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“Tens of thousands” of nursing home caregivers could lose their job on Friday if the Centers for Medicare & Medicaid Services does not reissue a blanket waiver, the American Health Care Association said Monday.

Reissuance of the waiver would allow US nursing homes to employ temporary nurse aides during and beyond the COVID-19 public health emergency, the association said.

“Temporary nurse aides stepped up during the pandemic to serve our nation’s seniors in their hour of need, and now they are on pins and needles waiting to hear if they’ll have a job come Friday,” AHCA President and CEO Mark Parkinson said in a statement. “It’s time to cut the red tape and bring certainty to these heroic caregivers and their residents who have come to rely on them.”

June 6, CMS ended the section of the 1135 waiver that permitted the employment of TNAs. The aides at the time had four months to become a certified nursing assistant, as dictated in statute. Approximately half of the states have CNA training and/or testing backlogs, however, according to AHCA.

The federal agency is allowing short-term exceptions to continue to employ TNAs for individual states and facilities that submitted requests and are approved by the agency. As of Monday, according to AHCA, four states have had their statewide waiver requests approved, and more than 10 states were still waiting to hear from the federal agency regarding their application or for further information from CMS to be able to apply for the waiver.

“Federal data clearly shows that quality of care for residents remains high when temporary nurse aides are present. Our residents deserve continuity of care from caregivers they know, and these experienced aides deserve adequate time to build a permanent career in long-term care,” said Holly Harmon, RN, senior vice president of quality, regulatory and clinical services at AHCA/NCAL.

Nursing home workforce levels are at an almost 30-year low, according to AHCA, which also said that the facilities have lost more than 220,000 caregivers over the course of the pandemic.