Last month, the Centers for Medicare & Medicaid Services (CMS) released a memo explaining that the Affordable Care Act mandates enhanced annual nurse aide in-service training, specifically in the areas of dementia care and resident abuse prevention. As such, CMS has updated the Interpretive Guidelines for F-tag 497 (Regular In-Service Education), and these two topics are now required as part of each aide’s yearly 12-hour training.
The congressional intent of the change is simple: Frontline workers must catch up to long-term care’s rapidly changing demographics. The coming profusion of aging baby boomers will inexorably push skilled nursing facilities to capacity. So while the current long-term care resident population with dementia continues to increase, it was also recently argued that Alzheimer’s disease will be the defining ailment of the boomer generation. Quality dementia care has become a prominent national concern.
Understanding how to prevent resident abuse also goes hand in hand with dementia care, says Alice Bonner, director of the Division of Nursing Homes at CMS. People with dementia are at a “particularly high risk of abuse” because they may not be able to clearly communicate their needs, she says.
Although a nurse aide’s initial training had already covered dementia care and abuse prevention, the goal of this annual mandate is to generate a “system-wide effort throughout nursing homes everywhere in the country to provide the best care,” Bonner says.
“What we're really hoping will happen is that after the initial training, focusing on the nursing assistants, it will encourage facilities to bring the nursing leadership, the non-nursing staff and everyone onboard—because really, dementia care and abuse prevention is for everyone in the nursing home.”
TRAINING IN DETAIL
Now the training itself is where CMS has taken particular ownership, which means providers are soon going to be on the receiving end of some helpful materials. Karen C. Schoeneman is technical director of the Division of Nursing Homes at CMS and has been leading a team responsible for researching the best means of delivering this instruction to nurse aides.
Schoeneman’s team is working with both person-centered care experts and an educational contractor, which is analyzing current training products and developing new materials. In addition, the CMS team has been locating “best practice” facilities that excel in dementia care and abuse prevention and asking, “How did you make staff so interested to participate in this effort?”
STATE-BY-STATE DATA ON AIDES
PHI recently unveiled its State Data Center, which profiles nursing home aides, home health aides and personal care assistants in every state. The Data Center is interactive with a map overlay and various charts detailing: workforce size and projected employment growth; trends in wages for each direct-care occupation; and information on health insurance coverage rates and reliance on public assistance. It also includes links to legislation and regulatory developments, state-based initiatives such as training programs and other related resources.
Click here to visit the PHI State Data Center.
The hope is that all nursing homes in the country will receive sometime this winter—although no hard date was confirmed—a set of training materials for the purposes of nurse aide in-services.
Each set of training modules will tentatively include an instructor guide, which Schoeneman says might be “like a notebook,” and a set of DVD clips shot in a nursing home portraying relevant information. The instructor—typically a nurse educator or department head—will then be able to stop the taped material for discussion. “Each should be an hour’s worth of training for a classroom of eight,” she says. A filmed demo class may also end up being included for the instructor’s own benefit.
“We wanted to make sure all nurse aides had the opportunity to have some training products that were state-of-the-art and modern that they can learn from,” Schoeneman continues. “Because these behavioral techniques are not natural to do, you really have to learn them.”
Providers will not be limited to the CMS materials, however. Bonner says that the training is customizable to realistically suit all kinds of facilities.