To create career ladders for CNAs and reduce staffing pressures for nurses, industry stakeholders in multiple states are pushing to expand the privileges for CNAs so that they can serve as certified medication aides (CMAs) after training — and administer routine medications.
Allowing specially licensed CNAs to administer certain medications relieves nurses, enabling more ways to staff nursing homes, and this can ultimately lower operating costs.
Mission Health, which operates in nine states, runs a successful program involving CNAs who are licensed to pass medications, Mission Health CEO Stuart Lindeman told Skilled Nursing News.
“We don’t try to replace a nurse with [CMAs]. We just really try to move our nurses more into roles where they can have a bigger impact in the unit and on the patient,” he said.
Lindeman said that any prospective legislation to help expand CNA privileges is a positive for operators and patients, so long as CNAs are trained appropriately.
“The nurses can focus on the quality of care and the well being of the patient,” he said. “They’re not having to sit behind a medical med cart passing medication to patients and residents.”
In Georgia and Kansas, Mission Health facilitates a training program for CNAs interested in earning their medication technician certification. Lindeman said he has seen positive outcomes from the program.
Support for expansion in Illinois
In Illinois, the Medication Aide Pilot Program expired on June 30, 2019, but there is a push to renew it. The program was developed in order to afford licensed nursing professionals (RNs and LPNs) more time to provide critical resident care, while also heightening job satisfaction levels for nurses and offering a potential career path for CNAs.
“In every state we operate in, except for Illinois, we’re allowed to use CMTs or CMAs, or certified medication techs, which are CNAs who have a license and go through education and pass a test to pass medications,” Tim Fields, CEO of Ignite Medical Resorts, told Skilled Nursing News.
Lawmakers are now considering legislation that would permanently expand CNA privileges. Currently, 38 states do allow medication aides to dispense medication to patients under the supervision of a Registered Nurse (RN).
“A medication aide tracks prescription and non-prescription drugs that they administer to patients. Accurately documenting dosage times and amounts, as well as ensuring that patients swallow their medication, are primary duties of a CMA job,” the Illinois Healthcare Association wrote in support of the pending legislation.
Per the legislation, facilities that are approved for the use of Medication Aides must be in good standing by the Department of Public Health, and CMAs must complete 2,000 hours of practice as a certified nursing assistant within 3 years before application for licensure.
Once approved, CMAs can administer any approved medication except narcotics, which can only be given by a nurse. Fields said allocating more responsibilities to CNAs can help operators’ bottom line.
“You can do that sometimes at a lower cost, because nurses are the highest paid of those folks,” he said. “If you look at a monthly payroll basis, if I can offset nursing hours with CMT hours, I can also lower my operating expenses,” Fields said.
The shift can also help alleviate some staffing pressures, he said.
“You can staff creatively, you can staff differently, depending on call-ins, vacancies, and everyday functions,” he said. “People’s buildings have different physical plans, different units, different bed counts, etc. And so you can get really creative, and still deliver great care, but just do it through different positions. So there’s a lot of benefit there.”
Similar legislation in Florida
Florida is another state that currently does not allow pathways for CNAs to become medication technicians. However, that may soon change.
Two weeks ago, the Florida Senate unanimously passed SB 558, which would create a new professional category of Qualified Medication Aides, who would undergo specific training to administer routine medications as ordered and perform other tasks under a nurse’s supervision.
“Too much of nurses’ time and energy is spent on routine medication distribution, but when nurses can concentrate on higher-level care, they can better detect medical conditions early – leading to more successful treatment outcomes and fewer costly trips to the hospital for residents,” Kristen Knapp, Senior Director of Strategy & Communications for the Florida Health Care Association told Skilled Nursing News. “Adding QMAs to the care team could also help strengthen nursing centers’ workforce retention and alleviate shortages by increasing nurses’ overall job satisfaction.”
Knapp added that this would help create pathways for Certified Nursing Assistants (CNAs) to earn higher wages and broaden their career opportunities in nursing.
“CNAs with at least one year of experience would be eligible for the additional training to become a Qualified Medication Aide, helping to boost upward job mobility for these frontline caregivers,” she said.
Knapp said the Florida Healthcare Association is waiting for the companion house bill to be heard by the Legislature, and are hopeful that it will pass.
“We appreciate the Legislature for recognizing the historic workforce shortages that nursing centers have been facing and for supporting policies that will ensure a pipeline of skilled caregivers to meet the needs of Florida’s aging seniors and people with disabilities,” she said.
