Understanding Certified Nursing Assistants in Nursing Homes

Direct care workers -- certified nurse aides, home health aides, and personal and home care aides -- are the primary providers of paid hands-on care for more than 13 million elderly Americans. They assist individuals with a broad range of support including preparing meals, helping with medications, bathing, dressing, getting about (mobility), and getting to planned activities on a daily basis. Although direct care workers constitute one of the largest and fastest-growing sectors of the workforce, there is a documented critical and growing shortage of these workers in every community throughout the United States. There is significant need to attract many more direct care workers in the near future.
The U.S. Department of Health and Human Services is working to improve the quality of direct care jobs and stabilize this workforce on a number of fronts. For over a decade, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) has made the direct care workforce a major focal point of its policy research agenda. ASPE has convened expert meetings and conferences; produced seminal reports and reports to Congress on the long-term care workforce; reviewed state-based policies and provider practice initiatives; examined the utility and efficacy of worker registries, background checks, and wage pass-throughs; explored potential new sources of new workers; and sponsored a number of program evaluations and demonstrations. The Patient Protection and Affordable Care Act (P.L. 111-148) strengthens the investment in direct care work by authorizing several new initiatives aimed at improving the quality of direct care jobs, workforce development, and long-term care.
This chart book highlights findings from two new ASPE-sponsored national surveys: The 2004 National Nursing Assistant Survey and the 2007 National Home Health Aide Survey. Both surveys represent a major advance in the data available about two of America’s most important jobs -- certified nursing assistants working in nursing homes and home health aides working in home and hospice care settings. The chart book is intended to help multiple audiences understand these jobs, issues, and challenges; and to establish useful benchmarks as goals toward which improvement efforts might aspire.
Understanding Direct Care Workers: A Snapshot of Two of America’s Most Important Jobs -- Certified Nursing Assistants and Home Health Aides