providing an overview of how the traditional nurse aide training program will be modified during this time of crisis. The Nurse Aide Emergency Training program outlines a path to employment and the Nurse Aide Registry.

  1. Required training hours during pandemic
  1. The required nurse aide training will be temporarily reduced, but still comply with federal regulations of 75 hours with a minimum of 16 clinical hours.
  2. You are allowed to begin working after completing 16 hours of initial essential training.
  3. Essential topics to be covered in the 16-hour initial training before you will be allowed to provide direct resident care are:
  • Communication and interpersonal skills
  • Infection control
  • Safety/emergency procedures, including the Heimlich maneuver
  • Promoting resident independence
  • Respecting resident rights
  1. You must have a completion certificate or attestation of the 16-hour initial essential training curriculum (articulated above) prior to providing direct resident care. If you have this essential knowledge through a previous training program, reach out to your training program to provide this verification.
  2. The 16-hour initial training counts towards the 75-hour total, leaving 59 hours remaining (minimum 16 hours clinical).
  3. You should be proficient in the core competency checklist upon completion of your 75 hours of training and hands on experience.
  1. Nurse Aide Registry software TestMaster Universe (TMU) reporting
  1. Your employer will work with DHS to get you set up in the system as a nurse aide candidate in training.
  2. After training completion, you will be eligible to take a nurse aide competency exams (for up to one year after completing their training).
  3. You will be allowed to work beyond the typical 120 days without being on the registry.
  4. You will not appear on the Wisconsin Nurse Aide Registry until after you successfully test.
  5. Many test events have been canceled due to the pandemic, but once these start occurring again, test event processing will resume.
  6. You will appear on the Wisconsin Nurse Aide Registry after successful completion of both knowledge and skills demonstration competency exams.
Resources for Nurse Aide Emergency Training steps for interested health care providers
Alternative training resources for temporary nurse aides

These training resources have not been reviewed or approved by the DHS and may not include all of the elements required in Wis. Admin. Code § DHS 129.07(2)(b)2. Providers may also require additional training, whether online or hands-on/in person, or a combination thereof.

Contact us

Have questions or need additional information? Contact the Nurse Aide Training and Testing Program.

Last Revised: May 21, 2020

 RESPONSE RESOURCES FOR WISCONSINITES — www.dhs.wisconsin.gov/covid-19/help.htm