Support, Career Advancement, Training Stipends Crucial to Stop Exodus of CNAs in Nursing Homes

Nursing homes are still facing a staffing shortage despite gains made by individual operators, with certified nursing assistants (CNAs) in particular leaving the labor force because of lack of support services and career advancement, requiring “immediate and sustained action,” according to a study first published in The Gerontologist.

The CNA shortage threatens quality of care and endangers the health and well-being of CNAs themselves, researchers said. Collaboration across all levels of long-term care, and government, is needed to identify viable funding sources like grants or private sector initiatives.

Nine researchers with the University of Georgia led the study, which offered a wide range of solutions that compile what the sector has seen – or at least seen proposed – since the pandemic ended.

Researchers pointed to legislative action to raise Medicaid rates, along with marketing campaigns targeting potential CNAs, using existing CNAs as brand ambassadors of sorts at schools and community events.

The study touted a public database listing training and job opportunities for CNAs as well, with subsidized certification programs and training stipends. Wraparound services like mental health support, flexible online continuing education, and career tracks and promotion pathways with academic and on-the-job training options are all needed on a large scale, especially to improve retention, the study found.

Lastly, internal campaigns which increase respect for CNAs and acknowledge their essential role is crucial, but workplace culture takes time to change.

Future research can test the efficacy of proposed interventions, they said, and compare them with other interventions that have targeted the CNA staffing crisis. Through long-term research, program efficacy can be tested and a wide range of effective sustainable options can be offered to operators, researchers said.

Overall, CNAs need improved access to training, career advancement tracks and initiatives to increase pay and funding support, the study found.

One such program is the Georgia CNA Career pathway Initiative, which aimed to address early barriers to the workforce. The initiative led to the CNA Virtual Skilled Evaluation program, which helps CNAs overcome testing barriers, the University of Georgia said in a statement.

More than 6,000 CNAs in the state took their skills evaluations virtually and in turn increased access to the field.

CNAs make up one-third of nursing home staff and provide about 90% of all direct care, the study found.