Long-term care operator transitions TNAs to CNAs in ‘Grand’ style

The Valley Stream, NY-based The Grand Healthcare nursing and rehabilitation system recently graduated 85 home-grown certified nursing assistant students through its in-house training program.


The provider, which has 18 skilled nursing facilities and one assisted living community in the state of New York, designed a CNA training course at no cost to employees, which allows workers to launch new careers.


“I teach from my heart, because CNAs provide the most facetime with our residents. That’s where the quality of care starts,” Corporate Program Director, Nurse Aide Training Program,   Nona Bluestein told the McKnight’s Business Daily. “We had to make sure that they are hiring [for] skills, but they understand empathy, they understand why they’re there and what’s important.”


Grand Healthcare is “very forward-thinking and always trying to come up with innovative, out-of-the box ideas. …At whatever stage we’re at in the world of COVID, we really put together what I thought was a fantastic idea,” said Michael Hurtes, director of strategic operations.

The program is Bluestein’s brainchild. She said that she saw the need because the Centers for Medicare & Medicaid Services waver that allowed TNAs to work longer than four months without becoming certified is set to expire October 6. The waiver originally was meant to expire in June.


Bluestein said she found that a large number of people needed to become certified in a short period of time or Grand could lose hardworking employees who “came to our community during a pandemic that seemingly targeted the people at our facilities and decided that they wanted to help during a really difficult time.”


Hurtes noted that the temporary waiver brought workers into the field who might not previously have considered a career in healthcare.


“Now, in the nursing homes, we’ve been able to take these individuals and put them on track to have a real career in this position or going forward as an LPN or an RN,” he said. “We’ve taken on the cost of every aspect of this process, because we really do believe in the future of our employees.”


Bluestein said that Grand Healthcare was able to shave its CNA training program from 100 hours to 40 hours for TNAs who already have been performing the work. 


“This allowed them to become certified in a shorter period of time,” she said.


Shortening the program, Bluestein said, involved making some adjustments to the curriculum that she had been using and modifying her teaching style to a virtual learning model that would allow classes in each of the operator’s communities. An on-site proctor scans tests and sends them to Bluestein for grading.


“We had over 100 people that needed to be educated by June 7 [the original expiration date of the waiver]. At the time, I was the only educator for all of the buildings,” Bluestein said. “Every department kicked in on a corporate level to help support this.”


Not every student has tested out of the program yet, but Bluestein said that the results so far have been “excellent.” With the waiver period extended, she said she hopes to have approximately 200 new CNAs from the ranks of the current TNAs. She describes the experience as an “extended brand orientation” for the workers. 


Once the waiver period is over, Grand Healthcare will go back to its 100-hour CNA training program. Bluestein said the company hopes to open a freestanding school in the Utica, NY, area.


In addition to designing a curriculum, it’s important for providers that are considering adding a CNA training program to find someone who can teach“with a little bit of passion” and an understanding of why the CNA role is important in a facility, Bluestein said. 


Pre-established curricula and textbooks can help get a program started and supplement the company’s “twist” on core values and how they want the CNAs trained for their facilities, she said. It’s also important to have full support from everyone, from CEOs on down to the culinary director, to ensure that the employees are trained in every aspect of the job and to emphasize teamwork, Hurtes added.


For those employees who want to move into other levels of nursing certification, the company offers tuition reimbursement, as it has since before the COVID-19 public health emergency, Hurtes said.