Article Archive
March/April 2024

March/April 2024 Issue

Long Term Care: The Value of Certification Programs
By Sue Coyle, MSW
Today’s Geriatric Medicine
Vol. 17 No. 2 P. 10

Certifications offer long term care employees additional knowledge, skill, and career opportunities

Employees at long term care facilities serve a wide variety of individuals with an equally wide variety of needs. While the majority of residents in nursing homes are elderly and most commonly older than the age of 85, the National Center for Health Statistics reported in 2022 that 16.9% of residents were younger than 65. Such a large span of ages contributes to an already far-ranging pool of diagnoses. According to the National Center for Health Statistics, “The 10 most common chronic conditions among residents [of residential care facilities in 2010] were high blood pressure (57%), Alzheimer’s disease or other dementias (42%), heart disease (34%), depression (28%), arthritis (27%), osteoporosis (21%), diabetes (17%), chronic obstructive pulmonary disease and allied conditions (15%), cancer (11%), and stroke (11%).” Many residents have more than one co-occurring chronic condition.

Given the diversity of need within long term care facilities, the opportunity for care staff from nursing assistants to nurses to occupational therapists and more to further their knowledge and skills in relation to their patients is ever-present. No one, regardless of their level of education and experience, can be an expert in every aspect of care. And, in fact, when knowledge is lacking, the patients or residents can be negatively affected.

Kathy Warwick, RDN, LDN, CDCES, owner of Professional Nutrition Consultants, LLC, has seen this in the care patients with diabetes receive. “There are so many challenges involved in care for those with diabetes as they age,” she describes. “Diabetes is a complicated progressive disease that can accelerate and worsen many aspects of the aging process. And those living with diabetes in long term care usually have many other chronic disease conditions as well.

“In my experience, the general level of training and knowledge about the diabetes disease process is significantly lacking among the care staff in long term care facilities and home health situations. There are misconceptions about eating patterns, treatment of hypoglycemia, and appropriate targets for blood glucose,” she says, adding that quality of life and other health outcomes are affected when providers do not have adequate diabetes training.

The reverse, of course, is also true. Additional training and education can improve outcomes for individuals in long term care facilities. Certification programs focusing on health conditions such as diabetes and other common areas of service such as wound and palliative care offer an opportunity for employees at long term care facilities to expand their skillsets and further serve their residents.

Value of Certification Programs
The value of certification programs to long term care facilities is threefold. The patients, facilities, and individual professionals all benefit from the increased knowledge that comes from an employee pursuing a certification.

For the residents, the benefit is clear. A more highly trained care staff means higher quality service. “Certification programs are important as they help staff members obtain additional relevant evidence-based knowledge and training in order to better serve diverse resident needs,” says David Hage, PhD, MSW, LCSW, ACSW, C-ASWCM, CDP, an assistant professor of social work, gerontology minor coordinator, and geriatric care management certificate director at Misericordia University.

He adds that for the facilities, having employees who have completed certain trainings can be utilized as a marketing tool. Despite the growing need and demand for long term care, facilities still must advertise not only their presence but also the services they best provide. Having staff with specific certifications allows a facility to communicate to the prospective families and referring providers that the facility will be able to effectively meet common and unique needs as they arise.

Additionally, when facilities or organizations encourage and support their employees in pursuing certifications, they foster a work environment that values employees and their career development. “Certification programs and trainings are valuable to organizations to facilitate new skills and incorporation of current industry information into the work performed by their employees. For long term care facilities and home health, additional training programs can be incorporated into clear career path options, which improves employee recruitment and retention,” says Fritzi Gros-Daillon, MS, CSA, CAPS, UDCP, SHSS, director of education at Age Safe America.

“For individual employees,” she continues, “the skill sets are enhanced and there is a personal sense of accomplishment and support in the workplace as they uplevel their experience. Additional training provides new insights, new clinical information, or even a new technique to make the work tasks more efficient and effective.”

This was true for Warwick, who pursued her Certified Diabetes Care and Education Specialist (CDCES) certification after working for several months with a nurse who held the credential. “I realized that my working diabetes knowledge was limited. Most professionals only receive a basic level of instruction in diabetes as part of their academic coursework. Studying for the CDCES examination while working daily with people living with diabetes was one of the most interesting and challenging experiences of my early career,” she says.

