Information for long- term care facilities

Information for long- term care facilities

To implement this new role within your organization, please review the regulation, 105 CMR 755.000, and consider these best practices:

1. Be Aware of Student Learning Requirements: 
   • The CMA program is a 60-hour training program delivered over 8 weeks. The program consists of knowledge and clinical skills.
   • Students will need to complete the online learning modules at their own pace, each week.
   • Students will precept with their assigned preceptor each week.
   • Students will meet once a week via Zoom with their instructor. 
     • Facilities should consider "Work and Learn" time for CMA students 

2. Identify and Prepare Nurse Preceptors Early:

   An onsite nurse preceptor is required for the CMA student at your facility. Read about How to Become a Preceptor

   • Identify experienced RN or LPN preceptors.
     • Consider whether your organization will implement a recommendation or approval process for potential preceptors.
   • Ensure preceptors complete the required CMA preceptor course before any student from your facility starts the CMA training program.
   • Schedule time for the CMA students and their preceptors for their clinical learning. Clinical learning includes:  
     • Time for the students to practice the assigned, weekly medication skills.
     • Time for the Preceptors to teach and mentor the students.
     • Total anticipated time for the clinical learning is 3 hours per week.
   • Clarify preceptor expectations, responsibilities, and authority.
   • Provide incentives for preceptors as they serve as leaders and mentors for the CMA students.

3. Clearly Define CMA Scope and Responsibilities at Your Facility: Review and Update Policies and Procedures:

   While the state defines regulatory scope, facilities may wish to define operational scope. 

   Potential policy and procedure areas to review:

   • Job description for the CMA role.
     • Clearly explain how CMA duties differ from CNA duties. 
     • CMAs should not do CNA tasks while working as a CMA.
   • Supervision and reporting procedures.
   • Documentation requirements.
   • Error reporting processes.
   • Medication administration
     • CMAs are authorized by 105 CMR 775.000 to administer any non-narcotic drug, prescription or non-prescription that may be administered via oral, sublingual, buccal, inhalation, spray on oral mucosa, topical, nasal, ocular, or otic routes.
     • Facilities may wish to further restrict administration routes or medication administration through facility policy.

4. Prepare for a Cultural Shift:

   Introducing CMAs may change long-standing roles and expectations.

   Facilities should be prepared to:

   • Address concerns from CNAs, nurses, and managers.
   • Acknowledge that this is a new role—not “CNA plus.”
   • Reinforce that CMAs support nursing, not replace it.
   • Emphasize safety, supervision, and teamwork.
   • Socialize the CMA role across the organization.
     • Educate staff, communicate what CMAs do and do not do, and set clear expectations for supervision and communication.

5. Examine Staffing Patterns and Workflows:

   CMA implementation may affect staffing models.

   Facilities may wish to:

   • Examine medication pass workflows.
   • Adjust nurse and CNA assignments as needed.
   • Ensure nurses remain available for required supervision.
   • Avoid assigning CMAs unrealistic workloads.

6. Plan Supervision and Ongoing Learning:

   CMA supervision does not end after certification.

   Facilities should plan:

   • How nurses will be available for questions during medication administration.
   • What and how CMAs will communicate with their supervising nurse.
   • How new CMAs will transition from clinical learning to supervised practice.
   • How to continuously evaluate medication competency.
     • A CMA shall be evaluated by a supervisor at least once every six months.