What Is a Geriatric Nursing Assistant (GNA)?
A Geriatric Nursing Assistant (GNA) is a type of certified nursing assistant who receives specialized training to work with elderly patients, particularly in long-term care or skilled nursing facilities. GNAs perform hands-on care tasks such as bathing, feeding, toileting, mobility support, and emotional reassurance—helping maintain daily comfort and dignity for aging individuals.
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While the term "GNA" is often used in Maryland and select jurisdictions as a formal license designation, the role aligns closely with that of a CNA (Certified Nursing Assistant). GNAs are not Qualified Health Professionals (QHPs) and cannot bill Medicare or lead clinical workflows. However, they are essential team members in care environments that support patients with chronic or degenerative conditions.
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GNAs play a particularly important role in facilities that support CMS care management programs indirectly, by assisting QHPs and helping patients adhere to their care plans.
Key Functions of a GNA in Care Teams
Though not licensed to diagnose or treat, Geriatric Nursing Assistants (GNAs) perform daily tasks that are critical to maintaining quality of life and supporting successful care management. Their responsibilities allow licensed providers to operate more efficiently and focus on clinical priorities.
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Typical GNA functions in care teams include:
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Assisting with activities of daily living (ADLs) — hygiene, dressing, feeding, toileting, and mobility
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Monitoring and documenting patient conditions, including skin integrity, appetite changes, and mood
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Providing companionship and emotional support, particularly for residents with dementia or isolation risks
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Supporting fall prevention protocols and reporting safety hazards
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Helping patients adhere to treatment plans by managing routine comfort and compliance
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Collaborating with nurses and other staff to maintain stable care environments
In chronic care contexts, GNAs often serve as the eyes and ears of the care team, catching subtle changes that may trigger early interventions.
The Role of a GNA in Care Delivery
Geriatric Nursing Assistants are integral to the frontline of elder care, particularly in settings where patients require long-term, supportive services. While they do not hold clinical licenses, GNAs are deeply embedded in the daily delivery of care, serving as the primary point of contact for many patients.
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In care delivery settings, GNAs often:
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Observe and report health changes that may not be obvious to rotating clinical staff
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Ensure patients maintain dignity and comfort during extended care stays
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Act as a communication bridge between patients and the broader care team
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Support consistency in chronic care routines, especially for mobility, toileting, and feeding
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Help enforce infection control protocols and safety measures
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Provide non-clinical companionship, which can improve patient mental health and compliance
By handling these essential tasks, GNAs allow physicians, nurses, and QHPs to focus on diagnostics, treatment planning, and documentation—ultimately enhancing efficiency and outcomes in value-based care settings.
Billing and Supervision Rules for GNAs
Geriatric Nursing Assistants (GNAs) are not recognized by CMS as Qualified Health Professionals (QHPs) and therefore cannot bill Medicare or other federal payers directly for services. Their contributions are essential to patient care, but they must work under supervision from licensed clinicians or QHPs.
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Billing Limitations:
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GNAs cannot bill for Chronic Care Management (CCM), Principal Care Management (PCM), or Transitional Care Management (TCM) codes
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They cannot be the rendering provider on claims or sign off on patient care plans
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GNAs are not eligible to fulfill the “minimum 20 minutes” documentation requirement under time-based CPT codes
Supervision Rules:
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GNAs must work under the general or direct supervision of an RN, LPN, or QHP (e.g., NP, PA, MD) depending on state scope of practice laws
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Their tasks must be delegated by licensed staff, and most states restrict GNAs to supportive, non-invasive procedures
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While they cannot supervise other clinical staff, GNAs may act as peer mentors or aides-in-training supervisors in some institutions
Though not billable themselves, GNAs play a supporting role in helping QHPs meet documentation and engagement thresholds, particularly in value-based and long-term care programs.
Frequently Asked Questions about QHPs
1. What is a Geriatric Nursing Assistant (GNA)?
A GNA is a certified nursing aide with specialized training to care for elderly patients, especially in long-term care facilities and nursing homes.
2. Is a GNA different from a CNA?
Not significantly. A GNA is essentially a CNA with additional geriatric specialization, and the title is primarily used in specific states like Maryland.
3. Can GNAs bill Medicare for services?
No. GNAs are not considered Qualified Health Professionals and cannot bill CMS for services or fulfill requirements for time-based care codes.
4. Who supervises a GNA?
​GNAs work under the supervision of licensed providers such as RNs, LPNs, or QHPs (e.g., NPs, PAs, MDs). Their responsibilities are delegated and monitored by clinical leadership.
5. What’s the difference between a GNA and a medical assistant?
GNAs typically serve in residential or long-term care settings, focusing on basic daily care for elderly patients. Medical assistants usually work in outpatient clinics and assist with clinical and administrative tasks.
6. Do GNAs contribute to chronic care programs?
Indirectly. GNAs support continuity of care for patients with chronic illnesses by monitoring daily needs and reporting clinical changes, helping licensed providers act more efficiently.