CNA Requirements in North Carolina — Training, Exam & Registry

N.C. Department of Health and Human Services, Division of Health Service Regulation (DHSR) — Health Care Personnel Education and Credentialing Section (the section that operates the N.C. Nurse Aide I Registry). Nurse Aide II is a separate listing maintained by the North Carolina Board of Nursing and is not covered by this record. administers certified nursing assistant licensing in North Carolina. Every figure below is verified against the board’s own official pages and dated. Who must personally hold a credential — the contractor, the business, or the individual worker — is set out under Requirements.

What it’s called

The statutory and administrative noun in North Carolina is NURSE AIDE, and the state credential is a LISTING on the N.C. Nurse Aide I Registry — the terms ‘Nurse Aide I’, ‘NA I’ and ’listing’ are what DHSR uses. ‘CNA’ is the everyday name and North Carolina uses it too, but not for this credential: DHSR’s Unlicensed Assistive Personnel page names ‘Certified Nursing Assistants (CNA)’ as one of several job titles under the North Carolina Board of Nursing’s umbrella term UAP, alongside Nurse Aides (NA), Patient Care Aides, Home Health Aides, Patient Care Technicians, Medical Office Assistants, Medical Assistants, Medication Aides and Medication Technicians. ‘North Carolina CNA license’ and ‘CNA certification’ are folk terms — the state issues neither a licence nor a certificate here, and no card. THE NAMING TRAP THAT MATTERS MOST IS NURSE AIDE II. North Carolina has a second, higher aide level, and it is a different credential kept by a different agency: DHSR’s own FAQ answers ‘I am interested in becoming a Nurse Aide II. Where can I find more information?’ with ‘Contact the North Carolina Board of Nursing at 919-782-3211,’ and its registry page points to the Board of Nursing for ‘Nurse Aide I scope of practice information and Nurse Aide II information.’ A Nurse Aide II must ALSO be on the Nurse Aide I Registry to work as an aide in a nursing home. This record covers Nurse Aide I only. FOUR MORE SEPARATE REGISTRIES run out of the same DHSR section and are not this credential: Medication Aide – Nursing Home, Medication Aide – Adult Care Home, Geriatric Aide, and Home Care Aide; Feeding Assistant is a training curriculum rather than a registry. A registry-change form filed by a Nurse Aide I who also holds Medication Aide or Geriatric Aide status updates all of them at once.

License types & fees

Who does NOT need this license — exemptions

FOUR CARVE-OUTS, AND THE BIGGEST ONE IS A CLOCK RATHER THAN A CATEGORY. (1) THE FOUR-MONTH RULE. G.S. 131E-255(f), added by S.L. 2022-74 and effective July 1, 2022: ‘Notwithstanding the provisions of this section or any other provision of law, a nursing facility may employ or contract with health care personnel who are not listed on the Nurse Aide Registry to perform the duties of a nurse aide for a period of up to four months, consistent with subsection (d) of 42 C.F.R. § 483.35. As used in this subsection, health care personnel means unlicensed staff that have direct access to residents, clients, or their property.’ DHSR’s conditions are strict and are aimed at employers who might try to reset the clock: during the four months the individual must be employed full-time as a nurse aide and ‘actively working toward meeting the training and testing requirements’; a nursing home may not ‘Terminate and rehire an individual to restart the four-month period,’ may not ‘Restart the four-month period if the individual completes additional training and testing,’ and may not ‘Waive the required background checks prior to employment.’ The limit is cumulative across employers: ‘An individual cannot move from one nursing home to another and receive a new four-month period with each new employer. Previous Nurse Aide employment at any nursing home counts toward the four-month limit.’ One helpful exclusion: ‘Time spent completing clinical requirements as part of a NAT program does not count toward the four-month employment limit.’ At the end of four months an unlisted individual ‘may no longer work in the capacity of a Nurse Aide at any nursing home.’ (2) LICENSED NURSES SKIP TRAINING AND TESTING but are NOT exempt from listing — an RN or LPN working as a nurse aide in a nursing home must still be on the registry, and gets there by form rather than by examination. (3) MILITARY MEDICAL CORPSMAN TRAINING AND RETIRED OR NON-PRACTICING NURSES are exempt from the training program, not from the examination: 10A NCAC 13O.0301(k) excuses them from the Department-approved training program ‘unless the person fails to pass the State of North Carolina’s Nurse Aide I competency exam after three attempts.’ (4) STUDENTS in an N.C. nursing education program preparing for RN or PN licensure reach the examination through eligibility route E5 without a separate nurse aide training program. WHAT IS NOT AN EXEMPTION: the registry requirement is written around NURSING HOMES (‘anyone who works as a nurse aide in a nursing home must be listed’), and DHSR is explicit that aides working elsewhere carry their own risk at renewal time — ‘Nurse aides working in non-nursing home settings are responsible for making sure their work will qualify and that they can have their employment verified/renewal forms signed by a registered nurse (RN) at the appropriate time for renewal.’ Whether a particular non-nursing-home employer requires registry listing is set by that employer’s own licensure rules, and DHSR says so: ‘Additional requirements for registry access/registry verification may apply. Employers should ask their appropriate regulatory agency for guidance.’

