IHCA/INCAL Summary of Fifth Blanket Waiver for Residential Care Facilities and Additional Temporary Nurse Aide Guidance

Fifth Blanket Waiver for Residential Care Facilities and Additional Temporary Nurse Aide Guidance

On April 20, 2020, the Indiana State Department of Health (ISDH) issued a Fifth Emergency Order for Residential Care Facilities that adds the AHCA Temporary Nurse Aide Program as an option for training individuals to assist with patient care in residential care facilities during the public health emergency.  The AHCA program is an 8-hour fully online program and resources for this program are:

• AHCA Temporary Nurse Aide Program website
• AHCA Temporary Nurse Aide competency checklist
  • Note:  While ISDH has waived certain parts of state regulation for CNA training, state and federal regulations still require facilities to ensure nurse aides can demonstrate competency (42 CFR 483.35(c)).  This checklist must be used and be kept in the CNA’s employee file.  This checklist does not have to be performed by an ISDH-certified Nurse Aide Program Instructor and can be performed by any qualified person (such as an RN or LPN).

This approval is in addition to the Personal Care Attendant program previously approved, but contains some key differences.  Please refer to this chart for the two programs.  Both programs are active and can be used residential care facilities, as well comprehensive care facilities.  Each facility, whether a comprehensive care or residential care facility, that utilizes a temporary CNA approved through the AHCA Program must maintain documentation showing the CNA completed the AHCA Program, including passing its final assessment and competency check-off, and give notice to the ISDH by filling in the Temporary Nurse Aide – Registry Spreadsheet and emailing the completed document to aides@isdh.in.gov. 

The Fifth Emergency Order for Residential Care Facilities also allows Residential Care Facilities to temporarily employ formers CNAs whose certifications have expired or otherwise lapsed if the expiration or lapse occurred while the CNA was in good standing, with no findings of abuse, neglect , or misappropriation; the expiration or lapse occurred on or after January 1, 2019; the CNA worked at least 40 hours as a CNA during the one year period immediately preceding the expiration; and the facility ensures the former CNA provides competent CNA and other relevant nursing-related service.  If a former CNA does not precisely meet these requirements, a facility may request approval on a case-by-case basis from Jan Kulik, ISDH Director of Survey Supports and Guidance, at jkulik@isdh.IN.gov.