Organizational Readiness

The Certified Medication Aides (CMAs) position is an exciting new healthcare role in Massachusetts. CMAs are certified to safely administer medications through state-approved routes, under the supervision of a licensed nurse, to residents of long-term care facilities, in accordance with Massachusetts regulation 105 CMR 775.000. Read draft regulations here

Long-term care facilities in Massachusetts may wish to consider the following best practices in preparing to implement this new role within their organization: 

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 Polices 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 the 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 (Reg 105 CMR 775.000).

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