Fees

THE REGISTRY IS FREE; THE EXAMINATION IS NOT. Registry side — DHSR’s FAQ says it twice, once for listing and once for renewal: ‘Is there a fee associated with being listed on the registry? There are no registry fees.’ and ‘Is there a fee to renew my listing on the registry? There are no registry fees.’ Examination side — DHSR publishes the current and future price list on its Fees page for the Nurse Aide I examination: Written Examination and Skills-Based Practical Evaluation (Initial) $140, rising to $145 beginning January 1, 2027; Oral (English or Spanish) Written Examination and Skills-Based Practical Evaluation (Initial) $140, rising to $145 on the same date; Written Examination Only (Retest) $40, rising to $45; Oral (English or Spanish) Written Examination Only (Retest) $40, rising to $45; Skills-Based Practical Evaluation Only (Retest) $100, unchanged at $100 from January 1, 2027. That is a state-published schedule with a dated increase already announced — the January 1, 2027 column is DHSR’s own heading, ‘New Price Beginning January 1, 2027.’ NOT STATE FEES AND NOT SET BY DHSR: tuition charged by a community college, health care facility or private company running the training program. REIMBURSEMENT: no North Carolina source read on 2026-08-14 addresses employer reimbursement of training or testing costs, so this record claims none; the federal reimbursement rules for nursing-home employees live in 42 CFR 483.152(c) and 483.156(b), which DHSR does not restate.

Exam

Two components, and the state’s fee table treats them as separately retakeable. The exam consists of a written examination — available in an ORAL form in English or Spanish — and a skills-based practical evaluation. Rule 10A NCAC 13O.0301(f): ‘The State of North Carolina’s Nurse Aide I competency exam shall include each course requirement specified in the Department-approved Nurse Aide I training program as provided for in 42 CFR 483.152,’ and (g): it ‘shall be administered and evaluated only by the Department or its contracted testing agent as provided for in 42 CFR 483.154.’ DEADLINE AND ATTEMPTS: ‘Candidates must pass both the written and the skills examination within two (2) years from the successful completion date of a state-approved training program or within three (3) attempts, whichever comes first, to be placed on the North Carolina Nurse Aide I Registry’; the rule frames the same limit as a retraining trigger at three attempts. A FAILED CANDIDATE IS TOLD WHERE THEY FAILED: ‘If the State of North Carolina’s Nurse Aide I competency exam candidate does not pass the written or oral exam and the skills demonstration… the candidate shall be advised by the Department of the areas that the individual did not pass’ (10A NCAC 13O.0301(i)). A SCHEDULING CONSTRAINT MOST STATES DO NOT PUBLISH: DHSR states on its State Examination page that ‘The minimum number of students needed to complete the skills evaluation, at any given time, is five (5) students. Otherwise, a testing event will be cancelled.’ DHSR also publishes skills-exam seat availability and an unused-seats count for the calendar year. Format, question count and passing score are not published by DHSR — its FAQ answers ‘What is the format for the state-approved competency exam?’ with ‘Please review the Candidate Handbook available from Credentia,’ so this record states no score or question count.

