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Coronavirus Disease 2019 (COVID-19) Temporary Policy Updates: Nurse Aide Training and Competency Evaluation Programs and Paid Feeding Assistant Programs


On Friday, March 13, 2020, President Donald Trump declared a national emergency due to coronavirus disease 2019 (COVID-19), U.S. Department of Health and Human Services Secretary Alex Azar issued a section 1135 blanket waiver and Governor Henry McMaster declared a state of emergency for the state of South Carolina. As a part of the state’s preparation and response to COVID-19, the South Carolina Department of Health and Human Services (SCDHHS) is announcing several temporary policy changes to protect the health and well-being of South Carolina Healthy Connections Medicaid members, certified nurse aides (CNAs), CNA candidates, paid feeding assistants (PFAs) and health care providers.

These policy changes are a part of SCDHHS’ ongoing efforts to stop the spread of COVID-19 and other respiratory viruses in South Carolina. SCDHHS expects these temporary policy changes to sunset after the COVID-19 outbreak has subsided. Sunset dates and additional policy changes related to SCDHHS’ response to the COVID-19 outbreak will be communicated through future provider bulletins.

CNA Training and Certification

  • Classroom instruction: SCDHHS will allow CNA training programs to offer distance education learning. Classroom instruction, whether face-to-face or through distance education learning, must equal the required 60 hours.
  • Clinical instruction: SCDHHS will allow CNA candidates to receive clinical skills training in a simulation environment or in a health care facility under the direction of a registered nurse (RN). Clinical instruction must equal the required 40 hours.
  • CNA recertifications: SCDHHS will extend recertifications without proof of the eight-hour paid work requirement.
  • Reciprocity: SCDHHS will continue to honor reciprocity for CNAs.

Temporary Nurse Aides

The Centers for Medicare and Medicaid Services (CMS) is waiving the requirements at 42 CFR 483.35(d) [with the exception of 42 CFR 483.35(d)(1)(i)], which require that a skilled nursing facility and a nursing facility may not employ anyone for longer than four months unless they met the training and certification requirements under §483.35(d). To ensure the health and safety of nursing home residents, CMS is not waiving 42 CFR § 483.35(d)(1)(i), which requires facilities to not use any individual working as a nurse aide

for more than four months, on a full-time basis, unless that individual is competent to provide nursing and nursing-related services. To meet the competency requirement, nursing facilities may temporarily employ individuals who have completed alternative training paths that ensure that such individuals are competent to provide relevant nursing and nursing-related services. Such temporary aides must complete an eight-hour training program, which may be conducted through distance education learning or face-to-face, and receive at least eight hours of clinical training in a simulation environment or in a health care facility under the direction of an RN.

PFA Programs

  • SCDHHS will extend current PFA program recertifications.
  • SCDHHS will grant approval to nursing facilities seeking initial certification upon a desk review of training materials and required documentation.

Latest Public Health Guidance, Information and Resources

Medicaid providers and Healthy Connections Medicaid members should continue to refer to the Centers for Disease Control (CDC) and South Carolina Department of Health and Environmental Control (DHEC) websites for the latest information and resources not specific to SCDHHS programs or benefits. This includes checking the CDC and DHEC websites for the latest guidance on how to prevent the spread of the virus and appropriate care for individuals with suspected or confirmed illness.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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