Prospective nurse aides tell lawmakers of struggle to get tests scheduled
HARRISBURG — The exam required to become a certified nurse aide in Pennsylvania is so difficult to schedule that some prospective CNAs are giving up on employment in health care at a time when demand is greater than ever.
The demand is caused by a staffing crisis in Pennsylvania hospitals and nursing homes, members of the Senate Health and Human Services Committee were told Tuesday.
Pennsylvania’s CNA exam is only offered by one company, Credentia, which employs only 16 proctors, testifiers said. Prospective CNAs have reported waiting months for an exam date, driving hundreds of miles and then arriving to find it was canceled, they said.
The committee discussed a number of solutions, but in the end, Chairperson Sen. Michele Brooks of Mercer County suggested pursuing legal action against the company.
Temporary nurse aide positions were created to help nursing homes deal with staffing shortages, and a TNA can take an online exam and work in a long-term care facility while they prepare for the CNA exam.
But Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, said TNAs didn’t solve the staffing shortages and when the federal government eliminates the waiver allowing TNAs on Oct. 6, the situation will become much worse.
Shamberg said that the average nursing home in Pennsylvania has an eight-person wait list and roughly 30 open beds due to understaffing.
The creation of the TNA position was helpful for both understaffed nursing homes and people hoping to enter the medical industry, Shamberg said, but the red tape to take a CNA exam is so difficult that TNAs are finding jobs in new fields.
Jennifer Mankowski, executive vice president of Credentia’s program management and development, said the pandemic caused a lot of issues for CNA testing.
At the beginning of the pandemic, CNA tests were paused for five months, Mankowski said. When exams resumed, Credentia had a backlog of applicants and struggled to find proctors and coordinate with testing sites.
CNA exams may only be proctored by registered nurses, whom Mankowski said can be difficult to find. Many applicants expect double or triple the salary Credentia is willing to offer, she said.
Credentia has 16 nurses working as evaluators, and recently hired a recruiting firm to find more, Mankowski said. It has 40 nurses in the process of becoming evaluators.
Credentia has 21 sites where people can take the CNA exam, Mankowski said, up from 14 in January. But Blair County Republican Sen. Judy Ward pointed out that Pennsylvania has 67 counties, and there are no testing sites in the Altoona region, which Ward represents.
Mankowski said that when a nursing home applies to become a testing site, the process usually takes about a week.
Brooks, the committee chair, told her this was “removed from what’s actually happening.”
Brooks read a statement from a nursing home she said has been trying for six months to become the first testing site in Allegheny County. She said TNAs in that nursing home had to take their CNA exams in Erie, and read a statement from one of the TNAs.
“When I was at the testing site in Erie last Thursday, four-plus candidates arrived to take the skills exam and none of them were on the evaluator’s list of candidates to test that day,” Brooks read.
Other senators and speakers at the hearing also had issues with Credentia.
Kerri Kubalak, who helps people become CNAs through the Central Susquehanna Intermediate Unit, said Credentia has canceled some of her students’ exams three times. Each time, according to Kubalak, they have to wait two to four months for their next exam.
Credentia also registered two of Kubalak’s students on the CNA registry by accident, before they even took the exam, Kubalak said.
Multiple speakers described Credentia’s customer service as inadequate or nonexistent.
Brooks suggested the state pursue legal action against Credentia.
“It’s time to start making them meet the contract, as well as if we can assign any type of penalties,” Brooks said.