Renewal & continuing education

Every 24 months, and the renewal condition is WORK, not education or money. DHSR: ‘A nurse aide may renew through qualified work experience (at least 8 hours) completed during every two years.’ All four criteria must be met: ‘The work is for pay (monetary compensation); The duties are those of a nurse aide (refer to the N.C. Board of Nursing Nurse Aide I task list); The duties are supervised by a registered nurse; The number of hours worked is at least eight (8), during the aide’s 24 month registry listing period.’ HOW THE PERIOD IS CALCULATED: ‘The initial listing period starts on the day your name is added to the registry and ends, or expires, on the last day of the 24th consecutive month. At renewal, the new listing period starts on the last date you worked as a Nurse Aide performing nursing or nursing-related duties reported by a Registered Nurse on the Online Employment Verification Form and ends, or expires, on the last day of the 24th consecutive month.’ DHSR anticipates the resulting complaint and answers it: ‘Upon renewal, why wasn’t my listing expiration date extended for two more years? Expiration dates are calculated from the last date of qualified work that was reported.’ HOW IT IS FILED: online only. ‘The paper renewal form will no longer be accepted by DHSR after August 31, 2021. Nurse Aides must complete the Online Renewal Form. Registered Nurses must complete the Online Employment Verification Form.’ The RN’s signature ‘verify[ies] that RN-supervised nurse aide work was performed by the aide and the date(s) of the work. The RN signature does not verify competency,’ and the signing RN may be the aide’s direct supervisor ‘or another RN who has access to the employment records.’ WHOSE JOB IT IS: ‘It is the responsibility of the Nurse Aide I to know when their listing expires and how to renew.’ WORK THAT DOES NOT COUNT, in DHSR’s own list: work not delegated and supervised by an RN; fewer than 8 hours in the period; dates on payroll without actual nurse aide work performed, such as medical leave; volunteer work; sitter work; orientation activities where no nurse aide duties are performed; work an RN supervisor cannot support with documentation, facility records or personal supervision; work outside the Nurse Aide I scope; and private duty employment. Three explicit rescues from that last exclusion: ‘Nurse Aide employed by a licensed healthcare facility or agency to provide nursing or nursing-related services in the home is not considered private duty employment for registry renewal,’ and the Medicaid CAP/DA and CAP/C Waiver Programs likewise are not private duty. NONE. North Carolina requires no continuing education to keep a Nurse Aide I registry listing. The renewal condition is paid, RN-supervised nurse aide work — at least 8 hours in the 24-month listing period — and DHSR’s renewal instructions, its Nurse Aide I FAQ and 10A NCAC 13O.0301 contain no education, in-service or refresher requirement for the aide. The FAQ’s renewal questions run: what work qualifies, what work does not, how to file the online forms, how the expiration date is calculated, and whether there is a fee (‘There are no registry fees’) — with no course anywhere in the sequence. WHAT DOES EXIST IS A REFRESHER OPTION, NOT AN OBLIGATION: DHSR notes that ‘former nurse aides and emergency medical personnel can obtain refresher course and nurse aide transition course information from their local community college,’ and eligibility route E3 exists ‘For applicants that completed a North Carolina state-approved Nurse Aide refresher training program’ — a route back onto the registry, not a recurring duty. Tiers searched 2026-08-14: 10A NCAC 13O in full, the Nurse Aide I Registry page including its Renewal and Required Re-testing sections, the Nurse Aide I FAQ in full, the Registry Information page, the Education Requirements page and the Forms and Applications page. A separate federal duty falls on NURSING HOMES rather than on aides (in-service education under 42 CFR 483.95); no North Carolina source read restates it as a condition of the aide’s listing, so this record does not present it as one.

How to apply

Applications are handled by N.C. Department of Health and Human Services, Division of Health Service Regulation (DHSR) — Health Care Personnel Education and Credentialing Section (the section that operates the N.C. Nurse Aide I Registry). Nurse Aide II is a separate listing maintained by the North Carolina Board of Nursing and is not covered by this record.. Start at the official application page .

Verify a license in North Carolina

N.C. Division of Health Service Regulation, Health Care Personnel Education and Credentialing Section publishes a public license search , searchable by last four digits of Social Security number (required), first name (required), last name (required), up to four people per search or optional email address to receive status-change notices for 12 months. It covers One search covers five North Carolina registries at once: the Nurse Aide I Registry, the Medication Aide Registry for Nursing Homes, the Geriatric Aide Registry, the Health Care Personnel Registry, and Home Care Aide Specialty Training. TWO THINGS MAKE THIS LOOKUP UNUSUAL AND BOTH TRIP PEOPLE UP. First, you cannot search by name alone — the form requires the last four digits of the person’s Social Security number together with a first and last name, and it warns that ‘Individual Taxpayer Identification Numbers (ITINs) are not SSNs and will not return valid search results on this page.’ That makes this an employer-and-self tool rather than a browse-the-register tool. Second, every search returns a dated confirmation number: ‘Health care facility employers must keep a record of accessing the registries in their business files. This site gives an original confirmation number with every search. It is date and time specific. The confirmation number is the employer’s proof of access.’ The page also carries a currency stamp of its own — it stated that the information was last updated 08/14/2026 when this record was compiled — and a standing caution that the registries are updated regularly and should be re-checked. Results are produced by submitting the form rather than by opening a web address, so an individual person’s result has no address that can be linked or bookmarked, and an automated check of the address above sees only the empty search form. The Medication Aide – Adult Care Home registry is verified through a different address (mats.ncdhhs.gov), and the Home Care Aide Specialty Training list is published as a document rather than searched.

Records come from N.C. Division of Health Service Regulation, Health Care Personnel Education and Credentialing Section’s own system. LicensingAtlas does not hold license records and cannot confirm any individual’s status — the date on this page refers to the requirements described above, not to anyone’s credential.