“Having all the information and tools as a CDCES to help people understand diabetes and feel more confident in their self-management skills has been very satisfying for me. Many times, small lifestyle changes can prevent long-term damaging complications. Helping people living with diabetes feel empowered to take an active role in managing their chronic illness can greatly improve quality of life and longevity,” Warwick says.

Choosing a Program
Given the value that can come from a certification program, it’s important that individuals choose a program that offers quality education and will benefit them in their current positions and throughout their careers. Not all certification programs are equal, and not all certifications are available or applicable to long term care staff in various positions.

“The certifications that staff might wish to pursue in long term care settings will often vary by discipline and role,” Hage says. “Advanced practice nurses may consider one of the adult gerontological or psychiatric mental health nursing certifications from the American Nurses Credentialing Center. Social workers might consider one of the multiple National Association of Social Workers certifications in gerontology, case management, or hospice/palliative care,” he offers as examples.

When identifying possible certification programs, individuals should look at what they are already doing within their positions and what types of certifications may help them advance as desired. “Whether an employee is working in a long term care facility or in a home health agency, first they should look to the organization’s training plan and explore as many options as are provided. Inquiring as to which level of additional training makes sense for the career path of choice can give the employee some guidance as to which training topics, classes, or certifications best help them meet their career objective in that company,” Gros-Daillon says. She advises professionals to take note of new services that a company may plan to offer and to consider career advancement as well as areas of interest.

Once the topic is selected, “Individuals should consider certifications that are widely respected within the long term care industry,” Hage says. “They should consider certifications that are sponsored by reputable organizations. Certifications should require recipients to obtain new evidence-informed knowledge, skills, and continuing education. When considering a new certification, it would be helpful to verify its utility and reputation with facility supervisors and administration, professional associations, and trusted colleagues.”

Filling in the Gaps
There are, of course, barriers to completing certification programs. The time and costs involved can be prohibitive. For instance, “The process for [the CDCES] certification requires a minimum of two years working in your professional practice area prior to submitting an application and at least 1,000 hours specifically providing diabetes care and education within the previous five years. Applicants must also accrue 15 hours of continuing education applicable to diabetes before taking and passing a national examination,” Warwick explains. She adds that maintaining the credential requires continuing education or sitting for the exam every five years.

Without support, many professionals may not be able to commit to earning and maintaining such certification. Hage notes that facilities can assist by paying for training, testing, and renewals, and, when able, offering training and testing on-site.

Additionally, many staff at long term care facilities may not qualify for certifications that could help them in their positions. As aforementioned, which certifications are available to an individual often depends on the person’s profession. Certified nursing assistants cannot pursue programs designed for registered nurses or social workers, for instance. However, certified nursing assistants provide much of the direct care in a long term care facility and would likely benefit from additional training on common certification topics.

In those instances, individuals and facilities must look for training opportunities outside of certification programs to help fill in the gaps. After all, training and education for care staff leads to more quality care for residents.

— Sue Coyle, MSW, is a freelance writer in the Philadelphia suburbs.


The population of the United States is aging, quickly. With 10,000 individuals turning 65 every day, “the number of older adults will more than double over the next several decades to top 88 million people and represent over 20% of the population by 2050,” according to AARP. While many of those older than 65 will eventually reside in long term care facilities, a large number will also choose to age in place, for at least as long as possible. As a result, home health care is a growing field, with employment of home health aides expected to increase by 22% by 2032.

Those working in home health care in all roles are likely to face myriad challenges as they work to address not only their clients’ medical needs but also the safety and accessibility of the environment each individual is living in. While challenging, training—specifically certification programs—designed for home health care can help care staff deliver quality services to their clients aging in place.

For example, “Age Safe America offers the Senior Home Safety Specialist (SHSS) certification, which provides a holistic overview of home safety for older adults with a focus on home safety assessment, includes topics on fire safety, mobility and accessibility, and considerations for clients with dementia and other impairments,” explains Fritzi Gros-Daillon, MS, CSA, CAPS, UDCP, SHSS, director of education at Age Safe America.

The best-fit certification program will vary with respect to the care providers, their level of education and experience, and their current roles as well as career plans. Care providers should pursue a certification that is well regarded not only in health care but also in home health care, specifically, to ensure they are investing their time and energy into a certification that will benefit both their clients and themselves.